12/15/2013 09:21:00 AM
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The female condom flopped
when it was launched some 20 years ago, but it never disappeared
entirely and now a number of companies are entering the fray with new
products. Could its time have come?
Its formal name was the FC1, though many of us knew it as the
Femidom, or Reality, and jokers called it all sorts of names - plastic
bag, windsock, hot air balloon...
Two decades on, Mary Ann Leeper has yet to see the funny side
of such quips. "I so believed in that product," she says. "I so
believed that women would want to be able to take care of themselves. We
were naive, or I certainly was naive."
Leeper was the president of Chartex, the
company that made the FC1. Before the launch, there was an atmosphere of
curiosity and anticipation, but those involved underestimated just how
unfamiliar the large, slippery device would look and feel to customers
in Europe and the US.
Leeper traces the backlash to a single negative article in an influential US women's glossy magazine.
"That story was the pivotal story that became like a domino
effect," she says. "It was a shock to me, to tell you the truth. Why
would you make fun of a product that was going to help young women stay
healthy, that was going to protect them from sexually transmitted
infections as well as unintended pregnancy?"
The FC2 is 17cm (6.5ins) long - the smaller ring is flexible for easy insertion
To be fair, the FC1 had something of a design flaw. Made of
polyurethane, it was a bit noisy during sex, and it was inevitable that
comic stories of rustling under the bedclothes would be told and
re-told.
In the early years, Chartex's successor, the
Female Health Company, considered folding, but instead it set about
developing an education programme. Then one day in 1995, Leeper received
a telephone call from a woman called Daisy, responsible for Zimbabwe's
HIV and Aids programme.
"She said, 'I have a petition here on my desk signed by
30,000 women demanding that we bring in the female condom,'" recalls
Leeper.
It was the start of a set of partnerships that took the female condom to women in large parts of the developing world.
Projects in Nigeria, Cameroon and
Mozambique distribute female condoms via women's hair salons, which sell
them at a small mark-up, after explaining how they are used.
The FC1's successor, the FC2 - made of non-rustling synthetic
latex - is far more successful than many in the West realise. It is
available in 138 countries, sales have more than doubled since 2007, and
the Female Health Company has been turning a profit for eight years.
The vast majority of sales are to four customers - the US aid
agency (USAID), the UN and the ministries of health in Brazil and South
Africa. Donors and public health officials are keen on anything that
gives women the upper hand in what they call "condom negotiation" with
men.
Female condoms have other advantages too. They can be
inserted hours before sex, meaning that there is no distraction at the
crucial moment, and they don't need to be removed immediately
afterwards. For women, there is better protection from sexually
transmitted infections, since the vulva is partially covered by an outer
ring that keeps the device in place.
Continue reading the main story
"My gf says it takes a little getting used to putting them in. But... they feel WAY better than a condom. :-)"
"My boyfriend and I both love the female condom... Downsides are the need for extra lube inside the condom and it is a bit more messy to clean up afterward compared to the male condom."
"Added feeling when the ring hits. Enjoyed a lot. Hard to use at first, but once you get uses to it, it's nice. Can be little embarrassing putting it in."
Reviews of the FC2 from undercovercondoms.com
Female condoms v sliced bread
"Greatest invention since sliced bread, better than male condoms. It's frustrating, that it's not readily available everywhere...""My gf says it takes a little getting used to putting them in. But... they feel WAY better than a condom. :-)"
"My boyfriend and I both love the female condom... Downsides are the need for extra lube inside the condom and it is a bit more messy to clean up afterward compared to the male condom."
"Added feeling when the ring hits. Enjoyed a lot. Hard to use at first, but once you get uses to it, it's nice. Can be little embarrassing putting it in."
Reviews of the FC2 from undercovercondoms.com
User feedback is also pretty good.
A 2011 survey found that 86% of women were interested in using the method again and 95% would recommend trying them to friends.
"Many people report that female condoms heighten sexual
pleasure," says Saskia Husken from the Universal Access to Female Condom
Joint Program (UAFC). For men, they are less tight than male condoms.
For women, the large ring of the condom - which remains outside the
vagina - can also be stimulating.
In Africa, the free availability of female condoms at clinics
has led to an unexpected fashion trend. Women have taken to removing
the flexible ring from the device and using it as a bangle. "If you are
[romantically] available you have a new bangle on," says Marion Stevens
from the female health campaigning body Wish Associates. "If you are in a
long-term relationship your bangle is old and faded."
A demonstration of the female condom in a marketplace in Nigeria
Meyiwa Ede, from the Society of Family Health in Nigeria, says
that while men are often excited by the prospect of sex without having
to wear a regular condom, women are taken aback by their first glimpse
of the device.
"They look at it and say 'OK - are you saying I have to put that in myself?'" she says.
Ede's team of demonstrators use a mannequin to show the
condom is inserted and compare the task to using a new phone -
bewildering at first, but second nature after a while.
In most developed countries there is still that 20-year-old image problem to overcome.
"I think the issue is when you open the package they're
already open - they're not like male condoms that are in these neat
little packages and then they're unrolled," says Mags Beksinska from the
University of the Witwatersrand in South Africa. "In fact, they're the
same length as a male condom so if you hold the two together open,
they're not that different."
Clockwise from top, the Woman's Condom, Cupid and VA Wow
Beksinska is the lead author of a clinical trial recently published in the Lancet of three new models of female condom:
- The Woman's Condom, already available in China and soon to be distributed in South Africa, is the fruit of a 17-year project by Path - an NGO that specialises in health innovation - which has tested more than 50 versions. Out of the packet, it's smaller than the FC2. It looks like a tampon, with most of the condom gathered into a rounded polyvinyl capsule, which dissolves inside the vagina. Once it has expanded, dots of foam help keep it in place.
- The Cupid is available in India, South Africa and Brazil. It is vanilla scented and comes in pink or natural colours. It is currently the only model besides the FC2 to have been qualified by the World Health Organization (WHO) for public-sector purchase. A smaller version aimed at the Asian market is in trial.
- The VA Wow, like the Cupid, contains a sponge which helps users to insert the condom and prevents it slipping.
The Lancet study, which showed that all were no less
reliable than the FC2, improves their chances of gaining wide acceptance
internationally.
Other radically redesigned female condoms are either available now, or will be soon.
Two female condoms from Innova Quality
The Air Condom, on sale in Colombia, features a little pocket of air to aid insertion.
The Panty Condom, made by the same Colombian
manufacturer, Innova Quality, is packaged with a special pair of
knickers, which keep the condom in place, though this product currently
lacks a distributor.
Meanwhile, a female condom known as the Origami is about a year away from market launch in the US.
Its designer, Danny Resnic, who started to work in this area
after contracting HIV because of a broken condom in 1993, paid close
attention to the jokes about the FC1.
"There's a reason it looks like a plastic bag - it is a plastic bag," he says. "It's putting a round peg into a different-shaped hole."
His female condom is oval-shaped, which mirrors the female
anatomy he says. It is packaged as a teat-shaped capsule (see image at
the top of this story), and once inserted it expands like the bellows of
a concertina. The outer ring of the condom is designed to sit flat
against the labia, rather than dangling as some others do.
"It's an intimate product and a shared experience, for two
people," he says. "So our female condom is intended to be attractive for
both men and women."
Since the Origami condom is made from silicon, it has the added benefit of being reusable - it can be washed in a dishwasher.
Saskia Husken of UAFC says it's important for couples to have
a choice of products if the female condom is to achieve its potential.
"There is a need for variety," says Husken. "Some women
prefer one product and some prefer another, and men as well. We are not
all the same."
A 2010 study bears
this out. Researchers asked 170 South African women to try out three
different female condoms five times. After nine weeks, they could choose
to stop the research or continue, using the female condom of their
choice. Eighty-seven percent chose to continue, and by this time almost
all of them had a definite preference (44% opted for the women's condom,
while 37% went for the FC2 and 19% for the VA Wow).
The fact that 20 years have passed and the female condom has
not matched the success of the male condom - it still accounts for only
0.19% of global condom procurement, and costs about 10 times as much -
does not dent the confidence of these entrepreneurs.
Mary Ann Leeper explains how she came to realise that it could be a very long game.
Several years after the disastrous launch of the FC1, a man from Tampax came to talk to her. He said it had taken not years but decades before doctors put their faith in tampons, and women stopped seeing them as weird and gross.
"He showed me the learning curve," Leeper recalls.
"I said 'Oh God, don't tell me! Have I got to wait all this time? I don't know if I can last that long!'"
But the female condom evangelists may yet have the last laugh.
Mags Beksinska spoke to Health Check on the BBC World Service. Listen again on iPlayer or get the Health Check podcast.
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