How About My Non-Hormonal Options?: Contraception in Israel Part #3

About nine years ago, I spent three weeks tracking down the saga of why the Ortho McNeil all flex diaphragm was no longer available in pharmacies in Israel. I spoke to higher management in the Janssen office who distributes ortho products in Israel. (I caught her on vacation in Amsterdam.) Individual importers of contraceptive gel and devices to Israel, and even Hector, who worked in the rubber plant in Venezuela that manufactured the diaphragm for Ortho. After much digging and conversation, the conclusion was that the Jannsen company didn’t feel that the 25,000 NIS licensing fee they needed to pay to keep importing the diaphragm was worth the investment, since diaphragm sales were abysmal. Since then, sales of the Milex diaphragm have been relegated to a sole distributor who takes orders over the phone and sends the gel and contraceptive device to women in the Israel post, in brown paper packages.

Seven years ago, I attended an ECS (European Contraceptive Society) conference in Greece to meet the newly chosen sole worldwide distributor of the Caya, the brainchild of the nonprofit Path, a Seattle based nonprofit looking to create a woman-centered device to reduce HIV transmission in sub-Saharan Africa. With a 1 million dollar Gates Foundation grant, they created the one size fits all, no fitting needed Caya Diaphragm. Last year, distribution finally arrived in Israel, through a distribution company called Terragreen Medical.

But before I tell you how to get it, let’s review the function of the diaphragm. This rubber cap, with spring coil in the rim, is made to be inserted physically and cover the woman’s cervix, acting as a physical barrier to sperm entry. The diaphragm should be used in conjunction with a spermicide gel that coats the device. It is reusable, and need only be inserted prior to relations. Women who have negative side effects from hormone contraception, or for whatever reason, prefer to continue to ovulate and not interfere with the hormone cycle, are usually the ones who seek out this method.

There are two other barrier methods available in Israel: the cervical cap and the sponge. Although off the shelves for a number of years, it came back with a vengeance about ten years ago and can now be purchased at large chains like Super-Pharm. It is a disposable sponge with spermicide inside, that is also inserted prior to relations.

I should also mention that there are women who choose to use FAM (Fertility Awareness Method) where a woman learns to recognize her signs of ovulation and either uses a barrier method during her fertile period or chooses to abstain for those days. Check out the website www.poriutivit.com for more information on this method and how you can learn more about it in Israel.

So how do we go about purchasing these items?

To purchase a Milex diaphragm you need to:

Be fitted by a:
1. kupah gynecologist who has been trained (inquire directly with the doctor)
2. a private doctor who fits diaphragms
3. a trained nurse/midwife who fits (about 12 or so throughout Israel)
Contact the current distributor, Medipaz, with the prescription, to place your order.