Condoms

Condoms are the most effective way of preventing sexually transmitted infections (STIs), including HIV. Condoms are also an effective method of contraception.

There are 2 types of condoms: condoms worn on the penis and condoms worn inside the vagina.

Condoms worn on the penis are made from very thin latex (rubber), polyisoprene or polyurethane. They're designed to stop a man's semen from coming into contact with his sexual partner.

Condoms are the only contraception that protect against STIs and pregnancy.

At a glance: condoms

If used correctly every time you have sex, condoms are extremely effective at preventing STIs. Condoms are also 98% effective at preventing pregnancy. This means that 2 out of 100 women using male condoms as contraception will become pregnant in a year.

In real world use, about 15 in every 100 women a year who use condoms as contraception become pregnant (85% effective). This is due to incorrect use, condoms bursting, or slipping off.

In most areas you can get free condoms from sexual health clinics and some GP practices, pharmacies or young people's clinics. In many areas you may be able to have free condoms delivered by post.

Oil-based products, such as moisturiser, lotion and Vaseline, can make latex and polyisoprene condoms less effective. Oil-based products are safe to use with condoms made from polyurethane.

Water and silicon-based lubricant, available in pharmacies and sexual health clinics, is safe to use with all condoms.

It's possible for a condom to slip off during sex. If this happens, you may need emergency contraception or Post Exposure Prophylaxis (PEP) for HIV, and to get checked for STIs.

Condoms need to be stored in places that aren't too hot or cold, and away from sharp or rough surfaces that could tear them or wear them away.

Putting on a condom can be an enjoyable part of sex. It doesn't have to feel like an interruption.

If you're sensitive to latex, you can use polyurethane or polyisoprene condoms instead.

A condom must not be used more than once. Use a new one each time you have sex.

Condoms have a use-by date on the packaging. Don't use out-of-date condoms.

Always use condoms that have the BSI kite mark and the CE mark on the packet. This means that they've been tested to high safety standards.

How a condom works

Condoms are a barrier method of protection. They can prevent the spread of STIs by stopping contact between the condom wearer's penis and a sexual partner's skin, especially the thin moist skin found on the tip of the penis, vulva, vagina and anus and any sexual fluids like semen or vaginal fluids. Condoms can prevent pregnancy by stopping sperm from reaching an egg by creating a physical barrier between them. Condoms can also protect against STIs if used correctly during vaginal, anal and oral sex.

It's important that the man's penis does not make contact with the woman's vagina or anus before a condom has been put on. This is because semen can come out of the penis before a man has fully ejaculated (come). If this happens, or if semen leaks into the vagina or anus while using a condom, seek advice as soon as possible.

You can get advice about emergency contraception from your GP, pharmacy or sexual health clinic. You can get advice about PEP to prevent HIV from your sexual health service or A&E.

You should also consider having an STI test.

How to use a condom

1. Take the condom out of the packet, taking care not to tear it with jewellery or fingernails – do not open the packet with your teeth.
2. Place the condom over the tip of the erect penis.
3. If there's a teat on the end of the condom, use your thumb and forefinger to squeeze the air out of it.
4. Gently roll the condom down to the base of the penis.
5. If the condom won't roll down, you're probably holding it the wrong way round. If this happens, throw the condom away because it may have sperm on it, and try again with a new one.
6. Apply plenty water or silicon-based lube if you are having anal sex or if you're having vaginal sex and need more lubrication.
7. After sex, withdraw the penis while it's still erect. Hold the condom onto the base of the penis while you do this.
8. Remove the condom from the penis, being careful not to spill any semen.
9. Throw the condom away in a bin, not down the toilet.
10. Make sure the man's penis does not touch his partner's genital area again.
11. If you have sex again, use a new condom.

Condoms with spermicide

Some condoms come with spermicide on them. Spermicide is a chemical that kills sperm. Spermicides that contain the chemical nonoxynol-9 do not protect against STIs and may even increase your risk of getting an STI. It's best to avoid using spermicide-lubricated condoms, or spermicide as an extra lubricant.

Who can use condoms?

Most people can safely use condoms. There are many different varieties and brands of male condom. It's up to you and your partner which type of condom you use.

Condoms may not be the most suitable method of contraception for everyone.

Some men and women are sensitive to the chemicals in latex condoms. If this is a problem, polyurethane or polyisoprene condoms have a lower risk of causing an allergic reaction.

Men who have difficulty keeping an erection may not be able to use male condoms. This is because the penis must be erect to prevent semen leaking from the condom, or the condom slipping off.

Advantages and disadvantages of condoms

It's important to consider which form of contraception is right for you and your partner. Take care to use condoms correctly, and consider using other forms of contraception as well.

Advantages

When used correctly every time you have sex, condoms are a reliable method of protecting both partners from STIs. They're also effective at preventing pregnancy.

You only need to use them when you have sex. They do not need advance preparation and are suitable for unplanned sex.

In most cases, there are no medical side effects from using condoms.

Condoms are easy to get hold of and come in a variety of shapes, sizes and flavours.

Disadvantages

Some couples find that using condoms interrupts sex. Communicating about sex with your partner can help avoid embarrassment and make sex better.

Condoms are very strong, but may split or tear if not used properly.

Some people may be allergic to latex, plastic or spermicides. You can get condoms that are less likely to cause an allergic reaction.

A man has to pull out after he has ejaculated and before the penis goes soft, holding the condom firmly in place.

If condoms aren't used properly, they can slip off or split. Practice and communication with your partner can help avoid this.

Can anything make condoms less effective?

Sperm can sometimes get into the vagina or anus during sex, even when using a condom. This may happen if:

• the penis touches the area around the vagina or anus before a condom is put on
• the condom splits or comes off
• the condom gets damaged by sharp fingernails or jewellery
• you use oil-based lubricants with latex or polyisoprene condoms – this damages the condom
• you're using medication for conditions like thrush, such as creams, pessaries or suppositories – this can damage latex and polyisoprene condoms and stop them working properly

Do not use 2 condoms at the same time as a form of 'double protection'. The friction is likely to break the condom.

As well as condoms, you can use other forms of contraception, such as the contraceptive pill, for extra protection against pregnancy. Other forms of contraception will not protect you against STIs. You'll still be at risk of STIs if the condom breaks.

Using lubricant

Condoms come ready lubricated to make them easier to use, but you may also like to use extra lubricant, or lube. This is particularly advised for anal sex, to reduce the chance of the condom splitting.

Any kind of lubricant can be used with condoms that are not made of latex. If you're using latex or polyisoprene condoms, do not use oil-based lubricants, such as:

• body oil or lotion
• petroleum jelly or creams (such as Vaseline)

This is because they can damage the condom and make it more likely to split.

If a condom splits or comes off

If the condom splits or comes off, you can get emergency contraception or STI testing at your GP or sexual health clinic. Emergency contraception can also be accessed at most pharmacies.

Depending on the type of pill, you need to take the emergency contraceptive pill up to 72 hours or up to 120 hours (5 days) after unprotected sex. The intrauterine device (IUD) can be used as emergency contraception up to 5 days after sex.

PEP for HIV is available from sexual health clinics and out of hours from A&E.

Risks of using condoms

For most people, there are no serious risks using condoms. Some people are allergic to latex condoms but you can get condoms that are less likely to cause an allergic reaction.

Where can you get condoms?

Everyone can get condoms for free, even if they are under 16. They're available from:

• your local free condom service provider
• sexual health clinics
• some GP practices
• some pharmacies

You can also buy condoms from:

• pharmacies
• supermarkets
• websites
• mail-order catalogues
• vending machines in some public toilets
• some petrol stations

If you buy condoms online, make sure that you buy them from a pharmacy or other legitimate retailer. Always choose condoms that carry the BSI kite mark and the European CE mark as a sign of quality assurance. This means they have been tested to the required safety standards.

Contraception services are free and confidential, including for people under the age of 16.

If you're under 16 and want contraception, the doctor, nurse or pharmacists won't tell your parents (or carer). They'll provide you with contraception as long as they believe you fully understand the information you're given and are able to use the contraception safely.

Doctors and nurses have a responsibility to make sure that you are safe and free from harm. They'll encourage you to consider telling your parents (or carer), but they won't make you. The only time that a professional will not be able to keep confidentiality is if they believe you're at risk of serious harm, such as abuse. If this was the case they would usually discuss it with you first.