The cervical cap was originally developed in the 1800s, although it was not approved for use in the United States until 1988. To buy it, you'll need a doctor's prescription, and you must be fitted by a trained practitioner.
How it works. Somewhat similar to the diaphragm, the cervical cap is a small rubber dome that covers the cervix and holds spermicide against the cervical opening. The difference is that, instead of being anchored by the vaginal muscles and pubic bone, the snugly fitting cap is held in place by surface tension or suction.
The failure rate of the cervical cap for women who have never given birth is similar to that of the diaphragm 20 percent. In women who have delivered a baby, however, the rate rises to 40 percent. Pregnancy and childbirth cause the cervix to become softer and more pliable, and hence less capable of staying in place.
How to use it. Most women find that it's a little harder to insert and remove a cervical cap than a diaphragm. It may take a little practice and patience until you get it right. After your doctor fits you for a cap, be sure you understand the steps for insertion and removal, as well as how to check for proper fit.
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Inserting the cap.
To use the cap, place a small amount of spermicide in the dome, filling it about a third of the way. Don't use too much, and don't put any on the rim of the cap. This could break the suction and cause the cap to slip out of place. Find a comfortable position you may want to lie down, stand with one leg raised on a chair, or squat with your knees apart. Squeeze the rim of the cap between your thumb and forefinger and insert it into your vagina as far as you can. Then, with one finger, push it along the rear wall of your vagina and up to your cervix. Make sure that the dome of the cap is pointing down toward the opening of your vagina. Then push it up firmly onto your cervix. Make sure that the cap fits snugly by running a finger all the way around the rim. If you have inserted the cap correctly, you should be able to feel your cervix through the cap, though it should not completely fill the dome. (This extra space allows room for the spermicide and cervical secretions.) During the first few months of use, check often to make sure the cap is in place. Ask your doctor or pharmacist about obtaining an "introducer" for your cervical cap. This device may make insertion easier.
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Timing.
You can insert the cervical cap up to 48 hours in advance. Wearing it longer can cause a vaginal infection and is not recommended. You don't need to use more spermicide with repeated intercourse, but you must leave the device in place for at least eight hours after sex, and should not douche before taking it out. Use a method other than the cap during your period; the flow of menstrual blood could break the suction.
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Care of the cervical cap.
To remove the cap, reach into your vagina with one finger and tilt the cap to one side, breaking the suction. Then slip your finger under the rim and pull the cap out. After each use, wash the cap with mild soap and warm water. Clean the groove inside the rim with a cotton swab. Dry the cap and, if you wish, dust it lightly with cornstarch before storing it in its case. Petroleum jelly and some other oils and lubricants can cause the rubber of the cervical cap to deteriorate. Do not use any of these products without first consulting your physician. Some doctors recommend that you get a Pap smear before being fitted for a cervical cap, and another smear 3 months after you begin using it. You'll need another fitting if you have a miscarriage or deliver a baby. Cervical caps should be replaced every 1 to 2 years, depending on your doctor's advice.
The cervical cap may be a good alternative for women who have had repeated urinary tract infections with use of the diaphragm. It's also more convenient (you can insert it up to 48 hours in advance), and less messy (you won't need as much spermicide). Like the diaphragm, it may also provide some protection against certain types of sexually transmitted diseases.
The cervical cap is not a good choice for all women. Some have difficulty inserting and removing it. Others cannot find a size to fit the shape of their cervix. In addition, the device is not available everywhere in the United States, and some doctors have not been trained to fit it.
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Placing a Cervical Cap
Cervical caps are held in place by suction, so it's important that you have a good fit. When maneuvering the cap into place, slide the upper rim along the rear wall of your vagina until it lodges behind the cervix with the cap pointing downward, then flip the lower edge of the rim up over the front of the cervix. As with a diaphragm, always apply a bit of spermicide to the dome but with a cervical cap, avoid getting any on the rim. |
