Understanding The Contraceptive Cap: The Advantages and Disadvantages

As a healthcare practitioner providing contraception advice to female patients, you will need to talk to your patients about a contraceptive option called the diaphragm or cap.

You can explain that a diaphragm or cap is a small, dome-shaped device that fits over the cervix, the opening to the uterus. It is made of soft silicone or latex and is inserted into the vagina before sex, and the diaphragm or cap prevents sperm from entering the uterus and fertilising an egg.

Diaphragms and caps are barrier methods of contraception, which means they work by physically blocking sperm from reaching the egg. They are also reversible, so you can tell your patient they can stop using them whenever they want to become pregnant.

To use a diaphragm or cap, your patient will need to:

• See their healthcare provider to get the right size diaphragm or cap fitted. 
• Wash their hands thoroughly with soap and water. 
• Apply a spermicide to the inside of the diaphragm or cap. 
• Insert the diaphragm or cap into the vagina, ensuring it covers the cervix. 
• Leave the diaphragm or cap in place for at least 6 hours after sex. 
• Remove the diaphragm or cap after 6 hours or sooner to have a bowel movement or to urinate. 

Advantages of using a diaphragm

You can explain to your patient that diaphragms and caps have several advantages over other forms of contraception, including the following:

• They are effective at preventing pregnancy. When used correctly, diaphragms are 92-96% effective at preventing pregnancy. Caps are slightly less effective, at 88-92%.
• She can stop using a diaphragm or cap at any time to become pregnant. 
• They are free on prescription. 
• They are comfortable to use. Diaphragms and caps are made of soft silicone or latex and are designed to wear comfortably. 

Disadvantages of using a diaphragm

However, it would help if you also made her aware that diaphragms and caps also have some disadvantages. They require some skill, and it may take a bit of practice for her to ensure it is fitted correctly. She may need time to learn how to easily insert and remove a diaphragm or cap and feel confident using one.

Some other disadvantages she must be made aware of can include:

• Using a diaphragm can be messy. The spermicide used with the device can be messy to apply and remove. 
• Diaphragms and caps may not be 100% effective for women with children or weak pelvic muscles, so they must be assessed for suitability.
• Diaphragms and caps do not provide any protection against STIs. 

If your patient is considering using a diaphragm or cap, she should be encouraged to talk to her healthcare provider to decide if a diaphragm or cap is the right contraceptive option for her.

PDUK provides professional training courses for healthcare practitioners such as nurses, clinicians and allied healthcare workers. We highly recommend two training courses in contraception and gynaecological core skills.

AOL17 A primary care provider’s guide to contraception: Online

This study day is designed for healthcare professionals who want to develop or refresh their understanding of contraception options available in the UK.

The day will cover the following topics:

• The latest contraception choices available in the UK
• How to safely apply this knowledge in the clinical setting
• The benefits and risks of each contraception method
• How to counsel patients on contraception

A80 Gynae core skills for first contact practitioners: Online

This interactive one-day course is designed for primary care practitioners involved in managing and referring women presenting with gynaecological issues.

The course will cover the following topics:

• The diagnosis and management of common gynaecological conditions
• The role of primary care in the prevention and early detection of gynaecological issues
• How to make appropriate referral decisions for women with gynaecological problems