Female+Condom

Yijin Zhang

 **Female Condom** **Definition** A female condom is a thin lubricated sheath worn by a woman inside of her vagina during sex intercourse (“Female C ondoms,” 2009). It acts as a barrier contraceptive to reduce the risk of many sexually transmitted diseases (STDs) and unintended pregnancy by completely lining the vagina.

The female condom has a flexible ring at each end. 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 o utside the vagina and covers part of the external genitalia (“Female Condom,” 2011).

**Types** There are two types of female condom: FC1 and FC2. FC1 female condom is made of polyurethane and is a bout 17cm (6.5 inches) in length. There is silicone-based lubricant on the inside of the condom, but additional lubrication can be used. The condom does not contain spermicide. FC2 female condom is the new generation female condom. It is made of synthetic nitrile, a type of sy nthetic rubber that is latex-free (“Female Condoms,” 2009).

**History** FC1 female condom has been available in Europe since 1992 and was approved by the US Food and Drug Administra tion (FDA) in 1993. FC2 female condom, on the other hand, was only announced in 2005 and put into large-scale production in 2007. The FDA approved the FC2 in December 2008 and the World Health Organization has stated that the product is acceptable for bulk procurement by UN agencies (“The Female Condom,” 2011).

**How to Use Female Condom?** The female condom can be inserted up to 8 hours before intercourse and are only effective when placed prior to intercourse. Even though it might be awkward to first start using female condoms, they get easier with practice. Allow time to insert the condom before sexual intercourse.

Here are the directions for using female condom correctly: 
 * First check the expiration date and make sure it is still valid for use. Also make sure that the package is unopened and does not contain any holes. Gently rub the package to evenly spread the lubricant before opening the package.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Wash your hands and find a comfortable position. You can stand with one foot up on a chair, sit with your knees apart or lie down.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Hold the female condom so that the open end is hanging down.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Squeeze the inner ring with your thumb and middle finger.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Insert the inner ring into your vagina with the help from your index finger.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Patiently and gently push the inner ring as deep as possible until it slides into place. Take some time to do this as female condoms are slippery with lubrication. Make sure the female condom is not twisted in any ways.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">The outside ring of the female condom should lie against the outer lips of your vagina and about one inch of it should be outside of your body.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Guide the male’s penis into the female condom so that it does not enter the vagina during sex.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">To remove the female condom after intercourse, squeeze and twist the outer ring gently to lock the sperm inside the pouch and pull the female condom out.
 * <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Place the used female condom in a waste container. Do not flush it or reuse it.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">If the female condom slips during intercourse or it completely enters the vagina, intercourse needs to be stopped immediately. Take out the female condom carefully to avoid spilling the sperm. Use a new female condom if intercourse is in need to be continued. At the mean time, be prepared to use emergency contraception in case some sperm leaks.

<span style="font-family: Arial,Helvetica,sans-serif; letter-spacing: 0px;">Visual helps are freely available online. For example, here is a link to an animated video on Youtube: [|__http://www.youtube.com/watch?v=zjmoQlAQP4Y__] (FemaleHealthCo, 2009). Directions should als <span style="font-family: Arial,Helvetica,sans-serif;">o be printed on the back of the female condom packages.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">**Effectiveness** <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">If women use the female condom every time they have sexual intercourse, it is 95% effective to protect against pregnancy for perfect use. This means that if 100 women use the female condom all the time and always correctly, 5 women will become pregnant in a year (“Female Condoms,” 2009).

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">However, it is sometimes hard to be ever perfect. If women use the female condoms, but not perfectly, it is 79% effective. This means that if 100 women use the female condom, 21 or more women will become pregnant in a year (“Female Condoms,” 2009). In terms of protection against STDs such as Human Immunodeficiency Virus (HIV), it is not clear exactly how effect the female condom is.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">**Availability** <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">The female condom is available under many brand names, including Reality, Femidom, Dominique, Ferry, Myfemy, Protectiv and Care. There is also a recent version of the female condom that is made from natural latex. It is manufactured by Medtech Products Ltd, India and 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 (“Female Condom,” 2011).

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">FC1 female condom can be purchased in drugstores and supermarkets without a prescription. It comes in only one size and costs between $2.50 and $4. FC2 costs much less.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">**Advantages** <span style="font-family: Arial,Helvetica,sans-serif; letter-spacing: 0px;">The female condom gives women the control over their own sexual health. With it, women gain the choice to protect themselves when their partner does not want to use a male condom. The female condom protects the vagina and vulva without forgoing <span style="font-family: Arial,Helvetica,sans-serif;">a male partner’s stimulation. Since the female condom only applies for external use, it does not cause hormonal side effects either. Moreover, not only the female condom can be inserted before intercourse, which means that it will not require the penis to be erect for insertion, it does not ask for immediate withdrawal after ejaculation either.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Compared to the male condom, the female condom is not tight or constricting and it is equally lubricated. In fact, additional oil and water-based lubricants can be applied if demanded too. Last but not the least, the female condom does not affect future fertility as some birth control pills would.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">**Disadvantages** <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">The female condom, however, has some disadvantages too. For example, since the outer ring has to stay outside the body, the female condom will be always noticeable during sex. FC1 female condom may make noises during sexual intercourse because of its plastic material.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Moreover, as the female condom requires careful insertion, it might be sometimes difficult to put on when sexual activity is not planned ahead. It also risks the ability to break or leak like the male condom. Lastly, the female condoms may be three times more expensive than male condoms.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">**Empowerment of Women** <span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Society has long been giving men and women double standards on the issue of sexual behaviors. For example, virginity is often emphasized for women while men are expected to have several partners. Moreover, social perception towards women and men also tended to give more power to men to decide when, where and how to carry out sexual activities. Communicating about sex has been difficult because of this gender stereotype. For example, men sometimes do not want to use male condoms and women are unwilling to ask them to.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">A study by the UK Institute of Education in four countries (Costa Rica, Indonesia, Mexico and Senegal) showed that the female condom can empower women in sexual communication. Female condom can not only protect women from pregnancy and STDs but is also accept for many men (“Communication barrier,” 2001). This indicates women’s greater capacity to negotiate safer sex by using female condom. <span style="font-family: Arial,Helvetica,sans-serif; letter-spacing: 0px;">Another study conducted among street-based sex workers in Campinas, Brazil noted that sex workers perceived a number of benefits to the female condom. For example, female condom could be used if the client does not <span style="font-family: Arial,Helvetica,sans-serif;">like male condoms. One of the sex workers also mentioned that female condoms can be conveniently inserted when she went to the bathroom, without clients’ notice. In other words, female condom also grant women more autonomy and choices over sex protection. (“Acceptability of the Female,” 2001)

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">However, female condom is still not as widely used as male condom. In 2005, only 12 million female condoms, as compared to 6 and 9 billion male condoms, were distributed to women in the developing world (“Female Condom,” 2011). Greater awareness needs to be build among women to initiate using female condom.

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">**References** <span style="color: #5d5d5d; font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; margin: 0px;"><span style="color: #000000; font-family: Arial,Helvetica,sans-serif; letter-spacing: 0px;">Acceptability of the Female Condom After a Social Marketing Campaign in Campinas, Brazil <span style="color: #000000; font-family: Arial,Helvetica,sans-serif;">. (2001). //Horizons.// Retrieved from [|__http://www.popcouncil.org/pdfs/horizons/fcbrazilsum.pdf__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">CondomDepot. (2008). [Graph Illustration]. //Female Condom Instructions//. Retrieved from [|__http://www.condomdepot.com/learn/detail.cfm/cid/227__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Communication barrier? The female condom gets couples talking about sex. (2001). //Eldis//. Retrieved from [|__http://www.eldis.org/id21ext/h7pa1g3.html__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Female Condom. (2010). //Cedar River Clinics.// Retrieved from [|__http://www.fwhc.org/birth-control/femalecondom.htm__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Female Condom. (2011). //Wikipedia//. Retrieved from [|__http://en.wikipedia.org/wiki/Female_condom__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">Female Condoms. (2009). //Center for Young Women’s Health.// Retrieved from [|__http://www.youngwomenshealth.org/femalebarrier1.html__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">FemaleHealthCo. (2009). Female Condom - How to Use - Animated Video [Video file]. Retrieved from [|__http://www.youtube.com/watch?v=zjmoQlAQP4Y__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">MedGadget. (2008). [Graph illustration]. //New Female Condom to Face FDA Gavel.// Retrieved from [|__http://medgadget.com/archives/2008/12/new_female_condom_to_face_fda_gavel.html__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">The Female Condom. (2011). //Avert.// Retrieved from [|__http://www.avert.org/female-condom.htm__]

<span style="font-family: Arial,Helvetica,sans-serif; font: normal normal normal 12px/normal Arial; letter-spacing: 0px; margin: 0px;">The Female Condom Information Resource. (2011). [Graph Illustration]. //The Female Condom.// Retrieved from [|__http://www.female-condoms.org__]/