Step Up Your Condom Game: A Comprehensive Guide to Protected Sex
Let’s talk about variety and safety.
If you harken back to the hours you spent sitting in high school sex ed, you might have a clearer mental picture of your gym teacher brandishing a banana than of any concrete information about condom options and etiquette.
Let's get caught up.
According to The National Survey of Sexual Health and Behavior (NSSHB), when having vaginal sex, Americans use condoms 25% of the time. Condoms are used least by adults over forty and are used most by teenagers. In fact, condoms are the most popular contraceptive choice of sexually active teens in the United States.
What do condoms do best?
Short answer: Condoms pair beautifully with vaginal and anal penetrative sex, and oral sex as well!
Condoms have the potential to be 98% effective at preventing pregnancy if used perfectly every time. However, in the real world, condoms are about 85% effective. This means that a person using condoms as their primary form of birth control has a 15% chance of getting pregnant within one year of use. Ways to reduce the risk of pregnancy include using a condom every time you have penis-in-vagina sex, making sure the condom you’re using is intact and not expired, and putting the condom on properly.
Condoms are the one form of contraception that can help protect against transmitting STIs. This is why it can be a great choice to use condoms during penetrative sex even if you already use a birth control method such as an intrauterine device (IUD) or the pill.
As reported by the CDC, condoms are better at preventing STIs that are transmitted through bodily fluids (semen, vaginal fluid, and blood), such as chlamydia, gonorrhea, trichomoniasis, and HIV. They are less effective at protecting against STIs that are transmitted via skin to skin contact, such as HPV and herpes, because condoms do not cover 100% of the skin in genital areas. Talking to your partner about their STI status is the best way to know what type of protection you will want to use during sexual activity.
Condoms are a great choice for protection against STIs if you are having anal sex. Since the rectum does not self-lubricate like the vagina, receiving anal penetration has the potential to create more friction, which can result in tiny tears in the tissue inside the anus. This can increase the risk of contracting HIV and other STDs. Wearing a condom each time you have anal sex and using lots of silicone or water-based lubricant can make anal sex both safer and more pleasurable.
So many options... how do I choose?
When choosing a condom, you’ll find that different products vary in efficacy, comfort, physical sensation, cost, size, and shape. Which condoms work best for you (and consenting partners!) will depend on what you most want to get out of your condom experience. You’ll just want to make sure the condoms you buy are FDA approved to ensure quality.
Here’s the breakdown of your options.
Most of us are familiar with standard latex condoms. Latex is popular because it is incredibly flexible and durable which makes for condoms that are long lasting with a low risk of breakage. Some common complaints about latex are that the condoms are too constrictive of the penis, they taste and smell bad, or they dampen sensation. Some people are allergic to latex and need to use non-latex condoms to avoid skin irritation and other symptoms.
These condoms are a good alternative for those who have latex sensitivities. These condoms protect against pregnancy and STIs. Polyurethane is a plastic that is less stretchy than latex which gives it a slightly higher breakage and slippage rate than latex condoms. However, in a comparison study, more users experienced a comfortable fit and increased sensitivity with polyurethane condoms compared to latex condoms.
Polyisoprene is a form of synthetic latex that is processed in such a way that it will not trigger latex allergies. Polyisoprene condoms maintain the stretchiness and durability of latex that you won’t find with polyurethane. This is a great alternative for people who have a latex allergy.
Lambskin or Animal Membrane
A lambskin barrier works as an effective method of birth control. However, according to the CDC, these condoms do not protect against STIs! Animal membranes are too porous to properly protect against the transmission of STIs like HIV and Hepatitis B.
Internal Condoms (Female Condoms)
These condoms are worn inside the vagina instead of on the penis. Compared to external condoms (male condoms), they are about 79% effective with typical use and 95% effective with perfect use. These condoms can have some great benefits that external condoms don’t have. First, you can place them in the vagina well before you start getting handsy with another human being so you don’t have to slow your roll to put protection in place before having penetrative sex. Second, internal condoms are great if your sex-partner who has a penis finds that standard condoms don’t fit, fall off frequently, or are uncomfortable.
Dental dams are thin sheets made out of either latex or polyurethane. They protect against STI transmission by covering the vagina or anus during oral sex. Despite being constantly ridiculed on the internet as a barrier no one ever uses, dental dams are important if you or a partner has an STI that could be transmitted through oral sex! Herpes can be transmitted between partners during vaginal-oral sex. Several other STIs, including Hepatitis A, can be transmitted during anal-oral sex. Dental dams do not protect against pregnancy and are not used during penetrative sex.
A common complaint people have about condoms is that they are uncomfortable. They’re either too constrictive or too loose. They bunch or they break. They deaden sensation. Having a condom that fits properly isn’t just important for safety, it can also really improve your experience of sex. In fact, up to 35% of people may need a smaller condom and 15% of people may need a larger one. Some companies are beginning to offer a much wider array of fit options to accommodate real world penises. Esquire created a great guide to choosing the right condom for penises of all sizes.
Anything Else I Should Know?
Some condoms come with spermicide on them. Spermicide is made of a chemical called nonoxynol-9 that can cause irritation to the tissues in the vagina and the rectum if used frequently. This abrasion can slightly increase your risk of contracting HIV from an HIV-positive sex partner. It can also increase the risk of urinary tract infections. For these reasons, you may not want to use condoms with spermicide. If you feel really anxious about possible pregnancy, consider adding another form of birth control such as the implant or an IUD which are more than 99% effective at preventing pregnancy.
Lube is an awesome and cheap way to improve sex in general. It makes everything more slippery and sensitive which, as far as sex goes, is usually the right direction. However, not all lubes are appropriate in all situations. When using latex condoms, never use oil based lubricants. They can degrade latex and polyisoprene and increase the likelihood of condom breakage. This applies to brand name oil-based lubricants but it also applies to things like massage oil, Vaseline, household lotion, and kitchen products such as coconut oil and olive oil. Instead, invest in a water-based lubricant, which is compatible with all condom materials. Check out our Lube Basic to help guide your quest for the right lubricant!
Do it right.
Finally, if condoms are your go-to choice for protection, make sure you know how to use them properly every time. This can raise their effectiveness from 85% to 98%...that’s a big difference!
Here’s a quick review:
Check the expiration date on the condom wrapper.
Pinch the unopened condom to make sure you can feel a little air bubble inside. If there’s no air bubble, the condom package may not be intact and the condom could be dried out or otherwise damaged.
Open condom gently with your fingers. Don’t use teeth, scissors, or other sharp objects.
Pinch the tip of the condom to leave room for ejaculate.
Roll the condom down erect penis with the rim of the condom on the outside.
Hold the condom against the base of the penis when pulling out after ejaculation.
Tie off the condom after removing and dispose.
Feel like you deserve a reward for reading this entire article? Check out this map to find free condoms in your area.
Louise is an associate marriage and family therapist who writes about sex and relationships. Want more juicy facts about sex from a feminist, research-based, perspective? Check out more of her writing and follow her on Instagram @swoon.sex.ed.