November 25, 2018 0

Condoms: common questions and misconceptions

Condoms: common questions and misconceptions

Are condoms effective? Are they always necessary? What is the correct way to put one on? Even if you’re not the one wearing the condom, it’s helpful to know the answers. In Clue’s 2018 study with the Kinsey Institute Condom Use Research Team (KI-CURT), 75% of women said condom use is something they decide about together with their partner. Read on to get informed, so you can make the best decisions for you about sex, protection, and pregnancy.

How effective are condoms?

Are condoms an effective form of birth control?

Yes. Studies have found that about one in 50 women using condoms perfectly over an entire year of sex will experience a pregnancy. If you take into account people who use condoms incorrectly, they are still highly effective, with a rate of 15 pregnancies occurring out of 100 women having sex over a year (1). When you use a condom correctly, it’s a very effective form of birth control—and protection against sexually transmitted infections (STIs).

Do condoms protect against all STIs?

It depends. They are most effective against STIs which are transmitted through bodily fluids. Consistent and correct use of latex condoms or internal condoms is associated with a significant reduction in the combined incidence of gonorrhea, chlamydia, and syphilis in women considered to be at high-risk for contracting STIs (2, 3, 4). If you have penis-in-vagina sex with a condom, you are 80% less likely to contract HIV, compared to sex without a condom (5).

Some STIs like herpes, human papillomavirus (HPV), or genital ulcer diseases like syphilis and chancroid are spread via skin-to-skin contact. If a condom does not cover the infected area, then a condom cannot offer protection from these STIs. However, if the infections are limited to areas where the condom covers, then the risk of spreading these diseases will be reduced (6). Condoms have been shown to protect against these STIs, as well as reduce the risk of human papillomavirus (HPV) transmission—if the condom covers the infected skin (8).

What if my partner doesn’t want to use a condom?

If your partner doesn’t want to use a condom, talk with them about why, and see if you can find a solution together. You might not be able to change their mind, but you can set your own boundaries. For example, you might decide that if someone wants to have sex with you, they need to use a condom. If they don’t want to use one, that’s up to them, but then they don’t get to have sex with you.

Condoms can help people feel more relaxed about sex, and reduce worries about STIs and unplanned pregnancy (9). Many condoms have extra features (like tingling lubrication or ribbing) that can make sex more pleasurable for both partners. If a condom is uncomfortable, there are different sizes and types of condoms that can offer a better fit. Using the correct size is important, as condoms that are too small or tight may be more likely to break, and condoms that are too big may be more likely to slip off.

Do I need to use a condom if…

Do I need to use a condom for oral or anal sex?

Yes, if you want to be protected against STIs. Sexually transmitted infections, including HIV, syphilis, herpes, gonorrhoea, HPV, trichomoniasis, and chlamydia, can all be passed on during oral sex (10). This is why it’s recommended to protect yourself and your partner by using condoms (or dental dams) during oral sexual activity. Flavored condoms are available for those who don’t enjoy the taste of latex.

Meanwhile, a US study found that when condoms were used for anal sex with an HIV-positive partner, they were 70% effective in preventing transmission of the virus (11). Using a personal lubricant can also make anal sex safer. Using a silicone or water-based lubricant decreases the chances of condom breakage while having anal sex, in contrast to oil-based lubricants, saliva, or no additional lubricant at all, which all increase the chances of condom breakage (12).

Do I need to use condoms if I’m on the pill? What if I’m in a monogamous relationship?

If you want to be protected from STIs, then yes. The pill doesn’t protect you or your partner from STIs, but condoms do. Also, if you forget to take a pill or have been vomiting for any reason (e.g. illness), the effectiveness of the pill is lower and you could still get pregnant. If you track taking your pill in Clue, the app will let you know what to do if you miss a dose, including when you need to use back-up protection—like condoms.

A monogamous relationship won’t automatically protect you from STIs, or pregnancy. Anyone can get a sexually transmitted infection, sometimes even without noticeable symptoms. Although some STIs produce discharge or other visible signs, it’s not always possible to tell by looking at someone if they have an STI.

I don’t have any sex involving a penis. Do I still need condoms?

No penis, no problem? Not quite. If you’re sharing sex toys, then covering them with condoms is a good way to prevent the development of bacterial vaginosis (BV) or transmission of STIs. Remember to change the condom each time you change partners, or when you change from anal to vaginal use.

Do I need to use condoms during my period?

Yes. It’s still possible to get pregnant during your period, although the day-specific risk is variable and depends on your cycle, age, and health. Clue’s 2018 study with the Kinsey Institute’s Condom Use Research Team found that condoms are used less often (15% less) during menstruation. This is important because rates of STI transmission and acquisition are higher at certain times of the menstrual cycle—including during menstruation. Using a condom for period sex can prevent pregnancy and protect against STI transmission.

How to use condoms

What is the correct way to put on a condom?

  1. Check the expiration date printed on the wrapper or box and make sure the condom is not past its expiry date.
  2. Open the package carefully—avoid using your teeth or scissors. Take a look at the condom to check that it’s not brittle, dried out or damaged.
  3. Make sure the condom is ready to roll on the right way: the rim should be on the outside so it looks like a little hat, and it will unroll easily. You can unroll it a little bit before putting it on to make sure it’s right-side out. If you accidentally put a condom on inside out, don’t flip it around and reuse it—get a new one.
  4. Put the condom on before any contact with a partner’s mouth or genital area (vulva, vagina, anus, buttocks, and upper thighs). Sperm may be present in pre-ejaculatory fluid (“pre-cum”).
  5. Lubricant (lube) can make sex feel better, and it helps stop condoms from breaking. You can put a few drops of water-based or silicone lubricant inside the tip of the condom before you roll it on. You can also add more lube to the outside of the condom after it’s on the penis.
  6. Pinch the tip of the condom and roll it on to an erect (hard) penis, leaving a little bit of space at the top to collect semen. Roll the condom down the shaft of the penis all the way to the base. For people who are uncircumcised, it might be more comfortable to pull the foreskin back before placing the condom on the tip of the penis and rolling it down.
  7. Wear the condom the whole time you’re having sex.
  8. After ejaculation, hold the rim of the condom while pulling the penis out of the other partner’s body. Do this before the penis goes soft, so the condom doesn’t get too loose and let semen out. Carefully take off the condom to avoid spilling any semen.
  9. Throw the condom away in the garbage—don’t flush it down the toilet.
  10. Condoms are not reusable. Roll on a new condom every time you have vaginal, oral, or anal sex. You should also use a new condom if you switch from one kind of sex to another (like anal to vaginal).

Does it matter which lubricant I use?

Yes. The best lubricant for vaginal or anal sex with a condom is water-based or silicone-based lube. Oil-based lubes (or any other oil products like petroleum jelly or mineral oil) should not be used with latex condoms, as they may cause them to break (13). Plus, sex with lube feels good! In a 2013 study, most women reported that lube made sex feel “more comfortable,” “more pleasurable,” and simply “better” (14). Many non-latex condoms (like those made of polyisoprene) are also sensitive to oil-based personal lubricants, so check the package (15).

Is it better to use two condoms instead of one?

No. One condom used correctly is all the protection you need. If you put two condoms on at once, there’s a higher chance of condom breakage. This also applies if you use a condom worn on the penis together with an internal “female” condom. Best to stick to one condom, and use some condom-safe lubricant.

Can I still use condoms if I’m allergic to latex?

Yes. A latex allergy doesn’t mean you need to stop having sex, or that the only option is unprotected sex. Many different non-latex condoms are available: made of lambskin, polyurethane and polyisoprene, AT-10 synthetic resin or synthetic nitrile rubber. These can be used in the same way as a latex condom, although lambskin condoms do not protect against STIs. Internal or “female” condoms are often made of polyurethane or nitrile, which is safe to use for people who are allergic to latex. Another benefit to polyurethane or nitrile internal condoms is that they can be used with all types of lubricants (including oil-based lubricants) (16,17).

What should I do if the condom breaks?

If you feel the condom break at any point during sexual activity, stop immediately, withdraw, remove the broken condom, and put on a new condom. If a condom breaks and you’re not using any other contraception, go to a clinic, pharmacist or doctor as soon as possible and ask about emergency contraception. You may also need to get tested for STIs.

Let’s wrap this up:

Now you know more about condoms, you can decide what level of risk is okay for you, and choose what kind of contraception or protection to use. Remember that only condoms can protect you against both pregnancy and sexually transmitted infections (STIs). The safest option is to use condoms and another form of birth control. If you’re taking the pill, you can track in Clue and get personalized advice on what to do if you miss a pill.

If after reading this you’re worried you might be pregnant, check out our guide to emergency contraception, advice about what to do if your period is late, and information on the symptoms of early pregnancy.

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