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Family Planning: A Global Handbook for Providers

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Family Planning

A GLOBAL HANDBOOK FOR PROVIDERS

Helping Continuing Users

  1. Ask how the client is doing with the method and whether she is satisfied. Ask if she has any questions or anything to discuss.
  2. Ask especially if she has any trouble using female condoms correctly and every time she has sex. Give her any information or help that she needs (see Managing Any Problems).
  3. Give her more female condoms and encourage her to come back for more before her supply runs out. Remind her where else she can obtain female condoms.
  4. Ask a long-term client about major life changes that may affect her needs—particularly plans for having children and STI/HIV risk. Follow up as needed.

Managing Any Problems

Problems With Use

May or may not be due to the method.

  • Problems with condoms affect clients' satisfaction and use of the method. They deserve the provider's attention. If the client reports any problems, listen to her concerns and give advice.
  • Offer to help the client choose another method—now, if she wishes, or if problems cannot be overcome—unless condoms are needed for protection from STIs, including HIV.

Difficulty inserting the female condom

  • Ask the client how she inserts a female condom. If a model is available, ask her to demonstrate and let her practice with the model. If not, ask her to demonstrate using her hands. Correct any errors.

Inner ring uncomfortable or painful

  • Suggest that she reinsert or reposition the condom so that the inner ring is tucked back behind the pubic bone and out of the way.

Condom squeaks or makes noise during sex

  • Suggest adding more lubricant to the inside of the condom or onto the penis.

Condom slips, is not used, or is used incorrectly

  • ECPs can help prevent pregnancy (see Emergency Contraceptive Pills).
  • Little can be done to reduce the risk of STIs if a condom breaks, slips, or is not used (see Male Condoms, Question 7). If the client has signs or symptoms of STIs after having unprotected sex, assess or refer.
  • If a client reports slips, she may be inserting the female condom incorrectly. Ask her to show how she is inserting the condom, using a model or demonstrating with her hands. Correct any errors.

Difficulty persuading partner to use condoms or not able to use a condom every time

Mild irritation in or around the vagina or penis (itching, redness, or rash)

  • Usually goes away on its own without treatment.
  • Suggest adding lubricant to the inside of the condom or onto the penis to reduce rubbing that may cause irritation.
  • If symptoms persist, assess and treat for possible vaginal infection or STI, as appropriate.
    • If there is no infection, help the client choose another method unless the client is at risk for STIs, including HIV
    • For clients at risk of STIs, including HIV, suggest using male condoms. If using male condoms is not possible, urge continued use of female condoms despite discomfort.
    • If neither partner has an infection, a mutually faithful sexual relationship provides STI protection without requiring condom use but does not protect against pregnancy.

Suspected pregnancy

  • Assess for pregnancy.
  • A woman can safely use female condoms during pregnancy for continued STI protection.