A new diaphragm has just been FDA approved marketed as “Caya”.
The barrier diaphragm has been around since the 1960’s for many women as a contraceptive choice for those that preferred not to use birth control pills or who couldn’t use hormones due to health problems (history of blood clots, smoker, etc).
Caya is a new reengineered single-sized diaphragm with a nylon spring to fit women of different body sizes. A study enrolling 300 women was randomized to an acid-buffering contraceptive gel and to nonoxynol-9 while using this new diaphragm. A total of 35 pregnancies occurred for an overall 6-month pregnancy rate of 10.4 per 100 women. Rates were higher for the nonoxynol-9 group. Also more than half the participants reported side effects such as urogenital pain, irritation, itching, abnormal vaginal bleeding, vaginal infection and bladder infections.
The pregnancy rate of this new diaphragm is not much different than the currently available diaphragm or condom. This may be why the diaphragm has lost popularity compared to hormonal contraceptives, intrauterine devices (IUD) or progestin-implants in recent decades.
For those women who cannot use hormonal contraceptives or the IUD, using the diaphragm WITH a condom may help contraceptive effectiveness and reduce pregnancy rates if used consistently.
Reference: Schwartz JL et al. Contraceptive efficacy, safety, fit, and acceptability of a single-size diaphragm developed with end-user input. Obstet Gynecol 2015 Mar 5; [e-pub]. (http: // dx.doi.org/10.1097/AOG.0000000000000721)