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Do condoms work?

Absolutely, yes, they work! Latex and synthetic (polyisoprene, nitrile or polyurethane) condoms have been tested and retested by manufacturers and researchers and are regulated by the U.S. Food and Drug Administration (FDA) to make sure people are getting great protection. When a condom is used correctly and consistently every time you have oral, anal or vaginal sex involving a penis, you are getting a lot of help at preventing pregnancy and/or the transmission of sexually transmitted infections (STIs).

Condoms may also be called “external condoms” because they fit over the penis, unlike internal condoms, which are inserted into the body. When external condoms are used correctly and consistently, they prevent pregnancy about 98 percent of the time. The typical effectiveness rate—where mistakes are made or condoms break—is about 82 percent. Internal condoms —also known as “female condoms” —prevent pregnancy about 95 percent of the time when used correctly and consistently.

External and internal condoms also reduce the risk of STIs that are spread through bodily fluids (pre-cum, semen, vaginal fluid and blood). Those STIs include HIV, gonorrhea, chlamydia, hepatitis B, trichomoniasis and syphilis. Some STIs, like herpes and genital warts, are spread through skin-to-skin contact. A condom may not cover all areas of the skin that are infected, such as the scrotum, anus, labia or even the inside of the thigh. So condoms may not fully protect against skin-to-skin transmission for these specific infections.

There are so many types of condoms. What is the difference between the different types?

It can be overwhelming to look at rows of condom boxes and not know if they all work equally well. The most important distinction to make between condoms is the material they’re made out of. Condoms can be made of latex, polyurethane, nitrile, polyisoprene or natural skin (lambskin). Only latex, polyisoprene, nitrile and polyurethane condoms prevent the spread of sexually transmitted infections (STIs). Most studies have been conducted on latex condoms, but for people who are allergic to latex, polyurethane, nitrile or polyisoprene condoms are a good choice. 

Types of Condoms
  • Latex condoms are the most common and affordable. They’re durable and can be used with a water-based lubricant, like Trojan’s H2O Closer. Trojan brand condoms are America’s #1 condom, according to US News & World Report 2018-2019 OTC Guide Survey, and the #1 pharmacist recommended brand, according to Pharmacy Times.
  • Polyurethane, nitrile or polyisoprene condoms are also very durable, and some people say these condoms permit even greater sensations than those made out of latex. Polyurethane, nitrile and polyisoprene condoms are a great alternative for people with latex allergies and can be used with any kind of lubricant because this material does not break down easily. A popular brand of polyurethane condom is Trojan Supra condoms.
  • Natural skin (lambskin) condoms do not protect against STIs because they have pores (tiny holes) that can allow STIs to pass through. They do protect against pregnancy, and some people use them only for that purpose.
  • Internal condoms (also known as “female condoms”) are a soft, loose-fitting nitrile sheath that can offer protection during vaginal sex and anal sex as well. This device has two flexible rings to hold it in place. The smaller ring goes inside the vagina and holds it in place. The wider ring remains outside the vagina during vaginal sex or the anus during anal sex. (Internal condoms are not FDA approved for anal sex.) Some people choose to use internal condoms for anal sex, in which case the smaller ring should be removed before placing the condom over the erect penis and inserting the penis into the anus.

How do I use a condom?

In order for an external condom to work correctly, it must be put on following the right steps. It also must be used consistently—meaning, each and every time a person has vaginal, oral or anal sex.

When a condom breaks, it’s usually because one of the correct steps wasn’t followed. Luckily, condoms come with instructions that should cover these same steps:

  1. Check the expiration date. This should be clearly printed on the box and on the condom wrapper. If the condoms have expired, even by only a few days, do not use them. The material they are made of and the lubricants they might have on them can break down over time, which means the condoms are more likely to break if they’re expired.
  1. When you store a condom to use it later, keep it in a cool, dry place, so as not to damage it. In practical terms, this means that you should not keep condoms in your pocket or wallet for a long time. Leaving them in a car for a long period is also a bad idea.
  1. When you are in a situation where you are about to have anal or vaginal sex, open the package carefully (don’t use your fingernails or your teeth) and remove the condom from the wrapper.
  1. Condoms are rolled up when they come out of the package. You need to figure out which is the inside and which is the outside of the condom. How do you tell? Hold the condom so it looks like a hat, with the thick, rolled-up part on the outside. As you look at it, you’ll be able to see how you would roll it easily over an erect penis.
  1. Pinch the tip of the condom to squeeze the air out of the condom. This will allow semen to collect in the tip at the top. The condom could break if the tip is not pinched and air bubbles are let in.
  1. Keep pinching the tip as you place the condom on the head of the erect penis.
  1. Keep pinching the tip with one hand as you roll the condom all the way down to the base of the penis with the other hand.
  1. After ejaculation (which doesn’t always happen) grasp the condom at the base of the penis and remove the penis (with the condom still on it) from your partner’s body.
  1. Turn away from your partner’s vagina or anus and carefully remove the condom from the penis. You can tie a knot at the end once it’s off so any semen inside doesn’t leak out.
  1. Wrap the condom in a tissue and throw it away. Do not flush it down the toilet.

Never reuse a condom.

To practice safer oral sex, you can use a flavored latex condom. There are many varieties of flavored condoms. For oral sex on a penis, follow the instructions above. When ejaculation happens, remove the penis from your partner’s mouth, then remove and discard the condom in the same way as described above.

For oral sex on a vulva or anus, if a dental dam (a latex sheet that can be used for oral sex on a partner’s vulva or anus) is unavailable, cut off the elastic ring at the base of a condom, and then cut the condom open with scissors. The condom will now look more like a sheet of latex. Place it on your partner’s vulva or anus with the flavored side up. 

When used correctly and consistently, condoms are highly effective at preventing STIs, including HIV, and pregnancy.

What do I do if a condom breaks?

If partners are having vaginal or anal sex and the condom breaks or slips off inside the vagina or anus before the partner with a penis ejaculates, the couple should stop having sex immediately. If they want to start having sex again right after this happens, they should put on a new condom before they continue.

If a condom breaks or slips off during vaginal sex, the partner with a vagina can still use emergency contraception (EC) within five days to avoid a pregnancy. Visit your campus health center or a pharmacy to get EC.

If the condom slips off inside of you or your partner and you can’t get it out, you can go to a health care provider and have it removed. Don’t worry, they’re used to this and know how to get it out easily.

If any couple is having anal sex and the condom slips off or breaks, there’s no risk of pregnancy—unless the partner who is being penetrated has a vagina and semen spills from the anus to the vagina—but there is risk of sexually transmitted infections (STIs), including HIV. It would be a really good idea for both partners to get tested.

These are the most common reasons a condom slips off or breaks:

  • It was put on incorrectly (the tip wasn’t pinched or it was rolled on the wrong way).
  • It was old (the expiration date passed).
  • It was ripped or exposed to high temperatures wherever it was stored.

If your condom breaks, review the steps for how to use a condom to make sure it doesn’t happen again.

How do I ask a partner to use a condom?

Sometimes people don’t want their partner to think they were planning to have sex since it seems more romantic for sex to “just happen.” But wanting to prevent an unplanned pregnancy and/or the transmission of sexually transmitted infections (STIs) is smart.

Being concerned about what others think can keep some young people from talking openly about safer sex. Talking openly and honestly with a partner about condoms and planning ahead of time how to protect each other from STIs and/or pregnancy is important.

Ideally, you should talk about using protection, such as a condom, before you even start engaging in sexual behaviors. When you talk openly and honestly about your expectations, both you and your partner understand that if you do have sex, then you will be prepared to use protection.

When you talk about using a condom, it doesn’t necessarily mean that you have committed to having sex. It just means that protecting your sexual health is important to you. Even if you have decided to have sex but then realize that sex doesn’t feel OK, you always have the right to say “no,” even at the last second. Partners need to respect the right of anyone at any time to change their mind. It’s a good idea to talk about boundaries and the best way to communicate during intimate and sexual encounters.

If you find that it is difficult for you to talk openly and honestly with your partner about using a condom, or sex in general, you might want to think about whether it’s the right time for you to have sex. Using protection is part of having sex and is nothing to be ashamed of.

What if my partner doesn’t want to use condoms?

Many people use the motto: “Safer sex or no sex!” While this can be the most protective way to look at using condoms, not everyone welcomes the use of condoms.

In a perfect world, it would be easy to have an honest conversation about safer sex with your partner before you include sexual behaviors in your relationship. Talking about safer sex before sexual behavior becomes part of your relationship can give you an opportunity to get closer to your partner emotionally and can help the two of you decide whether you’re on the same page when it comes to expectations about sex and protection. Unfortunately, many people find themselves trying to convince a partner to use a condom in the moment when they are feeling turned on, emotionally or physically vulnerable or even under the influence of drugs or alcohol.

If you take the time beforehand to have this important conversation, then you can anticipate any potential problems and take steps to avoid situations where it will be hard to get what you need. For example, if you let your partner know that you want to use a condom, and your partner feels defensive about it, then you can take time to let them know that you want to use a condom because you care about them, your sex life together and the future of your relationship.

Do I need to use protection during oral sex?

Yes. Although the chance of getting or giving a sexually transmitted infection (STI) during oral sex is less likely than with penile-vaginal or anal sex, it is still possible. Many STIs can be passed from the mouth to genitals and vice versa. STIs, including chlamydia, gonorrhea, HPV, herpes, hepatitis B and syphilis, can be spread by giving or receiving oral sex. There is a small risk for getting and giving HIV through oral sex, especially if a person has cuts or sores in their mouth.

Anytime pre-ejaculatory fluid, semen or vaginal fluid enter the body, whether through the mouth or another opening, there’s a risk of transmitting an STI if either partner has been infected. HPV and herpes are not spread through fluids—they are spread through skin-to-skin contact with an infected area. It’s tough to tell whether a person has an STI though. Sometimes, people have infections and don’t even know it.

This doesn’t mean that you can’t enjoy oral sex. But it does mean that it is important to plan ahead, talk to your partner and use protection. One way to make oral sex safer is to get tested for STIs regularly. Pay attention to your body, and if anything seems different, get checked out by a health care provider right away.

If you think you might have oral sex, using a latex barrier or other safer sex method is your best chance of avoiding most STIs. A condom can be used on a penis to protect partners from STIs. Many condom brands have flavored condoms to make using one during oral sex more enjoyable.

A dental dam—a thin sheet of latex—can be used for oral sex on a vulva or anus. You can get dental dams at a health center. Sexual partners can also cut a condom lengthwise to create a sheet that works like a dental dam to use as a barrier between a person’s mouth and a vulva or anus.

Does sex feel different with a condom?

If you ask most people, they would say, “Yes, it feels different with a condom”—but you would get a range of descriptions. Some think it feels better. Some think it feels worse, and some think it just feels different.

Some people say that sex feels better with condoms because they can relax and not worry about pregnancy and sexually transmitted infections (STIs). And others like using condoms because they can feel different sensations while using them.

A common complaint about condoms is that “you can’t feel anything.” But some people love using condoms because they can last longer before ejaculation or they like the sensations of ribbed condoms. Some people might say they feel distanced from their partners when they use condoms. But condoms protect you and your partner, so that can also make you feel closer.

There are lots of brands and types of condoms out there. If you’re worried about a different sensation or a condom ruining the experience, you might think about polyurethane condoms. Polyurethane conducts body heat better and can feel sheerer. You can also try thin latex condoms, such as Trojan UltraThin. If you are uncircumcised and experience pain when you put on the condom, you may have adhesions between the glans and shaft of your penis, which can be easily remedied at a doctor’s office.

If you are someone who experiences less pleasure when your partner uses a condom for oral, vaginal or anal sex, you can add lubricant (both on the penis before you put the condom on as well as on the condom after it’s on) to help decrease friction between your skin and the condom. You can add lubricant to a condom that is already lubricated or one that is not. You can also make sure your partner is using a condom that fits well. There are different shapes and sizes of condoms, so read each label to find out what might work best for you and your partner. Try different ones until you find one that works for both of you—kind of like an adventure! Flavored or unlubricated condoms can be used for oral sex.

And finally, even when it feels a little different when you use a condom, just remember that only condoms can protect you from most STIs, such as HIV. For heterosexual couples, they also do “double duty” by backing up hormonal contraception, like the pill, patch or shot, to protect you from an unplanned pregnancy or they may serve as your sole method of effective pregnancy prevention. 

How can you avoid getting a sexually transmitted infection (STI)?

The most effective way to avoid getting an STI is to abstain from sexual touching below the waist, such as rubbing bodies without clothes, vaginal-penile sex, oral sex and anal sex. If you choose to have sex, your next best bet is to practice safer sex, which means using either an external condom or an internal condom (also known as a “female condom”) and/or dental dam every time you engage in sexual behaviors, getting tested regularly for STIs and asking your partners to do the same.

STIs cannot spontaneously occur. There is risk only when one person already has an STI. Since most STIs don’t have symptoms, you can’t rely on what you see to tell you whether or not an infection is present. So it is better to be safe.

While different STIs are transmitted in different ways, most either are spread through skin-to-skin genital contact or contact with sexual fluids (and sometimes blood) in the mouth, anus, vagina or the urethra of the penis. Most other kinds of close sexual contact with an infected partner carry some risk—sometimes extremely low, sometimes very high—of getting an STI.

If you decide to be sexual with a partner, here are some things you can do to reduce your chances of getting an STI:

  • Get tested regularly, and always get tested before you have sex with a new partner. Your partner should also be tested.
  • Communicate with your partner before having sex. Ask your partner if they have ever had an STI and if it was treated. Ask when your partner last got tested for an STI and if they are willing to get tested again. Ask them if they practiced safer sex with past partners and if that included oral sex. Know that people sometimes don’t know they have an infection or may not consider certain behaviors risky, when in fact they are.
  • Learn about STIs—how they are transmitted and which activities are low risk and which are high risk—so that you can make informed decisions about how to protect your sexual health. For example, kissing and massage are low risk. Unprotected vaginal or anal sex is higher risk.
  • Even if you have both been tested and nothing has shown up, you should still practice safer sex every single time you have sex so that you both remain safe and protected.

You should also use condoms if you have oral sex involving a penis. Flavored condoms are made specifically for oral sex and are available in most drugstores. During oral sex that involves a vulva or anus, use a dental dam, such as a Sheer Glyde Dam, to cover the vulva or anus. A condom cut lengthwise and placed over a vulva or anus is also an effective barrier. Using non-microwaveable plastic wrap—the kind used for food storage—during oral sex on a vulva or anus is better than not using any protection. Still, a Sheer Glyde Dental Dam offers the best protection during oral sex on a vulva or anus because it is less likely to break if stretched thin the way plastic wrap can.

What is important to remember is that latex, polyurethane, polyisoprene or nitrile condoms are highly effective, but sometimes people don’t use them correctly or consistently. To make sure you know how to use a condom, review the steps [link to FAQ].

If my partner and I are both virgins, is there any way we could have a sexually transmitted infection (STI)?

If neither of you has had any kind of sex, then it’s unlikely. But the tricky part is defining “virgin” and “sex.”

Sexually transmitted infections (STIs) can spread through oral, vaginal and anal sex and genital skin-to-skin contact. For example, some STIs can be passed through certain types of sexual skin-to-skin contact, like when you rub bodies with no clothes on. So when you and your partner use the word “virgin,” make sure you both mean the same thing. There is very little risk for STIs if neither of you has had any sexual experience at all.

Even if neither of you has an STI, it’s still a good idea to get in the habit of using condoms each and every time you have sex. Condoms provide protection from pregnancy and STIs, and even though you may not have concerns about STIs now, it’s a good habit to get into using condoms.

Is it possible to have a sexually transmitted infection (STI) and not have any symptoms? If so, how can I know if my partner is infected?

Yes, it’s possible to have a sexually transmitted infection (STI) and have no symptoms. This also means that your partner can have one and not know it.

If symptoms do occur, they often do so in places that are difficult to see. For example, HIV—the virus that causes AIDS—can live in the body for 10 years without a person showing any symptoms.

HPV is perhaps the most common STI because it usually has no symptoms; people spread it without knowing they have it. Many STIs show no symptoms. Unfortunately, the long-term consequences of untreated STIs can be very harmful to your health.

The only way to know for sure if you or your partner has an STI is to get tested. Visit your campus health center.

I’m on the Pill and my partner and I have been tested for sexually transmitted infections (STIs). Can we stop using condoms?

It’s great that you’re using contraception and that you’ve been tested for sexually transmitted infection (STIs). That shows you’re taking responsibility for your sexual health. We recommend that you continue to use external condoms or internal condoms (also known as “female condoms”) for two reasons.

First, contraceptive pills are good at preventing pregnancy as long as you take it at about the same time every day. If you forget to take the Pill, the chance of pregnancy increases, so condoms give you extra protection. In addition, the Pill is not 100 percent effective; even if you take it consistently, there’s still a slight chance of pregnancy. Therefore, using the Pill and a condom each time you have sex reduces the chance of pregnancy.

Secondly, contraceptive pills do not provide protection from STIs. Research shows that many young people begin relationships using condoms and another hormonal contraceptive method, but then stop using condoms later on. At this point, they are not protected from STIs, and while they think their partner isn’t with anyone else, sometimes people have multiple partners. Obviously this doesn’t apply to everyone, but with the added benefit of increased pregnancy protection, why not keep condoms in the picture? Also, many times STIs don’t have any symptoms, and you or your partner may be a carrier without knowing you have an STI. It’s best to protect each other from the possibility of pregnancy or STIs.

Got a question about STIs? Visit the American Sexual Health Association (ASHA) website or call ASHA’s Resource Center Hotline for STD questions and concerns at 1-919-361-8488.

I’ve heard chlamydia and gonorrhea are curable with antibiotics, so what’s the big deal if I get them?

Chlamydia and gonorrhea are common, curable infections caused by bacteria. But just because they are common and curable doesn’t mean they aren’t a big deal.

The thing with chlamydia and gonorrhea is that they often have no symptoms, so it is often impossible to know if you have them or if your sexual partner has them, unless you are both tested. They can be transmitted through vaginal, anal and—although less likely—oral sex.

When a person with a penis gets these bacterial infections, if they have symptoms, it hurts when they pee. They may experience swelling of the testicles or discharge from the penis. For a person with a vulva, there can be pain when peeing and an unusual discharge from the vagina. While not as common, it is possible to get chlamydia or gonorrhea in the throat if you give oral sex to an infected person. It’s also possible to get these infections in the anus or rectum through anal sex.

Both chlamydia and gonorrhea can be cured with antibiotics; however, a person can transmit them to a partner until they have finished taking all of their antibiotics. Also, even if you’ve been treated and cured of chlamydia or gonorrhea once, you can still get them again if you have sexual contact with an infected partner.

If left untreated, they can cause severe infections in the reproductive system and can even cause sterility and infertility, meaning a person would be unable to become pregnant or contribute to a pregnancy down the road. A health care provider tests for chlamydia or gonorrhea in the anus or genitals, by swabbing the anus, cervix or urethra at the tip of a penis. Health care providers can also do urine tests and look for traces of discharge in the urine.

The best way to avoid chlamydia and gonorrhea—and any STI—is to always use a condom and other safer sex methods when you have sex, communicate openly and honestly with your partner and get tested with a partner before having any kind of sex.

Visit your campus health center for STI testing. 

Have more questions? You can learn more at the website for the American Sexual Health Association.

What are the different kinds of sexually transmitted infections (STIs)?

There are three different kinds of sexually transmitted infections STIs: bacterial, viral and parasitic.

  • Bacterial infections are caused by bacteria. They include chlamydia, gonorrhea and syphilis. These can be cured by taking antibiotics.
  • Viral infections are caused by a virus. They include herpes (HSV-1 or HSV-2), human papillomavirus (HPV), hepatitis B, hepatitis C and human immunodeficiency virus (HIV), the virus that causes AIDS. HSV-1, HSV-2 and HIV stay with a person for life and can be passed to partners even if there are no symptoms. There is no cure for HSV-1, HSV-2 or HIV. In some cases, HPV and hepatitis B can be cleared from the body, but there are also times when they stay with a person for life. 
  • Parasitic infections are caused by parasites (tiny bugs) that live on the body or in pubic hair. They include scabies, pubic lice (“crabs”) and trichomoniasis. They can be spread through skin-to-skin sexual contact and from sharing bath towels, bedding and clothing. Scabies can be treated and cured with topical or oral medications. Pubic lice can be cured with prescription soap. Trichomoniasis can be cured with an antibiotic.

What is an internal condom (also known as a “female condom”) and how does it work?

An internal condom is a pouch made of nitrile that is worn internally—inside of the vagina during vaginal sex or inside of the anus during anal sex.

When worn inside the vagina, an internal condom can prevent pregnancy and sexually transmitted infections (STIs). It has a ring on each end with one end open and the other end closed, and the ends are connected by a condom-shaped tube. The closed end with the smaller ring is inserted into the vagina and fits around the cervix, which is the lower part of the uterus. The wider ring stays just outside the vaginal opening. This is where the penis is inserted during penile-vaginal sex.

To insert this condom anally, remove the smaller ring from the closed end of the condom, place the condom over the erect penis and insert the penis inside the anus during anal sex. The wider ring stays just outside the anal opening.

Internal condoms can only be used once. Never use an internal condom and an external (or “male”) condom together. They could rub together and break, and you’ll end up with no protection.

When used perfectly during penile-vaginal sex, an internal condom prevents pregnancy about 95 percent of the time. The typical use rate is a lot lower—79 percent—because people don’t always use them correctly.

Just like external condoms, internal condoms only prevent the transmission of STIs that are passed through body fluids—HIV, gonorrhea, chlamydia and syphilis. Some STIs, like herpes and some strains of HPV, are spread through skin-to-skin contact. Condoms may not cover areas of the skin that are infected, such as the scrotum, labia or even the inside of the thigh. So condoms—both types—may not protect against these kinds of infections.

If you ask users of internal condoms what they think of them, you get a range of opinions. Some people say the internal condom stimulates the clitoris, which can increase pleasure during intercourse. Others say it slips or is uncomfortable during sex if the rings rub or pull against the penis or vagina.  

Internal condoms are available online. You may also be able to find them at your campus health center.