The diaphragm is an important type of birth control. The woman controls the method and it does not involve taking a drug. Also, the birth control can be reversed right away. The diaphragm is often used with a spermicide - a chemical to kill sperm. Many women feel that the spermicide is awkward and messy to use. Spermicides may increase the risk of infections in the urinary tract. Some health care workers think that spermicide does not help with birth control.
This review looked at trials of diaphragms used with and without spermicide. We looked at how well each method worked, how safe it was, and whether women liked using it.
We did computer searches for randomized trials that compared the diaphragm only to the diaphragm with spermicide. We also looked at reference lists to find trials. In addition, we wrote to researchers to find more studies.
We found one trial that looked at using the diaphragm with and without the spermicide. Of the women who used the diaphragm only, slightly more got pregnant than did those who used the diaphragm with spermicide. The study was too small to know how well the spermicide worked with the diaphragm for birth control. Large trials would help to address this issue. Current evidence gives no reason to change the practice of using spermicide with the diaphragm.