They’re Safe, Effective, and Pleasurable — Why Aren’t Internal Condoms More Widely Used?

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By Deekshita Ramanarayan, Research Intern

You know about external condoms (or male condoms) — you see them sold widely in stores and hear about them everywhere. But what, if anything, have you heard about internal condoms?

February 14 is National Condom Day, and to celebrate, we want to highlight an important but often overlooked tool in sexual and reproductive health and rights: internal condoms. Internal condoms are the only prevention method that a woman can initiate that effectively protects against unintended pregnancy, HIV and other sexually transmitted infections (STIs). Rather than going on the outside of the penis, the internal condom is inserted in the vagina or anus.

And while it may be often overlooked, this prevention method is beneficial for both pleasure and health.

In October 2018, when the FDA reclassified the “female condom” to the “internal condom,” it also officially approved the condom for use in anal sex. This change opens up opportunities for additional research and programming to promote internal condoms to a broader audience. It also sets the stage for greater inclusivity, especially within the LGBTQ+ community. By removing internal condoms’ association with gender, it makes them more accessible to people of all genders and sexual orientations.

Internal condoms add another option for women to initiate and control their sex lives without relying on their partner. Unlike most external condoms, which are made of latex, the internal condom is made of nitrile, making them a great option for people who are allergic to latex. They are also an option for people who cannot use hormonal contraception, but still need protection against unintended pregnancy, HIV, and other STIs. The inner and outer rings increase stimulation, resulting in a more pleasurable experience for both partners. Internal condoms can be inserted up to eight hours before sex, which means that women don’t have to worry about making sure they have protection in the moment. They also may provide increased protection against STIs spread through intimate skin-to-skin contact as they cover more of the external surface around the vagina and anus.

Despite these benefits, internal condoms are not as widely used as they could be. While internal condoms are available in more than 140 countries worldwide, many people don’t know where to find them or how to use them. Plus, they are still not promoted to the same level as external condoms. For example, in 2014 internal condoms only made up 0.9 percent of all condoms distributed through global health efforts.

Cost can be a major barrier for people interested in using internal condoms. In the United States, internal condoms cost up to $3 more than external condoms (compared with $1 for external condoms). However, if you have a doctor’s prescription, you can get internal condoms for free in the United States. Worldwide, the cost varies, but internal condoms are consistently more expensive. Yet when internal condoms are made available alongside external condoms, they increase the number of protected sex acts and empower whole communities. Therefore, it’s crucial to focus global health efforts on both promoting internal condom availability and providing instruction and education to make them easier to use.  

Many governments worldwide, including the United States, have shown commitment to procuring and distributing internal condoms in countries that receive global health assistance. Currently, the FC2 condom, produced by the Female Health Company, is the only FDA-approved internal condom in the United States. Female Health Company has made and renewed commitments through the Family Planning 2020 coalition to expand access to internal condoms and provide training and education in communities across the world.

To spread knowledge, availability, and use for this dual prevention method, advocates for internal condoms established Global Female Condom Day, which is celebrated annually on September 16. Additionally, global HIV programs such as PEPFAR and The Global Fund to Fight AIDS, Tuberculosis, and Malaria include internal condoms in their programming. Internal condoms must be promoted throughout all types of health services so they can have the greatest impact.

We still have a long way to go in raising awareness about and increasing the use of internal condoms. This year on National Condom Day (which is also Valentine’s Day), share your love for women-centered approaches to sexual and reproductive health and rights by talking about the internal condom with your partners and loved ones.

Check out our fact sheet to learn more about internal condoms.

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