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What is the Deal with the Female Condom?(11/27/2009) by Sharon A. Rachel, M.A., M.P.H. The front page of the New York Times on March 11, 2009 was dominated with headlines about the usual – politics and the struggling economy. What was probably overlooked by most, buried in the daily health report, were two sentences about the FDA’s approval of the new female condom. It is quieter and less expensive than the original, and it may see broader overseas distribution and aid in the reduction of HIV infection. "What? There was an original female condom?" you might ask. Why, yes! The first and only FDA-approved female condom in the United States was the sole product of the Chicago-based Female Health Company, first approved in 1993 under the brand name Reality®. The product was changed in name only to FC® in 2006. It only saw modest sales in the United States, but has been adopted more broadly overseas, particularly in sub-Saharan Africa and Asia, where the HIV burden is far more rampant. FC2®, the newest product by the Female Health Company, is identical to the original in appearance and function; however, while the original FC® was made out of polyurethane, FC2® is made of nitrile, a synthetic rubber that is less costly to produce. The company is optimistic that less expensive production will lower retail cost of FC2® considerably, and broaden overseas distribution, driven by UNAIDS. The female condom is a lubricated sheath or pouch made of synthetic plastic that is worn in the vagina during sexual intercourse and protects against unintended pregnancy and STIs. The closed end is inserted into the vagina before intercourse and is anchored in place behind the pubic bone by a flexible inner ring. The open end hangs outside of the vagina. The user must carefully guide the penis inside the female condom during intercourse and ensure that the penis remains inside the condom at all times. After ejaculation, the user twists the condom closed and pulls it out of the vagina. The female condom is approved for one-time use only. During typical use the female condom is 79 percent effective in preventing pregnancy, and when used perfectly is 95 percent effective. Likewise, it is also estimated to reduce the rate of STI infection by 97 percent, though the typical effectiveness for preventing STIs is unknown. The female condom has a higher typical user failure rate than, say, male condoms, because it is initially more difficult to use. Due to its higher failure rates than male condoms, women should also have Plan B® handy, two pills that can be taken up to 120 hours (5 days) after unprotected intercourse or intercourse in which the primary contraceptive fails to prevent unintended pregnancy. Other disadvantages of this method include its higher price, sparse commercial availability and lack of variety in options when compared to male condoms. Additionally, FC® makes noise during intercourse (think of squishing a plastic sandwich bag in your hand), though FC2®’s appeal is that it is less noisy than the original. The noise factor can be mitigated by the use of additional lubricant. Finally, insertion may require creative positioning and manual dexterity to place the female condom properly in the vagina, and due to attitudes in all cultures (though with varying levels of severity) women may hesitate to touch their own genitalia. It is recommended that health care providers offer patient counseling on how to use the method and that users practice inserting and removing the female condom several times before using it during intercourse. So with all those disadvantages, how can it be worth it? Well, like all contraceptives, there are advantages to its use too. Currently, the female condom is the only woman-initiated barrier method that protects against pregnancy and STIs. Other woman-initiated barrier methods include the diaphragm, cervical cap and Today® sponge, which protect against pregnancy but not STIs. Also, since the lower portion of the female condom remains outside of the vagina covering a portion of the labia minora, it may provide slightly better protection against STIs that are spread through skin-to-skin contact, namely herpes and human papillomavirus (HPV), which causes cervical cancer. Finally, since female condoms are not made out of latex, users who are sensitive to latex can still enjoy barrier protection against pregnancy and STIs, and female condoms can be used with water, silicone and oil-based lubricants (oil-based lubricants cannot be used with latex male condoms since oil deteriorates latex). "Yea, but how am I going to get a guy to use this?" In my opinion, therein lies the greatest advantage of the female condom: partner communication – the cornerstone of sexual health! Ideally, communication about sexuality and relationships should start well before the sexual activity. Negotiate which contraceptive to use. Why not enhance foreplay and give your partner a chance to try inserting it? Or, in relationships when open communication and negotiation simply are not an option for the woman, the female condom can be used discreetly, since it can actually be inserted several hours before intercourse. The fact of the matter is that the female condom is a woman-initiated method. Guy won’t use a condom? Now the woman can! No contraceptive is perfect for everyone, so it’s great that there are so many options available to us. The female condom will probably never be as popular as the male condom, but it is an option, and it has been shown to be effective in preventing HIV and STIs, and that counts for a lot in this day and age. Health professionals as well as consumers must be educated about the female condom and its availability must be demanded both within and outside of the United States for use to increase. With proper user education and partner communication, we can see the female condom accepted as a realistic and practical contraceptive choice. Source: www.loveandhealth.info This article appears in the following topics: |
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