Guest Blogger: Have you heard about internal condoms? Probably not and this is why.
Internal condoms, much like the name suggests, are condoms that can be inserted into the vagina or anus in preparation for penetrative sex. Never heard of them before? Understandable. Only one brand of internal condom, the FC2 Female Condom from Veru Health, has been approved by the FDA for use in the US. These condoms, though not the most popularized condom on the market, are used by hundreds of thousands of Americans. But now, with a change in distribution policies by Veru Health and the current administration’s new change to the Affordable Care Act that allows any employer to opt out of covering birth control in their insurance plan, these internal condoms may be substantially less accessible to those who rely on them.
In June of this year, Veru Health made the decision to stop selling the FC2 in the retail market and switch to a prescription-only business model. Brian Groch, the chief commercial officer of Veru Health, said this decision came from seeing very low retail sales of the product. If it was changed to prescription only, individuals would be able to get it for free under ACA’s birth control mandate. At first glance, that idea seems reasonable enough. However, looking further into the situation, this decision could mean removing access to internal condoms for people who rely on them to prevent pregnancy and STIs.
The National Health Statistics Reports indicated that only about 0.3% of women used internal condoms as their primary birth control method. While that number initially seems rather low, there are 125.9 million adult women living in the US, meaning over 375,000 women nationally rely primarily on internal condoms for birth control purposes. That’s as many people as the entire population of Salt Lake City, West Valley City, and Cottonwood Heights combined. This number does not include the other individuals (men, women, non-binary, and other gender non-conforming folks) who may use internal condoms as a method of STI prevention during anal sex.
If every individual who needed the FC2 had health insurance, access to a doctor for a prescription, and access to a pharmacy to pick up their condoms, this may not be an issue. But the actual situation is that roughly 10% of Americans do not have health insurance, and even those who do often have high co-pays for visits to a healthcare provider in order to get a prescription. Even for those with insurance, there is now no guarantee that the FC2 will be completed covered by an individual’s health insurance agency, particularly now that employers are not obligated to cover birth control in their insurance plans. The FC2, which already cost a pricy $3.50 per condom when sold on the retail market, could conceivably cost up to $20 per condom for those without insurance.
Veru Health has several suggested workarounds for this issue. They’ve partnered with an app that offers doctor’s consults for $5 so that individuals can get a prescription for the FC2. They also say that many of their users get the FC2 from free clinics and other public health organizations, such as Planned Parenthood. The problem with relying on public health organizations and clinics to offer the FC2 is that we also find ourselves having issues accessing the condom. With the change in distribution strategy, the supplier that Planned Parenthood here in Utah used was no longer stocking the product. We are currently working to get our pharmacy licensed to carry the FC2 so we can continue to distribute them through our various clinics and outreach efforts, but as it stands we are running low on product and could potentially run out before we get another shipment in, taking yet another resource away from our patients and users of the FC2.
Maybe you’re asking now, “Why is this internal condom so great? Can’t people just use external condoms?” That’s a fantastic question! Internal condoms have a few distinct benefits over external condoms:
- The FC2 is made of nitrile and polyurethane rather than latex, meaning they work for individuals who have latex allergies or sensitivities.
- Because they’re latex free, that means that are also compatible with oil based lubricants (which degrade latex condoms).
- Internal condoms are one size fits all, unlike external condoms. They have plenty of space for larger partners or toys and are flexible enough to fit smaller individuals as well.
- Internal condoms currently offer the only way that receptive partners can have full control over STI prevention. This can bring some peace of mind for receptive partners because trends such as stealthing (non-consensual condom removal) have been receiving attention in the recent past.
- Internal condoms can be inserted up to four hours before sexual contact occurs. While putting external condoms on can definitely be turned into a fun and sexy experience, it can also sometimes be an interruption. Putting an internal condom in place beforehand can bypass that interruption and head straight into the action.
Veru Health indicated that they think one of the issues with the low retail sales is that there is a lack of awareness of the product, how it works, and its benefits. They suggested that perhaps now that the FC2 was prescription only, healthcare providers might be more likely to advocate for its use and prescribe it to patients. If the company wanted to promote sales of their product, however, wouldn’t it be more effective to create an awareness campaign aimed at prescribers without taking the FC2 off the retail market, or to aim a campaign at the broader population so they might be more likely to go out and buy it. Taking the FC2 and placing it behind pharmacy counters so the general population can no longer see it certainly does not seem like the best way to raise awareness of its existence.
Sam is the current Supporter Engagement Intern at Planned Parenthood Action Council of Utah. They love dinosaurs and are currently studying Gender Studies and Health Promotion at the University of Utah.