Women who have cervical infections or inflammations, abnormal PAP smears, herpes, or active pelvic inflammatory diseases should not use cervical caps. Certain shapes of cervices, either very short or very long, and cervices that have been severely injured, cannot be easily fitted.

Learning to insert and remove the cap requires practice and patience. Like any new skill, it takes time to master. Some women catch on immediately and others take longer to learn. Some women find it difficult to insert at first and others find removing more difficult. Before learning how to use the cap it is important to learn how to feel your own cervix. The cervix feels somewhat like the end of your nose, only softer, and is located far back in the vagina.

After choosing from one of four possible sizes of cervical cap for a particular woman, I have her put it in and take it out at least three times, checking each time to see that she has correctly placed it over the cervix. The key to successful use is to make sure that the cervix is covered at all times. Failure of the cap results from incorrect placement (the cap can stick to the vagina wall) or the cap not being used at all, or the cap becoming accidentally dislodged during sex.

Disadvantages of the cap include being harder to insert and remove than the diaphragm, at least initially, and requiring, like all barrier methods, conscientious use every time you have sex. Also the cervical cap cannot be used during menstruation, as the menstrual blood may break the suction. Thus, during menstruation, another method of birth control has to be used such as condom or diaphragm. Occasionally, a man can feel discomfort during sex at certain times of the menstrual cycle, if his penis hits the rim of the cap.

In Chicago, a doctor and dentist are working with the idea of a custom-made cap with a one-way valve that allows cervical secretions to drain and that can be left in place for long periods of time. This could be a promising development for the future.

If you are considering a cervical cap, you have to know yourself and your sexual lifestyle well enough to be certain that you are the type of person who will actually use the cap every time you have sex.

The cap is not always easy to obtain, except in major centers. Contact your nearest women's center or Planned Parenthood Center to get a list of practitioners and clinics that fit cervical caps. The cap costs about $35.00, roughly the same as the diaphragm.

Resources

THE COMPLETE CERVICAL CAP GUIDE, by Rebecca Chalker (Harper and Rowe 1987). This book is a practical and well illustrated guide on how to use the cap and how to make sure it is properly fitted.

In the United States, you can contact the CONCORD FEMINIST HEALTH CENTER, 38 South Main St, Concord, NH 03301. 603-225-2939, for a list of practitioners and clinics that fit the cap.