These may sound like tools of the long lost past, but they are making a comeback as more people are seeking non-hormonal birth control options. Here is why we like all three:

All three…

  • Give the wearer a lot more control

  • Are non-hormonal options

  • Are options for those with latex allergies

  • Have the potential for insurance coverage


Now for the differences, starting with cervical blockers.

The cervical block is one of the oldest forms of birth control. In ancient times, everything from sponges, to grasses, seaweeds and crushed roots were utilized. The Greeks would even use half a scooped-out pomegranate!(1) Since then we’ve upgraded to silicone, but the overall concept is the same—a barrier is created around the cervix to prevent sperm from entering. Major cock block.

V. important note: All cervical blocks require spermicide to be effective as silicone alone will not kill off the sperm.


A diaphragm is a cup that is inserted into the vagina. According to Bedsider,(2) when used correctly, it is up to 94% effective. Emphasis on the “used correctly” as we ain't perfect (the effectiveness is obviously lower for imperfect use- about 88%)

More on how to use a diaphragm here.

Need to knows:

  • You must use spermicide.(3)

  • Make sure it is covering your cervix correctly. It is possible for it to move around during intercourse.(4)

  • Insert before intercourse. You can insert up to two hours beforehand. If you don’t have sex in those two hours, you must add more spermicide before having intercourse.

  • Make sure you remove it correctly. It needs to stay in at least six hours post-intercourse as sperm cells may still be alive up until that time.

  • To protect against bacteria growth, it should not be left in for over 24 hours. If you have intercourse again, before 24 hours is up, don’t remove the diaphragm, but do add more spermicide.(5)

  • The diaphragm lasts for two years.

  • It requires a fitting by a healthcare professional

  • The diaphragm DOES NOT prevent against STIs. It can be used in conjunction with a penis condom.

  • It can be worn during your period, but should not be worn if you have any kind of vaginal infection. A new diaphragm should be obtained if you used it with an infection.

  • Only use water-based lubricants while using a diaphragm.

Why we like it:

  • Puts the wearer in complete control

  • A non-hormonal option

  • Latex-free for those with allergies

  • It is typically covered, at least in part, by insurance

  • If your partner has a penis, it is unlikely they will feel it

How to get it (and learn more):


A cervical cap is a small, sailor’s hat-shaped cap that is inserted into the vagina to block sperm from entering the cervix.  In the U.S., the FemCap is the only cervical cap available. FemCap claims it is 92-98% effective if used correctly, though Planned Parenthood and Bedsider list much lower effectiveness rates (71-86%). We got in touch with the creator of FemCap, Dr. Alfred Shihata, to ask about this discrepancy. He said that "The Planned Parenthood report was on the First Generation FemCap which is obsolete, was not approved by FDA, and was NEVER in the market." What is on the market now is the "Second Generation FemCap that is approved by the FDA... and that effectiveness rate is FDA approved."  

This leaves us wanting to remind you to always bring your questions and concerns to your care provider when deciding what form of birth control is best for you. 

Need to Knows:

  • Must use spermicide(6)

  • While it doesn’t require a fitting, it does require a prescription. There are different sizes, but they are not fit to your individual body

  • You should get a new one every year to prevent against bacteria growth

  • It is said to be more effective for those who have not yet given birth(7)

  • Must be put in before sex and left in for at least 6 hours after sex, as sperm cells can live that long.  It should not be kept in for more than two days. If you have sex again within that time frame, you can leave in the cervical cap, but must add another dose of spermicide

  • DOES NOT prevent against STIs. You can use a penis condom in conjunction.

  • Can be cleaned with antibacterial soap and water, then dried and stored in its case between uses

Why we like it:

  • It’s specially designed to move around, so the chance of it moving out of place during intercourse is lower

  • It has a loop for easier removal 

  • Puts the wearer in complete control

  • A non-hormonal option

  • Latex-free for those with allergies

  • It is typically covered, at least in part, by insurance

  • If your partner has a penis, it is unlikely they will feel it


  • Cervical cap is smaller than the diaphragm

  • You can leave a cervical cap in longer than a diaphragm (up to two days instead of 24 hours)

  • The cervical cap isn’t recommended to be used during bleeding, whereas a diaphragm can be

  • The cervical cap does not require a fitting, but the diaphragm does.  However, the cervical cap does require a prescription

  • Cervical caps are not fitted to your body, whereas diaphragms are. Instead, the cervical cap comes in a few different sizes

  • The cervical cap has a ring/loop to help you pull it out


Internal condoms, otherwise known by the brand name FC2 Female Condom, are soft plastic pouches that go inside the vagina. They are not in the "cervical blocker" category because they work a little differently. If you use them perfectly every single time you have sex, internal condom effectiveness is 95%. It may even be as high as 98% percent. But again, we ain't always perfect. 


  • Here’s how to use them correctly!

  • The internal condom SHOULD NOT be used in conjunction with a penis condom

  • It can’t be used with the NuvaRing, Cervical Cap, or Diaphragm

  • Anal or oral sex would be off-label use

  • Internal condoms are not reusable!

Why we love it:

  • IT DOES prevent against STIs!

  • You don’t need to use spermicide with it

  • No prescription needed for purchase

  • A hormone-free option

  • Puts the wearer in complete control

  • Can use water or oil based lubricants

  • Made without latex for those with allergies

  • Insurance may cover it!

  • According to FC2, the material it’s made with can produce heat, which can equal pleasure. Plus there is an outer ring that may provide clitoral stimulation. Interest piqued.


  • Internal condoms prevent against STIs, cervical caps and diaphragms do not

  • When used perfectly, internal condoms are the most effective at preventing pregnancy

  • Internal condoms are not reusable, whereas the cervical cap and diaphragm are

  • Internal condoms do not require spermicide, whereas the cervical cap and diaphragm do

  • Internal condoms do not require a prescription, whereas the cervical cap and diaphragm do


Remember, CYCLES+SEX is never providing medical diagnosis. We hope to spark your interest and provide you with tools, questions and resources to bring to your support team and providers so together, you can find what works best for your unique body. 


Research + Contributions by: Jacqueline Gunning, Researcher, Veggie Lover and Women's Health Advocate, CA


(1) Knowles, Jon. “A History of Birth Control Methods.” Planned Parenthood Federation of America, 2012.

(2) “Diaphragm – Birth Control Method.” Bedsider, 2017, www.bedsider.org/methods/diaphragm#how_to.

(3,6) “Spermicide | Spermicidal Lube, Gel & Foam.” Planned Parenthood, www.plannedparenthood.org/learn/birth-control/spermicide.

(4,5) “How to Use the Diaphragm | Follow Easy Instructions.” Planned Parenthood, www.plannedparenthood.org/learn/birth-control/diaphragm/how-do-i-use-a-diaphragm.

(7) “Cervical Cap – Birth Control Method.” Bedsider, 2017, www.bedsider.org/methods/cervical_cap#costs_tab.