Diaphragms disappear from shelves

Health clinic official says they're no longer recommending the birth control device to women because it's not being made.

A standard diaphragm made by Ortho-Janssen Pharmaceuticals Inc., now discontinued.

Canadian clinics are no longer prescribing diaphragms to women. The diaphragm, one in a small handful of non-hormonal birth control methods, seems to have disappeared from clinics and pharmacies alike, leaving some diaphragm users panicked.

"The whole point of birth control is to give women choice and if you're taking [the diaphragm] off the market, it takes away from my ability to choose," Lindsay Duncan, a long-time user of diaphragms says.

A representative at Planned Parenthood in Toronto says that the organization hasn't been fitting women for the diaphragm for the last year and a half.

While rumours of tight supply abound there's been no consensus among distributors, medical staff and pharmacists about why the diaphragm is currently unavailable.

Diaphragm F.A.Q.

What is a diaphragm? 

A diaphragm is a shallow, dome-shaped latex disk that fits within the vagina and covers the cervix to block sperm from reaching the uterus. The diaphragm must always be used in conjunction with
contraceptive foam or gel (spermicide) to increase its efficiency. 

How is it used? 

The diaphragm must be inserted at least one hour prior to sexual intercourse. Before insertion, about one teaspoon of spermicidal foam or gel should be placed in the cup of the diaphragm and smeared around the rim of the cup. The diaphragm is then inserted into the vagina, aiming for the tailbone. It must be left in for at least six hours after intercourse.

How do you get it? 

The diaphragm is prescribed by a physician and fitted to each woman's vagina. The diaphragm comes in sizes ranging from 65 mm to 85 mm and usually costs between $30 to $60 dollars and should be replaced every
two years. 

Advantages 

  • Offers privacy and control, because women can insert it before sex. 
  • Prevents unwanted pregnancy 
  • No hormonal side effects
  • It can reduce (but not prevent) the likelihood of STIs such as chlamydia, as the diaphragm can prevent the infection from reaching the uterus.

 

Disadvantages 

  • May be difficult to insert  
  • Requires planning  
  • Requires a fitting at a clinic
  • Some women may be sensitive to latex and/or the chemicals found in contraceptive foam. 

Effectiveness 

If used perfectly, the diaphragm can be used to 94 per cent effectiveness. Typical use has a failure rate of 84 per cent. This means that 16 out of every 100 users may be become pregnant. Compared to other forms of birth control (such as IUDs, hormonal birth control or condoms) the diaphragm is considered a less effective method for preventive pregnancy. 

Side Effects  

  • Urinary tract infections
  • Vaginal irritations
  • Yeast infections

Lawtons Drugs has confirmed it will no longer carry spermicidal foams and gels, which must be used in combination with diaphragms in order to be effective.

Jane Collins, Nurse Manager of Student Health Services at Saint Mary's University, says in the last two years she's only had one student come in requesting information about the diaphragm.

That was last week, when she became aware of the difficulties in finding diaphragms. She is still contacting pharmaceutical representatives in an attempt to locate diaphragms for the clinic but has been unsuccessful so far.

McNeil Pharmaceuticals, a Johnson&Johnson company that manufactured a diaphragm called the "All-Flex," says it discontinued the product in the fall of 2008.

Caldwell Consumer Health, which manufactures spermicidal products, says it discontinued sales in Canada. They continue to distribute in the United States and online.

"We can't give out something that we don't have access to," says Barbara Vye, Manager of Dalhousie's Health Services Clinic. "[Diaphragms] are not being made."

The Sexual Health Clinic in Halifax, which offers a variety of sexual health services including birth control methods, says it is no longer recommending the diaphragm to patients.

"We don't advocate [the diaphragm] because it's no longer available," says Kate Moir, a member of the Sexual Health Clinic's administrative staff.

However one manufacturer, CooperSurgical, says it is still distributing its diaphragm product, called "Milex," to pharmacies across Canada, including Lawtons in Nova Scotia.

Jolanta Scott-Parker, Executive Director for the Canadian Federation of Sexual Health, says doctors are most likely unaware of the alternative diaphragm, which is why they're no longer prescribing it.

"CooperSurgical is distributing their diaphragm but it's an alternative manufacturer and that's probably why doctors aren't aware of it," says Scott-Parker.

Despite discord surrounding the availability of the diaphragm, it is certain that the market for non-hormonal birth control methods - not a large one to begin with - is decreasing. This leaves women with even fewer alternatives to hormonal birth control than before. Those methods that are still available are rarely spoken about and even less prescribed.

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