Overall, female barrier methods, including the diaphragm (DIE-uh-fram), have not been widely used or accepted (J. L. Schwartz & Gabelnick, 2002). The number of women using diaphragms dropped from 5% in 1988 to 2% in 1995, and to nearly zero in 2002 (Alan Guttmacher Institute, 2005a). However, the diaphragm works well to block the cervical entrance and protect it from early cervical changes associated with cancer (Hatcher et al., 2004; Moench et al., 2001).
Today, diaphragms are made of either latex or silicone and come in several different sizes and shapes that must be fitted by a healthcare provider. Like latex condoms, latex diaphragms should not be used with oil-based lubricants because these can damage the latex (see Sex in Real Life on page 415). In the United States, diaphragms range in cost from $20 to $35, the accompanying spermicidal cream or jelly costs approximately $13 per tube, and there is also a charge for an office visit. Again, all of this tends to be less expensive at family planning clinics.