Barrier Methods of Birth Control (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Introduction to birth control
- Barrier methods of contraception
- Male condom
- Female condom
- Contraceptive sponge
- Cervical cap
- Find a local Obstetrician-Gynecologist in your town
Male condoms are far more common than female condoms. A male condom is a thin sheath that is worn over the man's penis during sexual intercourse. The condom collects sperm so that the sperm are not released into a woman's vagina. Condoms are also called rubbers, sheaths, prophylactics, and many other names.
Condoms are made out of a variety of materials including latex, rubber, plastic polyurethane, and animal tissue. Condoms are also available in a variety of sizes, colors, styles, and thicknesses. They may be dry, lubricated, or treated with a spermicide. Although convenient, a wallet is not the best place to store condoms. Condoms last longer when they are stored under less moist conditions. In general, condoms have a shelf life of about five years if stored unopened in a cool, dry place.
A condom must be the correct size and fit the man's erect penis properly. There should be 1/2 inch (about 1.25 cm) at the tip of the condom to provide a space for the sperm-filled semen to collect. Some condoms have this feature built in.
Before there is any contact between the penis and the vagina, the condom is unrolled over the erect penis, making sure that the condom is not turned backwards or inside out. Some condoms come pre-lubricated. If additional lubrication is desired, a water-based lubricant should be used. Spermicides may be used as lubricants with condoms and may actually increase their effectiveness. Oil-based products such as Vaseline, vaginal creams, or mineral oil, may damage the condom and should never be used.
There is an obvious problem of lack of barrier protection if the condom breaks, slips, or comes off the penis. Condoms are quality controlled in the U.S. by the Food and Drug Administration (FDA) for manufacturing defects that could result in breakage. But condom failure can also be caused by the user and his partner. For example, long fingernails or jewelry can tear condoms.
Immediately after the male wearing a condom ejaculates, he should remove his penis from the vagina. The man should hold the condom firmly in place, at the base of his penis, as he withdraws from the vagina. He must be careful not to spill any liquid from the condom.
Each condom must be thrown out after a single use. A new condom must be used for the next act of intercourse. Male condoms are not reusable.
Condoms can be purchased over-the-counter (OTC) without a prescription. Most of the condoms on the market are made of latex. The estimated effectiveness of the latex condom is 87% to 90% or 10 to 13 pregnancies/100 women per year of sexual activity.
About 1% to 3% of people are allergic to latex. In such case, they may be able to use condoms made of polyurethane, a type of plastic. However, polyurethane condoms may break more easily than latex condoms and they do not protect against sexually transmitted infections (sexually transmitted diseases, or STDs).
Latex condoms are the condoms that afford the maximum protection against sexually transmitted infections including HIV (human immunodeficiency virus) and herpes virus. According to the U.S. Centers for Disease Control and Prevention (CDC):
Latex condoms, when used consistently and correctly, are highly effective in preventing transmission of HIV, the virus that causes AIDS. In addition, correct and consistent use of latex condoms can reduce the risk of other sexually transmitted diseases (STDs), including genital ulcer diseases. While the effect of condoms in preventing human papillomavirus (HPV) infection is unknown, condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease.
Animal membrane condoms, made from the intestines of sheep, when used with contraceptive foam, can be effective in preventing pregnancy but may not provide proper protection against all sexually transmitted infections. This is because the pores in the animal membranes permit small organisms such as viruses to pass through.
The most frequent complaint lodged against condoms is that their use decreases sexual pleasure for the male. This is an unfortunate attitude because male condoms are an effective, acceptable, inexpensive, and safe method of birth control.
Next: Female condom
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