Female condom

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Female condom
Female condom
Background
B.C. type	Barrier
First use	1988
Failure rates (per year)
Perfect use	5%
Typical use	21%
Usage
User reminders	?
Advantages
STD protection	Yes
Benefits	No external drugs or clinic visits required
Disadvantages
Weight gain	No

Recently "female condoms" or "femidoms" have become available. "The Female Condom" or just "female condom", now usually refers to a few versions of the FC female condom by The Female Health Company. It is sold under many brand names listed below. They are larger and wider than male condoms but equivalent in length. They have a flexible ring-shaped opening, and are designed to be inserted into the vagina. They also contain an inner ring which aids insertion and helps keep the condom from sliding out of the vagina during coitus.

• Brand names: FC Female Condom, Reality, Femidom, Dominique, Femy, Myfemy, Protectiv' and Care [1] It was formerly known as WPC-333 prior to receiving marketing rights.
• Versions and Materials: the "original FC" is polyurethane, the newer FC2 is made from nitrile
• Manufacturers: The Female Condom was invented by a Danish physician who obtained a U.S. patent for the product in 1988. The physician subsequently sold certain rights to the Female Condom, to Chartex. Wisconsin Pharmacal aquired Chartex and renamed it "The Female Health Co." [2]
• Pre-lubrication / Spermicide: silicone-based, non-spermicidal lubricant (the "prototype" WPC-333 had Nonoxynol-9)

Contents 1 Versions and materials 2 Anal sex 3 Effectiveness of The Female Condom 4 Costs, reuse, and lubrication of the (polyurethane) original FC 5 Worldwide use 6 Similar prophylactics that may not be available 7 References

[edit] Versions and materials

The Female Condom was first made from polyurethane. This version is officially called the "original FC". Newer iterations are made of nitrile and called "FC2" [3] (this material change was announced in September 2005).^[1] The newer nitrile condoms are less likely to make potentially distracting crinkling noises. It is hoped the nitrile condoms will also allow for significant reductions in female condom pricing.^[1]

Female condoms have the advantage of being compatible with oil-based lubricants as they are not made of latex.^[2] The external genitals of the wearer and the base of the penis of the inserting partner may be more protected than when the male condom is used, however see studies below. Inserting a female condom does not require male erection.^[3]

[edit] Anal sex

Although marketed only for vaginal sex, some researchers promote use of the "female" condoms for anal sex between men.^[4]

[edit] Effectiveness of The Female Condom

Some earily tests suggested the Female Condom offered better protection than male condoms, but real-world tests found the original FC to be less effective than male condoms, at preventing pregnancy for most people:

Earily tests:

• "Exposure to semen was significantly less (p = .001 and p = .03) when WPC-333 was used than when the male condom was used." [4].

• "RESULTS: WPC-333 had significantly fewer water leaks than the male condom at a p-value of .001. The combined probability of risks of leaks, tears and spillage inside the vagina using WPC-333 was 3.3%; the combined probability of risks using the male condom was 11.5%." [5]

Real-world experiments:

• "The label must compare the pregnancy rate for the female condom, which is approximately 26% per year versus 15% for the latex condom." "Wisconsin Pharmacal Co., studied 200 women who used the device for six months. In the study, the six-month pregnancy rate among U.S. women was approximately 12.5 percent, or an estimated 26 percent per year. This high rate is believed to have been the result of improper use of the device." [6]

• According to Contraceptive Technology: Eighteenth Revised Edition (chart here [7]), the typical use failure rate for the first-generation female condoms lies at 21%. This means that of the women who used female condoms as their only form of birth control, 21 out of 100 became pregnant within one year. Of the women who used the female condom "correctly" at every act of intercourse, 5% became pregnant after one year. The typical use failure rate for male condoms was 15%, while the perfect use failure rate was 2%. ^[5]

The effectiveness of the female condom at preventing STDs has not been studied to the same extent as male condoms, however it has been put forth that it should have similar effectiveness to preventing pregnancy. They are also dangerous for those who have polyurethane allergies.^[6] Sensitivities to silicone or polyurethane may also be a problem.

[edit] Costs, reuse, and lubrication of the (polyurethane) original FC

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.

Total cost includes 3 factors:

• Per unit price (USD): $4.70 for 1 shipped - $21.75 for 10 shipped Feb 27, 2007 [8]
• How many times it is used
• Cost of medical gloves if washing and disinfecting the Female Condom (These would have to be disinfected also.)
• Cost of a compatible lubricant:
  • The original FC may come with a lubricant in a container
  • J-Lube: This can make 6-8 gallons of "lubricantion" at a cost of $19 (USD) shipped (to the U.S.A). [9] Instructions and info here [10]
  • This water/silicone-based lubricant is about $19 (USD) shipped for 250 ml on Feb 27, 2007 [11]
  • Oils should not directly harm a polyurethane (or nitrile) female condom but may cause other health problems (which could weaken defenses against more serious STDs), or make it more difficult to clean and disinfect (without further weakening it).

Structure and irritation tests after washing and disinfecting: The following links are about re-using the polyurethane, original FC female condom. Re-using the polyurethane Female Condom is not considered as safe as using a new one, however the W.H.O. 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 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." [12] "CONCLUSIONS: From the results it can be concluded that washing, drying and re-lubricating the female condom up to ten time 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." [13] (That link also suggests that using liquid detergents are less likely to harm the condom than bar soap. Liquid soaps have been recommended for sex toys.) Warning: This article is not intended as a guide. Re-using a Female Condom that is not completely disinfected, could transmit STD's or sperm. Even cleaning the condom could expose the hands (then any body part the hands touch), to STD's. For example, the Wikipedia claims Herpes Simplex may infect any part of the body. Medical gloves may be necessary.

Using oil as an "improvised lube": This site claims that using oil based lubricants may be fine for the penis but can clog pores and lead to infections in the vagina [14] (no reference is given). Since the Female Condom is polyurethane and the majority of the lubrication would be on the penis side, oil may be a lubrication option. However, some males report that oil irritates the glans penis as this is a mucous membrane. Both oil and a water based lube could be used, but only the minimal lubrication that is necessary to insert the condom, should be used on the side of the body cavity. The penis is meant to slip through the condom; the condom is not meant to slip through the body cavity or it may slip inside and allow contact. Warning: This author is aware of no studies of the effectiveness of the Female Condom using oil as a lubricant or using "too much" of any lubricant. Too much lubrication of the penis may contact the receptive partner's body. Too little lubrication may cause the outer ring to be pushed inside the cavity, or breakage. The use of oil makes switching to a latex condom more risky (the oil may be inconvenient or difficult to wash off completely).

[edit] 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.^[7] 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 during intercourse turn off some potential users, as does the visibility of the outer ring which remains outside the vagina.^[3]

In November 2005, the World YWCA called on national health ministries and international donors to commit to purchasing 180 million female condoms for global distribution in 2006. Their statement stated 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 cents per piece. If 180 million female condoms were ordered, the price of the female condom was projected to decline to 22 cents per female condom.^[8]

Currently, 14 million female condoms are distributed to women in the developing world on an annual basis. By comparison, between 6 and 9 billion male condoms are distributed per annum.^[8]

[edit] Similar prophylactics that may not be available

• The Barrier
  • Coverage / How it is held in place: It fits over the outer vagina and perineum and is held in place with thick elastic straps that encircle the women's upper legs. The tube-shaped pouch is about 1 1/2 times larger and 2 times thicker than a male condom. The penis never directly touches the woman's outer or inner genitalia [15]
  • 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 Condomme
  • Coverage / How it is held in place: Has a 2-inch diameter flexible ring that covers the introitus, and a thickened dome of latex resembling a diaphragm at the deep end
  • Pre-lubrication / Spermicide: silicone lubrication

[edit] References

1. ^ ^{a b} Female Health Company (September 29, 2005). Female Health Company Announces International Availability of Second - Generation Female Condom at Significantly Lower Price. Press release. Retrieved on 2006-08-03.(PDF)
2. ^ The Product. FC & FC2 Female Condom. Female Health Company (2005). Retrieved on 2006-08-03.
3. ^ ^{a b} Boston Women's Health Book Collective. Our Bodies, Ourselves : A New Edition for a New Era. New York, NY: Touchstone. ISBN 0-7432-5611-5. 
4. ^ Gibson S, McFarland W, Wohlfeiler D, Scheer K, Katz M (1999). "Experiences of 100 men who have sex with men using the Reality condom for anal sex.". AIDS Educ Prev 11 (1): 65-71. PMID 10070590. 
5. ^ Hatcher, RA; Trussel J, Stewart F, et al (2000). Contraceptive Technology, 18th Edition, New York: Ardent Media. ISBN 0-9664902-6-6. 
6. ^ Table 7-2: Contraceptive Methods. A Guide to the Clinical Care of Women with HIV/AIDS, 2005 edition. U.S. Department of Health and Human Services, HIV/AIDS Bureau (2005). Retrieved on 2006-08-03.
7. ^ (September 26 to 29, 2005) "Global Consultation on the Female Condom". {{{booktitle}}}, Baltimore, MD: PATH. Retrieved on 2006-08-03. 
8. ^ ^{a b} PRNewswire (November 21, 2005). Statement of Dr. Musimbi Kanyoro, General Secretary, World YWCA. Press release. Retrieved on 2006-08-03.

Birth control edit
Sterilization:	Tubal ligation, Vasectomy, Essure
Post-intercourse:	Abortion: Surgical, Medical Emergency contraception
Intra-uterine:	IUD, IUS (progestogen)
Anti-estrogen:	Ormeloxifene (a.k.a. Centchroman)
Hormonal:	Combined: COCP ('the Pill'), Patch, Nuvaring Progestogen only: POP mini-pill, Depo Provera, Norplant, Implanon
Barrier:	Male condom,Female condom, Diaphragm, Shield, Cap, Sponge, Spermicide
Behavioral:	Coitus interruptus, Rhythm Method, Lactational, Fertility awareness Avoiding vaginal intercourse: Anal sex, Oral sex, Outercourse, Masturbation, Abstinence