What only it does
No other method covers both risks. Pill, IUD, implant, natural methods: all of them address pregnancy only. The condom is the only way to also reduce transmission of HIV, hepatitis, gonorrhoea, chlamydia and syphilis — which makes it, in many situations, not an alternative to the other methods but a complement to them.
It has three other rare properties: it is available with no appointment and no prescription, it can be used immediately, and it is often distributed free.
External and internal
| External | Internal | |
|---|---|---|
| Material | Latex, or latex-free polyurethane and polyisoprene | Nitrile, latex-free |
| Placement | On the erect penis, before any contact | In the vagina, up to eight hours before intercourse |
| Lubricant | Water- or silicone-based only with latex | Any type, including oil-based |
| Perfect use | around 2 pregnancies per 100 women per year | around 5 |
| Typical use | around 13 | around 21 |
The internal condom has one advantage of its own: it does not depend on an erection and can be put in place well in advance, which takes it out of the negotiation of the moment. Its outer ring also covers part of the vulva, which helps against herpes and human papillomavirus.
Where the effectiveness is lost
The gap between 2 and 13 almost never comes from breakage: it comes from usage errors, all avoidable.
- Put on mid-act rather than before any contact: the commonest and costliest error.
- Air left in the tip: trapped air is what bursts a condom, not friction.
- Oil-based lubricant on latex — oil, petroleum jelly, cream, body butter, some ointments: latex degrades within minutes.
- Two condoms at once, or an external with an internal: the friction weakens them instead of reinforcing.
- Late withdrawal, after the erection has gone: withdraw holding the base.
- Poor storage: back pocket, glovebox, wallet — heat and crushing damage the product. Check the date and that the wrapper is intact.
- Reuse, or the same condom when changing practice or partner: never.
If it breaks or slips
Two reflexes, in this order. Emergency contraception: the sooner it is taken the more effective, and it stays useful for several days — see emergency contraception. Infection risk: depending on the situation, preventive HIV treatment may be offered, but it must begin within 48 hours, ideally much sooner. Do not wait until the next day to find out. Testing is then planned for later, at the right interval.
"It doesn't stay on", "I can't feel anything"
These objections usually point to a size or lubrication problem, not an inevitability. Nominal widths vary by several millimetres between brands, thicknesses likewise, and a compatible lubricant changes the sensation markedly. Trying two or three brands resolves most cases.