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Ladies and Gentlemen: Use Your Condom Sense

condom image Condoms—men and women of all ages and from all walks of life are using them for birth control and/or protection from sexually transmitted infections.
A male condom (also known as a rubber) is a sheath worn over the penis. It is made of latex, animal tissue, or polyurethane. A condom is used to catch semen before, during, and after a man ejaculates. When used during vaginal sex, it helps protect against pregnancy. When used during vaginal, anal, and oral sex, it also helps protect against certain sexually transmitted diseases (STDs).

Condoms and Pregnancy Prevention

During sexual intercourse, a condom prevents sperm from entering the vagina. According to Planned Parenthood, about 15 out of 100 women will become pregnant during the first year of typical condom use, meaning inconsistent and at times incorrect condom use. Condoms have a 98% efficacy. The term efficacy refers to perfect condom use that is consistent and always correct, while effectiveness refers to typical use. Contraceptive foams, creams, jellies, films, and suppositories can also be used to provide additional protection against pregnancy, since they can kill sperm if the condom breaks. Some condoms are coated with a spermicide.

Latex Condoms and the Prevention of STDs

When used consistently and correctly, a latex condom helps protect against many STDs because it blocks the exchange of body fluids that might carry infection.
A study published in a 1993 issue of the Journal of Acquired Immune Deficiency Syndromes looked at the results of condom use in couples in which one partner had human immunodeficiency virus (HIV)—the virus that causes AIDS. During a four-year period, 123 couples who consistently used condoms did not transmit HIV. In 122 couples who did not consistently use condoms during the four-year period, 12 partners became infected with HIV.
Latex condoms help protect against the following STDs:
Latex condoms offer significant protection against:

Types of Condoms

Condoms come in various sizes, shapes, and materials. Here are some things to consider when buying condoms:

When to Use a Condom

A man should use a condom any time he has vaginal, anal, or oral sex, if there is even the slightest risk that either person has a STD. A condom should also be used to help prevent unwanted pregnancy. The condom should be put on before any contact and removed and thrown away immediately after ejaculation.
If you are embarrassed to talk to your partner about using condoms, practice talking before you are in a sexual situation. And have your talk well before you are in the heat of passion.

How to Use a Male Condom

Both partners should know how to put on and use a condom.
  • Handle condoms gently and store them in a cool, dry place so they do not become breakable.
  • Do not continually keep condoms in your back pocket, wallet, or car.
  • Do not use a condom that is too small or too large for you.
  • Pay attention to the expiration date.
  • Be careful not to tear the condom while unwrapping it.
  • Put the condom on the erect penis before sexual activity begins.
  • Unless the condom has a built-in nipple, leave a ½-inch space at the tip to collect semen.
  • Be sure to pinch air out of the tip with one hand.
  • Unroll the condom over the penis with the other hand, and roll it all the way down to the base of the penis.
  • Smooth out any air bubbles.
  • Lubricate the outside of the condom. Do not use lubricants that contain oil, such as Vaseline, baby oils, or vegetable oils, because they can weaken the rubber. Use a water-based lubricant, such as KY Jelly or Silk-e.
  • Pull out before your penis becomes soft.
  • To avoid spilling semen, hold the condom against the base of the penis while you pull out.
  • Throw the condom away.
  • Wash your penis with soap and water before embracing again.
  • Pull out quickly and replace the condom.
  • If semen leaks out, wash it away with soap and water.
  • If semen leaks into the vagina, you should consider using emergency contraception (see details below).
Emergency contraception is a method of birth control that can help prevent pregnancy up to five days after unprotected sex. It works best if taken as soon as possible, preferably within 72 hours. There are different types of emergency contraception available, both over-the-counter and by prescription. Age restrictions on purchase vary by the type of contraception. The youngest a woman can purchase emergency contraception without a prescription is age 15 with valid identification. This does not currently apply to all brands. Direct any questions you have to your doctor or pharmacist.

Benefits and Disadvantages of Male Condoms

The male condom:
  • Helps prevent pregnancy and STDs
  • Is inexpensive and easy to get
  • Does not require a prescription
  • May help a man stay erect longer
  • Usually has no side effects.
    • However, people who are allergic to latex should try polyurethane condoms. Condoms without spermicidal lubricant should be used for those who are sensitive to spermicides.
Some drawbacks include that the condom:
  • May dull sensation
  • Can interfere with spontaneity
Additionally, some men are self-conscious about using condoms.

Benefits and Disadvantages of Female Condoms

The female condom is a thin, soft, loose-fitting, lubricated pouch made of polyurethane that fits inside the vagina and also covers the vulva. An inner ring at the closed end is used to insert the device inside the vagina. The outer ring remains outside the vagina and covers the vulva. It can be used with any type of lubricant. The female condom is about 75% effective in preventing pregnancy.
Before engaging in sexual activity, the woman inserts the female condom into her vagina. The closed end of the tube should cover the cervix and the other end should slightly cover the vulva. The female condom should be discarded after use.
  • The woman controls use.
  • The female version is more comfortable for men and causes less decrease in sensation.
  • It may offer greater protection from STDs to the external genitals compared to male condoms.
  • This version is more convenient and allows for greater spontaneity because it can be inserted well in advance of intercourse.
  • They are easy to get and do not require a prescription.
The drawbacks to the female condom include that it is:
  • Less effective in preventing pregnancy and STDs than the male condom
  • Not aesthetically pleasing
  • Difficult to insert or remove
  • Relatively expensive
Another disadvantage is that, at times, the penis may slip between the device and the woman’s body.
Condoms can be used enjoyably and effectively for preventing pregnancy and many STDs. However, no protective method is 100% effective. According to the Centers for Disease Control and Prevention, the surest way to avoid transmission is to abstain from vaginal, anal, and oral sex, or to be in a long-term, mutually monogamous relationship with a partner who has been tested and you know is uninfected.

RESOURCES

Centers for Disease Control and Prevention http://www.cdc.gov

Planned Parenthood http://www.plannedparenthood.org

CANADIAN RESOURCES

Canadian Federation for Sexual Health http://www.cfsh.ca

Public Health Agency of Canada http://www.phac-aspc.gc.ca

References

Condom. Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/condom-10187.htm . Accessed June 17, 2013.

Condoms and STDs: Fact sheet for public health personnel. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/condomeffectiveness/latex.htm . Updated March 25, 2013. Accessed June 17, 2013.

Emergency contraception. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 3, 2013. Accessed June 17, 2013.

FDA press release. FDA approves Plan B One-Step emergency contraceptive without a prescription for women 15 years of age and older. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm350230.htm . Updated April 30, 2013. Accessed June 17, 2013.

Saracco A, et al. Man-to-woman transmission of HIV: longitudinal study of 343 steady partners of infected men. J Acquir Immune Defic Syndr . 1993;6:497-502.

Workowski KA, Berman S, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR . 2010;59(No. RR-12):1-110.

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