External Condoms

A banana has a condom over it with the words Safe Sex written on the condom Dainis Graveris/Unsplash

An external condom (oftentimes called a male condom, or simply condom) is typically a latex sheath that fits over the erect penis and prevents sperm from entering a sexual partner’s body. It is sold rolled up and stored in a foil or plastic packet. Condoms are highly effective at preventing pregnancy and protecting against sexually transmitted infections. Condoms come in different sizes, colors, and textures.

While most condoms sold are made of latex rubber, some are made from a thin polyurethane (plastic) or polyisoprene material. They, too, protect against STIs; they may also provide more sensation for those who have difficulty maintaining an erection when using latex condoms; and they can be used by people sensitive to latex. However, they break more often than latex condoms. Natural “skin” condoms (made of lamb membrane) protect against pregnancy but contain pores (microscopic holes) that are large enough to let viruses pass through (but not large enough to let sperm pass through). Therefore, skin condoms do not fully protect against some STIs, including HIV.

Condoms are a good way to share responsibility for birth control. When you don’t know whether you will be having intercourse, condoms can be very convenient. Although some partners carry condoms, you should not expect it. Protect yourself by carrying condoms with you. Condoms usually have an expiration date marked EXP on the package. Generally, condoms without spermicide are good for up to five years. Condoms with spermicide last about two years. Keep condoms in a cool and dry place, and throw away condoms past their expiration date. If you are not sure how old a condom is, throw it away and use a new one. Never use condoms that are brittle, sticky, damaged, or discolored. And never reuse a condom.

Effectiveness

Pregnancy Prevention
The contraceptive effectiveness of condoms varies from 85 to 98 percent depending on how well they are used. If used correctly for every act of intercourse from start to finish, condoms are 98 percent effective at preventing pregnancy. This means that if a hundred couples use condoms correctly every time they have intercourse for a year, two people will become pregnant. In real life, issues such as not putting the condom on properly, not always using one, or putting it on too late are common, so condoms have a typical use contraceptive effectiveness of 85 percent. That means that about one in seven people able to become pregnant will become pregnant in one year of using condoms.

Some condoms (“spermicidal” or “spermicidally lubricated”) contain spermicide, a chemical that kills sperm. The concentration of spermicide is so low in these varieties, however, that they appear to be no more effective at preventing pregnancy than condoms that don’t contain spermicide. If you combine using condoms correctly at every act of intercourse with a spermicidal foam, cream, film, or jelly in your vagina, you will have more effective birth control.

Sexually Transmitted Infection (STI) Prevention
The effectiveness of condoms in preventing transmission of STIs—such as HIV, chlamydia, gonorrhea, trichomonas, and hepatitis B—is similar to the effectiveness rate for pregnancy protection, or 80 to 98 percent. Protection from STIs that cause genital sores, such as syphilis, herpes, and chancroid, or from human papillomavirus (HPV)—genital warts—is decreased because the condom may not cover all of the areas that could transmit the infection. Nevertheless, condoms provide the best protection currently available against these infections.

Advantages

  • Does not require advance planning, clinic visits, or a prescription
  • Inexpensive and readily available
  • Can be carried easily and discreetly by all partners
  • Best currently available method of protection against STIs, including HIV, and may help prevent cervical cancer; by preventing STIs, condoms can protect the ability to get pregnant in the future
  • Allows all partners to participate in preventing pregnancy and infections
  • May decrease premature ejaculation and prolong intercourse
  • Catches the semen, so nothing drips from the vagina after intercourse
  • No systemic side effects
  • Does not affect menstrual cycles

Disadvantages

  • Requires a brief pause to put on
  • Can reduce sensitivity
  • Some people may have difficulty maintaining an erection when using a condom
  • Some people may have or can develop an allergy or sensitivity to latex; if so, condoms made from other materials can be used

Many of the disadvantages of condoms can be overcome with practice and experience or by switching to a different brand or type of condom.

While birth control methods, such as the birth control pill or the IUD, are highly effective at preventing pregnancy, most do not provide protection against sexually transmitted infections. Using a condom every time you have sex provides protection against unwanted pregnancy and STIs at the same time.

How to Use

Condom use can be fun for all partners when it is made part of sex. Discuss condom use before you have sex. Have more than one condom on hand, in case one is torn or damaged before use or is put on incorrectly, you have repeat intercourse, or change from anal to vaginal sex. Use a condom before the penis comes in contact with your mouth, anus, or vagina, as your partner may discharge a few drops of fluid long before ejaculating. While this pre-ejaculatory fluid is unlikely to cause pregnancy, it may expose you to HIV or other infectious organisms.

  1. Check with your partner(s) for consent.
  2. Ensure the condom packet is free of holes or tears. Carefully open the condom packet; do not use your teeth or other sharp objects.
  3. Unroll the condom a short distance to be sure you are unrolling it in the right direction (condoms only unroll one way). If you accidentally put the outside of the condom against the head of the penis, discard the condom and open a new one.
  4. Gently squeeze the tip of the condom and unroll it down to the base of the erect penis. The tip will hold the sperm. If you do not leave space for the sperm, the condom is more likely to break. If your partner’s penis is uncircumcised, pull back the foreskin before putting on the condom.
  5. It is important to have enough lubrication. If you do not use a lubricated condom, use a water-based lubricant such as K‑Y or Astroglide to prevent tearing or discomfort. If you are using a latex condom, the most common type of condom, never use Vaseline or other oil-based lubricants such as massage oils, suntan lotion, hand cream, or baby oil, as they can weaken the latex. With polyurethane or polyisoprene condoms, any type of lubricant can be used.
  6. Soon after ejaculation, the penis should carefully be withdrawn while it is still erect. Hold the condom firmly against the base of the penis to prevent leakage or slipping.
  7. Check the condom for visible damage, such as holes or tears, then wrap it in tissue and discard. Do not flush condoms down the toilet; this can cause plumbing problems. Condoms cannot be reused, so use one condom for each time you have sexual intercourse and then throw it away.
  8. If the condom breaks, slips off, or was not used, discuss the possibility of pregnancy or infection with your partner. Emergency contraception (EC) can be used after unprotected intercourse to prevent pregnancy.

Health Concerns

The only contraindication for using a condom is if you or your partner has a latex allergy. Severe swelling or difficulty breathing may indicate a latex allergy; if this happens to you or your partner, see a health-care provider immediately.

Some people develop a mild, local irritation or a rash after using a condom. This may be a reaction to the lubricant, spermicide, or perfumes used on the condom. If this happens to you or your partner, try using a different brand, or a condom without lubrication. If you still have a reaction, try switching to a nonlatex condom; or if you need protection only against pregnancy, you can try natural skin condoms.

Where to Get Condoms

You can find condoms in drugstores, supermarkets, online, some public bathroom vending machines, and on many college campuses. Many family planning clinics, youth organizations, and HIV prevention programs offer condoms for free. The cost in other places varies, depending on the brand and the store, so shop around. Nonlatex condoms are more expensive than latex condoms.

Managing Problems

Some people may experience decreased sensitivity with condoms. To enhance sensitivity, try different types of condoms, or add a water-based or silicone lubricant to the outside of the condom, or even a few drops to the inside tip of the condom.

Because heat can cause deterioration, do not store condoms for over a month in a wallet, pocket, or car.

Frequently Asked Questions

Can HIV get through a condom? In general, no. Latex, polyurethane, and polyisoprene condoms, if used correctly, prevent the spread of HIV. Condoms also protect against other STIs. Don’t use oil-based lubricants with latex condoms, as they can cause the latex to break down and could allow HIV to pass through. Natural membrane condoms may also allow the HIV virus to pass through.

Do condoms make intercourse less enjoyable? This varies from person to person. Some people dislike them because they can interrupt spontaneity, and some people find they decrease sensitivity. Condoms can also have some positive effects. For instance, both partners may enjoy intercourse more if they don’t have to worry about getting pregnant or contracting an STI. Using condoms also may prolong an erection and increase sexual communication.

Do condoms fit everybody? Some users believe that condoms are too small or tight for them. All condoms can stretch to accommodate various sizes. Larger-size condoms are available, although since the condom needs to be snug, most people should use the regular size.

Do condoms often break during intercourse? Condom breakage is relatively rare, but less experienced users may break condoms more often. To prevent breakage, use water- or silicone-based lubricant with latex condoms, and make sure your partner puts the condom on correctly. Condoms are also more likely to break if they are out-of-date, so check the expiration date on the package.

Does a person need to use condoms to protect against STIs when having oral or anal sex? Yes. STIs can pass from person to person during oral, vaginal, and anal sex. Condoms can be used during any of these sex acts to protect against STIs. Anal sex is a particularly high-risk activity, because the tissue in the rectum tears easily, giving easy access for the virus to enter the person’s blood. Using extra lubricant with a strong, preferably latex, condom is recommended.