Single Guy’s Lament: What Became Of The Female Condom?

female condom

(Anka Grzywacz, Wikimedia Commons)

By David C. Holzman
Guest contributor

David C. Holzman writes from Lexington, Mass., on science, medicine, energy, environment, and cars. He is Journal Highlights editor for the American Society for Microbiology and won a Plain Language Award last year from the National Institutes of Health. This essay began as a response to a CommonHealth post on why people have unsafe sex, and turned into much more.

Caution genes run in my family. My parents put seat belts in the ’57 Chevy in 1960, eight years before they became mandatory. In July, 1975, I bought Bell bicycle helmet serial number 7022. My cycling ensemble also includes one of those lime green jerseys that’s visible from the International Space Station.

And I was asking sex partners about Sexually Transmitted Diseases beginning in the early 1980s, when herpes — not HIV — was the main subject of such conversations. This despite the fact that the first time I did, the woman refused to discuss it, saying I could go to bed with her when I was ready to trust her. Condoms? Of course.

Journalist David C. Holzman

Now, in 2012, I still wouldn’t dream of leaving my seatbelt unbuckled, or biking without my helmet and jersey. I’ve never stopped asking new sex partners about STDs. But recent news reports have suggested that among the middle aged, rates of sexually transmitted diseases are rising while condom use is falling, and I have to confess:

At 59, I’ve worn condoms probably fewer than five times since the millennium, despite having been single for six of those years, during which time I’ve averaged one or two new partners a year, and despite the admonitions of my wonderful primary care doctor. The reason is simple: in my 20s and 30s, sex with a condom felt like getting massaged over a shirt. Now it feels like a massage through a winter overcoat.

I did don a condom last fall, when a new partner made a big deal of it. As a precaution, I took half a Viagra beforehand. (I don’t normally need the pharmaceutical pump; it was left over from earlier, when an antidepressant that I have long since discontinued had turned a Corvette into a Yugo.)

Despite my precaution, our effort to couple resulted in a deflationary event. I couldn’t feel a thing. Actually, I take that back. I did feel the condom squeezing me like a latex boa constrictor, then a softening like a leak in a bicycle tire. And then I felt lost. With that thing on, I would have needed a GPS to find my way in.

I’d like to note here that I take good care of my body. My diet is Michael Pollan-approved, my body mass index is 20, and I run more than 1,000 miles a year. But studies have shown that penile sensitivity declines steadily after the teens and 20s, so that by the 40s and 50s, men require more intense stimulation, says Culley C. Carson, III, Rhodes Distinguished Professor of Urology at the University of North Carolina. “And condoms add to the disability, if you will.”

female condom

Female condom (Wikimedia Commons)

I knew that there was an alternative — at least, there had been once. In 1993, I dated a woman who worked on reproductive issues at the National Institutes of Health. We initially used male condoms, but she soon introduced me to something called a female condom, which we used from then on. Then made of polyurethane, it fit inside the vagina, clinging snugly to the walls, held there by an inner and an outer ring. The sensation wasn’t quite as wonderful as using nothing, but for me, the sense of touch was like 20-20 vision rather than the somatosensory blurring that condoms induce. I marveled at the wonder of this device.

Nonetheless, for nearly the next two decades, I never even heard the phrase, “female condom,” nor did I read it, in the mainstream media or any health news outlet. It made few headlines at the major international AIDS conference this week.

Just prior to the date of the deflationary event, knowing that my hydraulics were not what they’d once been, I called a few drug stores to ask if they had female condoms. No one had heard of them.

New HIV diagnoses in people over 50 had doubled from 2000 to 2009.

Soon after, I began seeing news reports with titles like “Seniors’ sex lives are up — and so are STD cases,” and “Condom Use Lowest…Among Adults Over 40?”

In case you missed all that, there were two major sources. One was an editorial last winter in the Student British Medical Journal, written by Rachel von Simson, a medical student at King’s College London, and Ranjababu Kulasegaram, a consultant genitourinary physician at St. Thomas’ Hospital London. The two investigators found that in the UK, new HIV diagnoses in people over 50 had doubled from 2000 to 2009.

How much of that jump comes from unprotected sex? Not clear. They did not break it down by method of transmission, and von Simson says there are no data on condom use in older adults in the UK: “No one was interested in measuring rates until we already had a problem, making past comparison impossible, and still no one has got around to a large study.” Continue reading

Longtime Mass. Planned Parenthood Leader Stepping Down

Dianne Luby, longtime head of the Planned Parenthood League of Massachusetts

This just in from the Planned Parenthood League of Massachusetts: Dianne Luby, who has led the league for 13 years, has told the board that she’ll step down at the end of this year.

(My first thought: “Wow, 13 years is a long time to endure the level of controversy that swirls around a group like Planned Parenthood, with all its work on contraception and abortion.”)

The Planned Parenthood press release says that Ms. Luby worked to “change the public conversations around sexual health,” to introduce a new approach to sex ed, and to expand access to sexual health care, particularly in “underserved communities.”
From the press release:

“Thirteen years ago, my overarching vision was to make PPLM an essential part of the mainstream healthcare community and I am so pleased about how far we’ve come,” said Ms. Luby. “I feel that this is an excellent time for me to be moving on. Not only are we successfully completing our five-year strategic plan, we have also reached our $30 million Sexual Health Matters campaign goal, which funded a broad range of health care initiatives.”

Under Dianne’s leadership, some of PPLM’s most notable accomplishments include:

•Opening five new health centers in Springfield, Fitchburg, Marlborough, Milford, and Somerville and building a new, eco-friendly facility in Worcester.
•Broadening public understanding of the full scope of PPLM’s programs and services by introducing its “Sexual Health Matters” brand.
•Developing a comprehensive sexuality education curriculum for middle schools and high schools that is now in 131 schools and reaching over 30,000 students. Wellesley Centers for Women is conducting a rigorous five-year evaluation of the middle school program’s effectiveness with very positive early results. Continue reading

Politico: From Death Panels to Birth Panels, Bachmann Weighs In

Michelle Bachman speaking (markn3tel/flickr)

Didn’t Michelle Bachmann exit the GOP race for president already?

No matter, here she is, reports Politico, not so subtly suggesting that the Obama administration’s birth control coverage policy for women might lead inexorably to a government-mandated childbirth policy. Wow.

The Minnesota congresswoman said the Obama administration’s contraception coverage mandate could be a slippery slope to a point where a “health dictator” decrees that women could only have one or two children. Continue reading

Considering The Vasectomy


Who knew a vasectomy could make such a great read? But here it is, in GQ, a gripping, hilarious, heart-breakingly honest account of one guy’s decision to take charge of family planning by knife.

As he awaits the surgeon, author Benjamin Percy notices the “walls are busy with gruesome anatomical diagrams, cross sections that make the male genitalia resemble charcuterie.” Then the action begins: “They go to work, flopping back my penis, arranging tools on a tray, positioning a stool between my legs. I squint into the blinding lights while the nurse snaps on latex gloves and my doctor shaves my scrotum. Then it’s time.”

Percy takes us through his decision to get a “v-sec,” noting that he loves, loves, loves his two children. “But a third?” he writes. “Outnumbered, we would have to switch from man-on-man to zone defense, and I can’t help but shudder when I imagine a red-faced baby wailing through the night, the bank statements withering further, the walls crayoned, and the laundry hampers reeking of spit-up and poo. An unexpected pregnancy, in other words, would be a nightmare.”

So he takes the plunge and makes a date with the surgeon:

I don’t scream, but I clamp my jaw so tightly it clicks. I arch my back so much I end up looking behind me at the door. The technique differs from doctor to doctor. Some cut diagonally. Some puncture “keyholes” with a hemostat on either side of the scrotum. Mine scalpels a vertical slash right down the middle. The room is cold, but I am sweating. How I regret not accepting the Valium. The doctor explains the procedure as it progresses. Apparently some men don’t have pronounced enough vas deferens, the tubes that carry sperm outward from the testicles, making the vasectomy impossible. But mine look great, he says. I would tell him thank you if I had a voice.

He will now sever the right vas deferens and excise a length of the tube, making recanalization close to impossible. “Now,” he says, his voice lowering, “you may feel a hot nauseating spike of pain that reaches up your right side.” Nobody I have spoken to, nothing I have read, mentioned anything about hot nauseating spikes of pain. Before I can steel myself to the idea, I hear a snip. The noise of garden shears deadheading geraniums.

I am unable to breathe. I cannot see what the doctor is doing, but he very well might have shoved a furnace-baked length of rebar through my groin and into my torso. I am introduced to vast, intricate networks of pain I never knew existed. Continue reading

Blunt Amendment Dead In Senate, Political Jockeying Alive And Well

(Mark Sardella/flickr)

The so-called Blunt amendment, which would have allowed employers to opt out of health care coverage they found objectionable — i.e., birth control for women — was voted down in the Senate 51-48, The New York Times reports.

But U.S. Sen. Scott Brown’s support for the amendment has become grist for the political mill, with flying press releases, outraged advocates and chest-thumping about religious freedom and morality all around. Here’s a sample of reaction we’ve received:

Planned Parenthood reacted swiftly with this:

Planned Parenthood League of Massachusetts (PPLM) expressed disappointment over Senator Scott Brown’s vote today for the overreaching Blunt Amendment that seeks to deny individuals access to essential health care. This measure would allow any employer or health plan to deny any health care service they find objectionable. It takes refusal for basic health care well beyond birth control – an employer could deny access to in-vitro fertilization, HIV/AIDS treatment, and other essential health care services.

“The reality is that the Blunt Amendment undermines fundamental tenets of the Affordable Care Act and the integrity of our nation’s health care system,” said Dianne Luby, President/CEO of PPLM. “We’re very disappointed that Senator Brown supported this attack on basic health care access. Then again, he did campaign in 2010 on promises to be the critical vote to defeat health care reform.”

Scott Brown’s office released this:

U.S. Senator Scott Brown (R-MA) issued the following statement after voting for the Blunt Amendment to protect religious freedom and allow a conscience exemption in health care for people of faith: Continue reading

NPR: Why Catholics Say ‘No’ To Contraception, But ‘Yes’ To Viagra

NPR’s Julie Rovner asks an excellent question in her report today about the ongoing uproar over new federal rules that would require employers to cover contraception as part of an overall package of preventative care for women. She writes:

If health insurance plans offered by Catholic-sponsored entities refuse to cover contraceptives for women because of the religion’s moral teachings banning artificial birth control, do they cover Viagra for men?

She says she got several emails asking just that after her story on the Obama administration’s change in the initial rule mandating coverage of birth control. (As part of the change, Obama said that hospitals, universities and charities sponsored by religious groups could opt out of covering contraception if their insurance companies did offer it to employees.) Continue reading

Dems: Romney Did Not Fight Contraception Mandate In Mass.

Breaking News Update: The New York Times reports: “Obama Administration Plans to Offer ‘Accommodation’ on Birth Control Rule, Officials Say.”

Leading Democrats in Massachusetts are pointing to contraception as the latest example of a flip flop from former Governor Mitt Romney.

Contraception, with an exemption for churches, became a required benefit in Massachusetts in 2002, the year before Mitt Romney was sworn in as governor. Phil Johnston, who held top state health care and Democratic party positions, says Mitt Romney never tried to repeal the mandate.  “He never mentioned that it would infringe upon religious freedoms and during the four years that Governor Romney served, he was totally silent on that issue.”

Romney aides say his original health coverage bill proposed eliminating all insurance mandates for individuals and small businesses covered through what would become the Health Connector. Since most large businesses are self-insured, and thus not subject to state mandates, these aides say Romney planned to remove mandates for most residents.

Former Health Care for All director John McDonough echoes Johnston’s recollection that Governor Romney never singled out contraception as an objectionable mandate. “The poster child for bad mandates,” remembers McDonough, “was in vitro fertilization, because it is so expensive.” Continue reading

Cardinal O’Malley: Either Violate Our Consciences Or Drop Health Coverage

It appears that Cardinal Sean O’Malley, the Archbishop of Boston, is gearing up for a fight.

Responding to the federal government’s recent ruling that most health insurance plans, even those provided to employees of Catholic hospitals, colleges and charities, must cover free contraceptives for women, O’Malley lashed out at the ruling calling it “an alarming and serious matter” that “strikes at the fundamental right to religious liberty for all citizens of any faith.”

In a letter dated January 2012 posted on his blog, O’Malley adds that “the federal government, which claims to be by, and for the people has just dealt a heavy blow to almost a quarter of those people — the Catholic population — and to the millions more who are served by the Catholic faithful.”

Then he issues this call to action:

…unless the rule is overturned, we Catholics will be compelled and must be prepared either to violate our consciences, or to drop health coverage for our employees Continue reading

Commentary: Beyond Komen, Planned Parenthood Remains Under Attack

Despite the breathtaking turnaround by the Komen foundation today on funding for Planned Parenthood, the organization remains under attack, according to Judy Norsigian, co-founder and executive director of Our Bodies Ourselves, and Ellen Shaffer, co-director of the Trust Women/Silver Ribbon Campaign, a project of the Center for Policy Analysis. In a blistering blog post today, they describe another assault on Planned Parenthood, this one by the U.S. Conference of Catholic Bishops:

What Komen, and the evangelicals, and Republican Rep. Cliff Stearns, who launched the pointless political inquiry, and the U.S. Conference of Catholic Bishops are really mad at Planned Parenthood about is this:

Part of what they do is help people plan. Parenthood. You know. They support birth control. In some cases, they provide it. Like your corner drugstore, but better.

And this week, the bishops are howling about it because the Obama administration refused to grant a broad religious exemption to contraception coverage. Continue reading

Plan B: Pharmacies Say ‘No’ To Teen Girls Even When Law Says Yes

Bad news for all the people who were upset at the Obama administration’s decision earlier this month requiring that teenage girls have a prescription to get the “Plan B” emergency contraceptive:

New research suggests that the broader context for that decision is even more troubling than previously known. It finds that many pharmacy staffers are blocking teen girls’ access to the “morning-after” pill even when the teenagers have a legal right to it. And those barriers are particularly bad in poor neighborhoods, where unintended pregnancies are especially common.

Lead researcher Dr. Tracey Wilkinson

“There’s a lot of misinformation and misunderstanding regarding this medication, and that’s universal,” said Dr. Tracey Wilkinson, a general pediatrics fellow at Boston Medical Center and lead author of a research letter just out online in the Journal of the American Medical Association. “We have a really efficacious form of pregnancy prevention that might not be accessible because of misinformation that’s out there.”

The Dec. 7 Obama administration decision concerned over-the-counter access to Plan B for girls under 17, but the research by Dr. Wilkinson’s team found that even for young women 17 and up, and even for teen girls who have a prescription, getting hold of emergency contraception can be a problem. The administration’s decision was disappointing, she said, but the study found that “even the way things stand is not working.”

The researchers called 943 pharmacies in five different cities — Nashville; Philadelphia; Cleveland; Austin, Texas; and Portland, Oregon — in late 2010, a solid year after the FDA had lowered the age of permission for over-the-counter access to 17. (Younger girls can also obtain emergency contraception but need a prescription.) Continue reading