What is a female (internal) condom?

Dear Reader,   

A female condom (commonly referred to as an internal condom) is a method of contraception that's inserted inside of the user’s vagina or anus before sex. Made of soft nitrile (a synthetic rubber), it's shaped like a long tube or sheath — with one closed end and one open end — creating a barrier between the penis or sex toy and the vaginal or anal canal. Similar to the male condom (commonly referred to as an external condom), the internal condom can help prevent pregnancy and reduce the risk of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), when used consistently and correctly. As a note — the internal condom has only been approved by the Food and Drug Administration (FDA) for use in the vagina and using it in the anus is considered off-label use. That being said, because it's commonly used for that purpose, many sexual and reproductive health organizations have come up with guidelines for its use with anal sex. It’s great that you’re exploring this option, because knowing what it is, how to use it, and the associated pros and cons can inform decisions about how to protect yourself and your sexual partner(s).  

For someone who’s never used an internal condom, it might seem a bit intimidating. Rest assured, with a little practice it’ll feel a lot easier. Internal condoms are usually well lubricated and have a flexible ring at each end. These rings help to keep the condom in place once it's inserted. The fixed outer ring secures the opening while the moveable inner ring sits at the bottom of the condom to secure it in place. Similar to external condoms, the internal condom is open on one end to allow for insertion and is closed on the other end so it can collect any ejaculate.  

To use the internal condom:  

• First, check the expiration date and if it’s still not past the date, open the package carefully.  
• If you’re using the condom for anal sex, you can remove the inner ring. For vaginal sex, leave the ring inside the condom. 
• To insert the internal condom into the vagina, find a relaxing and comfortable position. Common favorites are standing with one foot on a chair, lying down, or squatting.  
• Squeeze the sides of the inner ring together and slide the condom into the vagina like a tampon, then push the inner ring up to the cervix. To insert it into the anus, you can just push the condom in with your finger.  
• Make sure the condom isn’t twisted, then pull your finger out and let the outer ring hang out. It’s good to let the outer ring hang out about an inch outside the vagina or anus. 
• When you’re ready for sexual activity, hold the condom open as the sex toy or penis is inserted to make sure it doesn’t slip in on the side.  
• After you’ve had your fun, twist the outer ring so that any ejaculate stays inside the condom and gently pull the condom out of the vagina or anus. Discard the used condom in the trash (don't flush it down the toilet!).  

List adapted from Planned Parenthood. 

You might also find it helpful to read the instructions on the box or condom packet to make sure you’re using it correctly. Some people like to practice inserting the internal condom a few times before having sex so they can become comfortable using it.  

Keep in mind that each internal condom can only be used once; if you and a partner are ready for round two (or three, or four…), you’ll need to use a new condom each time. It’s also critical to note that using an internal and external condom together can create friction, which increases the chance that one or both condoms will break during sex. Instead, it's a good idea to talk with your partner to determine which type of condom you both prefer.   

As you consider methods of contraception, it’s good to think about the pros and cons:  

Pros:  

• If used correctly and consistently every time, internal condoms can be 95 percent effective at preventing pregnancy (when accounting for errors such as an expired condom or not inserting correctly, it tends to be around 79 percent effective). They’re also effective at preventing sexually transmitted infections (STIs). 
• It allows those with a vagina to take the initiative with a barrier method of birth control.  
• The condom can be inserted up to eight hours before sex and be used during menstruation or pregnancy.  
• A full erection (for those who have a penis) isn’t necessary when a partner is using an internal condom.  
• It’s an option for those who have an allergy or sensitivity to latex or polyurethane.  
• It can be purchased over-the-counter (and may be free in some locations).  
• There are no hormones associated with this method, which may be an option for those who are sensitive to hormonal birth control or prefer not to use it for any reason.  
• It can help increase pleasure for you and your partner! It may stimulate the tip of the penis and the outer ring can rub against the clitoris. 

Cons:  

• Internal condoms can be more expensive than external condoms.  
• Some may find using them a bit awkward because the outer ring must stay outside of the vagina during sex.  
• It requires individuals to be comfortable touching the genital area since it needs to be inserted into the vagina.   
• It may cause irritation.  
• It’s a potentially noisy option, but adding some lube may help (although this may not be as much of an issue with newer versions).  

Currently, there’s only one brand of Food and Drug Administration approved internal condoms. They’re available at pharmacies, grocery stores, and online — usually wherever external condoms are sold. For answers to common questions and other information about this condom, check out the FC2® website and Planned Parenthood. For more information about other barrier methods of contraception, take a look at the Condoms category in the Go Ask Alice! Sexual and Reproductive Health archives.  

Hope this helps!