The Photo: Caya is a one-size-fits-most silicone diaphragm available (by prescription) in the U.S. as of June 2015. However Caya has been available without a prescription on-line through contraceptive suppliers outside the U.S. for several years. The device is 75mm long (from the relief arch and removal dome at the anterior end on the right in the photo above to the posterior rim on the left) and 67mm wide. The six bumps on the right end of the rim and a corresponding set on the opposite side are ‘grip dimples’ and provide gripping traction for fingers on the rim during compression for insertion. Caya was designed to fit women who take the four most commonly prescribed conventional diaphragm sizes; 65mm, 70mm, 75mm and 80mm and who have a pronounced (1 to 2 cm deep) post-pubic vault to hold the relief arch. Caya has a medium tension nylon spring that arcs downward when compressed to aid in slipping it under the cervix. On average, the ectocervix (the part of the cervix that protrudes into the vagina) is 3 cm long and 2.5 cm wide. The cervix cup is 55 mm in diameter and 3 cm deep which will allow it to accommodate most women’s cervix.
The 3 cm length of the anterior cervical wall and the anterior vaginal wall form a gap called the anterior fornix which along with the cervix is covered by the dome of a contraceptive diaphragm. Thus the anterior fornix is typically a 3 cm cleft into which the stretchy silicone membrane of a Caya can be pushed by the force of a thrusting penis, assuming the shaft is long enough to reach and penetrate the anterior fornix of an aroused partner.
Menstrual sex with Caya: Returning readers will recall that in my entry for February 17, 2016 “So many men, so little time!” I discussed the advantages of the Caya contoured diaphragm. However, I didn’t discuss using it for flow control during menstrual sex and readers have asked about that so I’m sharing my menstrual experiences with Caya.
Caya as a menstrual cup: For comparison a Diva Cup can hold one full ounce of menstrual flow (30 ml) and the average woman flows approximately 1 to 2 ounces (30-60 ml) per cycle. Depending on the size of the cervix the Caya cervix cup can hold up to 20 ml of flow if it is just being used for flow control and it has a strong seal. If Caya is to be used for flow control during penetrative vaginal sex then it should be emptied cleaned and reinserted prior to penile penetration as a thrusting penis will cause a dome even half-full to overflow. However, unless the user is flowing very heavily Caya should give the couple at least three hours of flow protection. Of course each woman is different since cervical size and flow rates will vary so there will be an interval of trial-and–error when determining the maximum interval and amount of flow that can be contained effectively depending whether it is on light or heavy days during active penile thrusting especially if a partner can reach into the anterior fornix.
When I’m menstrual and wearing a Caya for flow control and sex I’ll carry two so I can remove one and give it to my partner who enjoys drinking the contents of the cup clots and all while I insert the fresh empty one to collect flow during our penetrative encounter. With a Diva Cup positioned below the cervix and the woman sitting or standing the cervix isn’t immersed in flow, but with a diaphragm cupping the cervix it is submerged in flow so when the Caya is removed there is a bit more flow as vaginal discharge than with a Diva Cup. Of course the beauty of using a diaphragm for flow control is that you can have sex while minimizing the flow contributing to the coitial discharge afterward.
Increasing and checking a diaphragms vacuum: The wearer will want the best fit and strongest suction possible in the dome/cervix cup. The fit is first a matter of pelvic anatomy size and condition. However, if the bladder or colon is beginning to prolapse into the vagina (not uncommon in women who have given birth) the Caya may not seal effectively. A poorly sealing diaphragm can still be effective as a contraceptive barrier by using plenty of spermicide in the dome. However, it is not a good choice as a menstrual cup as it can leak flow since the weight of flow can break the seal.
After insertion and checking proper placement, by feeling the cervix under the dome with the anterior rim tucked up out of the way behind the pubic bone, the seal of a Caya can be increased by using the fingers to express the remaining air from the dome. When expressing air from the cup care should be taken to ensure a fingernail does not puncture the cup. With a strong vacuum the silicone membrane collapses against the cervix and may be pulled up slightly into the anterior fornix. This will increase the vacuum and the dome will gradually fill with flow and with strong suction the weight should not break the seal.
Strong seal test: The seal on a Caya with a strong suction fit should not break when gently tugging on by a finger in the removal dome or if there is flow in the dome while being penetrated from behind when the cup is upside down such that the flow is being held in the dome only by the strength of the seal. A good test of the seal is having intercourse entered from behind (doggie style or during ballet-sex (en pointe a la seconde bent over a table, chair or holding on to a barre) while menstrual with the Caya dome expressed to maximize the suction. With 10 ml (two teaspoons) or less in the dome it should not leak when thrust into. However, because of the dynamic movement of the rim against the vaginal rugae during penetrative sex there will be a slight sheen of flow on the vaginal walls. To minimize the likelihood of staining a man’s trousers with flow while having sex in public a condom can be used.
Lactational amenorrhea: lactational amenorrhea is the temporary infertility that occurs when a woman is amenorrheic (not menstruating) and fully breastfeeding. Since I’m lactating and still want to have a regular menstrual cycle I have to limit the number of times I breastfeed to prevent becoming amenorrheic since I enjoy the swings of my hormones when I’m fertile and menstrual. I’ve found that if I limit my breast feeding sessions to about one every six hours or not more than four in a 24 hour interval I can avoid becoming amenorrheic and still cycle regularly.
Lactating is not without its challenges: A wonderful source of information about breastfeeding problems is at WebMD. It covers painful lumps, blocked ducts, yeast infections or thrush and engorged Breasts. I use a lanolin-based cream made specifically for nipple inflammation. It’s PureLan 100 Nipple Cream by Medela which for me minimizes the likelihood of further problems. The WebMD article can be read HERE
The Flowers graduate: On Saturday March 26th the six remaining Personal Assistant candidates completed the nine week Pelvic Intensive course that I conducted at Blackthorn Castle. I am very pleased to say they have already been placed with executives in major corporations. Returning readers will recall that Heather had a seizure during a dive-sex encounter and was hospitalized in a private dive medicine facility in Milford Haven. She was released after several days of tests and observation and was released from the PA candidate program for medical reasons. She will still remain in Taryn’s organization, but with a far less rigorous physical schedule.