Many experts advocate the female condom as a suitable option for women, yet the only one available in the United States, the FC2, still remains widely unused.
U.S. sales of the female condom grew from 34.7 million in 2008 to 61.6 million in 2012, according to data from maker of the only one sold in the U.S., though female condom use is far less than male condoms, studies show.
Veronica Arreola, assistant director for the Center for Research on Women & Gender at the University of Illinois at Chicago, speculated the lack of female condom use in the U.S. may be related to social stigma about the product and lack of education on how to use it.
“I don’t know how many people know that these female condoms are available,” Arreola said. “There was an awful Jezebel article recently called ‘Stop trying to make female condoms happen.’”
Below the March 7 article on the Jezebel blog, written by Tracie Egan Morrisey, one of the first comments is from a user named “AllOfMyFlaws.”
She recalls herself and her female friends being given female condoms in college and experiencing confusion: “No one ever wanted to use them because no one knew HOW to use them,” she wrote.
This is where advocates for increasing women’s options when it comes to sexual protection come in.
Jessica Terlikowski, policy manager at the AIDS Foundation of Chicago, oversees female condom programming and advocacy for the Chicago Female Condom Campaign: Put a ring on it!, which is a coalition of HIV/AIDS, reproductive justice, women’s health and gay men’s health organizations that is dedicated to increasing access, affordability, availability, awareness and utilization of female condoms. The campaign began in 2010.
The Chicago Female Condom Campaign works with the Illinois Department of Public Health, the Chicago Department of Public Health, and the Cook County Bureau of Health Services to equip free distribution sites with female condoms, and educate distributors on how to properly use them, so they can educate those who may not know how to use one.
Distribution sites include public health clinics, community health centers, family planning centers, and similar sites that serve communities at greatest risk for HIV and sexually transmitted infections. Some select Walgreens also carry them.
Besides educating distributors, the campaign seeks to educate men and women on the correct ways to use female condoms and where to get them.
Marguerite Harrold is familiar with the public hesitantly reacting to female condoms.
“A lot of people had never seen female condoms and didn’t know how to use them,” said Harrold, who is coordinator of the Chicago Community Condom Project. “People really like them once they know what they are and where they can get them.”
Price may also be a factor, Arreola said. The female condom available in the U.S. sells at some outlets for $6 for a three-pack. A similar three-pack of a popular brand of male condoms costs about $4.
Judy Palmore, a health educator with the Chicago-based Female Health Company, which developed the FC2, the only female condom on the market in the U.S., said the educational aspect of female condoms is paramount.
“When people know how to use it and use it correctly, they are more likely to use it again,” Palmore said.
One of the most important aspects of the female condom is that it gives women more control over their own sexuality, Terlikowski said.
“There may be male partners that aren’t always willing and able to have a condom,” Terlikowski said. “Female condoms take away reliance on the partner for having safe sex.”
Two other benefits are that it can be inserted hours before the act and men might like the idea of a female condom more than they think.
“The FC2 has an inner ring that sits around the cervix and locks in behind the pelvic bone,” Terlikowski said. “Men have reported that the tip of their penis hits the ring and it’s pleasurable for them.
“Sex is a positive thing and we want people to enjoy it. “
The first female condom, which was manufactured by the Female Health Company, was approved by the U.S. Food and Drug Administration in 1993.
As far as having more options for female condoms, Arreola of the Center for Research on Women & Gender, said: “more options for birth control is always a good thing.”
Additional types of female condoms are coming to market in other countries around the world, said Kimberly Whipkey, a global advocacy specialist at PATH, an international nonprofit organization dedicated to improving health in low resource settings.
In 2009 around 26 million female condoms were provided through international and nongovernmental funding sources, compared to 10.7 million in 2006, however, global distribution of female condoms is still far less than male condoms, according to a 2010 UNAIDS “Report on the global AIDS epidemics.”
The Cupid female condom, which recently received clearance from the World Health Organization. It is now available in several countries including India, Brazil, Indonesia, South Africa and Mozambique. It is manufactured in India, made of latex and has a sponge for insertion.
Another is the Woman’s Condom, which was developed by Seattle-based PATH and is in early introduction, Whipkey said.
“Women and men from multiple countries evaluated and provided feedback during product development to refine the Woman’s Condom design,” Whipkey said. “So the device would be easy to insert, comfortable to use and provide good sensation.”
The Woman’s Condom currently has limited availability in China, where the product is manufactured, and will soon be available in select African countries.
It is also being evaluated in a contraceptive effectiveness study by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Whipkey said data from this study could be used as an initial step toward an application for approval by the U.S. FDA.