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Q&A: Female/Internal Condoms

April 16, 2013
The CSPH

condomEach week, The CSPH answers questions that have been submitted through our website and social media outlets like Twitter, Tumblr, and Facebook. This week’s question is:

What’s the best female condom?

Female condoms, also known as internal condoms or FCs, help prevent unintended pregnancy and sexually transmitted infections, including HIV. Although these products are frequently marketed with the terms “female” or “woman,” The CSPH prefers to use “internal condom” when possible, because it better reflects the truth about gender identity—that being female or male cannot be defined by having a prescribed set of genitals. Besides, this fantastic prophylactic is an effective safer sex option for good times all around, both within and beyond the vaginal walls as it can also be used during anal sex by persons of any gender. Please note that some of the language in this Q&A may be triggering due to the fact that many brands of internal condom still market themselves using “female” specific language; however, we have included it as part of our resource set due to the fact that they are quality barrier methods even if the language they use is problematic.

Internal condoms are unique because they are the only barrier method that can be initiated by the receptive partner, which may empower that individual to feel greater control over their personal health and protection. Additional benefits of internal condom use include the potential for advance insertion (up to eight hours before sex), protection of the skin surrounding the vagina or anus, and its thin, synthetic rubber material—compatible with both silicone- and water-based lubes—that may better preserve sensation.

Assuming that you live in the United States, the answer to your question is simple: the FC2 is the “best” option. Why? Because it is the only internal condom approved by the Food and Drug Administration and, therefore, the only one available for purchase.  Although there are hundreds of brands on the market for penis protection—in assorted colors, textures, and flavors—there are limited condom choices for receptive partners. The good news, however, is that this could change in the next few years, as there are some exciting products under development.

Seattle-based nonprofit PATH has designed a new model, the Woman’s Condom, with input from heterosexual couples in the developing world. Despite the numerous benefits associated with internal condoms, not only can they be challenging to insert, but their  physical appearance can also be uninviting, somewhat akin to a slippery windsock. To address these ergonomic and aesthetic concerns, PATH scientists gathered most of the seven-inch polyurethane pouch into a capsule about the size of an OB tampon. All you have to do is insert the compact capsule, and then the pouch unfurls while foam supports adhere lightly to the vaginal walls to stabilize the condom. The Woman’s Condom, also branded as O’lavie, has been available in China in limited distribution channels since late 2011 and clinical trials were recently completed in the United States.

Other promising advances in the world of internal condoms include the following models, which, like the “Woman’s Condom,” have been designed and tested specifically for vaginal intercourse:

The Cupid

Available in both natural and pink colors, it is the only FC that is vanilla scented. If these qualities alone do not motivate you to stockpile your shelves, consider the more user-friendly insertion method: the Cupid uses a non-biodegradable sponge, meant to be compressed between the fingers, to push the condom into the vagina. The sponge  also holds the condom in place during use, much like the inner ring of the FC2. This FC was pre-qualified in June 2012 for bulk procurement by the United Nations, upon recommendations from the World Health Organization’s (WHO) Female Condom Technical Review Committee. It is currently available in India, Brazil, Indonesia, the Netherlands, and South Africa.

Origami

Made of silicone to provide flexibility and durability during vaginal intercourse, this product is folded “origami style” and inserted by pushing the folded material into the vagina. While the design is intended to minimize its size for ease of insertion, after insertion, the condom will deploy to its full length during intercourse. The Origami has the potential to be a viable, reusable condom, due to its high-grade silicone material. This possibility of re-use, if found to be feasible, could lower manufacturing costs significantly. Clinical trials will commence in the U.S. in 2014. Furthermore, if these condoms become available in select animal shapes—like frogs, swans, or tigers—I predict a new contraceptive trend!

Panty Condoms

The Natural Sensation Panty Condom® offers sexy snatch protection with a discrete design that MacGyver would envy.  A reusable cotton thong, the Panty Condom® includes a replaceable pantyliner that contains a condom made of synthetic resin. The condom can be inserted by a penis or a finger, and the panty itself can be reused with another condom for additional acts of intercourse. One great benefit of this product is that you can wear it all day and, like a Girl Scout, be prepared. Additionally, it covers the entire vulva, which eliminates direct contact with the genital area and reduces the potential for sexually-transmitted infections such as herpes or HPV. Natural Sensation is available in parts of South America and Europe, though it has not received FDA or WHO approval. This FC is under review by the WHO Female Condom Technical Review Committee, and clinical work on function and acceptability is due to be undertaken in 2013.

If you wish to support the development and distribution of these fantastic products, consider joining the National Female Condom Coalition, or donating to PATH.  Unlike traditional condoms, FCs are considered a new “medical device” by the FDA and must undergo rigorous testing and research before widespread distribution, requiring funding and advocacy. Of the products that have already been approved, much of their availability is dependent upon donor organizations, such as the United Nations Population Fund, especially within the developing world.

For more information about the positive impact of FCs worldwide, check out the video submissions to PATH’s film contest, Female Condoms Are ________.  According to global citizens everywhere, from Bolivia to Kenya to the United States, “female condoms are sexy;” “female condoms are freedom;” “female condoms are for everyone.”