Condom Options
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Condom Options

Condoms. Mention them and most people—especially men—laugh. Maybe it reminds us of that first "rite of passage" purchase. "I'll have a candy bar, some bubble gum, a box of Kleenex, some Band-Aids, and a package of rubbers. And could you double bag that please?" Or maybe it reminds us of the first time we used a condom—or at least tried to!

The condom industry often looks to the lighter side to showcase and sell their product. "Welcome! And please use a condom before entering" greet you on entering at least one condom manufacturer's website. Lightheartedness aside, though, the use of condoms is a serious business.

What Is a Condom?

A condom is a thin sheath that fits snugly over a man's erect penis during sexual contact. Its purpose is to prevent bodily fluids from passing between sexual partners, and thus, prevent impregnation and/or transmission of sexually transmitted diseases (STDs) .

Various Types

Condoms come in many different shapes, flavors, and sizes (despite every man's instinct to buy "extra, extra large"). Regardless of differences in size and shape, there are only three varieties of material used for condoms— latex rubber, lambskin, and polyurethane.

Which Type Is Best?

Because only latex condoms are proven to prevent both pregnancy and the transmission of STDs (including the herpes and HIV viruses), they are the condom of choice. As Jacques Carter, a physician at Boston's Beth Israel/Deaconess Medical Center point outs, "Nearly all physicians recommend (latex condoms). They're tried and true and the data on their effectiveness are well-documented."

Lambskin condoms, which are actually made from part of a lamb's intestine, prevent pregnancy, and are considered by many to enhance (or, at least, not reduce) sensation during sex. But, they have a major drawback, the tiny holes inherent to lambskin allow STDs to pass between partners.

The more recently developed polyurethane condoms have two benefits—they're thinner, so like lambskin condoms, they allow for enhanced sensation. And they provide a solution for the small number of people who are allergic to latex. However, they are much more expensive than latex condoms. And, more importantly, scientific data as to how effectively they prevent the transmission of STDs are not nearly as well-documented as they are for latex condoms.

Exactly How Effective Are Latex Condoms In Preventing Pregnancy and STDs?

According to tests conducted by Consumers Union ( Consumer Reports , May 1995), latex condoms seldom break when used consistently and correctly. As a result, they prevent pregnancy approximately 95% of the time or better. However, since most couples don't always use condoms consistently or correctly, the "failure" rate for condoms in preventing pregnancy is around 12% (compared to 8% for birth control pills, 18% for diaphragms, 19% for withdrawal, and 20% for the rhythm method).

As for preventing STDs, latex condoms have no equal. Again, according to Consumers Union, when used consistently and correctly, latex condoms prevent the transmission of STDs 98-100% of the time.

What About Pre-lubricated Condoms?

From a pregnancy or disease standpoint, it doesn't matter. However, if you decide to add your own lubricant, only use water-based lubricants, since all oil- or mineral- based lubricants (like Vaseline, cold cream, mineral oil) quickly weaken latex. Some water-based lubricants also include a small amount of spermicide that may enhance the prevention of pregnancy and STD transmission. However, spermicides can irritate a woman's vagina or a man's urethra.

Does Condom Size Matter?

Although you may feel compelled to buy extra large, that may not be a good idea. If a condom is too large (loose) it is more likely to slide off, and if it's too small (tight) it is more likely to break.

Do's and Don'ts: Some Tips On Using Condoms

Put a condom on only after the penis is erect, and use a new one for every act of sexual intercourse. Ever try putting toothpaste back in the tube? That's easier than putting a condom on a flaccid penis. Place the tip of the rolled-up condom over the penis. If there is a reservoir tip, first squeeze out the air. If there is no tip, leave a half-inch space at the end for semen and squeeze the air out. Unroll the condom down the entire length of the penis (uncircumcised men should first pull back the foreskin). After ejaculation, but before the penis is soft, grasp the condom's rim and carefully withdraw from your partner. This discourages breakage or leakage.

Avoid carrying condoms in your wallet for longer than a few weeks at a time. And avoid storing them in extreme temperatures, such as your glove compartment. Both environments weaken a condom and make it much less useful.

To avoid any risk of STDs or pregnancy, put a condom on before any contact between your penis and your partner. To avoid tearing, don't use any sharp objects—scissors, your teeth, or nails—to open the condom wrapper. Throw them away if they're past the expiration or four years past the manufacturing date.

A New Slant: The Female Condom

Introduced in 1994 under the name "Reality," the female condom is a much larger rubber condom that is inserted into the vagina. Like the male condom, it is designed to prevent pregnancy and STDs. However, the product has not been met with great success. Users have complained that it squeaks and that its lubricant is uncomfortable. It's rumored that a newer version, one that attaches to special designer underwear worn during sex, is an improvement over the original. More importantly, a failure rate of over 25% has been reported. Although quoted as stating that the female condom was better than no protection at all, former US Food and Drug Administration commissioner, David Kessler, has recommended that couples continue to use male condoms.

The Lighter Side of Condoms

Though the use of condoms is a serious subject, discussion of them often focuses on the lighter side. This is reflected in their nicknames—lifesavers, parachutes, umbrellas, raincoats, rubbers, and gloves—as well as the way they are marketed. In addition to offering numerous types and sizes, many manufacturers also offer novelty condoms. One manufacturer offers ribbed condoms and numerous flavored condoms, including a calorie-free chocolate flavor.

However, one serious note. While many novelty condoms pass all industry standards, some do not. Those that don't meet industry standards are required by law to carry the warning that they are "For novelty use only".

Resources:

Consumers Union: Study of condoms
http://www.sexuality.org

Planned Parenthood Federation of America, Inc.
http://www.plannedparenthood.org

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca/index_e.html

Sex Information and Education Council of Canada
http://www.sieccan.org/



Last reviewed June 2008 by Jill D. Landis, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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