What is the Female Condom?

The female condom is a polyurethane sheath or pouch about 17 cm (6.5 inches) in length. It is worn by a woman during sex. It entirely lines the vagina and it helps to prevent pregnancy and sexually transmitted diseases (STDs) including HIV.

At each end of the condom there is a flexible ring. At the closed end of the sheath, the flexible ring is inserted into the vagina to hold the female condom in place. At the other open end of the sheath, the ring stays outside the vulva at the entrance to the vagina. This ring acts as a guide during penetration and it also stops the sheath bunching up inside the vagina.

There is silicone-based lubricant on the inside of the condom, but additional lubrication can be used. The condom does not contain spermicide. The female should not be used at the same time as a latex male condom because the friction between the two condoms may cause the condoms to break.

The female condom has been available in Europe since 1992 and it was approved in 1993 by the US Food and Drug Administration (FDA). It is available in many countries, at least in limited quantities, throughout the world. The female condom carries various brand names in different countries including, FC Female Condom, Reality, Femidom, Dominique, Femy, Myfemy, Protectiv' and Care.

How do you Use the Female Condom?

Open the package carefully. Choose a position that is comfortable for insertion- squat, raise one leg, sit or lie down. Make sure the condom is lubricated enough. Make sure the inner ring is at the bottom closed end of the sheath, and hold the sheath with the open end hanging down.

Squeeze the inner ring with thumb and middle finger (so it becomes long and narrow), and then insert the inner ring and sheath into the vaginal opening. Gently insert the inner ring into the vagina and feel it go up. Place the index finger inside of the condom and push the inner ring as far as it will go. Make sure the condom is inserted straight, and is not twisted inside the vagina. The outer ring should remain on the outside of the vagina. The penis should be guided into the condom in order to ensure that the penis does not slip into the vagina outside the condom. Use enough lubricant so that the condom stays in place during sex.

If the condom slips during intercourse, or if it enters the vagina, then you should stop immediately and take the female condom out. Then insert a new one and add extra lubricant to the opening of the sheath or on the penis.

To remove the condom, twist the outer ring gently and then pull the condom out keeping the sperm inside. Wrap the condom in the package or in tissue and throw it away. Do not put it into the toilet. It is generally recommended that the female condom should not be reused.

The female condom may feel unfamiliar at first. The female condom may feel different and some people find it difficult to insert. Some women find that with time and practice using the female condom becomes easier and easier.

What are the benefits?

• Opportunity for women to share the responsibility for the condoms with their partners
• A woman can use the female condom if her partner refuses to use the male condom
• The polyurethane, the material the female condom is made of, is less likely to cause an allergic reaction than a male latex condom. It's not clear whether latex or polyurethane condoms are stronger – there are studies suggesting that either is less likely to break. With both types, however, the likelihood of breakage is very small, if used correctly.
• The female condom will protect against most STDs and pregnancy if used correctly
• It can be inserted up to 8 hours before intercourse so it does not interfere with the moment
• The polyurethane is thin and conducts heat well so sensation is preserved
• Female condom can be used with oil-based lubricants
• No special storage requirements are needed because polyurethane is not affected by changes in temperature and dampness. The expiry date for female condoms is 5 years from the date of manufacture.

What are the disadvantages?

• The outer ring is visible outside the vagina, which can make some women feel self-conscious
• The female condom can make noises during intercourse. Adding more lubricant can help this problem.
• Some women find the female condom hard to insert and to remove
• It has a higher failure rate than non-barrier methods such as the pill
• It is relatively expensive and relatively limited in availability in some countries
• It is recommended that the female condom is only used once.

Can I reuse the female condom?

It is believed that limited availability and high cost have led some women to reuse female condoms in some countries. The World Health Organisation (WHO) recommends use of a new male or female condom for every act of intercourse for those people who use condoms for pregnancy prevention and/or STI/HIV prevention.

WHO does not recommend or promote reuse of female condoms but has released a document together with guidelines and advice for programme managers who may consider reuse of female condoms in local settings. The document 'The safety and feasibility of female condom reuse: Report of a WHO consultation' can be found at www.who.int/reproductive-health/rtis/docs/report_reuse.pdf

Using the female condom for anal sex

Some people use the female condom for anal sex. Although it can work effectively, it is difficult to use and can be painful. There is also the risk of rectal bleeding which increases the risk of contracting HIV. So it's better to use the male condom for anal sex with plenty of lubricant NOT containing Nonoxynol 9.

Support for the female condom

WHO and UNAIDS are encouraging the introduction of the female condom as a new method of preventing both pregnancy and infection and as an additional tool in efforts to respond to the needs of women and men in sexual and reproductive health. The female condom is also effective part of the solution in prevention of HIV/AIDS/STD in high prevalence areas.

Worldwide use and availability

The female condom is widely used in countries that actively promote its use, such as South Africa, Ghana and Zimbabwe. However in other countries, such as the USA, it isn't as popular. To become an accepted and available form of contraception, an effort needs to be made worldwide to promote the female condom and make it more available.

More information on how to use condoms, the different types and sizes can be found in our Using Condoms page.

Sources:

• WHO (2002) The safety and feasibility of female condom reuse: Report of a WHO consultation', Geneva, January 28-29
• Female condom re-use issues explored, Network 2003. Vol 22, No 4
• Re-use of the female condom: Now for the practical realities, Philpott, A., Reproductive Health Matters 2003, 11(22): 185-186

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