The Diaphragm – Now Available at Your Local Pharmacy

7/3/15 UPDATE – THE CAYA DIAPHRAGM IS NOW AVAILABLE IN THE US. HERE’S WHAT YOU NEED TO KNOW TO PRESCRIBE OR OBTAIN IT.

UPDATE  – JANSSEN PHARMACEUTICALS HAS DISCONTINUED PRODUCTION OF THE DIAPHRAGM AS OF FEB 2, 2014. SEE UPDATE HERE.

After a prolonged hiatus, during which diaphragms became as scarce as Elaine’s treasured sponges, the Ortho All Flex diaphragm is back, and it’s now latex-free. The over one-year (at least in my area) shortage happened as the manufacturer transitioned from the old latex to new silicone diaphragms, and suppliers everywhere began back-ordering this important barrier contraceptive.

I called Ortho today, and was informed that the new diaphragms have been available for a few months now. I checked with my local pharmacy, and they advised me they could get a size 75 within 24 hours. At online pharmacies, diaphragms sell for $40-$50. You’ll need to restock spermacidal gel at a price of about $15 a tube – good for 30 or so uses.

Milex also makes non-latex diaphragms (arcing spring and wide seal), but these diaphragms must be ordered by your doctor from Cooper Surgical, as opposed to you filling the prescription at the pharmacy. I’ve been purchasing these diaphragms for my patients for the past year, and will continue to use them for patients whose anatomy calls for the added secure fit of the wide seal or arcing spring.

These days, it seems I rarely prescribe the diaphragm – most women seem to prefer other methods. In my younger years, the diaphragm was a very popular method. It’s a good option if you don’t want to or can’t take hormones. Efficacy ranges from 84-94%, but in motivated couples who use it properly (Mr TBTAM and I were in that group for years), the diaphragm can be extremely effective.  It only works if you use it properly every time you have intercourse, so if that’s not you, then look elsewhere for your birth control.

Don’t use the diaphragm unless you know your partner is HIV negative, since the method requires the use of spermacides, which can increase HIV transmission from an infected partner. Although most women use it without problems, users of the diaphragm have a slight increase in vaginal infections and urinary tract infections.

For more information and to see if the diaphragm is right for you, visit Planned Parenthood’s website.
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More reading on the diaphragm from around the web

34 Responses to The Diaphragm – Now Available at Your Local Pharmacy

  1. I used the Ortho All-Flex for several years (maybe around 2005-2008?)… it worked well for us at that time. I have a hormone-sensitive growth on my liver (focal nodular hyperplasia) so I'm don't take hormones. I think the diaphragm is underused.

  2. Gosh, I thought those things were gone forever. It worked great for us and seemed to for carefully selected patients. Can't recall what happened to my set of fitting rings…guess they died of old age. Wonder if I can get Ortho to cough up a new set?

  3. One of the things we're finding a challenge in our practice (Canadian family medicine practice) is getting new fitting rings to do proper diaphragm fittings. Our rings fell apart and so far we haven't been able to get a new set. This is a common problem among my colleagues. Do you have a full set of rings? Have you been able to get them recently?

  4. when i went for my physical last week, the physician's assistant was running through the medication and vitamins i'd been advised to take, and she asked if i was "taking" my diaphragm. i guess it is no longer a very well-known BC method.

  5. family practice. and i am generally very happy with them, they've been great with my family for about ever, but i mentioned this to the doc.

  6. Yes – it can be hard to find the fitting kits these days. You can still get one from the Berlex company for free though, if you call them.

    I don't tend to prescribe these much anymore. Most people prefer a Mirena.

  7. We serve a lot of Plain families and use the diaphragm often. Cooper surgical also has diaphragms and have fitting kits (at cost). Also pessaries — a VASTLY underutilized device in OB / midwifery practices…

  8. Country midwife- Assume Plain families are Amish?
    I remember the days of arcing spring, flat spring, hinged spring and more types of diaphragms. I'd love the diaphragm more widely used. It's a great method in the right hands.

    Actually, we use a lot of pessaries in our practices here in NYC. For a different crowd, of course, namely the older women with prolapse.

    Nicholas Ferguson
    Lots of mirenas going in these days, huh? I have to say I'm holding back a bit on using them in the nullips and teens, despite the big push, although they have been great for the DUB crowd in perimenopause.

    Kathy a – that's a story for these modern times al right. Says more, I think. about the state of medicine than the state of diaphragms…

    Medstudentitis and Anonymouse
    You can order the rings from otho I believe, ask your rep. Or from cooper. We tend to just but a set of diaphragms and use those.

    mitchsmom- You sound like a perfect candidate for this method!

  9. Country midwife- Assume Plain families are Amish?
    I remember the days of arcing spring, flat spring, hinged spring and more types of diaphragms. I'd love the diaphragm more widely used. It's a great method in the right hands.

    Actually, we use a lot of pessaries in our practices here in NYC. For a different crowd, of course, namely the older women with prolapse.

    Nicholas Ferguson
    Lots of mirenas going in these days, huh? I have to say I'm holding back a bit on using them in the nullips and teens, despite the big push, although they have been great for the DUB crowd in perimenopause.

    Kathy a – that's a story for these modern times al right. Says more, I think. about the state of medicine than the state of diaphragms…

    Medstudentitis and Anonymouse
    You can order the rings from otho I believe, ask your rep. Or from cooper. We tend to just but a set of diaphragms and use those.

    mitchsmom- You sound like a perfect candidate for this method!

  10. I have used the diaphragm for almost 30 yrs with no surprises! I still use it at age 49- because I still do not want any surprises!

    I have 2 boys, am post-menipausal,
    and I don't like to take any medications if I don't hahve to.

    Only trouble I have with it is that it is difficult to find the gel to use with the diaphragm.

  11. I got a cervical cap when I was in college in the 1970s. It came from a Women's Clinc in Iowa City. We did the whole spectulm-thing on one another in an upstairs room of the clinic.

    After each child I managed to find a clinic that re-fitted them. My "baby" is now 21. A few years ago I asked my GYN about how to get a new one and she looked at me like I was nuts, so I've kept the old one and smear a bit more gel on it in case any of those cracks are bigger than they look.

    They use much less gel than a diaphram so a tube lasts longer and it's not drippy afterward.

    I'll probably just keep putting it on until I'm fully menopausal and then maybe I'll bronze it!

  12. Can't remember the last time I fitted a woman for a diaphragm. Used one for years–I have two grown-up 'diaphragm babies' however.

  13. Finally, the diaphragm. It has bothered me for years that the docs are not offering the option when we know that while the PILL is good pregancy prevention it has side effects and not just long term. My daughter has depression and some eating issues. When she is on the pill they are much more apparent;esp. the depression during pms days. I think the drug companies are responsible for this no-side-effects method becoming near obsolete. Some of younger gyn’s were born when the pill had taken hold and don’t even offer it. I asked a few of them and they laughed.They know that hormones,real and synthetic affect mood via the brain. They don’t ask their patients about depression when RXing the pill. The do ask if they smoke. I am not saying get rid of the pill, just put in the pile with the Nuva rings,Mirena’s,Yaz’s and Beyaz’s and the other pills with the shiny, sexy literature in in the waiting rooms. How many lawsuits have been filed against the diaphragm? I’d really like to hear from folks about this.

    • Anita – I agree that the diaphragm is a much underused method of contraception these days.
      Which does not mean the pill is a bad method.
      We need many different methods because we are all very different people. Its takes a very motivated person to use the diaphragm well, and some couples are just not in that category. I don’t think blame the drug companies for this (though I certainly blame them for many other things.) I find most women just don’t like the idea of the diaphragm. Never understood that, as I was a faithful diaphragm user for years. But it is as it is.

      Thanks for your comments and for reading.

      Peggy

  14. Nice to see some talk of the diaphragm–I realize I’m late finding this.

    I’m 38, and have happily used one for 12 years. The first ob/gyn I asked to fit me for one was reluctant, and pushed patch, pill, whatever, even though I came to the appointment with clear reasons why I preferred to try a diaphragm. Taking a pill or the like EVERY day seems like overkill, when there’s only a few fertile cycle days, anyway!

    I love that there are no side effects, and that I feel as if I’m actively doing something to take care of myself, rather than swallowing a pill and HOPING. And silly though it may be, it’s a little connection to the generations of women who used this before; I think it was the first bc option, and how freeing that must have been to the women of the 20s, 30s, etc.

    There’s a Yahoo list for users of barrier methods, caps and diaphragms, which is a good source for more info than one could need…

    • Clara –

      Nice to hear you’ve found the method that works for you. Every woman is different, and the more options we have the better chance every woman will find the method that’s right for her.

      Thanks for reading and for your comment.

      Peggy

  15. when I got married in 1980 I was a virgin and didn’t know too much about sex. at that time mt mother was using a diaphragm with conreaceptive jelly for birth control, but she told me that it could be fitted until I came back from my honeymoon and my vagina had been stretched open. I started on b.c. pills and used many different types. in 1990 after having all type of side effects from the b.c. pills I got fitted with a milex wide-seal #65 diaphragm. while my husband and I have a very active sex life, at least 3 times a week I have used the diaphragm successfully for 23 years without any problems whatsoever and at the present time I am going through premenapause and still using it.

  16. I am a 26 ye old who has tried patch,pill,iud and nothing works for me so my obgyn said lets try the diaphragm. Well she fitted me but no drug store can fill it? I tried Kroger, Walmart, CVS, Walgreens and public. I live in Georgia.. please help I atleast want to try it because nothing else is working for me and I don’t want to get pregnant anytime soon. My husbend and I had a baby 11 months ago. I don’t want to stop having sex. Please someone help.

  17. I called walgreens and they said that despite that list, their vendor, their only vendor, does not stock diaphragms. CVS can special order 2 sizes only- 65 and 75. I was fitted for a 60. I was going to order one from the UK, but they are no longer available to Americans. I’ve been researching this all day and am quite frustrated. I am 51 but still menstruating, don’t like hormones, and my previous diaphragm was a 65, almost 10years old, and giving me UTIs. I’m thinking I may have risk using no birth control at all. Condoms give me UTIs as well. Hopefully my fertility is super low at this point.

  18. Susan –

    I called Orrtho-Jaansen on your behalf. They have not made size 60 since 2008. But you should be able to get one from Milex /Cooper Surgical. I don’t know if they sell direct to consumer or if your doc must order. But they make a size 60.

    Good luck!

    Peggy

  19. Thank you so much for that information! A family member who lives in Germany is picking up a size 60 for me there and sending it. You don’t need an RX over there which I think is smart, just a fitting from the Dr to get your size. They also carry the new SILCS diaphragm there. Thank you so much for your help. It would be interesting to know what is really causing this scarcity.

  20. We obtained the Caya diaphragm from German and LOVE it. It is the most comfortable and easiest to use and we have tried many. My wife is a midwife and the whole bit about seeing a Dr. then paying an exorbitant pharmacy price after the hefty fitting fee (if you can even find a gyn capable of doing one) drives the cost into prohibitive territory.

  21. Is the Ortho All-flex diaphragm still available in the United States. A patient in the gyn office that I work for was fitted (rings in house) and given R. When she took it to the pharmacy they told her it was no longer available. I called one of the specialty pharmacies in town and was told the same thing by them. In fact they said they have no diaphragms available for order.

    Need some help.

  22. Hi, diaphragms can still be ordered and shipped from, EthicalFamilyPlanning.com as well as fitting kits for Doctors and clinics. With the Milex brand from Cooper surgical, the sizing is compatible with the All Flex.

    Anyone know why the All Flex was withdrawn? Just lack of demand? Less diaphragm users means less spermicide consumption so I guess Gynol and Gygel will be disappearing soon too!

  23. Hi Peggy!

    Such a nice surprise to do a search on diaphragm fitting sets and find your blog! Quick reminder: I am David Levy’s cousin………and a practicing midwife. Let’s get together. I live and work mostly in Catskill, NY, and still have my apartment in NYC. I left corporate midwifery and now have a private practice, specializing in doing home visits for GYN.

    Best,
    Nancey

  24. Hi there!! I’m trying to replace my old Ortho All flex, and I cannot locate the new Latex All Flex diaphragm out there ANYWHERE!! The Janssen Website has no listing for the product either?? Can anyone advise?? JoAnna

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