Lloydspharmacy.com Health

Written by Dr David Delvin, GP and family planning specialist

What are condoms ?

Condoms are sheathes that trap the sperm when a man climaxes ('comes'). Wearing them greatly reduces the chances of pregnancy. They also provide some protection against sexually-transmitted infections (STIs), including HIV. But this protection is far from 100 per cent.

What types of condom are there?

There are now two types of condom: male and female. However, in 2008, male condoms still remain far more commonly used than female ones, which have not ‘caught on’ in the way that was widely expected in the 1990s.

The latest official figures, for 2007, show that about 30 per cent of British women aged 16 to 49 say that the male condom is their current method of contraception. Only 2 per cent use the female condom.

The male condom

The male condom is also known as a sheath, a prophylactic, a rubber or a johnny.

It's usually about 7 inches (18 to 19cm) long, but various other sizes are available.

Most condoms are made of thin latex – a form of rubber. A polyurethane type is also available, which can be used by those who are allergic to latex. There is also a sheath made from animal intestine, but it is not easily obtainable.

Some brands of condom contain spermicides, but these chemicals can occasionally cause allergies.

A recent development has been a German invention: a condom which contains local anaesthetic on the inside, designed to combat premature ejaculation. Caution: the local anaesthetic can cause a sensitivity reaction in the skin of the man’s penis.

How effective are male condoms in preventing pregnancy?

A condom's effectiveness largely depends on the person who uses it. If a man pulls it on roughly, lets his partner snag it with her teeth, or only puts it on halfway through intercourse, this will greatly reduce the protection it offers.

When used correctly, a male condom is about 98 per cent effective. This means that only about 2 in every 100 women would get pregnant in the course of a year. This is more effective than several other forms of contraception, such as withdrawal or using spermicides (chemicals) alone. And it's far better than using nothing!

Warning!

Pregnancy may occur if:

you don't put the condom on before intercourse starts
the condom splits - unlikely if you handle it gently and avoid snagging it with rings, etc
you use an oil-based lubricant, such as Vaseline, body oils, creams or lotions – this can make holes in latex condoms.

What are the best male condoms?

Buy only condoms that carry either the European CE mark, or the BSI Kitemark (BS EN 600), or the approval stamp of your national Family Planning organisation - this means that they have had thorough quality checks.

The British Family Planning Association (fpa) strongly recommends using condoms with the British Kite mark wherever possible. They say the European CE mark simply means that the condom will not harm you, whereas the British Kite mark guarantees greater protection against pregnancy and infection.

Fun condoms, ie those with tickly bits, lights, or which 'say' things or play music when you put them on, are least likely to be effective in preventing pregnancy or infection.

How do you put them on?

Most packs of reliable male condoms come with step-by-step instructions, which you should follow carefully. Try not to get so carried away with passion that you rush things. Use this guide to help you.

Take the fresh condom out of the packet carefully. Avoid 'catching' it on your nails.
Do not blow it up, because this can weaken it.
There's usually a 'teat' at the end. Squeeze the air out of it.
Now roll the condom onto the erect penis. (Don't try putting it on before you're hard.)
Roll it all the way down to the base of your penis.
Some men lose their erection - through nerves - while rolling the condom on. If this sometimes happens to you, then get your partner to put it on for you - rubbing you at the same time.
As soon as you've climaxed, hold the condom firmly onto your penis with your fingers, and withdraw from the vagina. Take care not to spill any fluid.
Now, take off the condom, wrap it in paper or tissue, and dispose of it in a bin.
If you're going to have sex again that day, wash your penis and put on a new condom.
Never try to 're-use' a condom.

The female condom

The female condom (UK trade name: Femidom) was invented about 18 years ago. It looks like a tiny plastic bin liner. There is a ring round the opening and another one at the closed end – which is the end that goes into the top of the vagina.

It is made of polyurethane, and not latex. So it is unlikely to provoke allergies, and should not be damaged by oil-based lubricants.

It is pre-lubricated, but does not contain a spermicide.

How effective are female condoms in preventing pregnancy?

The female condom is pretty effective, as long as it is correctly inserted into the vagina - and provided the man doesn't put his penis outside it.

One trial gave a ‘success rate’ of 95 per cent over a year, but a couple who know what they’re doing and who use the device really carefully will run only a very low risk of pregnancy.

The woman (or her partner) puts the female condom inside her vagina before sex. You are not protected if you only put it in halfway through sex and risk getting pregnant. Many people don't realise sperm can be present in the man's pre-come fluid, which he secretes as he gets sexually excited. So putting the condom in after intercourse has started may already be too late.

Warning!

Always take the female condom out of the pack with care - don't tear it with fingernails or rings.

How do you put them in?

You may need to try out several 'insertion positions'. Some women put it in while lying down, others while standing with one leg on a chair, and others while squatting.

The insertion procedure is described in the leaflet inside the pack. What you do is this:

Hold the 'closed' end of the female condom (the tip), feeling the ring inside it.
Squeeze the ring between your fingers, in preparation for insertion.
With your other hand, open up the lips of your vagina.
Now push the squeezed ring inside, and up to the top end of your vagina. There's a diagram on the leaflet that shows you how to do this.
Next, put two fingers inside the female condom and use them to push the inner ring as far into the vagina as it will go – so the whole vaginal cavity is snugly lined.
Ensure that the outer ring now covers the opening of your vagina. The top of this ring should be approximately over your clitoris – something that a number of women have reported favourably on.
Guide the man's penis in through this outer ring – so he is inside the condom. Take care: it is easy to mistakenly put the penis outside the condom.
After sex, remove the female condom by twisting the outer ring and pulling it out gently.
Wrap and dispose of it (in a bin). Do not try and use it again.

Although the female condom is still nowhere near as popular as the male one, some couples do like it. And some women are keen on the idea that it lets them control their own fertility.

Many Family Planning Clinics stock Femidoms, but most couples buy their own, over the counter from pharmacies.

Last updated 30.09.2008