Female condom
Encyclopedia
A female condom is a device that is used during sexual intercourse
Sexual intercourse
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...

 as a barrier contraceptive and to reduce the risk of sexually transmitted infections (STIs—such as gonorrhea
Gonorrhea
Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are burning with urination and penile discharge. Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain...

, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

, and HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

) and unintended pregnancy. Invented by Danish
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...

 MD Lasse Hessel
Lasse Hessel
Lasse Hessel also known as "the family doctor", is a Danish inventor, author and MD noted for such inventions as the Femidom and the Femi-X pill, and an internationally acknowledged expert on nutrition and dietary fibre....

, it is worn internally by the receptive partner and physically blocks ejaculated semen
Semen
Semen is an organic fluid, also known as seminal fluid, that may contain spermatozoa. It is secreted by the gonads and other sexual organs of male or hermaphroditic animals and can fertilize female ova...

 from entering that person's body. Female condoms can be used by the receptive partner during anal sex
Anal sex
Anal sex is the sex act in which the penis is inserted into the anus of a sexual partner. The term can also include other sexual acts involving the anus, including pegging, anilingus , fingering, and object insertion.Common misconception describes anal sex as practiced almost exclusively by gay men...

.

The female condom is a thin, soft, loose-fitting sheath with a flexible ring at each end. They typically come in various sizes. Size should be carefully selected as not to cause any user discomfort, as well as to prevent errant sperm from bypassing the condom. For most vaginas, a moderately sized condom is adequate; women having recently experienced child birth should try a large first. The inner ring at the closed end of the sheath is used to insert the condom inside the vagina and to hold it in place during intercourse. The rolled outer ring at the open end of the sheath remains outside the vagina and covers part of the external genitalia.

Versions and materials

The FC1 female condom was first made from polyurethane
Polyurethane
A polyurethane is any polymer composed of a chain of organic units joined by carbamate links. Polyurethane polymers are formed through step-growth polymerization, by reacting a monomer with another monomer in the presence of a catalyst.Polyurethanes are...

. The second generation female condom is called the FC2 and is made from synthetic nitrile. (this material change was announced in September 2005, and full transition of the product line to FC2 was done by October 2009 ). The newer nitrile condoms are less likely to make potentially distracting crinkling noises. FC2 was developed to take the place of FC1, providing the same safety and efficacy during use, but at a lower cost. It is hoped the nitrile condoms will also allow for significant reductions in female condom pricing. FC2 is manufactured by The Female Health Company. The FC2 is the only available product under a woman's control that is approved by the U.S. Food and Drug Administration (FDA). Moreover, The World Health Organization (WHO) has cleared FC2 for purchase by U.N. agencies and the UNFPA (a U.N. agency) has incorporated the female condom into national programming. They are sold under many brand names, including Reality, Femidom, Dominique, Femy, Myfemy, Protectiv and Care.

A recent version of the female condom is made from natural latex, the same material used in male condoms. This condom does not make the noises some experience with plastic condoms. This type of female condom is manufactured by Medtech Products Ltd, India. It is sold under various brand names, including Reddy, V Amour, L'amour, VA WOW Feminine condom, and Sutra. One more clinical trial is required before it can be considered for FDA approval in the United States.

The global health nonprofit Program for Appropriate Technology in Health
Program for Appropriate Technology in Health
The Program for Appropriate Technology in Health is an international, nonprofit global health organization based in Seattle, Washington , with 900+ employees in more than 30 offices around the world. Its president and CEO is Dr...

 (PATH) has also developed a female condom tailored for use in developing countries. The Woman's Condom is manufactured by Shanghai Dahua Medical Apparatus in China and is currently undergoing clinical trials.

Costs and "reuse" of the original FC and FC2

The per unit price of female condoms is higher than male condoms but there is some evidence to suggest that polyurethane female condoms can be washed, disinfected, and reused.

Re-using the polyurethane female condom is not considered as safe as using a new one, however the WHO says, "Batches of new, unused female condoms were subjected to seven cycles of disinfection, washing, drying and re-lubrication, reflecting the steps and procedures in the draft protocol, but at considerably higher concentrations of bleach
Bleach
Bleach refers to a number of chemicals that remove color, whiten, or disinfect, often via oxidation. Common chemical bleaches include household chlorine bleach , lye, oxygen bleach , and bleaching powder...

 and for longer durations. All female condom batches met the manufacturing quality assessment specifications for structural integrity after the test cycles. ... Disinfection, washing, drying, re-lubrication and reuse of the device were not associated with penile discharge, symptomatic vaginal irritation or adverse colposcopic findings in study volunteers." A presentation at the 1998 International AIDS conference concluded that "washing, drying and re-lubricating the female condom up to ten times does not significantly alter the structural integrity of the device. Further microbiological and virological tests are required before re-use of the female condom can be recommended."

Research suggests that the FC2 female condoms are a cost-effective method of HIV prevention even at low levels of use. The data shows that the cost-effectiveness would increase significantly at higher levels of use. A study conducted in 2005 by Dr. David Holtgrave, Chair of the Department of Health, Behavior and Society at Johns Hopkins University's Bloomberg School of Public Health, examined the projected public health impact that the FC2 female condom would have at different levels of use in two developing countries: South Africa and Brazil. The study concluded that FC2 use would generate significant cost savings at all levels of implementation by preventing thousands of HIV infections and saving millions of dollars in health care costs.

Lubrication

As with all barrier contraceptives, water or silicone-based lubricants are safe to use with any female condom. Oil should not be used with a female condom made of latex
Latex
Latex is the stable dispersion of polymer microparticles in an aqueous medium. Latexes may be natural or synthetic.Latex as found in nature is a milky fluid found in 10% of all flowering plants . It is a complex emulsion consisting of proteins, alkaloids, starches, sugars, oils, tannins, resins,...

.

FC2 Female Condom comes pre-lubricated with a non-spermicidal, silicone based lubricant. The FC2 is made of nitrile so oil-based (or water-based) lubricants can be added on the inside and outside of FC2 Female Condom or on the penis.

Advantages

FC2 Female Condom gives women control and choice over their own sexual health; women can protect themselves when their partner does not want to use a male condom; female condoms provide enhanced sensation for men as compared to male condoms ; female condoms may provide enhanced sensation for women as compared to male condoms ; FC2 is hypo allergenic and is safe to use with people who are allergic to rubber latex; FC2 may be inserted hours before intercourse; female condoms are not dependent on the penis being erect for insertion and does not require immediate withdrawal after ejaculation; FC2 is not tight or constricting; FC2 is highly lubricated and the material warms to body temperature.

The external genitals of the wearer and the base of the penis of the inserting partner may be more protected (from skin-to-skin transmitted STD
STD
STD may refer to:* Sexually transmitted disease* Doctor of Sacred Theology * São Tomé and Príncipe dobra, the ISO 4217 code for the currency of São Tomé and Príncipe...

s such as herpes and HPV) than when the male condom is used, however see studies below.

Worldwide use

Sales of female condoms have been disappointing in developed countries, though developing countries are increasingly using them to complement already existing family planning and HIV/AIDS programming. Probable causes for poor sales are that inserting the female condom is a skill that has to be learned and that female condoms can be significantly more expensive than male condoms (upwards of 2 or 3 times the cost). Also, reported "rustling" sounds from the original version of the female condom during intercourse turn off some potential users, as does the visibility of the outer ring which remains outside the vagina.

In November 2005, the World YWCA
YWCA
The YWCA USA is the United States branch of a women's membership movement that strives to create opportunities for women's growth, leadership and power in order to attain a common vision—to eliminate racism and empower women. The YWCA is a non-profit organization, the first of which was founded in...

 called on national health ministries and international donors to commit to purchasing 180 million female condoms for global distribution in 2006, stating that "Female condoms remain the only tool for HIV prevention that women can initiate and control," but that they remain virtually inaccessible to women in the developing world due to their high cost of 72¢ per piece. If 180 million female condoms were ordered, the price of a single female condom was projected to decline to 22¢.

In 2005, 12 million female condoms were distributed to women in the developing world. By comparison, between 6 and 9 billion male condoms were distributed that year.

Similar prophylactics that may not be available

  • The Barrier
    • Coverage / How it is held in place: It fits over the vulva and perineum and is held in place with thick elastic straps that encircle the women's upper legs. The tube-shaped pouch is about 1½ times larger and 2 times thicker than a male condom. The penis never directly touches the woman's outer or inner genitalia
    • Material: latex
  • The Bikini Condom
    • Coverage / How it is held in place: "looks like a G-string panty"
    • Effectiveness: thicker and less slippage than male condoms, a breakage rate of 0.5%, compared to 1–2% for male condoms
    • Advantages: condom pouch can be automatically introduced into the vagina with coitus, reported heightened sensation for women
    • Cost—reuse: "can be used 5–10 times"
  • Women's Choice Female Condom
    • Coverage / How it is held in place: Has a 2 inches (50.8 mm) flexible ring that covers the introitus
      Introitus
      The introitus is an entrance that goes into a canal or hollow organ. Introitus is another name for the vaginal orifice.Introitus has also been used for classifying uterine prolapse:*1st degree prolapse: cervix is in the vagina...

      , and a thickened dome of latex resembling a diaphragm at the deep end
    • Pre-lubrication
      Personal lubricant
      Personal lubricants are specialized lubricants to reduce friction between body parts, or between body parts and other objects...

       / Spermicide
      Spermicide
      Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods...

      : silicone lubrication

External links

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