%0 English Abstract
%T [The diaphragm and the adolescent].
%A Goncalves ID
%A Peixoto RM
%A Mendonca M
%J J Bras Ginecol
%V 98
%N 9
%D Sep 1988
%M 12282426
暂无%X The diaphragm is one of the least accepted methods of birth control by adolescents.  It consists of a cup made of latex with a metallic ring at its base, its diameter ranges from 50 to 105 mm, and in its concave part a spermatocide can be placed to immobilize and destroy spermatozoa.  It acts as a physical barrier to sperm at the cervical canal.  By maintaining vaginal acidity and by making it difficult for cervical mucus to neutralize the vaginal ph, a hostile environment is created for spermatozoa.  Its failure rate is 24-29 pregnancies per 100 women years.  The right size has to be fitted to allow for the 3-5 cm increase in the depth of the vagina during sexual excitation in nullipara.  It can be inserted 4-6 hours prior to intercourse in order not to interfere with sexual spontaneity, and removal should not occur until 8 hours later.  Indication is for adolescents with infrequent sexual activity, those who stopped using the pill, or whose IUD had been removed.  It is contraindicated for various medical conditions and infections.  Toxic shock syndrome can occur, it it stays in too long.  It offers some protection against sexually-transmitted diseases and cervical neoplasm due to the lack contact with the seminal fluid.  Allergic reactions to spermatocides can occur in addition to various side effects due to ill-fitting diaphragms.  The low acceptability by teenagers is attributable to its lower rate of effectiveness than the pill and little motivation for its use, although it should be recommended for those who are afraid of the side effects of the pill and IUD.