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Here's What You Should Know About Internal (Female) Condoms

Here's What You Should Know About Internal (Female) Condoms

  • Sonia Easaw, M.S., MPH
    Reviewed By: Julie Lamonoff, CNM, OBGYN-NP, Shannon DeVita DNP, FNP-BC, CPNP-PC
    Updated:
  • Top takeaways:
  • The internal (female) condom is inserted into the vagina before sex.
  • It's a woman-controlled, hormone-free method.
  • Both prevents pregnancy and protects against sexually transmitted infections (STIs)
  • Takes some practice to insert
  • May be pleasurable for both partners

Though the internal (female) condom has been around for almost 30 years, it remains a wallflower while the external (male) condom stays in the limelight. Here's everything you need to know about internal (female) condoms—from how to use them and how they feel to how to get them.

If you're looking to try female condoms and also need birth control pills, see if you're eligible to get both methods for free with a prescription from The Pill Club.

It's time for the internal condom, previously known as the female condom, to shine—both as a non-hormonal birth control method and as a barrier method for STI protection.

What is the internal (female) condom?

First things first: The terms "female condom" and "internal condom" mean the same thing. In 1993, the original female condom hit the market after winning approval from the U.S. Food and Drug Administration (FDA).

The FDA renamed "female condom" to "internal condom" in October 2018. The best definitions are often the most straightforward: The FDA says the internal condom is a "sheath-like device that lines the vaginal or anal wall and is inserted into the vagina or anus" before sex and discarded after.*

*Note: Despite the FDA's definition of the internal condom category, internal condoms available in the U.S. are still only approved by the FDA for vaginal use for the prevention of pregnancy and STIs.

You can find the internal condom sold in the U.S. under the name FC2®.

Internal (Female) External (Male)
Inserted into vagina or anus Covers penis
Protects against STIs Protects against STIs
Contraception Contraception

Unlike the external (male) condom that covers the penis, the internal condom is inserted deep into the vagina to cover the cervix.

Both the internal condom and the male condom protect against sexually transmitted infections (STIs) and act as contraceptives to prevent unintended pregnancy. However, you shouldn't use an external (male) condom with an internal condom at the same time.

The internal condom also has the following distinguishing characteristics:

  • Inner ring made of soft plastic (polyurethane)

  • Outer ring and tube made of nitrile (non-latex)

  • Lubricated inside and out

  • Feels natural and warms to body temperature

You can get the FC2 Internal Condom for $0 out-of-pocket cost with most health insurances at drugstore pharmacies, family planning clinics like Planned Parenthood or through telemedicine such as The Pill Club.

Uninsured or underinsured people (meeting qualifications) can buy directly through the manufacturer or get them from local health departments and points of community distribution.

Unfortunately, the internal condom may be harder to find than the male condom. See if you can get free FC2 internal condoms along with a prescription for birth control pills from The Pill Club.

How to use an internal condom

The internal condom is a good choice if you know how to use it correctly, and emergency contraception like Plan B is available if a failure event occurs.

Here are some basics when using the internal condom:

  • Most women insert the internal condom between 2 to 20 minutes before sex.

  • It's designed to be used once and should not be reused.

  • You can choose between the internal condom or the male condom. They can't be used together.

  • Though it contains lubricant, feel free to add additional lube (water-, oil- or silicon-based).

  • You can use spermicide for extra protection.

Researchers say there haven't been any serious side effects or allergic reactions associated with the internal condom. It's not made with latex if you or your partner is allergic to latex condoms, then you are in luck!

How to insert an internal (female) condom

It takes a little bit of practice, but inserting the internal condom gets easier over time. Inserting the internal condom is a lot like inserting a tampon or menstrual cup.

The CDC recommends starting in a comfortable position and following these steps to insert an internal condom:

female-condoms-how-to-insert-steps-infographic

Step 1: Carefully open the package and remove the condom.

Note: The thick, inner ring on the closed end is what's used to place the condom into the vagina and hold it in place. The thin, outer ring is open and remains outside of the body.

Step 2: Squeeze the flexible ring at the closed end with your thumb and forefinger and insert it into the vagina like a tampon.

Step 3: Push the inner ring with your finger as far up as it can go while the thin external ring stays outside the vagina.

Step 4: Guide partner's penis into the open end of the internal condom.

Step 5: To remove, you can twist the outer ring and gently pull the internal condom out of the vagina and toss it in the trash. After a bit of practice, it gets easier to insert!

How do internal condoms work?

Internal condoms were designed for women to control and insert themselves in order to prevent pregnancy and STIs. Instead of relying on the male condom or negotiating its use, women can choose the internal condom as an alternative.

Like the male condom, the internal condom is a barrier method device (like diaphragms, cervical caps, and sponges) that functions as a physical barrier, stopping sperm from entering the vagina and staying inside a woman's body. It's a non-hormonal birth control that also serves as a barrier for sexually transmitted infections like HIV.

The internal condom works as a barrier: the closed end of the condom is inserted deep into the vagina, anchoring in place the sheath lining the vaginal walls, working as a wall to prevent sperm from coming inside. .

How effective are internal condoms?

The FDA only approves medical devices that demonstrate they are safe and effective. After looking at several scientific studies, the FDA concluded that "the FC2 Female Condom is effective and has a favorable safety profile," with a failure rate of less than 5%.

When the FDA says that the internal condom has a failure rate of 5%, they're saying that the chances of pregnancy during a year of "perfect use" would be 5%. Researchers say that "perfect use" is "defined as following the directions for use"—when it's used each time correctly during vaginal sex.

Yet, it's not a perfect world. Even though there haven't been any efficacy studies of the FC2 Female Condom, the CDC says that the failure rate of its predecessor condom during "typical use" (including inconsistent or incorrect use) is approximately 21%. This means that out of 100 women who use the female condom in a year, about 21 may get pregnant. On the other hand, the male condom has a failure rate of 13% with typical use and 2% with perfect use.

Here's a quick table that compares the failure rates of male and internal condoms:

Failure rate Internal condom Male condom
Perfect use 5% 2%
Typical use 21% 13%

The male condom and internal condom have similar failure scenarios, like if the condom tears or breaks during sex. But there's an additional failure scenario with the internal condom: one of "misdirection," where the penis slips in between the condom and vagina instead of staying inside the condom.

How do internal condoms feel?

The original design of the internal condom left much to be desired. A 2007 Times article said, "couples complained that the female version was awkward, unsightly, noisy and slippery...'the yuck factor was a problem.'" Luckily, scientists tried again on a new design.

After the redesign, the internal condom redeemed itself with couples. The Times article from above reported that the new internal condom was:

  • Made of softer & thinner material to better transmit warmth

  • Easier to insert, as one end is bunched up almost like a tampon

  • During sex, it moved more like a vagina than the old design

And it seems that couples are catching on to the new design. A 2013 survey of college women found that they felt the new version of the internal condom was:

  • Durable but thin material

  • Lubricated

  • Pleasurable to both

  • Nonrestrictive

  • Tailored to women's bodies

The manufacturer of FC2® says that it's "made from a material that conducts heat and makes sex feel natural."

What are the pros of the internal condom?

Perhaps the best aspect of the internal condom is its role in empowering women. Since the beginning, those who've been closely watching the journey of the internal condom call the internal condom a "tool for women's empowerment." It's given women the chance to actively "negotiate protection with male partners and to practice healthy behaviors."

Here are some pros of using the internal condom:

  • The only woman-initiated method currently available that can prevent unintended pregnancy and protect against sexually transmitted diseases (infections)

  • A female-controlled protection method for HIV prevention (especially important given the lack of an HIV vaccine and that heterosexual transmission is the leading cause of HIV transmission in women)

  • Made of nitrile so it is hypoallergenic and can be used with your sexual lubricant of choice (latex condoms cannot be used with oil-based lubricant)

  • Can be inserted in advance of foreplay or sex for interruption-free intimacy

  • If covered by insurance, available for $0 out-of-pocket cost with a prescription

What are the cons of the internal condom?

Over time, the acceptability of the internal condom may grow, especially from health care providers themselves. Yet, there are still obstacles for now when it comes to people being willing to try it.

Here are some cons of using the internal condom:

  • Like other barrier methods, the failure rates of using the internal condom are higher than other forms of birth control (like birth control pills).

  • They could be more challenging to insert and use than male condoms.

  • Some couples might initially dislike its "large size" and appearance, though plastic models of how to use it can't replicate how the internal condom will adhere and work within the body.

  • Due to lower demand, it's more expensive than the male condom and is available in fewer places.

Where to buy internal condoms

Because they are less popular than male condoms, internal condoms are a little harder to find. One study about the availability of the female condom (published in 2016) found that in the Philadelphia area, only 1% of providers carried the internal condom, while 77% sold the male condom.

The FC2 website says that there are only 3 ways to purchase the internal condom:

  1. Through prescription via a telemedicine provider (like The Pill Club) or an in-office healthcare provider;

  2. Through their assistance program for the uninsured and underinsured; and

  3. Through community distribution.

The Pill Club is one of the telemedicine providers that partners with FC2.. You can get a prescription for FC2 through us with an online health consultation if you're interested in birth control pills as well.

Takeaways: Internal (female) condoms 101

Indeed, the internal condom hasn't caught on yet in the U.S. But it's a shame that it hasn't, especially given that it's a woman-controlled, hormone-free method that both prevents pregnancy and protects against sexually transmitted infections (STIs).

It can be a little more challenging to insert and use than a male condom, but you should be good to go with a bit of practice and instruction. Some say that the internal condom is pleasurable for both partners since its material transmits natural warmth, and each condom comes pre-lubricated. The outer ring could stimulate the woman's exterior genitalia (vulva and clitoris), and it contains a lubricant.

female-condoms-pill-club-fc2

If you're interested in joining The Pill Club, you can consult with our medical team about birth control pills and receive free FC2 Internal Condoms in your package, along with free goodies sent right to your door.

Perhaps in the future, more people will be interested in internal condoms. Here's to that day, and many more, when women get as many options as possible for their reproductive and sexual health.

Sources:

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