A new diaphragm has become available in the United States – It’s called Caya, and it’s available in a single size and by prescription only, and is designed to be used with a nonoxynol-9 contraceptive gel.
Caya was developed as a collaboration between PATH and CONRAD, two non-profits responding to the needs of women for easy to use, effective, non-hormonal, user controlled contraception. Researchers at CONRAD, in a user-centered design process, worked their way through over 200 different prototypes to arrive at the current one-size, non-latex diaphragm, which was initially called the SILCS diaphragm. The SILCS diaphragm was evaluated in research studies in the US and internationally, and proved not only to be equally effective to currently marketed diaphragms, but also easy for women to learn to insert and remove. The diaphragm was licensed to Kessel in 2010, who now markets it as Caya in over 25 countries.
Caya was FDA-approved last year and will now be distributed in the US by HPSRx.
WHO SHOULD USE CAYA?
The diaphragm is a great option for women unwilling or unable to use hormonal contraceptives or the IUD, and who are motivated enough to use a method with every act of intercourse. Breastfeeding women are a group who may especially like the hormonal-free aspect of the diaphragm.
EFFICACY
The diaphragm is by no means the most effective contraceptive available. If 100 women use it for 12 months, 17.8 with will become pregnant; with perfect use, there will be 14 pregnancies. However, in motivated married couples, efficacies close to 95% have been reported with previous diaphragms, a fact I can attest to, having been a highly successful diaphragm user myself for many years.
User coaching could make a difference in efficacy – in Caya clinical trials, correct insertion increased from 76 to 94%. when users were coached rather than simply given written instructions.
Combining the diaphragm with use of the male condom brings contraceptive efficacy close to 100%. Combining it with fertility awareness could also increase efficacy, as women using fertility awareness would avoid intercourse or use a condom during more fertile days. I would predict that breastfeeding women, whose fertility is lower to start with, probably will experience high rates of contraceptive efficacy with Caya.
HOW TO GET CAYA
Caya is available by prescription only. The cost is $85. Spermacidal jelly is extra – cost for this will depend on where you buy it and how often you have intercourse and need to use it.
- Prescribers. Although Caya does not require a traditional fitting visit, clinicians can order free “Try Before You Buy’ disposable test units to be sure patients are comfortable using Caya and know how to insert it. Those clinicians who want to stock and sell Caya directly to their patients can order it directly from HPSRx. Otherwise they can simply write their patients a prescription and fax it to the pharmacy or give it to the patient.
- Patients: You have three options for obtaining Caya –
- Your Clinician. You clinician may stock Caya and be able to sell it to you directly.
- Your Local Pharmacy – Get a prescription from your clinician and take it to your local pharmacy. Your pharmacist may have to order Caya if they do not have it yet in stock.
- Mail Order – Get a prescription from your clinician and send it by mail with an order form to either American Mailorder Pharmacy ($80 plus $5 shipping) or Health Warehouse pharmacy ($85 w/ free shipping) , two mail order pharmacies who are stocking Caya for distribution. (Click the pharmacy link for the order form and address). You can also order spermacidal jelly along with your diaphragm, but it’s cheaper to get it from other vendors..
Don’t foget spermacidal gel.
Caya won’t work without it.
Spermacidal Gel is available without a prescription at pharmacies and online. The manufacturer is offering Options GYNOL II Gel or Contraceptrol pre-filled applicators at a cost of $18.50 and $17.50, respectively. By comparison, the cost of these spermacides is between 11 $11 and $15 from most online vendors, plus shipping.
Use of nonxynol-9 spermacidal gels can increase HIV transmission rates if you’re exposed to an HIV infected partner. I’d recommend that you and your partner have negative HIV testing before considering giving up condoms and moving to the diaphragm for birth control.
How to Insert Caya
Instructions are here. The manufacturer also has a video.
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ADDITIONAL READING
Learn how Caya was developed – a story of innovation and collaboration between non-profit and for-profit sectors.
Are you aware of a local pharmacy in NYC area that is willing to order caya? I’ve called several and have not found one yet.
Order it from ethicalfamilyplanning.com or Amazon UK. The US is the only one requiring a prescription for a piece of Darn silicone. You can order it online from UK easily without all the drama of finding a pharmacy or doctors willing to fit and prescribe Caya
You cannot order it from the UK if you live in the USA. Its illegal because the USA requires a script. Amazon will NOT ship to USA from Amazon UK.
It took me forever to get a hold of one of these. I had to order from American Mail Order Pharmacy. The Caya is FDA approved, but hardly any Rx distributers have it yet.
Good luck!
** PS I have and use it. Definitely a fan, although fit is a tricky learning process 🙂
I am married 40 yo female that has been using the milex wide-seal diaphragm for 15 years. just recently I got the new caya diaphragm, both my husband and I just love the new caya. most of the time I put it in at night and my husband pulls it out in the morning before I get out of bed. I use it with contragel. we plan on using this method until I go through menapause
Everything old is new again. This is definitely an improvement since it doesn’t have to be fitted. (Wonder what happened to that set of fitting rings I used to have?)
Is there any way to get this through a pharmacy that takes insurance coverage? I have spent hours in local pharmacies and on the phone and have had no success.
American Mail Order Pharmacy takes insurance, if your plan covers this type or contraception. (My insurance didn’t cover it, but they were really nice to work with.)
I feel so sorry for all the women in the US who are treated like little children. I live in Germany and can just walk right into a pharmacy and buy the caya and the caya gel/contra gel, which does not contain Nonoxynol-9 :-), together for 50 Euro, what is about 60 US Dollar. All women should be able to choose their contraceptive methods according to their needs. I can not see how a caya is more dangerous to use then for example a menstruation cup, which is available all over the US.
Verena, it’s true. I am so angry at this paternalistic country (USA)! I can’t even get a diaphragm without jumping through ridiculous hoops. Stupid conservative white men!
I ordered mine on eBay. Took forever but finally got it. Asked at local pharmacies to fill a prescription for a diaphragm; you would have thought I had three heads! CVS refused to even entertain finding one for me!
In the USA, look up the NDC number(s) for the diaphragm(s) you are considering and call or take the NDC numbers, WITH the dashes, to your provider or pharmacies. Also, since the ACA took effect, most insurance will also cover the spermicidal gel with a prescription! so your non-hormonal birth control CAN be FREE!….. Find and Take the NDC(s) of the spermicides too!
GOOGLE search: FDA Access NDC and use the “.gov” website
my body just didn’t like hormonal birth control so after having 2 children by age 28 I got fitted with a milex wide-seal diaphragm. after using the diaphragm for 12 years I decided that my husband and try the new caya DIAPHRAGM. BOTH MY HUSBAND AND I love this method and I put contrajel on the inside of it.both of us love this new method of birth control control. since we usually have sex at least 3 times a week and it has certainly kept me from getting pregnant over the years. we plan to use the caya until I am no longer fertile.