Non-Hormonal Contraception

The Diaphragm offers inexpensive, reusable, non-hormonal opportunities for protection from pregnancy. They date back to the 1800’s when they were made of cloth and referred to as “womb veils.” In the 1960’s the Diaphragm, made out of silicone, was the contraception of choice in 10% of women in the 1960’s. Although less than 1% of women use the diaphragm currently, it is coming back full circle. Women are looking to other avenues for protection that don’t require surgery or synthetic hormones. I am particularly excited for a potential Diaphragm that should soon be available over-the-counter (OTC) in Europe called SILCS. The “one-size-fits-most” over the counter without a prescription SILCS Diaphragm coming soon with FDA approval, has a hook for easy removal. It is currently being studied with antiviral gels for the prevention of Sexually Transmitted Infections as well as for contraceptive use.

European women can purchase a diaphragm OTC without prescription right now whereas in the US women must first be fit for a diaphragm in the office. The only way that Diaphragm’s are available in the US are with a prescription from the pharmacy in the US now.

The same reason that Diaphragms quickly dropped from favor is the same reason they are coming back as popular use. Birth Control Pills are convenient and effective (99%), IUD’s (both copper and hormone derived) requires surgical insertion and deliver materials into the body, be it copper or hormones. Women want to take more control of their bodies with the least amount of chemicals, synthetic hormones and procedures. I used to have to educate women about this method and now they are coming to me, requesting it. What a switch!

The Diaphragm, once inserted correctly, is meant to block the opening to the uterus (the cervix) and in tandem with a spermicidal, stop the sperm from moving up through the cervix. It is 94% effective when used correctly with a Nonoxynol-9 spermicidal cream or gel.

Although there are many advantages to the diaphragm, side effects can include increased risk of Urinary Tract Infections and vaginal irritation.

The SILCS diaphragm. Photo: PATH/Glenn Austin. Reproduced from the PATH website at www.path.org.

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