title: FemCap with removal strap: ease of removal, safety and acceptability.
abstract: OBJECTIVE
  FemCap is a silicone-rubber barrier contraceptive approved for marketing in the United States. To address reported problems with removal and dislodgment, the device's developer added a strap to the device and increased the height of the brim. This trial assessed whether the new design reduced removal difficulties and had any effects on dislodgment, genital pain/discomfort, safety, and acceptability.
  
  
  METHODS
  Women used the strapped device for 8 weeks with follow-up visits at 2 and 8 weeks. Outcome measures were obtained through diary cards, questionnaires, and naked eye examination. Data from these 120 women were compared with data from 419 women who used the unstrapped FemCap in a previous contraceptive effectiveness study.
  
  
  RESULTS
  The strapped device was not significantly easier for users to remove than the unstrapped device. Similar odds of dislodgment and cervical/vaginal irritation were seen with the two devices. Both female and male participants were significantly more likely to report pain/discomfort with use of the strapped device. Female users of the strapped device were significantly more likely to say they disliked their device. In six weeks, two pregnancies were observed, but pregnancy was not an endpoint in the study and no conclusions should be drawn regarding pregnancy rates.
  
  
  CONCLUSIONS
  The modifications to the FemCap did not significantly improve the ease of device removal and appears to have resulted in significantly more female and male partner pain/discomfort and decreased acceptability, compared with the unstrapped device.
authors.affiliation: CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA. cmauck@conrad.org
authors.forename: Christine K
authors.initials: CK
authors.lastname: Mauck
authors.forename: Debra H
authors.initials: DH
authors.lastname: Weiner
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Creinin
authors.forename: David F
authors.initials: DF
authors.lastname: Archer
authors.forename: Jill L
authors.initials: JL
authors.lastname: Schwartz
authors.forename: Helen C
authors.initials: HC
authors.lastname: Pymar
authors.forename: Susan A
authors.initials: SA
authors.lastname: Ballagh
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Henry
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Callahan
mesh_terms: D003274:Contraceptive Devices, Female / Q000009:adverse effects; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain; D017060:Patient Satisfaction; D011247:Pregnancy; D012747:Sexual Partners; D011795:Surveys and Questionnaires