Condoms 101

They can prevent unwanted pregnancy and offer protection against disease

THURSDAY, Feb. 12, 2004 (HealthDayNews) -- Who doesn't know that Feb. 14 is Valentine's Day, with such attendant pledges of love as chocolates, flowers and possibly diamonds?

But did you know the day has also been proclaimed National Condom Day?

Public health officials hope to use the designation to draw attention to the role condoms can play in helping to prevent unwanted pregnancies and potentially limiting the spread of sexually transmitted diseases (STDs).

Condoms have been used to protect against STDs since the 16th century and unwanted pregnancy since the 18th century. The earliest known illustration of a man using a condom during intercourse is painted on the wall of a French cave and is estimated to be 12,000 to 15,000 years old, according to Planned Parenthood Federation of America.

Yet even with the condom's long history, public health experts say most people still have a few things to learn about proper use.

"People who are trying to avoid pregnancy or STDs need to use a condom correctly each and every time they have sexual intercourse," says Dr. Jim Allen, president of the American Social Health Association, a North Carolina-based organization devoted to sexual health.

If used properly, "the failure rate of condoms [for pregnancy prevention] can be as low as 2 percent," says Dr. Vanessa Cullins, vice president for medical affairs for Planned Parenthood Federation of America. That means two women of 100 who rely on a condom for contraception will get pregnant in a year of use.

People tend to hear that failure rates are high with condoms, she says. And they are higher with improper use. For instance, typical users experience a 15 percent failure rate -- that is, 15 women of 100 whose partners use condoms will get pregnant in a given year.

If both failure rates produce anxiety, Cullins suggests doubling up on birth-control methods. "The best way to protect against both unintended pregnancy and sexually transmitted infections is really to practice dual-method use," she says. That might be a male condom and the birth control pill, she adds.

Another option, Cullins says, is to use the condom as the main method of protection and rely on emergency contraception as a backup if the condom breaks. Emergency contraception involves taking the same hormones found in regular birth control pills after unprotected intercourse to prevent pregnancy from occurring.

Condoms offer some measure of protection against such sexually transmitted diseases as chlamydia, gonorrhea, syphilis and trichomoniasis, although there's debate over just how effective they are. Still, any protection is important in light of the 15 million new STD cases in the United States every year. But, federal health officials add, condoms can't offer complete safety against such diseases.

Condoms do offer significant protection for both women and men against HIV, the virus that causes AIDS, officials say.

Latex condoms are preferred over natural skin condoms such as lambskin, Cullins and Allen agree. "Latex condoms, which are regulated by the FDA [U.S. Food and Drug Administration] and are highly reliable and readily available and inexpensive, are effective," Allen says.

Another option are female condoms, Allen notes, so "a woman can make the decision to use it herself. She doesn't necessarily have to involve her partner."

Yet even knowledgeable, veteran condom users make mistakes, health experts agree.

"The biggest source of problems is 'user error,'" says Allen. For instance, if lubricants are used on the condom, only water-based ones should be used. "If you use a vegetable-based oil or Vaseline for lubrication, you weaken the latex, and they are more likely to rupture," he says.

Finally, condoms should be removed immediately after orgasm, Allen says. "That's because after orgasm, the penis normally shrinks. That can allow leakage."

More information

For a fact sheet on condoms, visit Planned Parenthood Federation of America. For proper condom use, check with the American Social Health Association. This National Institutes of Health report examines condoms' ability to protect against sexually transmitted diseases.

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