The Bottom Condom

Bottom Condom

There are a lot of problems associated with condoms. Latex tastes and smells bad, and some people have bad reactions to it. Condoms should fit snugly on the penis, but that can lead to a loss of erection.  Some people forget to wear a condom correctly, if at all.  Others just get bored with using condoms and want something different.

The good news is that there’s a non-tightly fitting, non-latex, easy-to-use alternative on the market for a decade? It’s called the bottom condom.

The bottom condom is often called the “Reality™ condom” or “Female condom.”

(Note: The Reality condom will only be available by prescription in 2018 and MAP will no longer be able to distribute it after 2017)

It’s like a regular condom only larger, and it is inserted in the rectum (or vagina) instead of being rolled onto the penis. Inside the condom there’s a small ring that holds it inside the rectum. There’s also large ring that holds the bottom condom in place outside making slippage very difficult. It’s also made out of polyurethane instead of latex, so it’s safe for people who are sensitive or allergic to latex. Polyurethane also warms to skin temperature more quickly and feels more like skin.

A few tips on using the bottom condom:

Be sure to practice inserting it before having sex. It’s different than the regular condom; so make sure you know how to use it before trying it with a partner. Use a lot of lube. Since bottom condoms aren’t latex, you can use a variety of different lubes, including oil-based ones.

This video, though not safe for work (NSFW), does a great job of explaining how men can use the bottom condom: 

The bottom condom is a bit more expensive. Fortunately, MAP’s Risk Reduction team has plenty. Just ask us for one next time you see us out and about or stop by our office.

The bottom condom is a great alternative to traditional condoms, but some people do have problems using them. They may not be for everyone. Compared to regular condoms, rates of slippage and rectal bleeding were slightly higher with the bottom condom, but not by much.

This great alternative to traditional condoms is available, but it’s not widely used. Why is that? Why are you just now hearing about the bottom condom?

Because of homophobia.

Did you know that the bottom condom was originally created and tested on gay men? The bottom condom couldn’t be approved because of the Food and Drug Administrations’s position in the 1990s that to do so would run counter to sodomy laws. According to the Bay Area Reporter at the time:

“The invention, which was tested on Chicago gay male couples in a 1990 trial, is a wide tube of extremely thin plastic, about three times as big as a conventional condom, with a flexible plastic ring around the closed end. Although the Chicago men expressed a high degree of satisfaction with what was then called the "Aegis," and evidence showed it was probably safe and effective, the Food and Drug Administration refused in 1992 even to consider it for possible use in preventing HIV transmission during anal sex….A spokeswoman at Female Health Company (FHC), which manufactures Reality/Aegis, told the Bay Area Reporter that FHC President Mary Ann Lieper was explicitly told at an FDA obstetrics/gynecology department Device and Diagnostics panel meeting, "Because sodomy is illegal in many states, we cannot support a male condom."

The FDA’s position has not yet changed, but that doesn’t mean you can’t use the bottom condom anyway. At MAP, we believe that the bottom condom is an effective tool for bottoms to use to prevent sexually transmitted infections (STI) and HIV.

Notes and Citations:

(Safety and Acceptability of the Reality™ Condom for Anal Sex Among Men Who Have Sex with Men AIDS (03.28.03) Vol. 17; No. 5: P. 727-731; Cristina Renzi; Stephen R. Tabet; Jason A. Stucky; Niles Eaton; Anne S. Coletti; Christina M. Surawicz; S. Nicholas Agoff; Patrick J. Heagerty; Michael Gross; Connie L. Celum - Monday, April 21, 2003)

"’Female Condoms’ for Male-Male Sex: FDA DENIES REALITY TO GAYS” Mark Salinas, Bay Area Reporter, Feb 29, 1996.

Note: The Aegis Barrier Pouch was not FDA approved for distribution as an anal condom.