Using the female condom: pluses and minuses

Published: Thursday, February 9, 1995

By Susan Ward

The long-awaited female condom has finally made its way to the shelves providing women with an alternative to traditional male condoms and other contraceptive methods. Reality is the first female condom approved by the Food and Drug Administration.

Reality condoms are made of polyurethane which is highly resistant to breaks and tears during use, with a breakage rate of less than 1 percent compared to four percent in male latex condoms. But like male condoms, Reality may sustain a puncture from fingernails or jewelry being inserted.

However, it is less effective in preventing pregnancies than other barrier methods. For example, the male condom has a pregnancy rate of 8 percent, but the female condom has a pregnancy rate of 26 percent. This means that out of 100 women using either method for one year, eight will become pregnant using the male condom compared to 26 using the female condom. This rate is higher than any barrier method.

The female condom may provide some prevention from transmission of sexually transmitted diseases (STDs), based on the notion that if a condom can prevent pregnancy, it can also help prevent some STDs.

The female condom is larger than the male condom, but it is not a snug fit. It has two rings; the inner ring is free-standing and it is used to insert the condom into the vagina. It covers the cervix much like a diaphragm. The condom lines the inner vagina resembling a plastic pouch. The second ring covers the vaginal opening and remains open outside the body.

The female condom is designed for a single use and can be inserted for up to eight hours before sex; however, most women insert the condom only minutes before sex.

The manufacturers recommended that women practice putting Reality in without having sex so they get familiar with the method, the way it feels and the way it looks. Detailed instructions are included in the package along with diagrams to guide the user.

There are several advantages to the female condom. One is that it is non-prescription and available over-the-counter. Second, it is not messy like some other barrier methods. And for those women who have partners who refuse to use male condoms, the female condom can provide protection from pregnancy and sexually transmitted diseases.

There are some drawbacks to the female condom. One is cost. At Student Health Services pharmacy, a box of three female condoms is $7.50. A box of 12 lubricated male condoms is $5.50. Second is the failure rate, most commonly due to the outer ring being pushed into the vagina during sex, or the outer ring slipping to the side when the penis is inserted. Third, some women experience difficulty inserting Reality, similar to the diaphragm or cervical cap. Some women also report being embarrassed in front of their partners using a method that protrudes from their bodies.

Still, Reality affords a sense of control for women who, for one reason or another, have partners who do not use male condoms.

The female condom is available at Student Health Services. For more information about Reality or to talk to a health care provider about its use, please call SHS at (310) 825-4073.

Ward is a graduate student in the School of Public Health.