II. Efficacy
- Overall Failure rate: 10-14% (3% with perfect use)
-
Sexually Transmitted Disease transmission
- Cervical gonorrhea Relative Risk < 0.97
- Urethral gonorrhea Relative Risk < 0.51
- Pelvic Inflammatory DiseaseRelative Risk < 0.6
- HIV Transmission to partner: 10% (86% if no Condom)
- Avoid Condoms with Nonoxynol-9 (Gynol II)
- See Spermicide
- Associated with irritation and no additional protection against pregnancy
- Increases risk of Gonorrhea and HIV Transmission
III. Risks Factors: Breakage (occurrence: 1 in 161 acts)
- Shearing (5.9% with anal sex)
- Lack of lubrication
- Petroleum based lubricants (Vaseline, oils, fungicides)
- Hot, humid climates
IV. Types
-
Latex
- Standard recommendation
- Best data in protection from Sexually Transmitted Infection and pregnancy
- Latex Condoms are effective in STD prevention in vaginal intercourse and anal intercourse
- Additional FDA approval for anal use (e.g. One Condom) applies more to marketing than efficacy
- Natural membrane
- Does not prevent Sexually Transmitted Disease
- Use inside of latex Condom if Latex Allergy
- Polyurethane (e.g. Avanti, Tactylon)
- Less biodegradable
- Consider in Latex Allergy, or when patients are on an oil based vaginal product (e.g. Clindamycin, Clotrimazole)
- Higher breakage rate (3.8% compared with 1.2% latex)
- Higher slippage rate (4.9% compared with 2.0% latex)
- Higher six month pregnancy rate
- Polyurethane Condoms: 9%
- Latex Condoms: 5.4%
- References
V. Preparation: Sizes
- Length: 160-180 mm
- Flat Width: 49-52 mm
- Thickness: 0.04 - 0.07 mm
VI. Complications
- Allergic Reactions to latex
- Infection risk
- Risk if Condom left in vagina
- Urinary Tract Infection risk increased
VII. Prevention: Condom breakage or slippage
- Be gentle
- Do not open package with knife or scissors
- Avoid tearing with teeth, rings or Fingernails
- Store in cool, dry place
- Do not store in glove compartment
- Avoid storing in wallet
- If kept in wallet, do not use after 1 month
- Check expiration date on package
- Hold Condom during withdrawal
- Apply Condom early in sexual encounter
- Avoid removing Condom until after ejaculation
- Have adequate Condom supply
- Do not reuse Condoms
- Consider using a water based lubricant (e.g. K-Y Jelly)
- Do not use oil based lubricants (breaks down Condom)
VIII. Management: Condom Problems
- Condom breaks
- Wash vulva and anus
- Insert Spermicide in vagina
- Consider Emergency Contraception
-
Latex Allergy
- Use Polyurethane or polyisoprene Condom
- Woman latex allergic
- Use latex Condom inside of natural membrane Condom
- Man latex allergic
- Use natural membrane Condom inside of latex Condom
IX. References
- (2022) Presc Lett 29(5): 30