Common
problems with condoms
Allergy
If you notice irritation, redness or itching after using a condom,
you may wonder if you are allergic to the condom. In fact, allergy
to rubber (latex) condoms is very unusual, but it would be sensible
to switch to a polyurethane type such as Durex Avanti. There
have been no reports of allergic responses to the polyurethane
material.
In fact,
irritation is more likely to be due to nonoxynol 9 or nonoxynol
11, a spermicide (i.e. it kills sperm) that is an ingredient
of some lubricated condoms (but this is becoming less commonly
used). So try avoiding condoms that are labelled 'spermicidally
lubricated'.
Another
possible cause of irritation is too much friction, so use
extra lubrication.
Put some of the lubricant inside the top of the condom so that
it covers the surface of the penis as you roll the condom
on.
Putting
it on and taking it off
Condom manufacturers never mention this problem in their leaflets.
They simply tell you to unroll it onto the hard, erect penis,
and preferably to pinch the teat or closed end to keep it empty
at the same time. To do this properly, you need three hands
or the assistance of a cooperative partner. It is no wonder
that a survey conducted by the University of Sydney, Australia
– which asked men about what really happened when they
used condoms – found that two-thirds of them sometimes
or often lost their erection while trying to put the condom
on, so it was then impossible to put it on properly. Many disliked
using a condom because it drew attention to this wilting
problem (Reproductive Health Matters 1994;3:55–62).
The
researchers suggest that, to make things easier for yourself,
you should not try to pinch the teat at the end of the condom
as you put it on. They found that pinching the teat makes
no
difference to the likelihood of the condom breaking or slipping
off during intercourse. Latex condoms are designed to stretch
enormously, so there is no reason why the presence of 1 ml
or so of air in addition to 3–5 ml of semen should
'burst' the condom. They also suggest that instead of rolling
the condom
on, as recommended by the manufacturers, you could try pulling
it on like a sock with your thumbs or fingers inside. Using
this method, you can put it on securely even if your penis
is
not fully rigid. Obviously you have to be careful not to damage
it with your nails. In their study, the researchers found that
people who used this method had less chance of the condom slipping
off or breaking.
If the
condom does not reach the base of your penis or is difficult
to roll down, then it is probably inside out. Take it off and
try again with another one.
Slipping
off
If you find a condom slips off, you probably assume it is too
large for you. In fact, it is probably too small. If the condom
is too tight you probably aren't unrolling it fully down the
penis. This means that, during intercourse, the ring at the
base of the condom is entering your partner's vagina, where
it can be dragged off. If the condom is the right size, the
ring will be right at the base of your penis, and will remain
outside the vagina during sex.
If you
have difficulty putting the condom on properly try the 'pull-on'
method(see above). Finding the right size may be a matter of trial
and error, because only a few manufacturers clearly show the
length and width on the pack. The consumer magazine Which? measured
various brands; the lengths varied from 168 to 191 mm, and the
circumference from 98 to 111 mm. The other problem is that most
men don't really know how the size of their erect penis compares
with other men, so are unsure whether they need a large condom
or not. And most men only consider length whereas, just like
short fat legs in stockings, a short fat penis also needs a
large condom.
After ejaculation,
when the penis quickly becomes limp, the condom can easily slip
off, spilling sperm into your partner's vagina. At this stage,
you must hold the condom firmly round the penis so that it remains
in place until you have withdrawn.
Splitting
or breaking
Research has shown that condom breakage is not a myth –
it can happen.
How
commonly do condoms split?
A few surveys have tried to find out how often condoms
split, but have given wildly differing results. Here are
some figures.
-
The University of Sydney, Australia, ran a study of
condom breakage in three brothels. They supplied the
fresh condoms, together with forms to fill in if there
was an accident and little plastic bags to put the torn
condoms in so the researchers could analyse in the laboratory
how and why they tore. Of the 1,269 condoms the sex
workers used, only 6 were broken. Next, they did a survey
of ordinary men, and found that their breakage rates
were far higher – about 7%, including breakages
while putting the condoms on (Lancet 1989; :1487–88)
-
A USA study asked 92 couples to keep a sex diary, totalling
4,637 condom usages. Six condoms split while being put
on, and 13 split during sex – a total breakage
rate of 0.41% (Contraception 1997;56:3–12)
-
French researchers did a telephone survey of 20,000
people, asking about condom breakages. The breakage
rate seemed to be 3.4% (American Journal of Public Health 1997;87:421–4)
- A US survey found a breakage rate of 3.1%, The chance of breakage decreased with experience in using condoms (Sexually Transmitted Diseases 2005;32:35–43)
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Why
condoms split
Damage from ripping the packet open with teeth,
scissors, knives or pencils is a common cause of tears.
Inexperience.
Practice with condoms makes perfect, which is probably why,
in the University of Australia study, the sex workers had the
lowest breakage rate. The study also found that men were most
likely to break condoms if they didn’t use condoms often,
and if they rolled the condom on rather than pulled
it on.
Lack
of lubrication may be another reason for breakage.
Prostitutes tend to use additional lubrication, which may be
another reason for their lower breakage rate.
Penis
size is a possible factor. Condom manufacturers say
that condoms are designed to stretch enormously, so a large
penis should not make a condom more likely to break. However,
a study from Australia suggests that you are more likely to
break a condom if you have a thick penis, but length of the
penis does not make any difference (International Journal of Sexually Transmitted Disease and AIDS 1998;9:444–7).
What
to do if a condom slips or breaks
If a condom slips off during intercourse, or if it breaks, the
woman should visit her doctor or a family planning clinic as
soon as possible for emergency contraception.
Emergency
contraception – used to be called the morning-after
pill.
-
Emergency contraception prevents pregnancy after intercourse
has occurred - so it is a back-up if another method
fails (such as when a condom breaks or slips off, or
you forget a pill)
-
In fact it can be taken up to 72 hours after intercourse
– not just on the morning after, but the earlier
the better
-
The main side-effect is nausea (in 50%) and vomiting
(in 20%)
-
It usually consists of a single dose, or two smaller
doses taken 12 hours apart
-
In the UK (not in Ireland), you can buy it from a chemist
for about £20, but only if you are aged 16 or
above. It can only be given to you by a trained pharmacist,
who will try to check that you are 16 or over. You cannot
simply pick it up from the shelf
-
You can also obtain it from your doctor, from a family
planning clinic or from an NHS walk-in centre (see Useful
contacts). If you are a college student, your college
website may give advice about getting emergency contraception
from the Student Health Centre. As a last resort, you
could try your Accident and Emergency (casualty) department
-
The next period is unpredictable – it might be
earlier or later than usual
-
Emergency contraception doesn't always work, so if
your next period is late you might be pregnant.
Have a pregnancy test to check
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