We have used a diaphgragm along with FAM for almost 6 years now. I was told to keep it in after sex for 5 hours (it does get uncomfortable) but I was never told to fill the thing with spermicide. The outside edge is "lined" essentially and then a small amount goes in the diaphgragm itself. We have had no accidental pregnancies from using this as a method of birth control. A container of spermicide will last anywhere from 6-12 months for us.