By Jessica Gilbey
In light of the recent French ban on the contraceptive pill Diane 35, following four deaths in the past twenty five years and the safety alert issued by The Therapeutic Goods Administration, it seems an appropriate time to rethink the available contraceptive methods and their associated risks. Oral contraceptives are known to increase the risk of some cancers[i], venous thromboembolism and cardiovascular diseases. Those are only a few of the most frightening in a long list of hazards. I think there is room here for a skit involving a Steve Irwin impersonator wrangling with a hefty pamphlet of contraceptive related health risks.
Since proudly (re)discovering the diaphragm, considering myself some kind of birth control archaeologist delving into the profane purses of eighties cult movies, it has puzzled me as to why so few women choose it and healthcare professionals are reticent in suggesting it to patients searching for contraceptive options. The diaphragm was invented in 1842, which makes it one of the oldest methods of contraception. Could this still be dusted off and utilised as a viable method today? What could be better than a safe sex solution that furnishes feminine control without necessitating/negotiating the partner’s potential permission, knowledge or cooperation, doesn’t interfere with a woman’s menstrual cycle or long-term fertility and has no dangerous side effects such as other conventional forms of contraception, provided it is used correctly?
Aesthetically speaking, the diaphragm is coolly understated, retro and comes complete with pink ‘Polly Pocket’ style case. Additionally, it isn’t detectable, doesn’t affect sensitivity for either partner and can conveniently be used during menstruation and double as a ‘moon cup’ or catching mechanism that can be emptied when needed, effectively replacing tampons or pads. It can be washed and reused over and over again and lasts for up to two years.
Some might be dubious about the efficacy of the diaphragm in preventing pregnancy. As with any method, consulting a family health planning clinic physician is important when choosing contraception and it is the only way to learn how to insert the diaphragm and have it correctly fitted. The diaphragm works by careful insertion into the vagina before sex, where it provides a barrier preventing sperm from entering the cervix. With perfect use (which means that the diaphragm is used consistently and correctly) the pregnancy rates are quite low and a study published in the International Reproductive Health Journal in 2001 found the cumulative pregnancy rate to be 10.1 per 100 women, which was on the low end of previous studies of the diaphragm, and this compared favourably to the pregnancy rates taken for oral contraceptives and intrauterine devices. As with any barrier method, there is little protection against most STDs, thought there is substantial evidence that protecting the cervix can reduce the risk of contracting HIV and other STDS. Of course, this is a more likely option for those who are considering other non-STD protective avenues, but wish to take advantage of a safe alternative to other methods.
Instead of fecklessly opening a pill packet and overlooking the weighty wad of side-effects and health hazards, we should at least refuse to click ‘okay’ without carefully considering the facts and instead seek out the supply of safe, convenient and cervically commendable contraceptive alternatives such as the humble diaphragm, whose only flaw is that it could probably use a little rebranding.
[i] Women who use oral contraceptives have an increased risk of breast cancer, cervical cancer and benign liver tumours, but reduced risks of ovarian and endometrial cancer.