An All-Flex silicone arcing spring diaphragm
Offering advice and support: I try to stay away from involvement with high school girls in town. I have more than enough to do with my work at St Lucy’s as well as my full time job with the ballet. But several weeks ago a friend who is a pit boss at the casino and the mom of 15 and 17 y/o daughters in city schools came to me for advice. She understands the culture here and both girls are on birth control pills, to ‘regulate their cycles’. Well, I’ll accept that explanation as it’s the standard reason at their ages. So she wasn’t concerned about pregnancy as much (although that is always a concern in a mom’s mind) as she was about the unintended consequences of oral sex.
Safe sex: Oral sex is usually thought of as ‘safe sex’ because there is no danger of pregnancy. But the community is finding out the hard way that in addition to transmitting STIs oral can have additional dangers. That’s because there was a recent instance of a very popular girl in her daughter’s school who had a pulmonary embolism when her boyfriends blew air into her vagina while giving her oral. He did it with her permission so that they both could hear her Queef, which they thought was hilarious. Apparently she had been letting him fill her vagina with air for months and they had been getting away with it until at the end of her most recent period while the walls of her uterus were still raw an air bubble got in her bloodstream and caused a clot that lodged in her lung. She claimed the clot was caused by her birth control pill, Yaz, but the nature of the clot and the fact that there was no sign of deep vein thrombosis, points to the fact that her BF caused it by filling her vagina with air. It used to be that blowing into a vagina was known to be dangerous and girls were taught that and wouldn’t allow their sex partners to do it, but times have changed and some young women are paying dearly for their lack of knowledge or - if they know - willingness to take that sort of risk. It can be very dangerous, but I’m not against having air forced into my vagina if I take the proper precautions. [See my post about ‘Vaginal Breathing’ for more about having orgasms using compressed air.] Actually, I find it great fun when a partner forces air into me using his mouth. I get a lovely full feeling having my vagina expanded with air, but there is a safe way to do it and that is to use a gas guard.
My friend wanted me to meet with a group of her friends who are mom’s who have daughters and a few who have sons in the city schools to talk about the danger of forcing air in the vagina and if there was a way to protect their girls. They were all past the point of trying to get their teens not to do it, knowing full well that some would try it anyway. They were interested in how to protect their daughters. As I mentioned earlier the way for a woman to protect herself against vaginal over-pressure events is to wear a gas guard. I asked if any of the girls had a Mirena or ParaGard or any other framed IUD inserted and was told that none did. That was good news because you shouldn’t wear a diaphragm or cervical cap with IUD strings hanging out of the cervix because removing the barrier can pull out the IUD if the strings stick to the barrier. Finding that none of the girls had an IUD I recommended to the moms that they have their daughters fitted with All-Flex diaphragms.
I recommended All-Flex because it is made of silicone, is rugged, is the easiest style to insert correctly and can be ordered through local pharmacies. The possible problems with using an All-Flex is if the girl takes a very small size (All-Flex isn’t made in sizes smaller than 65 mm) or has a very shallow pubic notch it wouldn’t be right for her. Most teen’s first diaphragms are 65 mm and few women have shallow pubic notches so I thought they would probably be ok, and they were. The girls have all been fitted and all but one took 65 mm devices. The other took a 70 mm. I was pleased that they were already sexually active so their vaginas had been stretched a bit by dildos and their partner’s penises. The moms wanted to know if All-Flex was the same style that I used for dive-sex (the word is getting around about my fondness for dive-sex) and when I told them that it wasn’t they wanted to know why I wasn’t recommending the one I used. I didn’t want the conversation to get diverted to my involvement in dive-sex which several of the women tried to do. I kept them focused on protection during oral sex, but I did tell them why I wasn’t recommending the style diaphragm I use.
Differences in latex Vs silicone gas guards: I explained that while the use as a gas guard was similar in the two situations (oral sex and submerged intercourse) the ambient conditions were quite different. The girls don’t need a diaphragm to protect the upper reproductive tract that can safely handle the wide variations in pressure encountered during dive-sex below 30 feet. All their daughters need is a single atmosphere device to prevent embolisms during an oral over-pressure encounter. And, the only diaphragm that provides protection below 30 feet is made of latex, which isn’t as well tolerated by users because of the possibility of latex allergy, latex is more susceptible to damage from oily lubes and meds, latex is more likely to contribute to infections and the flat spring rim of the latex diaphragm is more difficult to insert correctly. My explanation relieved any concern about my choice of an All-Flex for their daughters.
Fitting and wearing regimen: We talked a bit about getting the girls fitted and that it would be good to go to one of the local clinics that fit entertainers with diaphragms because the fitters are highly experienced and will provide a supportive fitting experience. I wanted to stay away from having anything to do with having local girls as young as 14 being fitted with diaphragms – though the reasons could be that it was needed as a pessary - because they are below the age of consent. But what the teens do while using their diaphragms is up to them. I did talk to the moms about their daughter’s gas guard wearing regimen. I recommended that the girls insert their barriers before each time they are around their BFs because teens are very spontaneous and if they are going to have oral they really needed to be protected rather than ending up with a lot of ‘just-this-once’ encounters where the teen’s gas guard is at home while she is being eaten during lunch in the back seat of a car in the school parking lot.
The moms said that most of their daughters were really freaked out about their friend’s pulmonary embolism so if they can develop the habit of wearing their diaphragm before the horror of what happened wears off things might just work out. I suggested the moms mention to their daughters that gas guards are worn by some celebrity entertainers. That’s true, they do, and because out here local teens look up to young super club and cabaret entertainers as role models they are more likely to wear their protection if they think that Tara or Mila or Anna is wearing one too.
SILCS is an intravaginal barrier device currently under development. It is made of silicone with an arcing ring. SILCS has a pre-shaped rim to cling high in the vaginal vault and a finger cup on one edge for easy removal. It will be a one-size-fits-all device. I would appriciate your expert opinion on this new contraceptive Diaphragm. http://www.path.org/projects/silcs.php
ReplyDeleteHi Anon… Actually, SILCS is a single size (70 mm) one-size-fits-most device of advanced design. I like the design, but I hate the fact that it will be available in only a single size. Current thinking is that SILCS may be available as early as 2011. The FDA has yet to approve it for use in the U.S. I am very skeptical about the effectiveness of one-size-fits-most contraceptive devices.
ReplyDeleteThe intention of PATH is to develop a simple inexpensive device that poor women in under-developed countries can use without the attendant costs of medical providers, pelvic exams and fitting visits and in this they may be successful. The four most prescribed diaphragm sizes in the U.S and Europe are 65 mm, 70 mm, 75 mm and 80 mm. Currently diaphragms are made in sizes from 60 mm to 90 mm.
That SILCS will only be available in a single 70 mm size is worrying. A single 70 mm size is too small in a traditionally shaped diaphragm for many women and using a too small device would decrease its overall effectiveness for users. That’s because a traditionally shaped diaphragm that is too small will expose the anterior rim to the likelihood of being thrust underneath by a partners thrusting penis. With the penis under the dome at ejaculation sperm is deposited against the unprotected cervix. The curved relief arch (on the anterior rim) of the SILCS design may (or may not) go some way to minimizing the problem of under-thrusting, but we won’t know about that for years.
I have no doubt that if SLICS becomes easily available in under-developed areas where it will give women something to use where previously they had nothing, then it is a major step forward. I’m not at all certain that it is as good as or better than a properly fitted and correctly inserted traditionally shaped diaphragm.