Condoms
Early condoms were made of linen or pig or sheep's gut, tied at the end with ribbon. After sex, they were rinsed out and reused!
An 18th-century illustrated condom, featuring three naughty nuns, was sold at a Christie's auction for £3,300. There is no truth in the story that condoms were invented by a Dr Condom, physician to Charles II Although it has been suggested that condoms were used by the Ancient Egyptians, the earliest actual report of a condom was by the Italian anatomist, Fallapio in 1564. He claimed to have invented a linen sheath, made to fit the penis, as protection against syphilis In England, condoms are known as 'French Letters'. In Italy, they used to be called 'English Overcoats'
What are condoms?
A condom is a stretchy tube of latex rubber or polyurethane. One end is closed. Most condoms have a small pouch at the closed end (the teat), which collects semen and holds it in the condom. Condoms are designed to fit over the erect penis, so put the condom on when the penis is erect. If you try to put it on to a soft penis, it will fall off.
How effective are condoms?
Latex condoms have a contraceptive failure rate of 3% per year. This means that if 100 couples having regular sex used condoms correctly every time (see Using a condom – do’s and don’ts) for a year, 3 of the women would become pregnant. Of course, if you do not use condoms every time you have sex, or if you do not use them properly, they will not be as effective, and the ‘failure rate’ would be about 15%.
Condoms have an important advantage over other types of contraception – they give good protection against sexually transmitted diseases. As a result, many women who use the contraceptive pill for protection against pregnancy, still like their partner to use condoms.
Choosing a condom
The range of available condoms is bewildering. With so many sizes, shapes and thicknesses on offer, how do you know which to choose? Obviously, you are safest with a well-known brand bought from a pharmacist or brand vending machine. Always check the sell-by date and the Kitemark. Otherwise, the best plan is to try several until you find one that is comfortable for you. The preferred shape – be it straight, flared or contoured – seems to be a matter of personal choice. Researchers at the University of Exeter gave a variety of condoms to over 400 young men and women, and asked them to complete a questionnaire rating each condom for comfort and sensitivity. The results showed that roughly equal number of people preferred each shape – there was no outright winner. So just because a friend recommends a certain type, don't assume it will be right for you.
Some people prefer a thicker condom because it may make intercourse last slightly longer. Thicker condoms usually have words such as 'ultra-strong' or 'super strong' on the packet. Anyone intending to have anal sex must use an ‘ultra-strong’ or ‘super-strong’ condom.
Most condoms are made from latex rubber. If you think your condom reduces sensitivity or you dislike the rubbery, latex smell, try a polyurethane condom such as Durex Avanti or eZ.on. Polyurethane condoms feel thinner than they actually are, because they conduct body heat better. Avanti is as effective for contraception as the latex type and eZ.on slightly less so (Cochrane Review, Issue 3. Cochrane Library, 2004). However, non-latex condoms are slightly more likely to break.
Some condoms contain casein, a substance derived from animals; however, vegetarian/vegan-friendly condoms are available (see Useful contacts).
Using a condom – dos and don’ts
-
Do buy your condoms from a pharmacist or reputable brand vending machine or other reliable source, not from a street trader.
-
Do check the sell-by date when you buy - the further ahead it is, the better.
-
Do choose a reputable brand that has the British Standard Kitemark on the pack and an expiry date of over 2 years from now. The Kitemark means the sheaths are properly tested. Expiry dates are usually 5 years after manufacture. Alternatively, choose a pack marked 'BS EN 600' - this is the European standard, which is similar to the British Standard.
-
Do make sure you have several with you, in case you damage one or it goes on wrongly.
-
Do be careful as you unwrap the condom – they can be damaged by teeth, fingernails and jewellery.
-
Do be careful not to unroll the condom inside out (except eZ.on, which can be put on either way).
-
Do use a water-based lubricant if needed, such as KY Gel, Senselle, Replens, or Sylk, Durex Play lubricant or Boots lubricating Jelly.
-
Do put the condom on before your penis touches your partner's genitals. It is possible for a woman to become pregnant if any sperm are spilt near the entrance of the vagina even if you do not have full intercourse. Sperm can ooze out of the penis before ejaculation happens (‘pre-cum’).
-
Do pull the foreskin back before rolling on the condom (obviously, this does not apply if you have been circumcised).
-
Do hold the condom on after you have ejaculated, otherwise it may slip off as you go soft and spill sperm.
-
Do remember that the more you use condoms, and the more familiar you are with them, the more comfortable and efficient you will become.
-
Don't feel embarrassed at the thought of buying condoms. As the Planned Parenthood Federation of America says, 'Be proud. Buying condoms says you are responsible and that you accept your sexuality as a normal part of living'. If you really are embarrassed, get them from a slot machine in a pub/bar toilet.
-
Don't take any notice of a large CE mark on the pack. This is a European mark, compulsory on all condom packs after June 1998. It is to do with free trade in Europe, and is not a guarantee of quality.
-
Don't ever buy a pack that has no Kitemark but says it 'conforms to' or 'surpasses' British Standard 3704. This is a con. They may not have been tested at all.
-
Don't use a condom that is past its sell-by date or which feels sticky or very dry.
-
Don't rely on a gimmick condom (glow-in the-dark, musical etc.) for contraception.
-
Don't use Vaseline, hand cream, butter, baby oil or any other oils for lubrication with latex rubber condoms (see Lubrication for more advice)
-
Don't use a condom more than once; use a new one each time you have intercourse.
-
Don't flush it down the toilet after use, because it could cause a blockage. Wrap it in tissue or toilet paper and chuck it in the bin.
Talking about using condoms
It can be very awkward talking to a new partner about condoms. For some really practical advice, look at the website of the Planned Parenthood Federation of America. Click here to see some of their ideas for responses to partners reluctant to use a condom.
Lubrication
Some people find that sex is more enjoyable for themselves and their partner if they use a lubricant. Condom manufacturers admit that the lubrication they put on the condoms may not be enough, but adding more would make packaging difficult. Lubricants are especially useful if your partner has vaginal dryness, and will also help prevent wear and tear on the condom. Smear the lubricant on the outside of the condom after you have put the condom on.
Don’t just use any old thing as a lubricant. Most condoms are made of latex rubber, and oils can cause latex to break down, reducing the strength of the condom by up to 95% in 15 minutes.
Lubricants that should NOT be used with latex rubber condoms
Baby oil
Cooking oil
Massage oil
Body lotion
Bath oil
Hand cream
Suntan oil
Petroleum jelly (Vaseline)
Hair conditioner
So choose a water-based lubricant, such as KY Gel, Sylk (see Useful contacts), Boots Lubricating Jelly, Durex Play lubricant, Senselle or Replens. The packet should tell you whether a lubricant is water-based or not. If you are unsure, ask the pharmacist or family planning clinic. Spit is not a good idea, because it dries fast and could theoretically transmit HIV or hepatitis (see Oral sex).
Some condoms are made from polyurethane, not latex rubber. These are not damaged by oily substances.
Common problems with condoms
Allergy
If you notice irritation, redness or itching after using a condom, you may wonder if you are allergic to the condom. In fact, allergy to rubber (latex) condoms is very unusual, but it would be sensible to switch to a polyurethane type such as Durex Avanti. There have been no reports of allergic responses to the polyurethane material.
In fact, irritation is more likely to be due to nonoxynol 9 or nonoxynol 11, a spermicide (i.e. it kills sperm) that is an ingredient of some lubricated condoms (but this is becoming less commonly used). So try avoiding condoms that are labelled 'spermicidally lubricated'.
Another possible cause of irritation is too much friction, so use extra lubrication. Put some of the lubricant inside the top of the condom so that it covers the surface of the penis as you roll the condom on.
Putting it on and taking it off
Condom manufacturers never mention this problem in their leaflets. They simply tell you to unroll it onto the hard, erect penis, and preferably to pinch the teat or closed end to keep it empty at the same time. To do this properly, you need three hands or the assistance of a cooperative partner. It is no wonder that a survey conducted by the University of Sydney, Australia – which asked men about what really happened when they used condoms – found that two-thirds of them sometimes or often lost their erection while trying to put the condom on, so it was then impossible to put it on properly. Many disliked using a condom because it drew attention to this wilting problem (Richters J. Reproductive Health Matters 1994;3:55-62).
The researchers suggest that, to make things easier for yourself, you should not try to pinch the teat at the end of the condom as you put it on. They found that pinching the teat makes no difference to the likelihood of the condom breaking or slipping off during intercourse. Latex condoms are designed to stretch enormously, so there is no reason why the presence of 1 ml or so of air in addition to 3–5 ml of semen should 'burst' the condom. They also suggest that instead of rolling the condom on, as recommended by the manufacturers, you could try pulling it on like a sock with your thumbs or fingers inside. Using this method, you can put it on securely even if your penis is not fully rigid. Obviously you have to be careful not to damage it with your nails. In their study, the researchers found that people who used this method had less chance of the condom slipping off or breaking.
If the condom does not reach the base of your penis or is difficult to roll down, then it is probably inside out. Take it off and try again with another one.
Slipping off
If you find a condom slips off, you probably assume it is too large for you. In fact, it is probably too small. If the condom is too tight you probably aren't unrolling it fully down the penis. This means that, during intercourse, the ring at the base of the condom is entering your partner's vagina, where it can be dragged off. If the condom is the right size, the ring will be right at the base of your penis, and will remain outside the vagina during sex.
If you have difficulty putting the condom on properly try the 'pull-on' method. Finding the right size may be a matter of trial and error, because only a few manufacturers clearly show the length and width on the pack. The consumer magazine Which? measured various brands; the lengths varied from 168 to 191 mm, and the circumference from 98 to 111 mm. The other problem is that most men don't really know how the size of their erect penis compares with other men, so are unsure whether they need a large condom or not. And most men only consider length whereas, just like short fat legs in stockings, a short fat penis also needs a large condom.
After ejaculation, when the penis quickly becomes limp, the condom can easily slip off, spilling sperm into your partner's vagina. At this stage, you must hold the condom firmly round the penis so that it remains in place until you have withdrawn.
Splitting or breaking
Research has shown that condom breakage is not a myth – it can happen.
How commonly do condoms split?
A few surveys have tried to find out how often condoms split, but have given wildly differing results. Here are some figures.
The University of Sydney, Australia, ran a study of condom breakage in three brothels. They supplied the fresh condoms, together with forms to fill in if there was an accident and little plastic bags to put the torn condoms in so the researchers could analyse in the laboratory how and why they tore. Of the 1,269 condoms the sex workers used, only 6 were broken. Next, they did a survey of ordinary men, and found that their breakage rates were far higher – about 7%, including breakages while putting the condoms on (Lancet 1989; :1487-88)
A USA study asked 92 couples to keep a sex diary, totalling 4,637 condom usages. Six condoms split while being put on, and 13 split during sex – a total breakage rate of 0.41% (Contraception 1997;56:3-12)
French researchers did a telephone survey of 20,000 people, asking about condom breakages. The breakage rate seemed to be 3.4% (Am J Public Health 1997;87:421-4)
Why condoms split
Damage from ripping the packet open with teeth, scissors, knives or pencils is a common cause of tears.
Inexperience. Practice with condoms makes perfect, which is probably why, in the University of Australia study, the sex workers had the lowest breakage rate. The study also found that men were most likely to break condoms if they didn’t use condoms often, and if they rolled the condom on rather than pulled it on.
Lack of lubrication may be another reason for breakage. Prostitutes tend to use additional lubrication, which may be another reason for their lower breakage rate.
Penis size is a possible factor. Condom manufacturers say that condoms are designed to stretch enormously, so a large penis should not make a condom more likely to break. However, a study from Australia suggests that you are more likely to break a condom if you have a thick penis, but length of the penis does not make any difference (International Journal of Sexually Transmitted Disease and AIDS 1998;9:444-7).
What to do if a condom slips or breaks
If a condom slips off during intercourse, or if it breaks, the woman should visit her doctor or a family planning clinic as soon as possible for emergency contraception.
Emergency contraception – used to be called the morning-after pill.
-
Emergency contraception prevents pregnancy after intercourse has occurred - so it is a back-up if another method fails (such as when a condom breaks or slips off, or you forget a pill)
-
In fact it can be taken up to 72 hours after intercourse – not just on the morning after, but the earlier the better
-
The main side-effect is nausea (in 50%) and vomiting (in 20%)
-
It usually consists of a single dose, or two smaller doses taken 12 hours apart
-
In the UK (not in Ireland), you can buy it from a chemist for about £20, but only if you are aged 16 or above. It can only be given to you by a trained pharmacist, who will try to check that you are 16 or over. You cannot simply pick it up from the shelf
-
You can also obtain it from your doctor, from a family planning clinic or from an NHS walk-in centre (see Useful contacts). If you are a college student, your college website may give advice about getting emergency contraception from the Student Health Centre. As a last resort, you could try your Accident and Emergency (casualty) department
The next period is unpredictable – it might be earlier or later than usual
-
Emergency contraception doesn't always work, so if your next period is late you might be pregnant. Have a pregnancy test to check
Credits: www.healthpress.co.uk
|
