Demystifying the internal condom: a guide for anyone whose sex life demands options

Getting tested for sexually transmitted diseases (STDs) and sexually transmitted infections (STIs) can be scary. But regular STD and STI testing is an important part of your sexual health. According to data released by the Centers for Disease Control and Prevention in 2018, STD rates have continued to increase for four consecutive years. From 2013 to 2017, gonorrhea cases increased by 67% and syphilis cases nearly doubled.

April is STD Awareness Month, and now is a good time to get tested and learn more about your prevention options. When you think of prevention methods, regular latex condoms probably come to mind first. But you should also know about the internal condom (formerly the female condom). It’s an easy-to-use alternative that we think everyone should consider including in their sexual repertoire.

We spoke with Julia Bennett, director of learning strategy for education at Planned Parenthood Federation of America, about internal condoms. Bennett explained what internal condoms are, how they help protect against STIs, and how they’re different from regular condoms. Here are answers to some common questions you might have.

What is an internal condom?

“Internal condoms (formerly known as ‘female condoms’) are an alternative to regular (external) condoms. They provide great protection from both pregnancy and sexually transmitted infections. However, instead of going on a penis or sex toy, internal condoms go inside either the vagina (for vaginal sex) or anus (for anal sex). People of any gender can use them for vaginal or anal sex. To use an internal condom for anal sex, simply take the inside ring out.”

How do internal condoms work?

“Internal condoms are made of nitrile (a type of soft plastic). They create a barrier between people’s genitals during anal or vaginal sex. This barrier stops sperm and egg from meeting, which prevents pregnancy. It also helps prevent STIs from spreading. Internal condoms put up a barrier, so you don’t come in contact with each other’s semen (cum), pre-cum, or genital skin, all of which can spread STIs. But you do have to use them every time you have sex, from start to finish, for them to work.”

Can anyone use an internal condom?

“Last fall, the U.S. Food and Drug Administration (FDA) renamed the internal condom, as it was previously known as the ‘female condom.’ The FDA moved the internal condom from a Class 3 medical device to a Class 2 medical device—the same as other condoms. This change will help make internal condoms easier to access in the future. The reclassification also underscores their versatility—anyone can use them, regardless of gender identity or sexual orientation.”

How effective are internal condoms?

“Internal condoms are really good at preventing both STIs and pregnancy. About 21 out of 100 people who use internal condoms for birth control get pregnant each year. If you use them from start to finish every time you have vaginal sex, they can work even better. Keep in mind that you can get even more pregnancy prevention powers by using internal condoms along with another birth control method (like the pill or IUD). That way you’ve got protection from STIs, and double protection from pregnancy.”

What are the benefits of using internal condoms?

“There are a lot of benefits to internal condoms:

They help prevent STIs. Condoms, including internal condoms, are the only method of birth control that also protects against STIs.

They may feel more comfortable. Some people find internal condoms more comfortable than other condoms since they don’t fit snugly around a penis. They may feel even more comfortable (and pleasurable) if you use water or silicone-based lube, too. [Editor’s note: Internal condoms are a great option for those whose penises are larger than standard- or large-size condoms.]

They’re latex-free. This makes them a great option for people allergic to latex.

• They can increase sexual pleasure. During vaginal sex, the internal condom’s inner ring may stimulate the tip of the penis, and the external ring can rub against the vulva and clitoris. That little something extra can feel great for both partners. You can also insert the internal condom before sex, so that you don’t have any interruptions.”

Are there any disadvantages to using them?

“You need to use an internal condom every time you have sex, which may be hard for some people to stick to. You also have to be sure to put them on correctly. They also may take some getting used to, if you/your partner are new to them. Practice inserting them, or even make it a part of foreplay by having your partner insert it.”

Where can you buy an internal condom?

“While the recent reclassification will hopefully lead to easier access in the future, right now internal condoms can sometimes be a little hard to find. Currently, the only brand available in the U.S. is the FC2 Internal Condom. It’s available online at the FC2 Internal Condom website, at many Planned Parenthood health centers, family planning and health clinics, and by prescription in drugstores. Some health centers may provide them for free. Otherwise, internal condoms cost about $2-3 each if your insurance doesn’t cover the cost. They’re usually sold in packs of 12.”

If you use an internal condom, should you still use a regular condom, too?

“There’s no need to double up on condoms, no matter what kind of condom it is. One is all you need. Each kind of condom is designed to be used on its own, and doubling up will not give you extra protection.”

What’s a big misconception around internal condoms that isn’t actually true?

“There are so many kinds of condoms to choose from to meet the needs of you and your partner. Trying different kinds can be a fun way to help you find what works best for the both of you. And contrary to popular myth, condoms don’t ruin the mood—people who use condoms rate their sexual experiences as just as pleasurable as people who don’t. Using any type of condom, including the internal condom, is a good way to lower stress and focus more on having a fun, pleasurable sex life. In fact, many people say they find sex more enjoyable when they use condoms because they aren’t worrying about STIs or unwanted pregnancy.”

What should you tell your partner if they don’t want to use a condom?

“If your partner doesn’t want to use a condom, ask why. That can help start an honest conversation about your health. Sometimes it’s about finding the right type of condom, using condoms along with lube, or explaining why you want to use them. Stress that your health (and your partner’s health) is your priority—and that sex without protection is not an option. Then decide who will get the condoms, and make a plan to use them every time, the whole time you’re having sex.”