Internal Condoms

A external condom against a white background.

An internal condom (sometimes called a female condom) is a pouch that is inserted into the vagina before intercourse to prevent pregnancy or into the vagina or anus to reduce the risk of sexually transmitted infections. In the United States today there is only one brand of FDA-approved internal condom, the FC2.

The FC2 is a thin sheath with a soft ring at each end. For vaginal insertion, the smaller, closed ring, covered with polyurethane, fits over the cervix and rests behind the pubic bone, acting as an anchor. The larger, open outer ring stays outside the vagina and covers part of the perineum and labia.

Because it is not made of latex, it will not deteriorate when used with oil-based lubricants. It can be inserted up to several hours before intercourse but should be removed immediately after. The FC2 is pre-lubricated with a silicone-based lubricant and does not contain spermicide. It does not require precise placement over the cervix. External and internal condoms should not be used at the same time, because the added friction between the two condoms could cause them to break. Like the external condom, the FC2 internal condom is intended for onetime use.

In the United States, the FC2 is available over the counter. They are slightly harder to find than external condoms, but many health and family planning clinics, including Planned Parenthood facilities, have internal condoms. You may also purchase them on the FC2 website. Many drugstores also carry FC2, but by prescription only. If you have a prescription, most insurance companies will cover the cost. Each internal condom costs about $2-$3.

Effectiveness

FC2 is 95 percent effective in preventing pregnancy when used consistently and correctly; with typical use, it is 79 percent effective. Although the research on internal condoms is not as extensive as that on external condoms, consistent and correct use of the internal condom appears to provide a level of protection against STIs, including HIV, similar to that of the external condom. Internal condoms work best when you use them correctly and consistently each time you have sex.

Advantages

  • Does not require advance planning, clinic visits, or a prescription.
  • Provides protection against STIs, including HIV.
  • You don’t have to rely on a partner to use an external condom on the penis.
  • Provides broader coverage than the external condom, covering the labia, the perineal region, and the base of the penis; this may decrease the chance of passing the viruses that cause genital warts and herpes.
  • The outer ring may stimulate the clitoris and make intercourse more enjoyable.
  • May help you know your body better.
  • No systemic side effects.
  • Does not affect menstrual cycles.

Disadvantages

  • Not as effective in preventing pregnancy as hormonal methods or an external condom.
  • Costs somewhat more than an external condom and may not be as readily available.
  • Requires a brief pause to put on.
  • Can take practice before insertion becomes easy.
  • Some people find that the rings cause discomfort.

How to Use

FC2 use can be fun for all partners when it is made part of sex. Discuss condom use before you have sex. Insert FC2 before you have any genital contact.

  1. Carefully open the packet and find the inner (smaller) ring, which is at the closed end of the condom. If you’re using the condom anally, remove the inner ring. If you’re using the condom vaginally, leave the inner ring as is.
  2. Get into a comfortable position to insert the condom. This could include lying down, squatting, or standing with one foot on a chair.
  3. For vaginal insertion, squeeze the inner ring together and push it up into your vagina with your finger. The outer ring stays outside the vagina. For insertion into your anus, simply push the condom in with your finger.
  4. The outer larger ring should hang about an inch outside your vagina or anus.
  5. When your partners penis is hard, you will need to guide the penis through the outer ring, to make sure that the outer ring is not pushed to the side of the vagina. If you find that the outer ring is being pulled into your vagina during intercourse, add extra lubrication inside the condom or to the penis. You can use any kind of lubricant, water- or oil-based, with the FC2.
  6. After sex, remove the internal condom (if you are lying down, do this before you stand up). Squeeze and twist the outer ring to keep the sperm inside the pouch. The condom should come out easily when you pull. After removing the condom, dispose of it in the trash; do not flush it down the toilet.

Frequently Asked Questions

  • Does the FC2 come in different sizes? Does it have to be fitted? No, the FC2 does not need to be fitted. It comes in one size that is designed to fit most.
  • Can the FC2 be used with external condoms? No. The FC2 should not be used at the same time as external condoms, because the added friction between the two condoms could cause them to fail.
  • Is the FC2 as effective as external condoms? The FC2 has efficacy similar to external condoms and other barrier methods.
  • Can spermicides or lubricants be used with the FC2? Yes. It is perfectly safe and effective to use the FC2 with spermicides and all types of lubricants (oil-, silicone-, or water-based).