Female condoms for anal sex

  • In one study, around a quarter of gay men who had tried them for anal sex said they would be willing to use them again.
  • Female condoms are not licensed for anal use.

The Reality condom was approved in the USA in 1992 for vaginal contraceptive use. Although female condoms are essentially not designed for the purpose, some gay men have used them and it seems they do provide an effective barrier during anal sex. Heterosexual couples may also use female condoms during anal sex.

Research published in 20031 assessed the safety and acceptability of the Reality condom for anal sex among gay men. The study enrolled 56 monogamous seroconcordant gay male couples who had not used condoms in the past three months and they were randomised to use latex male condoms or the female condom for anal sex. On study entry the men were given 10 female or lubricated male condoms to use with lubricant during the following six weeks. In the second six weeks the couples crossed over and began using the other condom type.

Receptive partners were more likely to report pain or discomfort with the female rather than the male condom. Both partners were significantly more likely to report female condom slippage during use or withdrawal. Rates of condom breakage were similar for female and male condoms.

After using both sets of condoms, both active and passive partners were significantly less likely to be willing to use female condoms in the future with partners of unknown HIV status than they were to be willing to use male latex condoms; (21% of receptive and 26% of insertive partners would be willing to use female condoms, compared to 61% of both receptive and insertive partners who were willing to use male condoms. The main reason reported by those who would be willing to use the female condom with future partners of unknown HIV status were that the female condom was more comfortable, easier to use, and perceived to be stronger and safer.

The researchers suggested that gay men who are considering using the female condom might require training relating to slippage and methods for avoiding semen spillage that might expose the anal mucosa. They added "further work is warranted on design modifications, safety and acceptability of the female condom in HIV-negative gay men".

How to use them

The following points may be useful in talking to someone about using the female condom for anal sex. Of course the language should be adapted to best meet the needs of the patient, or client.

  • The easiest way to use the female condom for anal sex is to wear it like a 'male' condom. Put lubricant in the female condom and then place it over the penis (or a dildo). Use plenty of lubricant on the outside of the female condom or around the arsehole before fucking.
  • Alternatively, you could try to insert the female condom in the rectum first, as for vaginal fucking. Use plenty of lubricant around the anus, and loosen it with a finger in readiness for the female condom. Make sure your fingernails are cut short.
  • After removing the female condom from its wrapper, hold the inner ring between your thumb, index and forefinger, and squeeze it so that it forms an oval. Don't remove the inner ring, as this will lead the female condom to become tangled, and could lead to breakage.
  • Push the female condom up into the rectum as far as you can, using the inner ring as a guide, whilst spreading your arsehole with your other hand. You may find this easier if you raise one leg onto the side of the bath, or a stool.
  • Then put your index finger inside the female condom, until you feel the bottom of the inner ring. Push up as far as you can, but do not insert the outer ring.
  • You will find that the outer ring, and perhaps a small part of the female condom, is on the outside of your arsehole. That's meant to happen, and should stop the female condom from slipping inside.
  • Use more lubricant inside the female condom, to keep it moist, and add it whenever you need it during fucking.
  • Check every now and again during fucking that the outer ring of the female condom hasn't slipped inside your arsehole, or that the penis hasn't slipped between the female condom and the arsehole. If it has, stop, remove the female condom, and use a new one before starting again.
  • Don't re-use the female condom. The female condom is designed for vaginal sex and for single use. Some gay men are reported to have used a female condom when being fucked by multiple partners. If you use it more than once for anal sex, we don't know the strains that it could put on the sides of the sheath, which might easily tear. And if you get a lot of semen in the female condom, we don't know how effective it is in holding it in, or whether any seepage into your rectum could take place. It is likely that fucking in somebody else's cum would be risky for the active partner.
  • Removing the female condom. Because the female condom lines the inside of the rectum, your partner doesn't have to withdraw immediately after coming. You can remove the sheath when it suits you, making sure that no semen is spilt. Twist the outer ring to keep the semen inside, then pull gently. Throw away the used female condom.

References

  1. Renzi C et al. Safety and acceptability of the RealityTM condom for anal sex among men who have sex with men. AIDS 17(5) 28: 727-731, 2003
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.