When to Start

Any time the client wants.

Explaining How to Use

Important: whenever possible, show the client how to insert the female condom. Use a model or picture, if available, or your hands to demonstrate. You can create an opening similar to a vagina with one hand and show how to insert the female condom with the other hand.

Basic Steps	Important Details
1. Use a new female condom for each act of sex	Check the condom package. Do not use if torn or damaged. Avoid using a condom past the expiration date—do so only if newer condoms are not available. If possible, wash your hands with mild soap and clean water before inserting the condom.
2. Before any physical contact, insert the condom into the vagina	Can be inserted up to 8 hours before sex. For the most protection, insert the condom before the penis comes in contact with the vagina. Choose a position that is comfortable for insertion—squat, raise one leg, sit, or lie down. Rub the sides of the female condom together to spread the lubricant evenly. Grasp the ring at the closed end, and squeeze it so it becomes long and narrow. With the other hand, separate the outer lips (labia) and locate the opening of the vagina. Gently push the inner ring into the vagina as far up as it will go.Insert a finger into the condom to push it into place. About 2 to 3 centimeters of the condom and the outer ring remain outside the vagina.
3.Ensure that the penis enters the condom and stays inside the condom	The man or woman should carefully guide the tip of his penis inside the condom—not between the condom and the wall of the vagina. If his penis goes outside the condom, withdraw and try again. If the condom is accidentally pulled out of the vagina or pushed into it during sex, put the condom back in place.
4. After the man withdraws his penis, hold the outer ring of the condom, twist to seal in fluids, and gently pull it out of the vagina	The female condom does not need to be removed immediately after sex. Remove the condom before standing up, to avoid spilling semen. If the couple has sex again, they should use a new condom. Reuse of female condoms is not recommended (see Question 5,).
5. Dispose of the used condom safely	Wrap the condom in its package and put it in the rubbish or latrine. Do not put the condom into a flush toilet, as it can cause problems with plumbing.

Supporting the User

Ensure client understands correct use

• Ask the client to explain the 5 basic steps of using the female condom while handling one.
• If a model is available, the client can practice inserting the condom in the model and then taking it out.

Ask the client how many condoms she thinks she will need until she can return

• Give plenty of condoms and, if available, lubricant.
• Tell the client where she can buy female condoms, if needed.

Explain why using a condom with every act of sex is important

• Just one unprotected act of sex can lead to pregnancy or STI—or both.
• If a condom is not used for one act of sex, try to use one the next time. A mistake once or twice does not mean that it is pointless to use condoms in the future.

Explain ECP use in case of errors in condom use—including not using a condom—to help prevent pregnancy (see Emergency Contraceptive Pills). Give ECPs if available.

Discuss ways to talk about using condoms

Discuss skills and techniques for negotiating condom use with partners (see Bringing Up Condom Use).

Lubricants for Female Condoms

Plastic female condoms come lubricated with a silicone-based lubricant. Unlike most male condoms, which are made of latex, plastic condoms can be used with any type of lubricant—whether made with water, silicone, or oil.

Some female condoms come with additional lubricant in the package. Some clinics may be able to provide clients with more lubricant. If a client needs additional lubrication, she can also use clean water, saliva, any oil or lotion, or a lubricant made of glycerine or silicone.

• Suggest to a new user that she practice putting in and taking out the condom before the next time she has sex. Reassure her that correct use becomes easier with practice. A woman may need to use the female condom several times before she is comfortable with it.
• Suggest she try different positions to see which way insertion is easiest for her.
• The female condom is slippery. Some women find insertion easier if they put it in slowly, especially the first few times.
• If a client is switching from another method to the female condom, suggest that she continue with the previous method until she can use the female condom with confidence.

Also if:

• She has difficulty using female condoms correctly or every time she has sex.
• She recently had unprotected sex and wants to avoid pregnancy. She may be able to use ECPs (see Emergency Contraceptive Pills).