Internal Condoms

What is the internal condom?

The internal condom was first approved by the FDA in May 1993 for sale in the US. The version currently on the market, the FC2, is a loose-fitting, pre-lubricated, 7-inch nitrile pouch that fits into the vagina or anus. As a birth control method, it acts as a barrier, preventing semen from being deposited in the vagina. It can also protect against sexually transmitted infections (STIs), including HIV, by preventing the exchange of fluids (semen, vaginal secretions, blood), and also provides some protection against the skin to skin transmission of STIs like herpes.

In the US it is sold under the name "FC2 Female Condom." Because it can be used for anal or vaginal sex (see below) and so by people of any gender, we call it the internal condom on this page. This same product is sold under different names in other countries. It is available without a prescription in most major drug stores. It is also available through the manufacturer's website. It is sold in packs of 3 or 6 and costs 2 to 4 dollars per condom. Internal condoms are available to Brown students for $1 each at Health Education, which is on the 3rd floor of Health Services.

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How is it used for vaginal sex?

There is a loose, flexible ring inside the condom at the closed end of the pouch. A slightly larger ring is attached to the condom at the open end. The ring at the closed end holds the condom in place in the vagina. The ring at the open end rests outside the vagina. If the condom is correctly placed in the vagina, it forms a "lining" along the walls of the vagina. The internal condom can be put in up to 8 hours or just a few moments before sex.

Lubrication

  • Be sure the lubricant is evenly spread inside the pouch by rubbing the sides of the pouch together.
  • If you need to, add more lubricant. Because the internal condom is made of nitrile, not latex, it is safe to use oil based lubricant, but water or silicone lubricants are also an option.
  • If you like, you can also apply lubricant to the outside of the vaginal opening and on the penis.

Insertion

  • Find a comfortable position. Three possible options are standing with one foot on a chair, squatting with your knees apart or lying down with your legs bent and knees apart.
  • Hold the internal condom with the open end hanging down. Squeeze the inner ring (at the closed end) with your thumb and middle finger and insert it into the vagina just past the pubic bone. This inner ring lies at the closed end of the sheath and serves as an insertion mechanism and internal anchor. Make sure the condom is inserted straight and not twisted into the vagina.
  • The outer ring forms the external edge of the sheath and remains outside the vagina after it is inserted. This part of the condom may help prevent skin-to-skin transmission of STIs during sex.

During sex

  • During sex, it may be helpful to use your hand to guide the penis into the vagina inside the internal condom. It is important that the penis is not inserted to the side of the outer ring. If the condom seems to be sticking to and moving with the penis rather than resting in the vagina, stop and add lubricant to the inside of the condom (near the outer ring) or to the penis.

After sex

  • Squeeze and twist the outer ring to keep the semen inside the pouch.
  • Remove it gently before you stand up. Wrap it in a tissue and throw it away in the garbage. Do not flush it down the toilet because it can clog up the plumbing.

Internal condoms should not be used simultaneously with male condoms because the friction between the two condoms may cause the condoms to break. Do not reuse any type of condom. Use a new one every time you have sex.

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Can it be used for anal sex?

The internal condom is not specifically approved or recommended for anal sex, but it can be an option to try if you or your partner have a latex allergy (the condom is made of nitrile) or if you have had other problems with using male condoms for anal sex. Because all research was done for vaginal sex in the development of this method, design modifications may be needed in the future to make this an optimal method for anal sex. Further studies on use of the internal condom for anal sex also need to be done to determine effectiveness rates. You can read about some of the limited existing studies here

How is it used for anal sex?

There is a loose, flexible ring inside the condom at the closed end of the pouch. A slightly larger ring is attached to the condom at the open end. The ring at the closed end holds the condom in place inside the anus. The ring at the open end rests outside the anus. If the condom is correctly placed in the anus, it should form a "lining" against the walls of the anus. The internal condom can be inserted up to 8 hours or just a few moments before sex.

Lubricant

  • Be sure the lubricant is evenly spread inside the pouch by rubbing the sides of the pouch together.
  • Because the internal condom is made of nitrile, not latex, you can use oil based lubricant, but water or silicone lubricants are also an option.
  • Apply lubricant to the outside of the anal opening and on the penis.

Insertion.

  • Find a comfortable position.
  • Squeeze the inner ring (at the closed end) with your thumb and middle finger and insert it slowly into the anus. (You can also remove the ring and use the condom without it if this is more comfortable.) If the condom is slippery to insert, let go and start over.
  • With your index finger inside the pouch, push the inner ring (if you have not removed it) and the pouch the rest of the way into the anus. Insert the ring past the sphincter muscle if possible. This step may be hard to do on the first couple of attempts.
  • Make sure the outside ring lies outside the anus, with about one inch of the open end of the pouch outside the body. This part of the condom may help prevent skin-to-skin transmission of STIs during sex.

During sex.

  • You may notice that the condom moves around during sex. A side-to-side motion of the outer ring is normal and will not reduce your protection.
  • The condom may also move up and down in the anus. As long as the penis is covered and all fluids remain contained in the pouch this also should not reduce your protection.
  • During sex, it may be helpful to use your hand to guide the penis into the anus inside the condom. It is important that the penis is not inserted to the side of the outer ring. If the condom seems to be sticking to and moving with the penis rather than resting in the anus, stop and add lubricant to the inside of the condom (near the outer ring) or to the penis.

After sex.

  • Squeeze and twist the outer ring to keep the semen inside the pouch.
  • Remove it gently before you stand up. Wrap it in a tissue and throw it away in the garbage. Do not flush it down the toilet because it can clog up the plumbing.

Internal condoms should not be used simultaneously with male condoms because the friction between the two condoms may cause the condoms to break. Do not reuse the internal condom. Use a new condom every time you have sex

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How effective is the internal condom in preventing pregnancy and STIs?

Studies of the internal condom show that it, if used perfectly, 5% of women will experience a pregnancy within the first year of use. In typical use (which includes imperfect insertion and inconsistent use), 21% of women will experience a pregnancy within the first year. The rate of breaks or tears in the internal condom is less than 1%, compared to 4% with the male condom.

Like the male condom, the internal condom provides good but not complete protection against all STIs. Infections that are transmitted through skin to skin contact-- such as herpes or HPV (genital warts) may still be transmitted via areas of the skin that are not covered by the condom.

What are the benefits?

  • The internal condom provides an opportunity for receptive partners to share responsibility for the use of condoms.
  • You can use the internal condom if your partner refuses to use male condoms.
  • The nitrile is less likely to cause an allergic reaction than a male latex condom. It also tears less often.
  • The internal condom is available over the counter without a prescription. Unlike a diaphragm, it does not need to be fitted by a medical provider (one size fits all).
  • The internal condom will protect against most STIs if it is used correctly. It also covers much of skin surrounding the vagina or anus for additional protection in that area.
  • The outer ring of the internal condom may stimulate the clitoris during vaginal intercourse.
  • The internal condom can be used for protection against STIs during oral sex. Its design allows for protection during tongue insertion and fingering of the vagina or anus.
  • It can be inserted up to 8 hours before sex so it does not interfere with "the moment."
  • The polyurethane is thin and conducts heat well so sensation is preserved.

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What are the disadvantages?

  • The outer ring is visible outside the vagina or anus, which may make some people self-conscious in front of their partners.
  • It often makes crackling and popping noises during intercourse. Extra lubricant may help this problem.
  • It has a higher failure rate for pregnancy prevention than non-barrier methods such as oral contraceptive pills.
  • It is somewhat cumbersome to insert.
  • Each internal condom can be used just once and is relatively expensive.

What if the internal condom tears or doesn't stay in place during sex?

If a problem occurs during the use of the internal condom for vaginal sex, a woman may want to consider using Emergency Contraception (EC). EC is available at Health Services 24 hours a day and should be taken within 120 hours (5 days) after sex, the sooner the better. If you are a Brown student, call Health Services at 401.863-1330 to find out if you should take EC.

If a problem occurs during the use of the internal condom for vaginal or for anal sex, you may want to consider STI testing. Click here to learn more about STI testing options.

How much do internal condoms cost and where can I get them?

Internal condoms are available to Brown students for $1 per condom from Health Education, in our office on the 3rd floor of Health Services. Elsewhere, internal condoms typically sell for $2-3 each. They are available in drugstores and other outlets where condoms are sold.

Links you can use

To learn more about the internal condom, you can visit:

Planned Parenthood

The Manufacturer’s Website

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Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.