The diaphragm: a hormone-free option

If you would rather avoid hormones and only use contraception when you need it, the diaphragm is worth knowing about.

What it is

A diaphragm, sometimes called a cap, is a soft silicone dome you place over the neck of the womb before sex, used with a contraceptive gel. It is a barrier: the dome and the gel together stop sperm getting through. The modern Caya is one size, so unlike older diaphragms it does not need fitting.

How well it works

This is the honest part. With careful, consistent use a diaphragm is around 87 percent effective, which means it is less reliable than the pill, patch, ring, injection or a coil. It works best for people who will use it every single time, correctly, with gel. It is not the best choice if a pregnancy would be very difficult for you.

The pros and cons

The pros: no hormones at all, you only use it when you need it, you are in control of it, and it is reusable for about two years. The cons: you have to use it every time and leave it in for at least six hours afterwards, some people get irritation or urinary infections, and it does not protect against sexually transmitted infections.

How to get it with us

Start a short online assessment. Because the Caya is one size, there is no fitting; we send it to you with guidance, and a doctor or nurse can talk you through using it. You will also need a contraceptive gel.