The Male Condom

The male condom is a latex rubber, plastic or lambskin sheath placed over the erect penis before vaginal intercourse, preventing pregnancy by blocking the passage of sperm.  Condoms can be used only once. Some have a spermicide (e.g. nonoxynol-9) added to kill sperm, but this has not been proven to provide any additional contraceptive or STD protection over the condom alone. Because it acts as a mechanical barrier, a condom prevents direct contact with semen, infectious genital secretions, and genital lesions and discharges thus providing contraception and STD protection.

Except for abstinence, latex condoms are the most effective method to reduce the risk of infections causing AIDS, other HIV-related illnesses, and other STDs, although they do not provide protection against all STDs. For people who are allergic to latex, polyurethane condoms are a good alternative.  

• Proper lubrication may reduce condom tearing. If the vagina or the condom is not well lubricated and external lubrication is desired, select a water-based lubricant, such as K-Y jelly.  Oil-based lubricants, such as petroleum jelly (Vaseline), lotions, or massage or baby oil, should not be used because they can weaken the condom and cause it to break. These lubricants are also not healthy for the vagina. Some condoms are prelubricated. These lubricants do not increase birth control or STD protection, just comfort.
• If you feel a condom break or slip, withdraw immediately and consider using emergency contraception if pregnancy is an unacceptable option.  To use condoms properly, the penis should be removed from the vagina immediately after ejaculation, taking care to secure the condom while doing so.
• Of the different condoms, latex provides the best protection against STDs.  Plastic/polyurethane condoms have been shown to protect against HIV as well, but they are recommended only as a second choice for those with latex allergies, an increasingly common problem.  Plastic condoms may also slip off more easily than latex. Lambskin condoms provide excellent contraception and comfort, but they do not protect against HIV or other STDs as well as latex does.
• Condoms have expiration dates; inspect and respect them!  Beware of condoms that may have been in a man's wallet for a while.  Not only may they have passed their expiration, but they may be dried out and therefore crack or break more easily. Also:  be sure you have a proper fit:  if a condom is too tight, it is more likely to break. If it is too loose, it's more likely to slip off.
• Avoid novelty condoms; these generally do not protect against STDs.
• Vending machine condoms are fine to use if they are made of latex, are marked "for disease prevention," and have not been exposed to direct sunlight or excessive heat in the machine.
• Condoms marketed as "stronger" or more "sensitive" do not offer more or less protection; thinner condoms may be more prone to tearing.
• There is no difference in pregnancy or STD protection in ribbed or unribbed condoms.  Selection is simply a matter of personal preference.
• Do not use condoms that are brittle, gummy or discolored.
• To be fully protected, use a condom during any sexual activity, whether vaginal, oral or anal.

Condoms confer excellent protection against pregnancy and STDs, but only when they are used carefully, consistently, and correctly.  Condoms are an effective, inexpensive form of birth control, although their actual usage effectiveness rate is much worse than birth control pills. Of 100 women whose partners use condoms inconsistently or imperfectly, 14 will become pregnant in the first year of use. Only three will become pregnant if condoms are used appropriately.  Based upon these numbers, one group of researchers calculated that if all women in the US who are currently using the Pill switched to condom usage tomorrow, there would be up to 687,000 additional unintended pregnancies within one year! Common excuses for not using condoms include that it just doesn't feel as good as having sex without a condom.  The risks of not using a condom, however, may make you feel much worse-and may wipe out your sex life altogether, whether it's an unwanted child to care for or an unwanted disease.  One person is infected with HIV every 13 minutes-other common infections include gonorrhea, chlamydia, syphilis, herpes and genital warts.

Even though their main purpose is to prevent unplanned pregnancy, condoms can also help protect fertility by preventing transmission of STDs that cause infertility, such as chlamydia and gonorrhea. Women whose partners use condoms are at much lower risk of hospitalization for pelvic inflammatory disease (PID) and infertility than those whose partners do not.

Click here for more information on birth control.

Created: 10/31/2001  -  Donnica Moore, M.D.