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Condoms

An external (male) condom, also known as a rubber, is a sheath of thin, strong material worn over the erect penis during intercourse to catch the ejaculated sperm. Condoms are made of latex, polyurethane or “natural skin”. Condoms are either pre-lubricated or non-lubricated; choosing one or the other is a personal preference.  However, additional lubrication may be added to a condom so that intercourse will be more comfortable. Condoms reduce the risk of pregnancy and sexually transmitted infections (STIs).  Internal (female) condoms are also available and are made of polyurethane (plastic) or nitrile (a synthetic rubber).

How effective are condoms?

When perfectly used, women whose partners use male condoms reduce the risk of pregnancy by 98% while typical use of condoms increases the risk of pregnancy by reducing the effectiveness to 85%. This is because condoms can break, come off, or are used incorrectly before, during, or after intercourse. There is also no evidence that adding spermicide to a condom further reduces risk of pregnancy. Spermicides can increase risk of HIV transmission, and are not recommended. 

When latex condoms are used correctly and consistently, they can reduce the risk of getting sexually transmitted infections like chlamydia, gonorrhea, trichomonas, and HIV. Condoms are not 100% effective in preventing STIs. Polyurethane condoms are as effective as latex condoms in preventing pregnancy and STIs and are options for people with latex allergies. “Natural skin” condoms prevent pregnancy but do not reduce risk for STIs because the natural pores in “natural skin” condoms still allow for viruses and bacteria to pass through, as oppose to sperm due to their size.

How do I talk to my partner about condoms?

It is important to talk to your partner about using condoms before you have sex.  Be honest and direct about your feelings.  Let your partner know that you are concerned about both of you.  It’s easier to have this talk before you are about to have sex.  

How do I use a condom?

•           Use a new condom for each sexual act (vaginal, oral or anal) and make sure you are applying it to an erect (hard) penis.

•           First, check the expiration date on the package which is generally located on the back of the condom package and gently press the package to test for air in the package. If the condom is expired or has no air in the packaging, grab another condom package.

•           While opening the package be careful not to tear the condom with teeth, fingernails or anything sharp. Push the condom to one side before opening.

•           Once you have opened the condom, check to make sure you identify the correct way to unroll the condom. To do this, make sure the condom rim rolls down and the tip points up. If you unroll the condom the wrong way, you will have to throw it out and start over. If the penis is uncircumcised, pull the foreskin back before putting the condom on.

•           Put the condom on the erect penis while holding the ½ inch reservoir (for catching the ejaculate) at the tip. Roll the condom down the shaft of the erect penis while smoothing out air bubbles until the condom is fully unrolled at the base of the penis. 

•           Use lubrication on the outside of the condom if needed. For extra pleasure, you may add a drop of lubrication into the reservoir of the condom before putting it on.

•           Have intercourse. Check the condom for tears. If the condom breaks during sex, withdraw immediately.  If pregnancy is a concern, emergency contraception is available without a prescription.

•           After ejaculating and before the penis becomes limp (soft), pull the penis out while holding the base/rim of the condom firmly.

•           Take the condom off being careful not to spill any semen and tie the opening into a knot. Dispose of the condom in the trash. Condoms should never be flushed down the toilet.

•           Carefully wash the genitals and hands before another sex act.

•           If you are worried about how to use a condom, practice using one before you have sex.

How do I take care of condoms?

Condoms should be stored in a cool, dry place.  Heat can cause the condom to break more easily so don’t carry them in a pocket or wallet exposed to body heat.  Make sure the package is sealed by checking for air when you are ready to use one.  Adequate lubrication makes condom breakage during sex less likely.  If you need extra lubrication, use lubricants like Wet, Astroglide, K-Y, or saliva with latex condoms.  Avoid oil based lubricants like massage oils, baby oil, and body lotions as they can weaken the latex and cause a tear.  Some vaginal yeast medications can also weaken the latex. 

What are the advantages of condoms?

•           When used correctly, condoms can reduce the risk for pregnancy and STIs. 

•           They are easily available at drugstores, clinics and discount stores, and at our locations of Health and Wellness (3rd floor of the IU Health Center and M005 of the Indiana Memorial Union).

•           They can prolong pleasure for both partners especially for men who have problems with premature ejaculation.  

•           Not worrying about pregnancy or STIs can help both partners relax and make sex more enjoyable.

What are the disadvantages of condoms?

•           Some people can develop an allergy to latex which can cause itching, burning or irritation. Switching to a polyurethane condom will solve this problem. 

•           Some men and women complain that condoms dull sensation. There are many different brands of condoms that come in different sizes and styles.

•           Finding the right type of condom can help this problem. Putting on a condom as a part of sex play before intercourse can overcome concerns of interrupting spontaneity.

Common Condom Errors

The results of a study*, conducted with IU male students, found that a large proportion reported a variety of errors and problems in using condoms.  These errors and problems could increase condom failure or decrease the effectiveness of the condom. Some errors reported, include:

•           74% failed to check the condom for visible damage.

•           61% did not check the expiration date.

•           60% did not discuss condom use with partner before sex.

•           43% put a condom on after starting sex and 15% removed it before sex was over.

•           42% reported they wanted to use condoms but none were available.

•           40% did not leave a space at the tip.

•           35% reported slippage or breakage during sex.

•           30% placed the condom on upside down and flipped it over.

•           Nearly 14% reported that a condom slipped off during withdrawal.

*SOURCE: Crosby, R.A., Sanders, S.A., Yarber, W.L., Graham, C.A., & Dodge, B. (2002).  Condom use Errors and Problems among college Men.  Sexually Transmitted Diseases, 29, 552-557.

Resources:

•           http://www.plannedparenthood.org/health-topics/birth-control/condom-10187.htm  (includes a video on how to use a condom correctly.)

•           http://www.lifestyles.com/health.php

•           http://www.kinseyconfidential.org

•           http://www.goaskalice.com

•           http://bedsider.org/

•           http://www.advocatesforyouth.org/publications/publications-a-z/416-condom-effectiveness