Three years ago, a 28-year-old Mumbai-based photographer passed on a female condom–that was gifted to her by someone who did not want to use it — to a friend. “I gifted it to another friend who I thought would use. As for me, I was not sure how it works, and have also heard it’s uncomfortable,” she said. But, as it turned out, even the friend never used it.
Nandni Sharma, a 38-year-old Delhi-based publicist relates to the episode and shares a similar sentiment. When asked if she would like to use female condoms, she replied, “not sure”. This is despite the fact that she first read about female condoms in a “woman’s magazine couple of years ago, and was intrigued how they worked”.
Female contraceptives are known to be extremely beneficial; they not only help prevent unwanted pregnancies but are equally important for promoting safe sexual practices. “If used correctly, they are 95 per cent effective. They protect against unplanned pregnancy and sexually transmitted infections (STIs),” said Dr Anubha Singh, gynecologist, IVF expert, and medical director, Shantah Fertility Centre, Vasant Vihar, New Delhi.
In comparison to contraceptives like male condoms and Emergency Contraceptive Pills (ECPs), however, female condoms are lesser-known and even lesser-used, according to experts. So, what is holding women back?
Indianexpress.com reached out to experts in various fields to understand the importance of talking about female contraceptives, especially female condoms, that are considered “cumbersome” to use.
According to Himani Bajaj, 31, a PhD research scholar at Ambedkar University Delhi who has undertaken research focused on young women’s experience of negotiating contraceptives, none of her 35 subjects in the age group of 18-32 years “had ever used a female condom”, with ECPs or male condom being the preferred choices. “Some of them cited the fact that it is simpler to pop a pill or ask the male partner to put a male condom instead of placing the condom inside the vagina,” shared Bajaj.
What are female condoms?
Female condoms act as a contraceptive barrier that can be worn inside the vagina. They prevent unwanted pregnancies by stopping sperm from meeting an egg while also preventing sexually transmitted infections that may occur due to body-to-body contact. Female condoms can be placed into the vagina upto eight hours before getting intimate with a partner.
They are made of either polyurethane, natural rubber, or synthetic rubber, all of which do not use MBT/ZMBT or mercaptobenzothiazole, a chemical material that has recently been identified as a potential carcinogen by the International Agency for Research on Cancer, as per World Health Organization.
What are the benefits?
Dr Shobha Gupta, gynecologist and IVF expert from Mother’s Lap IVF Centre, Pitampura, New Delhi, said female condoms provide the same benefits as male condoms but “allow women to take more active and independent responsibility for preventing pregnancy and the spread of STIs”. “When you use female condoms, you don’t need to rely on your male partners to provide and wear their own condoms. Other benefits include convenience, male genital erection is not required, increased sexual arousal, and it rarely causes allergic reactions,” she said.
How to use a female condom?
Find a comfortable position. While holding the outside of the condom at the closed end, squeeze the sides of the inner ring together with your thumb and forefinger and insert into the vagina. “It is similar to inserting a tampon. Using your finger, push the inner ring as far up as it will go until it rests against the cervix,” explained Dr Gupta.
Is it for every woman?
“It depends on one’s needs and preferences. It also depends on its availability, as not much awareness is there,” Dr Gupta said.
“What is that? We only keep male condoms,” said a chemist from a well-known pharmacy that indianexpress.com reached out to over the phone.
This lack of availability coupled with promoting safe sex practices prompted Pee Safe, an intimate hygiene brand, to recently foray into the female condom segment with Domina. “The female population today is aware of its rights, including those related to hygiene and sexual health. Internet penetration has further influenced buying behaviour. Our aim is to not only address this segment but also ensure that we play a part in preventing sexually transmitted infections like AIDS,” said Vikas Bagaria, founder, Pee Safe.
Known as India’s first manufacturer of female condoms, Cupid Limited’s sale figures are around 25,000 pieces per annum, mostly on “online platforms”. “We have done sales of around 23 million pieces in 2019-2020 worldwide for female condom. Most of this sale is to the Ministry of Health in countries like South Africa and Brazil. If the Indian health ministry also procures and promotes the use of female condoms, then its awareness and demand will increase in India. The MRP of our two-piece wallet of female condoms is Rs 95,” said Swapnil Dhage, marketing manager, Cupid Limited, which manufactures Cupid Angel female condoms.
However, as per technology research company TechNavio, in terms of market scope, the APAC region, driven primarily by India and China, is set to be the fastest-growing market for female condom. It estimates that the global market size for this product category is approximately 800 million. The sales, like Dhage pointed out are mostly online, considering very few physical pharmacies keep stock.
Even as the market is set to witness an upward trajectory, currently, the “unavailability”, high cost, lack of basic know-how of insertion techniques, and awareness have been pointed out as viable causes for the lack of such contraceptive use.
While a pack of 10 male condoms costs Rs 180, a pack of two female condoms is priced around Rs 100. “The costing is more due to the construction of the condom as a male condom has just latex whereas a female condom also comes with a ring, and a synthetic rubber or polyurethane,” stressed Dhage, while stating that actual manufacturing cost “can’t be disclosed owing to business reasons”.
Despite many studies and evidence showing positive user experience and acceptance, female condoms have remained out of most government programs, said Dipa Nag Chowdhury, programme director, Population Foundation of India. “Some studies have also highlighted concerns around its acceptance by men. Additionally, pricing and packaging are also some of the other issues seen as reasons for their poor uptake,” explained Nag Chowdhury.
So, what can be done? “Going forward, female condoms must be popularised and made available to all women, as an integral part of the world’s commitment to providing universal access to sexual and reproductive health and family planning services,” said Nag Chowdhury.
Dr Singh added, “Based on past research on the rate of successful use of barrier methods of contraception, the results are divided into two categories: perfect use or typical use. In reality, only a few people use the female condom correctly every time. Proper education, therefore, should be given on how to use them perfectly.”