Published February 2020
Why and How to Use Condoms
“Condoms and the barrier method go back to the beginning of time,” says Lauren F. Streicher, MD, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause. “They can help prevent pregnancy and sexually transmitted infections (STIs).”
What Is a Condom?
Male condoms are sheaths that go around the penis during sexual intercourse. To use a male condom, check the packaging to make sure it is not expired or damaged. Remove the condom and roll it down an erect penis, leaving room at the top for semen by pinching the top as you roll it on.
Female condoms, or internal condoms, are tubes inserted into the vagina for protection during sexual intercourse. To use a female condom, check the packaging to make sure it is not expired or damaged, then use your fingers to insert the tube into your vagina. Wrap the remainder of the condom around the vulva and walls of the vagina for additional protection. You can also use internal condoms for anal sex.
“Contraception has always fallen on the lap of women,” says Dr. Streicher. “Female condoms are not widely appreciated because we’re not as familiar with them, but they empower women to take STI safety into their own hands.”
What Are Condoms Made Of?
“Roughly 80 percent of condoms in the store are latex,” says Dr. Streicher. “Latex is great in terms of protection, but the downside is some people have a latex sensitivity or allergy.”
“Lambskin condoms typically come lubricated, but they have small pores and therefore aren’t the best for preventing infection,” says Dr. Streicher. “If you’re concerned about pregnancy, they are fine, but if you’re concerned about STIs, they’re not the way to go.”
Synthetic (polyisoprene, polyurethane or polyethylene)
“The effectiveness of synthetic condoms against STIs has not been well studied,” says Dr. Streicher. “The bottom line is, if you are concerned about STIs, use a latex condom if you can.”
“Oil-based lubricants, such as coconut oil or baby oil, are not condom-compatible,” says Dr. Streicher. “Water-based and silicone-based commercial lubricants are condom-compatible.”
Condoms and Risk
When used properly, condoms are effective at reducing risk of STIs, but they cannot prevent 100 percent of STIs 100 percent of the time. The only way to have absolute protection from STIs is to abstain from any genital contact.
Condoms are effective against STIs that are transmitted through genital fluid, such as chlamydia, gonorrhea and trichomoniasis. Condoms are less effective for STIs transmitted by skin-to-skin contact, such as genital human papillomavirus (HPV).
Timing is crucial for optimizing protection with condoms. Condoms are most effective if you use them at the first point of sexual contact, not just before penetration.
“Most people put condoms on too late,” explains Dr. Streicher. “In a perfect world, anytime there is intimate genital or genital-oral contact, you should use a condom to prevent herpes and HPV and STIs transmittable via skin-to-skin contact.”
Condoms are 98 percent effective at preventing pregnancy provided they are used at the onset of genital contact and do not break or leak. In the event of unprotected intercourse, emergency contraception is effective and available over the counter.
It’s important to have an open conversation with your sexual partner about how you’re going to protect each other from STIs and prevent pregnancy. Talk to your physician about contraception methods and STI prevention methods that will work with your lifestyle.