Abstract:
Frequently asked questions about the female condom include questions about its effectiveness as a contraceptive, which is as high as the other barrier methods and can approach 95% with perfect use. Its effectiveness in preventing transmission of sexually transmitted diseases and HIV infection is speculative but promising because the condom material is impermeable to the causative agents. The female condom is safe to use except by people who are sensitive to polyurethane or silicone. The condom is made in one size and has a closed inner ring and an open outer ring (which remains outside of the vagina during use). The condoms are prelubricated, and additional water-based lubrication can be used. The accepted shelf life of the female condom in the US is two years, but this may be extended. The female condom is impervious to normal changes in temperature, altitude, and humidity; however, it can be ripped by a sharp object such as a fingernail or jewelry. The female condom can be used with other nonbarrier methods but should not be used in conjunction with a male condom or in the presence of a tampon. Pregnant or menstruating women and women of any age can safely use the device, and it can be inserted several hours prior to use. Studies have shown that many women like the device and would recommend it to others.Keywords:
Female condom
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This paper summarizes acceptability data published to date on the innovative female condom, and presents an additional study comparing the acceptability of the female condom and the latex male condom in a sample of low risk women attending private obstetrician/ gynaecologists' clinics in Nairobi, Kenya. Eighty-four percent of all subjects who completed interviewer-assisted questionnaires reported that they liked using the female condom, and more than two-thirds of all the women liked the female condom as much or better than the male condom. Fifty-five percent of the women would use the device in future if it were available. The least liked features were that the device was too large for easy insertion, messy to handle, and reduced sensation. Use became easier and more comfortable with experience. The most liked features were that the device made sex more enjoyable, protected against sexually transmitted diseases and pregnancy, and was under the woman's control. Male partner response was slightly less favourable, and sometimes resulted in women's noncompliance or discontinuation of use, despite the fact that such a device is supposed to empower women. This study provides preliminary data indicating that the female condom is a fairly acceptable method for some Kenyan couples, but recommends further research into safety, cost-effectiveness and hindrances to acceptability.A survey of 48 female volunteers recruited from 3 private gynecology-obstetrics clinics in Nairobi, Kenya, revealed preliminary support for the female condom as an acceptable family planning method. In the study's first phase, women were provided with 2 male and 2 female condoms to be used in the ensuing 3 weeks. In the second phase, they were supplied with 4 more female condoms. A total of 113 female condoms were used during the 2 study phases. Overall, 84% of women expressed favorable reactions to the female condom and 55% indicated they would use this method in the future were it available. In the first phase, 39% stated they preferred the female to the male condom, while 37% liked the 2 condoms about the same; all 12 women who completed the second phase preferred the female condom, suggesting that use becomes easier and more comfortable with time. Although 55% of male partners were reported to like the female condom the same or better than the male condom, and 39% liked it less; male partner disapproval was a major factor in study discontinuation. Enhanced enjoyment of sex, protection against pregnancy and sexually transmitted diseases, and female control were the most frequently cited positive attributes of the female condom; the device's large size, messiness, and reduced sensation were its least liked characteristics. Insertion difficulties and discomfort caused by the device's outer ring were common. There were 3 incidents (2.7%) of condom breakage and 11 (10%) of condom displacement during intercourse. More research on acceptability, cost-effectiveness, and safety is required before the female condom is slated for large-scale distribution in Kenya.
Female condom
Discontinuation
Kenya
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In early May 1993 the US Food and Drug Administration (FDA) granted speedy approval to Wisconsin Pharmacal to market the female condom Reality. The lubricated sheath has a flexible plastic ring on both ends with one ring remaining outside the body. Some women who have used the female condom consider it to be cumbersome unattractive and noisy. Nevertheless it is the first women-controlled barrier contraceptive that guards against sexually transmitted diseases (STDs). The FDA Commissioner recommends that couple using the female condom also use a male condom made of latex to provide the best protection against STDs and AIDS. In fact FDA has directed the manufacturer to place a warning on the label advising couples to do just that. Another required warning is that the pregnancy rate is about 26% higher than that of other female barrier contraceptives (e.g. diaphragm) but much lower than not using any contraceptives (85%). Misuse of the female condom is responsible for the high pregnancy rate but more experience with its use should reduce that rate. The manufacturer whose annual sales of other products is $13 million spent almost $8 million for the 5.5 year regulatory process. It plans to distribute Reality to family planning clinics before marketing it to pharmacies and other stores where consumers can already buy the male condom. It hopes to have implemented full-scale commercial distribution by the end of 1993.
Female condom
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Female condom
Health psychology
Diaphragm (acoustics)
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