When should I use a condom?

The simple answer to this is whenever you want to minimise the risk of pregnancy and/or transmission of sexually transmitted infections (STIs) during sexual activity. Sexual activity also includes oral sex - some STIs such as chlamydia, herpes and gonorrhoea can be transmitted during oral sex as well as during penetrative sex.

What protection does a condom give to me and my partner?

A correctly used condom gives two main forms of protection:

1) It reduces the risk of pregnancy
2) It reduces the risk of transmission of STIs such as herpes, syphilis and HIV.

Condoms are not quite as effective as some other forms of contraception in reducing the risk of pregnancy, but they are the only form of contraception that also offers protection against STIs.

How effective is a condom in preventing pregnancy?

A correctly used male condom is generally considered to be about 95% effective. If you wish to increase protection further you should consider:

• Using the condom in conjunction with spermicide (a chemical that kills sperm). Spermicides usually come in the form of a foam, cream or gel, and some are also effective against the HIV virus. Certain types of condom come ready-coated in a spermicidal lubricant. A condom used in conjunction with a spermicide is considered to be 96-97% effective.
  
• Using the condom in conjunction with another method of contraception (e.g. the contraceptive pill). The pill is considered to be 99% effective on its own, however it offers no protection against the transmission of STIs.

At what point should a condom be put on?

You should put on the condom before there is any contact between the penis and your partner's body. Fluid containing sperm and organisms that cause STIs can be released in the early stages of an erection. The penis must be erect before a condom can be fitted correctly however.

How do I use a condom?

In order to maximise protection you must be careful to use the condom correctly. If you have never used one before, read the instructions carefully and try practicing putting one on before you intend to use it for sex.

• Always check the expiry date on the wrapper.
• Wait until the penis is hard, but always put the condom on before the penis has any contact with your partner's body.
• Take the condom out of the wrapper carefully. Don't tear the pack open with your teeth, and be careful of sharp fingernails or jewellery.
• Before putting it near the penis, unroll the tip of the condom a bit to make sure it's the right way round and will unroll easily.
• Squeeze the tip of the condom to eliminate any air and place the condom over the tip of the penis.
• If your penis has a foreskin, you may find it easier to roll it back prior to putting on the condom.
• Roll the condom all the way down to the base of the penis.
• If you wish to use a water-based lubricant, rub it onto the outside of the condom once it is on the penis.

After sex, hold the condom at the base of the penis and carefully withdraw it from the vagina while the penis is still erect. Wrap the used condom in tissue and dispose of it in a bin. Never flush a used condom down the lavatory. Ensure that the penis stays out of contact with the partner's body.

Can condoms be used more than once?

Condoms should never be re-used. Even if a condom has only been used for oral sex it should be replaced with a new one before penetrative sex takes place, in order to minimise the risk of infection.

How should I talk to my partner about using condoms?

Buying and using condoms is all about being in control. Many people find it difficult to bring up the subject with their partner for the first time, and for that reason you may find that your partner is just as relieved as you when you start talking about it! You should try and discuss it early, but if you haven't talked about it in advance, try saying something like "Your condoms or mine?" or "We need to use a condom - I would never have sex without one". Your partner should respect you for it. If not, you may question whether the relationship is really ready for sex.

Should I always carry a condom?

Be prepared. Always carry a condom with you in your pocket or your purse. It doesn't mean that you are planning to sleep around. It just shows that you are responsible and that you care. It just makes sense! Remember also that drink (and some drugs) can affect the way you behave, and if you don't have a condom with you, you may decide to take a chance that you will regret in the morning.

Is it OK for a woman to carry a condom?

Of course! Thousands of women buy condoms and carry them around in a purse or handbag. Taking control of yourself and your body, rather than depending on your partner to provide a condom, is the sensible and responsible thing to do.

Do I need to use condoms for oral sex?

Condoms should be used for oral sex because some STIs (including HIV) can be passed on during oral sex, particularly when semen is swallowed or enters cuts or sores in the mouth. Try using flavoured condoms for extra fun.

Stopping to put on a condom is a real passion-killer! What can I do?

If you find that fitting a condom is interrupting your foreplay, try taking a different approach and make it part of your foreplay! Either partner can fit a condom and many women love the experience of fitting a condom onto their partner's penis. There's no reason why everything should grind to a halt to allow the condom to be fitted, providing it's done correctly.

I find that my sexual pleasure is reduced when a condom is used. What can I do?

You could try using a ribbed variety for extra stimulation or alternatively try an extra-fine condom for increased sensitivity.

I've heard a lot about lubricants. Why should I use one?

Condoms come ready-lubricated, however many people find that the use of a supplementary lubricant adds to sexual enjoyment. It can also reduce the risk of the condom tearing, particularly during anal sex. If you choose to use a supplementary lubricant you should only ever use an approved water-based one. Oil-based lubricants such as vaseline or massage oils are not designed for this purpose, and can damage the latex of the condom.

Are all condoms the same size?

Condoms come in a range of shapes and sizes, and just because they are made of thin latex that stretches doesn't necessarily mean that one size fits all. Only you and your partner can decide which is the ideal condom for you. Try using a range of condoms and choose which is the most comfortable.

Is it possible for a condom to burst?

Condoms bearing the CE quality mark have been rigorously tested to ensure that they should be strong enough for normal use. Nevertheless you should always take care with sharp objects such as fingernails, jewellery, zips, body piercings and teeth, as they can tear the condom. The use of an approved water-based lubricant is recommended during anal sex.

I think we may have had an accident with our condom. What should we do?

If you have had unprotected sex or you think your condom may have failed, you can use emergency contraception such as the 'morning after pill' or the intra-uterine device (IUD). For maximum effectiveness the emergency pill should be taken as soon as possible after sex (to a maximum of 72 hours), therefore you should consult your GP, pharmacist or family planning clinic at the earliest possible opportunity. The IUD must be fitted within 5 days, so it may still be an option if you are too late to take the emergency pill. Your GP or family planning nurse will advise you and fit an IUD if required.

I am already taking the pill so why should I bother using a condom as well?

The contraceptive pill is considered to be 99% effective in preventing pregnancy, however it offers no protection whatsoever against the transmission of STIs. It therefore makes sense to use condoms every time you have sex - even if you're already on the pill - in order to offer some protection against infection. In addition, some medicines and antibiotics (as well as stomach upsets) may affect the effectiveness of oral contraception. If in doubt, talk to your GP or pharmacist, and use a condom.

Is it true that condoms can be affected by other medications?

Some medications which are applied to the penis or vagina may affect the efficacy of latex condoms. If in doubt, you should consult your GP or pharmacist about compatibility.

Should I take condoms with me when I go abroad on holidays?

You should take a supply of CE marked condoms with you if you go away - it may not always be possible to purchase them when you get there.

I'm going steady with my partner. Do we still need to use condoms?

If you are in a monogamous relationship the risk of infection from an STI is certainly reduced, however bear in mind that not all STIs have obvious symptoms, and either you or your partner may be infected without even knowing it. Getting tested is the only way of knowing for sure whether or not you or your partner are infected with an STI. In addition, there may be other risk factors involved (for example if you or your partner are an IV drug user sharing needles, any infection received could be quickly transmitted to the partner if a condom is not being used).

How should I store my condoms?

Condoms should be stored in a cool dry place. They can be damaged by heat or sunlight.

Are there any side effects associated with using condoms?

Condoms are a barrier method, and as such there are very few side effects compared with other methods of contraception. Some people may suffer from an allergy to latex, meaning that the use of latex condoms may cause irritation or loss of sensitivity. In this case, you can try using a non-latex condom such as Durex Avanti.

How should I dispose of a used condom?

They should be wrapped in tissue and thrown into a bin. Never flush used condoms down the lavatory.

Other Common Methods of Contraception

Apart from the male condom, there are several other methods of contraception in common use. Your GP or family planning clinic will help you decide which method is best for you and your partner. Be aware, however, that the condom is the only method that also offers protection against the transmission of STIs.

The commonest alternative forms of contraception include:

The Female Condom

The Female Condom (or 'femidom') is inserted into, and lines, the vagina. There are two rings to keep it in place, the smaller of which (at the closed end of the condom) is inserted while the larger one (the open end) lies flat against the outside of the vagina. It is considered to be 95% effective.

The Diaphragm ('cap')

This is a round dome-shaped piece of rubber that is inserted into the vagina and covers the neck of the cervix, thereby preventing sperm from entering the womb. In the first instance it must be fitted by a GP or family planning nurse as there are several different types and sizes available and it is important to use the correct one. Correctly used with spermicide they are considered to be 96-97% effective.

The Combination Pill

The combination pill is made up of oestrogen and progesterone and is taken daily for 21 days followed by 7 pill-free days. This type of pill uses hormones to simulate a state of pregnancy, thereby preventing the ovaries from releasing any further eggs. It is considered to be 99% effective, but there may be troublesome side effects such as depression and serious circulatory disorders (e.g. high blood pressure and stroke).

The Progesterone-only Pill

This type of pill is taken every day, without a pill-free phase. It doesn't always stop ovulation from occurring, but is designed to make fertilisation more difficult and prevent the implantation of a fertilised egg in the wall of the womb. It is considered to be 98% effective, but like the combination pill there may be troublesome side effects.

The Intra-Uterine Device (IUD or 'coil')

The IUD is fitted into the female's uterus (womb) by a GP or family planning nurse, where it can remain for up to 5 years. It works by preventing a fertilised egg from implanting itself in the womb. It is considered to be 98% effective, however it may cause the user's periods to become heavier and more painful.

If you require further advice on any aspect of contraception, family planning and sexual health you should consult your GP.