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Contraception - Management
What information should I give to a woman who is considering the female condom?

  • Provide information on:
    • The advantages and disadvantages of the female condom.
    • Correct use of the female condom.
    • Contraceptive efficacy of the female condom — when used consistently and correctly, female condoms are 95% effective at preventing pregnancy.
    • Efficacy of the female condom in preventing transmission of sexually transmitted infections:
      • Female condoms are likely to prevent transmission of all sexually transmitted infections — including human papilloma virus and cervical intraepithelial neoplasia — if used consistently and correctly.
      • However, male latex condoms are recommended as being more effective in preventing transmission of HIV, genital herpes simplex virus, syphilis, and gonorrhoea.
    • The (rare) risk of polyurethane allergy.
    • Precautions that may be necessary should the condom be displaced or break:
      • If there is a risk of infection, post-exposure prophylaxis against HIV infection should be considered.
      • If there is a risk of pregnancy, emergency contraception should be considered (see the CKS topic on Contraception - emergency).
    • The advisability of checking the expiry date.
  • Consider demonstrating use of the condom.
Clarification / Additional information
  • The female condom is not appropriate if:
    • The woman or her partner is allergic to polyurethane.
    • The woman's vaginal anatomy does not permit a satisfactory fit or stable placement.
    • The woman cannot learn the correct insertion technique.
  • Contraceptive efficacy:
    • The method failure rate for female condoms is 5%. That is, with consistent and correct use, 5 of 100 women will conceive over the course of 1 year.
    • The typical use failure rate is 21%. That is, when user failure is added to method failure, 21 of 100 women will conceive over the course of 1 year.
    • For comparison with other methods, see Effectiveness of contraceptives.
  • Emergency contraception:
    • Women who rely solely on condoms for contraception should be informed where emergency contraception can be obtained in case they think their method might have failed.
    • They may also be offered advance provision of oral levonorgestrel emergency contraception to use in these circumstances.
  • Correct use of the female condom:
    • A new condom should be used for each episode of sex, being inserted at any time before the penis comes into contact with the genital area. All condoms should carry the relevant kite marks and be within the use-by date.
    • Following insertion, the outer ring should rest closely against the vulva.
    • It is a good idea to guide the penis into the female condom so that it does not enter between the vagina and the condom.
    • To remove, the outer ring is twisted to keep the semen inside. The used condom should be wrapped in tissue and placed in the bin, not flushed down the toilet.
Basis for recommendation
  • Theses recommendations are based on guidelines published by the Faculty of Family Practice & Reproductive Health Care [FFPRHC, 2007a; FFPRHC, 2007d].

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