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Diaphragm versus diaphragm with spermicides for contraception.
1Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand. lynley.cook@ xtra.co.nz
The Cochrane Database of Systematic Reviews
|July 26, 2002
Summary
This review found no significant difference in pregnancy or discontinuation rates when using a diaphragm with or without spermicide. More research is needed to determine the contraceptive effectiveness of diaphragms used alone.
Area of Science:
- Reproductive Health
- Contraception
Background:
- The diaphragm is a barrier contraceptive method typically used with spermicide.
- Some clinical observations suggest spermicides may not enhance the contraceptive efficacy of diaphragms.
Purpose of the Study:
- To compare the effectiveness, safety, and acceptability of diaphragm use with and without spermicide.
Main Methods:
- A systematic review of randomized controlled trials was conducted.
- Searches included major databases and expert consultation for unpublished studies.
- Data extraction and analysis were performed by independent reviewers.
Main Results:
- Only one study met the inclusion criteria.
- No statistically significant differences in pregnancy or discontinuation rates were observed between diaphragm with spermicide and diaphragm without spermicide groups.
- The identified study was underpowered due to insufficient participant recruitment.
Conclusions:
- Current evidence is insufficient to differentiate the contraceptive effectiveness of diaphragms used with or without spermicide.
- Further robust clinical trials are required to establish definitive guidelines.