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Quick Reference Guide for Clinicians
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Choosing a Birth Control Method

(Updated June 2014)

Female Condom

Description

The female condom (FC) is a polyurethane (FC1®) or nitrile (FC2®) sheath with a closed flexible ring on one end and an open-ended ring on the other. FCs are coated inside and outside with a silicone-based lubricant. During ejaculation, the condom catches semen to prevent it from entering the vagina and cervix. FCs can be purchased at pharmacies.

Use

  • Female CondomThe closed end of the female condom is inserted into the vagina and positioned snugly between the posterior fornix and the pubic bone. The open end lies outside the vaginal opening.
  • The female condom can be inserted up to 8 hours before intercourse. It is removed and discarded immediately after intercourse.
  • Female condoms and male condoms should not be used simultaneously because they can adhere to each other and cause slippage or breakage of one or both devices.

Effectiveness

  • This method is effective. With consistent and correct use, female condoms have a failure rate of 5 percent. With typical use, the rate is much higher, about 21 percent.19

Risks

None

Side Effects

None

Contraindications and Precautions

None

Advantages

  • Only woman-controlled method that reduces the risk of transmission of STIs, including HIV83
  • Over-the-counter availability
  • Easily reversible
  • Can be inserted ahead of time to avoid interruption during sex
  • Can be used during menses

Disadvantages

  • Lower efficacy than some other non-barrier methods with typical use84
  • Less discreet than other methods
  • Vaginal discomfort, penile irritation
  • Required with every act of intercourse
  • May be noisy during intercourse

Counseling Messages

  • Condoms both provide contraception and reduce the risk of transmission of STIs, including HIV.
  • Patients who use another contraceptive method and are at risk for STI transmission should also use male (or female) condoms for STI prevention.
  • Correct use of condoms is essential to their effectiveness. (Providers should educate patients about correct use and strategies for negotiating condom use with partners. They should also provide patients with an opportunity to practice inserting and removing the condom during the clinic visit, if possible.)
  • Condoms should be used for all sexual activities that can transmit STIs.
  • Oil-based lubricants should never be used with condoms.
  • Spermicides such as nonoyxnol-9 should not be used with condoms; irritation from nonoxynol-9 has been shown to increase the risk of HIV transmission.82
  • Simultaneous use of the male condom and the female condom is not recommended.
  • It is important to check the expiration date on the condom packaging, because latex degrades over time and condoms more likely to break if used after their expiration date.
  • Patients who use condoms should obtain emergency contraception in advance. (Note that patients who are less than 17 years old will need a prescription for EC.)