Use of a diaphragm plus spermicide provides effective protection against pregnancy in motivated women and decreases the risk for some sexually transmitted diseases. Potential risks of this contraceptive method include the development of urinary tract infections and the possible teratogenic effects of nonoxynol-9, the active agent in most spermicides. Contraindications include a large cystocele or rectocele, uterine prolapse and recurrent urinary tract infections.