WHAT IS IT?
The internal condom is a form of non-hormonal contraception that acts a barrier during sex to reduce the risk of unintended pregnancy and reduce the spread of some STIs.
Internal condoms are designed to be used by persons with a vagina. The internal condom is a soft, loose-fitting, seamless sheath containing two flexible rings that anchor the condom in place. The internal condom is inserted into the vagina before sex and works by holding in the sperm and acting as a barrier between bodily fluids, preventing them from contacting the vagina. They can also be used anally, by inserting the condom into the rectum.
Internal condoms are made from a variety of materials including natural rubber latex, synthetic latex (nitrile), and polyurethane rubber (latex). Lubricants are often used with internal condoms to replace the natural lubricants produced by the vagina.
HOW DOES IT WORK?
The internal condom is designed to be inserted into a vagina or anus prior to sexual intercourse. The condom then acts as a barrier contraception method, preventing contact between sperm and the vagina.
The barrier formed by internal condoms also acts to prevent contact between bodily fluids and secretions from both sexual partners, reducing the risk of spread of some STIs.
The smaller (internal) ring at the closed end of the internal condom is inserted inside the vagina (or rectum) and sits over the cervix to anchor the condom inside the vagina. The larger open (external) ring at the other end of the condom sits outside the vagina or anus and acts as an external anchor while also providing some protection to reduce risk of STIs transmission.
The internal condom is coated inside with a silicone-based lubricant, but additional water or silicone based lubricants can also be used to increase comfort. The internal condom can be placed in the vagina up to 8 hours before sexual intercourse, and a new condom should be used for each repeated act of sex. The condom should not be placed in the anus ahead of time.
HOW EFFECTIVE IS IT?
There are much fewer studies investigating the effectiveness of the internal condom compared to the external condom.
Contraception (prevention of pregnancy) – As with external condom use, couples vary widely in their ability to use internal condoms consistently and correctly. For best protection, internal condom use is recommended in addition to at least one other effective method of contraception, such as the Pill.
- About 5% of people will become pregnant during the first year of perfect (ie, consistent and correct) use of the internal condom.
- About 21% will become pregnant during the first year of typical use.
Protection from STIs – Because they are used less frequently than external condoms, little information is available about the efficacy of internal condoms in reducing the spread of certain STIs. However, some small studies suggest the internal condom may provide an impermeable barrier to HIV and cytomegalovirus, as well as other STIs.
WHEN SHOULD I USE IT?
The use of condoms (either external or internal) is strongly encouraged for all sexually active individuals that are not trying to conceive, as condoms are one of the only effective barriers to prevent the spread of HIV and certain STIs.
If your partner has a penis or is using a toy and is not using an external condom, then an internal condom can be used for penetrative sex to reduce the risk of unintended pregnancy and lower risk of spread for certain STIs.
Internal condoms are not a useful barrier method during oral sex on any genitalia.
Condom use (either internal or external) is especially important when engaging in sexual activity with new/unfamiliar sexual partners, or if you have been/are engaging in sexual activities with multiple sexual partners.
HOW DO I USE IT PROPERLY?
- Carefully open the package: Just like with external condoms, you want to first open the package carefully with your fingers. As always check the expiry date and look for tears. Wash your hands if possible, and be careful if you have long or sharp fingernails.
- Lubricate the closed end of the internal condom: Next, put a little lubricant on the outside of the closed end (internal ring) of the condom (see graphic). Remember the smaller (internal) ring at the closed end of the internal condom will be inserted inside the vagina and sit over the cervix to anchor the condom inside the vagina. The larger open (external) ring at the other end of the condom sits outside the vagina and acts as an external anchor. Remove the inner ring if you are using the condom anally.
- Insert the internal condom: Next, you will need to insert the lubricated end of the condom into the vagina. When inserting the condom you will need to squeeze the inner ring together with your fingers until it makes a flat line and put it inside your body. If inserting in a vagina you will be placing it in a similar way as you’d use a tampon or menstrual cup, pushing it as far back as you can until it reaches your cervix. (the cervix can feel like the tip of a nose inside your vagina if you’ve never felt it before). Once all the way back remove the finger you used to push it up and make sure the external ring falls outside of your vagina or rectum by at least an inch. Internal condoms can be inserted up to 8 hours before vaginal sex and right before sex, if being used for anal sex.
- Sex with the internal condom: Now your partner will insert their penis or toy inside the internal condom that had been placed in the vagina or anus. The base will not grip them like an external condom’s base does. Take care to make sure that the penis, or toy, is being inserted inside the condom, rather than to the outside of the condom.
- Removing the internal condom: To remove the internal condom, have your partner withdraw the penis or toy — no need to hold anything. Then you twist the outer ring, and the part of the condom outside your body until it’s closed, gently pull it out and throw it away.
ADVANTAGES VS DISADVANTAGES OF USING INTERNAL CONDOMS:
ADVANTAGES: The internal condom offers several contraceptive and barrier benefits:
- It is a safe, effective, reversible method to prevent pregnancy and has no delay in return of fertility after stopping use.
- Protects against pregnancy and some STIs. It offers more coverage of external genitalia than the external condom, and may better protect from STIs transmitted via skin lesions or shedding.
- Offers an option to people whose partners cannot or will not use the external condom.
- Partners may find it more comfortable and less constricting than external condoms.
- Can be obtained easily at most pharmacies without any medical intervention.
- It is not affected by large weight changes or recent pregnancy/delivery.
- The external ring may increase sexual stimulation.
- Can be placed up to 8 hours before vaginal sex, does not require an erect penis, and can be removed any time after ejaculation so it can be less disruptive of intimacy.
- When made of synthetic materials (nitrile, polyurethane) they do not require special storage because synthetics are not affected by changes in temperature and dampness, can be used with oil and silicone based lubricants without weakening, are less likely than latex to trigger allergic reactions
DISADVANTAGES: The internal condom also has disadvantages that may lead to inconsistent, incorrect, or nonuse.
- Can be difficult to insert and remove correctly.
- More expensive than external condoms.
- Can potentially slip or break.
- Higher failure rate in preventing pregnancy than non-barrier methods and external condom.
- The outer ring is visible outside the vagina or anus and can make noise during sex, which can be unacceptable to either partner.
- Some people feel embarrassed or uncomfortable when obtaining internal condoms or suggesting use of condoms.
- Are not as widely available worldwide compared to external condoms.
- Unlike the external condom, the internal condom is not technically licensed for anal sex.