Embracing the Female Condom

NEW YORK-- Until recently, if a woman wanted to protect herself from sexually transmitted diseases, she had to convince her partner to wear a condom. The female condom, which has been available in drugstores across the country since last summer, has changed all that. "This is a device that the woman has an element of control over," says Dr. J. Courtland Robinson, an associate professor of gynecology and obstetrics at the Johns Hopkins Medical School in Baltimore, Maryland. "If the man says he's not going to wear a condom, she now has the option of wearing hers." Women who have been using the new contraceptive agree. Besides that, they say, it feels better than the traditional male condom. Best of all, it works. The female condom is as effective as the traditional male condom in protecting against pregnancy and sexually transmitted diseases (STDs), according to a recent study by Family Health International. The non-profit reproductive research group is based in North Carolina. The new device -- a polyurethane sheath with a ring at either end -- is not without its drawbacks. It is significantly more expensive than male condoms. And because part of the condom protrudes outside the vagina -- it's designed that way so that it will completely cover the female genitals and better protect against STDs -- it may be a little off- putting to the women's partner at first. Nevertheless, many women are happy with the new product. Debra Simmons, a 39-year-old Manhattan resident, says she now uses the female condom almost exclusively. "I like it better than the male condom," Simmons says. "That's because I feel like I'm in control. If the guy says he won't wear a condom, it doesn't matter. "This way I don't have to worry about getting pregnant or getting an STD. Because it's more durable, I don't have to worry about it breaking or tearing. I also like the fact that it protects my whole vagina. Basically, I just feel safer." Simmons also appreciates the way the new condom feels. It heats up to body temperature faster than the traditional latex condom, "and it feels a little smoother." Maria Sanders, a 29-year-old New York resident, agrees. "If you use a lot of lubricant, you really don't notice it at all," Sanders says. Sanders works for Planned Parenthood, and has experimented with free samples. "Another advantage to the female condom is that you can insert it ahead of time, like the diaphragm," she says. Wisconsin Pharmaceuticals, maker of the Reality brand of female condoms, advertises that their product can be worn for as long as eight hours before intercourse. There have been complaints that the female condom "squeaks," when couples use it. But Sanders claims that this problem can be eliminated by applying more lubricant. She says more women might use the female condom if its price were comparable to that of the male condom. Right now, female condoms are selling for about $2.50 each, roughly the same price as a box of 10 male condoms. But Sanders' boyfriend isn't as enthusiastic as she is. "They're okay," hedges George Thomas, 37. But, he cautioned, if it's the couple's first time, they should not use the female condom. "You have to get used to it," Thomas says. "The thing is so big. If it's the first time, it might turn a man off. You don't really see the male condom once it's on." Some men appear to like the female condom better, though. Simmons claims her boyfriend is happy with it. "He said he feels better sensation because it seems thinner," she says. "He likes them. He asks me if I'm going to wear one of those female things." Sanders says she was a little concerned about the original studies on the female condom that said it was only 87 percent effective at preventing pregnancy. The Family Health study, however, has found that the female condom is as effective as the traditional male condom in protecting against pregnancy and sexually transmitted diseases. The study followed 328 women, aged 18 to 40, from the United States and Latin America for six months. Overall, women from the United States had accidental pregnancy rates of 12.4 per 100 women, while the Latin American women had rates of 22.2 per 100. But when the researchers left out women who admitted to using the new contraceptive only sporadically, the pregnancy rates improved: 2.6 per 100 among women from the United States and 9.5 per 100 among the Latin American women. The researchers could not explain why pregnancy rates were higher among Latin American women. By comparison, use of the cervical cap or a diaphragm with spermicide results in accidental pregnancy 18 percent of the time. Unlike the male condom, the female condom requires some advance study. "We had a little trouble the first time because I didn't read the instructions," Sanders recalls. "But when I followed the instructions, it went quicker." Simmons says she used the female condom three times before she felt comfortable with it. The new condom has also sparked interest among HIV-infected women, according to Kathleen McGuinness, a nurse practitioner at the Women's Clinic of New York Hospital-Cornell Medical Center. It is being distributed by HIV prevention programs in several American cities. Federal regulations recently changed so that the female condom is now covered by Medicaid, a federal medical insurance system that assists low-income people. Surprisingly, even when they know that a woman is HIV-positive, some men will still refuse to wear a male condom, according to McGuinness. With the female condom, women feel they can protect themselves and their partners. "Men have heard that HIV is harder for them to get than women," McGuinness says. "But these men don't seem to understand that if they have a genital ulcer, it breaks the skin barrier, making it easier for them to get the virus." HIV-positive woman also worry that when they have unprotected sex, they may be at risk for more virulent strains of the HIV virus, as well as for other sexually transmitted diseases, McGuinness adds. "Basically they are a lot more prone to getting vaginal infections, like chlamydia trachomatis, genital herpes or human papilloma virus [genital warts]," she explains. "They know their immune systems are compromised, and that they are more susceptible." author

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