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Is the Female Condom Foolproof?

I read about female condoms in a magazine. Is there really such a thing? Where can I buy them? And do they protect you from STDs and HIV as well as regular condoms?

The female condom, sometimes called the "pouch," is essentially a male condom in reverse -- it's designed to be inserted into the vagina in much the same manner as a diaphragm. The first female condom was approved by the Food and Drug Administration in 1993, and to my knowledge, only one, the Reality Condom, has been marketed. It consists of a lubricated polyurethane sheath with a flexible polyurethane ring on each end. One ring is inserted into the vagina; the other remains outside, partially covering the labia. The condoms are available over-the-counter, and you should be able to find one in any drugstore. The cost is about three dollars.

Laboratory studies show the female condom to be an effective barrier against HIV and other sexually transmitted diseases. However, the FDA requires the labels on female condoms emphasize that for "highly effective protection" against STDs, including AIDS, it is best to use male condoms. When the FDA approved the female condom, the organization's commissioner, David A. Kessler, M.D., gave it a less than enthusiastic endorsement. He said the device was only "better than no protection at all." He also stressed that the male latex condom remains the best shield against HIV and that the agency acted when it did to give women an option for protection against HIV and STDs -- even though the protection afforded is less than ideal.

The female condom is also less than perfect as a contraceptive device. The label states that the pregnancy rate among users is approximately 26 percent per year. In comparison, the pregnancy rate among women who have unprotected sex is 85 percent; 12 percent with "typical" use of male condoms (here, "typical" means that a couple isn't always using condoms consistently and correctly); and about 2 percent with "perfect" condom use. The relatively high pregnancy rate with female condoms is due to improper use of the device. When used correctly, the pregnancy rate should be lower -- although no one knows just how much lower.

But don't aim for double protection by wearing a female condom and insisting your partner wear a male condom. You're likely to get less protection when using these condoms together -- the additional friction could cause one or the other to dislodge.


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