Female protective equipment

A student’s protective equipment for ballet-sex

The photo: A silicone Semina coil spring diaphragm mounted on an introducer to aid in its insertion and a pair of hard shanked Gaynor Minden pointes. Students wear both as gorgeous and effective protection for their cervix and toes during ballet-sex training.

Semina is effective and popular with teens: In my introductory sex-ed course, Contemporary Sexual Health, I use Semina diaphragms because they are effective as well as pretty (which makes very young women feel adult, attractive and confident) so a Semina is more likely to be used during surface-sex. The Semina with spermicide in the dome is a good non-hormonal option when young women reach menarche and begin to need protection for sexual intercourse as it will allow sex with unprotected men giving young women experience in coping with coital discharge.

Semina is manufactured and available primarily in Brazil. It is very difficult to get in the U.S. and it is only selectively available from private clinics in the UK. However, it can be worth the trouble for a student who needs encouragement, something that she thinks is pretty as well as adult and effective which can give her a boost in self confidence.

The diaphragm as an anterior fornix thrust-buffer: I’ve written about this before, but it bears repeating because for some of us it can be important. For a woman with a well endowed partner who can thrust painfully into her anterior fornix a traditional diaphragm can provide some thrust-buffering. I usually wear a latex Reflexions flat spring rim which is no longer commercially available or a custom fitted latex FS device made for me by my London Gyn clinic. In addition to thrust-buffering with my latex FS diaphragm I get a twofer! That’s because when I’m fully aroused so my cervix has been pulled up and back out of the way of an average length penis when Tiny Tim one of my magnificently endowed lovers enters me in missionary he can push the stretched latex membrane of the dome up into my anterior fornix. At the same time the pressure of the dome on the tip of my cervix forces my cervix deeper while the increasing pressure of the stretchy dome squeezes his glans as his thrusts push it deeper into my anterior fornix giving me an A-spot orgasm while buffering his thrusts by slowing or stopping them before he hits bottom while at the same time pulling the anterior rim far enough away from the back of my pubic bone to rub against my G-spot.  None of my friends using a diaphragm have had anything like the mind-fucking turns-me-to-jelly pleasure of a simultaneous two erogenous zone orgasms with a single contraceptive device.

Even when a woman can’t get the same over-the-top orgasmic pleasure I get from wearing a latex diaphragm women with well endowed lovers find peace of mind and increases her pleasure while using it as a thrust-buffer to prevent tearing the ligaments holding her uterus in place.

When a latex FS device is not available silicone diaphragms such as the Milex (Omniflex or Arcing rim) or Semina (coil spring), but not a Caya contoured diaphragm - because the Caya has a smaller diameter and deeper dome - work well for thrust-buffering. Of the silicone options I think a Milex arcing spring rim works best since with an Omniflex or Semina the coil spring rims are more flexible so tend to put less pressure on the tip of the cervix.

Even though the Reflexions flat spring diaphragm is no longer commercially available a Gyn clinic specializing in cervical barriers (like the Blackthorn Clinic in London) can have a latex FS device custom made. And because a latex FS rim device has better heat transfer properties and the flat spring rim is almost impossible to even intentionally under-thrust by a mischievous partner it is the preferred cervical barrier used by  latex fetish escorts and as a flood insurance device it can be used for dive-sex at any depth. The down side of a latex device is that it won’t last as long as a silicone one and can’t be used by couples with a latex allergy.

The pointe-shoe as a defensive weapon: Occasionally a dancer in pointe-shoes can find herself at a disadvantage with a male partner who won’t take no for an answer. It’s difficult to out run a man while you’re wearing pointes, but the hard blocks make ideal blunt force trauma weapons if you are willing to use them. A kick to the temple to fracture the skull and knock him out; A kick to the kneecap to crush the bones and make the knee fold to the side or back; or a flexed foot kick to the pelvis coming up under his penis to crush it against his pubic bone all can be effective, though a kick to the pelvis may not be effective if he is wearing a groin protector/sports cup. A dance belt won’t protect his genitals from a hard blow from below but a sports cup probably will.

However, I think it’s unlikely to find an amorous man wearing a groin protector in a dance setting, but dance belts are standard on performing males. I’ve found that crushing an attacker’s knee so he can’t chase me works best unless he has bent over so his skull is accessible with a sharp high kick with a pointed foot. Once his knee is shattered an attacker can’t stand and a knockout kick to his head is much easier.  For a woman with several years’ ballet training putting a foot into an attackers kneecap should be relatively easy as foot placement in space becomes second nature.

Tim is Returning to school: He is being posted to the Joint Services Command and Staff College (JSCSC) after he finishes his leave. It is located at Shrivenham in west Oxfordshire which is quite rural and rather near the eastern border of Wales. So perhaps if he can get an occasional day off we can fuck each others brains out for relaxation. In his case I’m all for doing what I can to keep up the morale of our military. Shrivenham is about 120 miles (a bit less than 3 hours in good weather) up the M50 to Caersws then another 1 ½ hours from there south west on the A470 toward Llanidloes and into the mountains to Blackthorn Castle.

Monday 30 May 2016 (Spring Bank Holiday): The Spring Bank Holiday is already underway and those who can took Friday off and made it a four day weekend. While Easter Term ends at Cambridge on 10 June and exams are rapidly approaching Bea came stay with me here at the castle for the long weekend and she brought a lover with her. Bryony and Claire (the Dryads) are with me as well as they are taking a break from their thesis research on member’s fetishes at my London fetish club (the Costume Club AKA Clever Cunts) on Holland Park Road since a great many members are off on holiday. They have brought male ballet dancers who can make the holiday just before the start of performances of The Winter’s Tale at the ROH. So Tim and I will not lack for marvelously compatible company.

An English Spring: The weather is what I’ve come to expect. At the Castle given its altitude midday temperatures are expected to be no higher than the high 50s (F) and rain is probable except perhaps on Sunday morning. But then the weather in London is forecast to be about the same with perhaps somewhat higher temps, but cloudy and rainy too. Ahhh, an English spring!

The accident, New product lines for Blackthorn

Joy riding – penetrated by a Sybian machine

The Photo: A Sybian machine plug, shown penetrating the rider’s vagina.

Edith’s accident: I hadn’t asked exactly how my great, great, great grandmother died. At 103 I thought ‘natural causes’ which for someone that age could have been a variety of ailments. However, when Emily, my Lady’s Maid, mentioned her mistress’s accident I asked what sort thinking it was a fall from tripping on a rug and hitting her head or some such thing. That wasn’t it at all. Emily found her previous mistress after she heard the Baroness moans and screams during orgasm suddenly stop while on a routine morning ride of her Sybian machine. She was found slumped forward with the top of her head on the floor while still pinned to the machine. Her doctor, from the local NHS practice, said it was a heart attack from the exertion and she died almost instantly. I should be so lucky being fucked to death when my time comes.

I wondered how she had managed her vaginal preparation for a machine fucking, but then remembered the hormone replacement therapy med pills and estrogen creams I saw when we went through her meds. Emily said she had no problems with dryness and was comfortable, relaxed and seemed rejuvenated by her daily ride.

New product lines: I’ve been working with my contacts in Vegas to establish commercial ties here with some of the Barony’s commercial ventures. Having a presence for Gepettos, ballet-boots and Labia Labs vaginal and fetishwear products is a must if we are to appeal to the up-market sexually liberated woman and ballet and rubber fetishists. So far I’ve been able to get the following companies to sell their products exclusively in my shops.

Labia Labs in the UK: I’ve gotten Jeff to agree that Labia Labs fitted devices such as sports plugs and Fet-tex rubber fetishwear will be licensed to Blackthorn Holdings Ltd as sole distributor for its vaginal and fetishwear products in the UK. Chris, my male Gyn, can fit vaginal devices and the shop assistants will be fitting Fet-tex catsuits at Blackthorn Ballet and Fetishwear.

Gepetto’s Ballet Boots in the UK: Gepetto will be sending his 26 y/o daughter Cleo to work at Blackthorn Ballet shoes and Fetishwear to fit his custom titanium unitized toe-box and shank leather ballet-boots. Cleo has been working in Gepetto’s Vegas shop for five years and is an expert fitter. The cost $2500 USD (about 1655 GBP) for a basic pair will eliminate wannabe clients and limit customers to dedicated fetishists and fashionistas.

Cervical barriers and menstrual cups: Wide seal silicone Milex Arcing spring and Omniflex (coil spring) rim diaphragms and Lamberts latex Reflexions flat spring diaphragms as well as FemCaps and several styles of menstrual cups are readily available in the UK and can already be fitted and purchased through the Blackstone Clinic.

It’s complicated: Marvin and I have been discussing my feeling of isolation from where the action is as I’m finding having nothing meaningful to do other than my ballet technique and pointe classes makes time seem to drag. Honestly, I need sexual stimulation and being in a castle, as lovely as it is – and I intend to make it even better - several hours by train from London is already getting on my nerves and I’ve been here less than a week!   I can become involved with the local woman’s clinic and will help the gardeners and cook revive the kitchen garden in the spring, but what I really need is male ballet partners to maintain my level of training and, quite frankly my need for sex.

 

 

Orientation week for St Lucy’s girls

A silicone Semina coil spring diaphragm mounted on an introducer

The Photo: A Semina coil spring diaphragm mounted on its introducer to aid in inserting the device. Made of pink silicone it is readily accepted by St Lucy’s teen girls who are fitted with it as their first diaphragm after menarche because they are more likely to use it since they think its cute, “It looks like a pink soap bubble”, as well as wearing one is an indication that they have become sexually mature and are being given the tools and training necessary to assume the responsibility for protecting their fertility.

St Lucy’s student orientation: My part in the orientation of new student is to help with pelvic exams, check to make sure they have had all their Gardasil (HPV vaccine) shots and have clean full panel STI tests, fit diaphragms and give them an overview of contemporary sexual health as it pertains to St Lucy’s students. We teach responsible sexual intercourse between the sexes and techniques for seducing men with your voice, body and actions.

Semina diaphragms: New students entering St Lucy’s who have reached menarche are fitted with silicone Semina coil spring diaphragms as training diaphragms regardless of what other form of contraception they use as they will need a diaphragm for upper reproductive tract protection – to prevent water and or air bubbles from being forced into the uterus by the hydraulics of a lover’s thrusts during dive-sex. A coil spring diaphragm can be used for dive protection down to about 30 feet below which the rim will begin to distort and leak due to water pressure. All the pools generally available to the students are no deeper than 30 feet other than mine, (The Pit) at 64 feet, and Adolph’s, (The Well) at 216 feet. For both those venues they will need Reflexions flat spring diaphragms for effective dive protection. The RFID chip in each student’s Semina helps us track who is in class and who has forgotten their Semina, an infraction for which there are penalties.

The smallest diaphragms commercially available are:  the silicone Semina coil spring 60mm, the silicone Milex arcing or coil spring 60mm and the latex Reflexions flat spring 65mm. If we need diaphragms smaller than 60mm Labia Labs here in town can hand dip latex diaphragms in any of the three rim styles. Only a few of the younger petite girls require a 55mm.

Rarely do St Lucy’s students use diaphragms as their primary method of contraception. We try to get them to use stringless copper bead (GyneFix) IUDs effective for three years as their primary method since with a copper IUD the wearer will continue to cycle naturally and St Lucy’s feels strongly that some of the most creative and productive  work a woman can do occurs during the fertile days of her cycle. Removing the strings from the GyneFix before implantation allows the wearer to wear a diaphragm for flood insurance w/o the possibility of having the strings stick to the diaphragm and be pulled out when the diaphragm is removed.  

Alice shops in Gepetto’s ballet-boots: We returned from Tahoe on Sunday, Aug. 17^th. First thing on Monday (after ballet class and breakfast) we all went with Alice to pick up her new lightly armored ballet-boots and she loves the scent of new leather boots how well they fit and how wonderful they feel even after walking in them in one of the up-scale malls for more than an hour. Our lace-splitter heels were all sheathed in heel guards so we wouldn’t damage the up-market shops hardwood and expensive rug covered floors

I’d promised myself I wouldn’t wear ballet-boots while out shopping as they tend to attract aggressive men, and jaundiced looks from store security (shopping in pointe shoes is for me a much more social experience), but Alice wanted to go into Neiman Marcus and Hermès, the one at The Crystals shops At Aria. So with Alice, Willow and me all in black calf length Gepettos boots and Emma in her black leathers no one was making comments though everyone- especially the men - was watching us and store security stayed well in the background. It’s impractical to go shopping for skirts or slacks in ballet-boots, but Alice did pick up half a dozen Hermès scarves and six leather key cases as gifts. And at Neiman Marcus she bought a purse size (.5oz.) bottle of Shalimar which she had forgotten to pack.

Ballet-sex in ballet-boots: Back at my place in the studio in her suite Alice took one of her lovers having him enter her from behind while she bent over and held on to the barre. It was her first ballet-sex in Gepettos boots. She loves how being on her toes in ballet-boots clenches her pelvic muscles so she has a much tighter grip then when on her back or astride and she told me afterward that Gepettos ballet-boots were so much more comfortable than her Brit-boots..

Since she is menopausal and on HRT her vaginal lining is still soft and well lubricated, but there is no danger of pregnancy no mater how many high quality sperm reach her tubes waiting for an egg that will never be released.  Afterward she inserted two fingers and swept around her cervix to speed expelling his ejaculate with Kegels before it had liquefied then came to me in my room and I helped her out of her boots. We undressed and went to bed where she milked me after which she gave me the most marvelous gasping, shuddering, moaning, mewing clitoral orgasm. Then we both had a wonderful nap basking in the afterglow of our sexual encounters.

Her Grace departs and school starts: Alice left yesterday, Sunday Aug 24^th, on Limnaea II to go to Washington to visit with her daughter, Fiona for a few days before returning to Virgin Gorda. Classes start at both UNLV and St Lucy’s today so we are back on what passes, for us, as a normal fall schedule.

The 2014 Autumnal equinox: 2014 Autumnal Equinox will occur on Tuesday September 23^rd in mid week in the middle of the fall term so the girls will miss classes for that week, but with preparatory studying and doing well in work up to that point they should have no problem getting time off to participate in “’prehistoric religious rites research” in Scotland.  

The red sea: sex during menstruation

Menstruation and a matching cashmere pashmina

Menstrual Synchrony: I’m CD3 and flowing heavily with a latex Reflexions inserted for flow control. My wards, Bea, Willow and the Swan Twins, Odette and Odile have been sweating enough with me during ballet classes we take together that their cycles have become synchronized with mine. Willow, was the last to sync in the past month as she was the latest addition to my brood of budding ballerinas. Returning readers will recall that they all have copper bead GyneFix IUDs implanted for contraception so they can enjoy sex and the hormonal swings of their natural cycles w/o having to worry about becoming pregnant.

Having our cycles in sync has its advantages and disadvantages. Disadvantages are that we all can get a bit short and crabby when menstrual and we have to watch that there is enough iron in our diets as women with copper IUDs can bleed more heavily than those who don’t. The advantages are that when we are all fertile together the energy, creativeness and our libidos peak and my girls are up for almost anything. For me a big advantage is that I can teach them together about menstrual sex (both ballet and dive-sex) while we are menstrual and not as each one became menstrual if her cycle wasn’t synched with mine.

Rim movement and leakage: Flexing of the rim of All-Flex and coil spring rims (Omniflex and Semina) and movement of the Reflexions flat spring due to a partner’s thrusts into the dome and our contractions during orgasm will cause a slight leakage of flow as the rim moves over the vaginal rugae, even for a diaphragm that has very strong suction in the dome. So a partner after withdrawal will be coated by a thin sheen of blood. I always like to suck that off his still erect penis and taste my flow and smell its scent which most menstrual sex lovers enjoy as well, I mean the scent and being immediately sucked off after ballet-sex.

FemCap during menstruation: Wearing FemCap while menstrual during surface-sex is not practical since the dome is so small that it will quickly fill with flow and dislodge. Wearing FemCap during dive-sex has a depth limitation of 20 to 30 feet due to the squeeze of water pressure on the dome. In addition wearing FemCap during menstrual dive-sex is questionable even at shallow depths since even though menstrual discharge is not flowing while in the water immediately after emerging a gush can dislodge the cap and spill a significant quantity of flow all over the wearer’s suit, legs and surroundings. You might be able to get away with wearing it on a very light day, but my advice is not to use FemCap at all while menstrual.

Menstrual ballet-sex: Ballet-sex as discussed here is defined as being penetrated from behind while sur les pointes a la seconde while bent over holding on to the barre. For menstrual ballet-sex where a diaphragm is used for flow control any rim style can be used. However, knowledgeable women prefer wearing Reflexions because it is nearly impossible to under-thrust the rim and during menstrual sex you really don’t want the dome contents to spill due to the rim being under-thrust. If you don’t mind the mess and wear old shoes that you don’t mind being stained then it’s usually quite safe for an STI free couple to go w/o contraception of any kind. The only caution is for women with very short cycles (there are a few) who become fertile before their periods are over. For those women a diaphragm and a good spermicide are always needed.

Pointe shoes for menstrual ballet-sex may differ in size from pointes worn for ballet-sex at other times during a woman’s cycle. The amount of foot swelling while menstrual can depend on her menstrual day and how long she has been on her feet which will determine if she needs to wear a larger size or remove some of the padding from the size she usually wears. If I’m wearing Gaynors I can usually just not wear toe pads and be comfortable enough. If I’m wearing Freed Classics I have to go up a half size and in Bloch Alpha I have to go up between a half and a full size and retain the padding in pointes made of traditional materials.

Menstrual dive-sex: Dive-sex as discussed here is defined as sex underwater using SCUBA equipment. However, the same cautions apply even if the couple is only in water up to their waists.  Dive-sex while menstrual is no different than when in other cycle phases as far as precautions that need to be taken in that a latex Reflexions flat spring should be worn for flood insurance. If one of the couple is allergic to latex then a Cooper Surgical silicon wide seal Milex arcing spring diaphragm should be used. That’s because with its two elbow hinges the Milex arcing spring is the next most difficult diaphragm to under-thrust. You should take a cramp relieving medication. 800 mg of ibuprofen usually does the trick for me when I have cramps which fortunately is seldom. Of course the best cramp relief is an orgasm so we all look forward to the first orgasms of the day when the red sea is flowing.

When menstrual and using a diaphragm for flow control a woman should always empty it and reinsert before entering the water for dive-sex and if wearing a style other than a Reflexions flat spring she should switch (unless there is an allergy to latex addressed above) to the Reflexions because it is the safest to use for flood control during underwater sex.  And underwater sex while menstrual can be the most dangerous from a pelvic health standpoint since the uterine lining is sloughing off and blood is flowing freely. That means if from a partner’s thrusting water or an air bubble is forced into the uterus while menstrual there is a greater chance for an infection or an air bubble getting into the bloodstream to cause clots in the lungs, heart or brain.

Water pressure will almost always stop menstrual flow while swimming or diving. However, after coming out of the water there can be a gush that if it’s on a heavy day and she’s been in the water a long time could overload the dome and spill.

Towel-Girl adversity training

Foul Play

The Illustration: Foul play is used with permission of the artist, ‘HD’ for which I’m grateful. The drawing used here depicts a diver during adversity training showing exactly what happens during a session when Cyndi and I wrestle in the lava tube to see which of us can disable the other to the greatest extant and how long it takes to safely recover. Unfastening an opponent’s weight belt, turning off K-valves, pulling off fins, flooding masks and pulling out regs are all considered fair tactics during training. No knives to cut hoses or puncture BCs or small vice-grip pliers to clamp hoses closed are allowed. Nor is opening the zippers of an opponent’s suit or pulling out vaginal devices allowed during training. And we have to stay in the aquifer current where we are tumbled around as we are swept toward the ocean while trying to open our k-valves again, purge and insert our regs and clear our masks. Of course if it comes down to a real fight then nothing is off the table if it gives you an advantage.

An ideal location: The lava tube aquifer with its strong constant unidirectional current, relatively smooth sediment free bottom and walls, good depth (60 feet) and cold water provide an added degree of difficulty to the environment making ideal training conditions for combatants to train in. To protect against the cold and being scraped along the lava floor and walls we wear 5 mm neoprene wetsuits and hoods which also limit our mobility when trying to reach behind to turn on the K-valve again.

Adversity training prep: Towel-Girls taking basic training learn to empty their bowels and bladders prior to suiting up, but with adversity training it’s standard to also insert a latex Reflexions flat spring diaphragm for upper reproductive tract flood insurance and apply a 10 ml prefilled applicator of an intimate silicone lube, DiveGel+, deep in the vagina prior to suiting up in case she is overpowered and forcibly penetrated. That way she’s also prepared for dive-sex if the sexual encounter is consensual which often happens with a male trainer after such an intimate struggle where the bodies of the couple have been in such close contact. And, since both Cyndi and I are CD 28 and spotting we should begin bleeding tomorrow which will add another dimension, cramps, (but not severe enough to disable her, they just make her more feisty) to our training.

Cyndi’s adversity training is part of getting her prepared for exam time with Adolph who is known for just that sort of attention to attractive women. But in Cyndi’s case she needs to successfully pass the exam in order to complete the next level of training. That requires her to survive that sort of aggressive ‘playing’ at least three times during a single encounter with him before she can be considered qualified as an elite level Red Door Towel-Girl. Then she will be allowed alone in a pool at Splash, (Adolph’s adult swim club) with a new client whose dive fetishes and mental stability are unknown.  At Splash a Towel-Girl’s encounters are monitored by security so there would be someone to rescue her if attacked, but she needs to survive the initial attack. T-Gs usually wear bikinis for encounters in warm relatively shallow (20 foot deep) encounter pools so the tight suits, current and cold water of this training venue should help build up a her stamina and confidence.

Hormonal free contraception: One of very popular things about Towel-Girls at Splash is that none of them use hormonal contraceptives so they all are cycling naturally. That allows Adolph to offer dive-sex with fertile and menstruating (It’s a premium service.) T-Gs protected only by copper IUDs and diaphragms. And there is considerable demand for dive sex with the girls at those times in their cycles. Dive-sex with young fertile woman using a arcing or coil spring rim diaphragm for contraceptive protection results in a high percentage of pregnancies because the rims of those devices can be and are easily under-thrust and that is just the sort of clients Splash attracts.

Which is why only latex Reflexions FS diaphragms are worn by Towel-Girls while working at Splash because the latex has far better heat transfer characteristics than silicone and the dome is much stretchier giving a client a much better experience while the flat spring rim of a correctly sized diaphragm is almost impossible for even an expert swordsman to under-thrust protecting the T-G from a client inadvertently or on purpose under-thrusting the rim and ejaculating in the dome.

How diaphragms and FemCap are fitted

A current Milex wide seal diaphragm fitting set.

Being fitted for a diaphragm or cap: On another forum a friend asked “How does a woman get fitted for a diaphragm or cervical cap?” I’ve written a great deal about the delights and problems with wearing a contraceptive diaphragm or cap, but I can’t recall ever posting about how one is fitted so I thought I’d write about that now.

Tools: The fitter should use a diaphragm fitting set. Currently available sets used in the U.S. contain one diaphragm in each of the five most commonly prescribed sizes (65 – 85mm) and the sizes are standardized across manufacturers in 5mm increments. I use an old Milex fitting set because it has the most sizes, eight, from 60mm to 95mm and they are silicone. The most recent Milex fitting set is shown in photo accompanying this post. If a fitter tells you that s/he doesn’t need a fitting set to properly size your diaphragm (and sometimes we get a patient who has been told that) you should terminate the visit and go to someone who knows what they are doing.

The fitting: For this discussion I’m assuming that the patient’s vagina isn’t blocked by an inelastic hymen that would prevent proper fitting and possibly intercourse and that her pelvic anatomy; post-pubic vault and cervical aspect will permit the effective use of a diaphragm. A bimanual (the first two fingers of the hand) exam is performed before which the bladder and bowels should be emptied. During the exam the fitter determines the tone of the pelvic floor, the amount of relaxation (which determines if an arcing, coil or flat spring rim would be best) and the depth of the vagina.

The distance from the posterior fornix to the back of the pubic bone is estimated by inserting the two fingers of a gloved hand behind the posterior fornix then bringing the thumb knuckle to rest on the pubic symphysis then removing the fingers with the thumb still in place. The distance from the longest finger to the thumb knuckle joint establishes the approximate size. With the thumb still in place the closest diameter diaphragm is selected from the fitting set to cover that distance. That’s the starting point.

I first try that one and if it seems to fit well I’ll try one size larger and one size smaller and have the patient feel the difference in the distances between the anterior rim and the back of her pubic bone for each so she knows what the rim of a correctly sized diaphragm feels like when checking with her fingers. Then I’ll have her walk around with the correct diaphragm inserted to show her than when properly inserted she can’t feel it. After which I’ll show her how to insert it and let her insert and remove the device several times while I’m there to answer questions.

Ideally, a woman using a diaphragm should have a pronounced post-pubic vault so the rim can be tucked up behind the pubic bone out of the way of a thrusting penis. A woman with a shallow or no post-pubic vault is not a good candidate because the anterior rim may be easily hit by the woman’s partner. With a properly fitted D in the unaroused state the woman should just be able to insert a finger between her pubic bone and the rim with the pad against the back of her pubic bone and the nail against the anterior rim.

It’s important that the patient should be unaroused during her fitting. She needs the largest size she can comfortably wear when unaroused. If she becomes aroused during her fitting she may be fitted with a too large diaphragm since when aroused the vagina lengthens (tents). Or, in an attempt to compensate for her arousal a fitter may prescribe a size that is too small for the patient. This may explain why some fitters seem to be prescribing diaphragms that are too small. A too large diaphragm, in addition to being uncomfortable, will press on the urethra and restrict urine flow which can contribute to a UTI. So it’s necessary to be very professional and quick when fitting patients. Even so quite a few patients become at least partially aroused. A too small diaphragm can be difficult to place correctly, more easily under-thrust and difficult to remove.

A woman should insert her D when she is not aroused. If she inserts when aroused, because the vagina lengthens, it becomes difficult and sometimes impossible to insert the D correctly. When that happens the posterior rim may go into the anterior fornix and the D is comfortable (as long as she remains aroused) while her cervix is unprotected. That’s why it is very important once the woman thinks her D is correctly placed, to feel with her fingers for her cervix under the dome. If she can’t feel her cervix under the dome it is not protecting her and she should remove and reinsert it.

The correct size of a diaphragm is weight sensitive. If a woman has a weight change of +/- 7 pounds she should have her fit checked. Typically (but not always) a weight gain will require a smaller size and a weight loss will require a larger size. A check to see if the diaphragm is too large, and pressing on the urethra, is to insert the diaphragm correctly when unaroused then urinate. There should be no restriction in urine flow. A properly sized and correctly inserted diaphragm is just as effective for parous women as nulliparous ones.

Cervical cap fitting: Currently there is only one cervical cap available in the U.S., FemCap. The maker’s website www.femcap.com has fitting guidelines that stress the woman’s obstetrical history as being the primary factor in determining which cap she should choose. However, it is a very good idea to have a proper fitting by an experienced FemCap fitter because aside from OB history some women’s cervix are larger or smaller than ‘the average’ (I take a 26mm when the guidelines say I should wear a 22mm) and some may have an anteverted or retroverted cervix that makes them a poor candidate for FemCap. That’s because the outer wall of the brim should seal flush against the vaginal wall and if the cervix is tipped significantly part of the brim won’t seal properly and will stick out where it will be hit by a thrusting penis. A properly fitting FemCap should seal flush against the vaginal wall and not touch the walls of the cervix. Contraceptive Technology says that FemCap is less effective for women who have given birth than for those who haven’t. FemCap can be purchased on-line w/o an Rx, but if you have purchased the wrong size or the cervix isn’t positioned to allow a good seal against the vaginal walls you are out the money for a device you can’t use.

Cervical caps like the Prentif cavity rim and Oves (now no longer generally available) were sized differently as they developed their seal by fitting tightly against the wall of the cervix, which meant that women who were good candidates for Prentif or Oves needed a smooth walled cervix with no flat spots, bumps or irregularities from birth trauma.