The simple truth is that many people don’t use external condoms correctly or consistently, particularly young adults, 55% of whom use external condoms, according to a 2015 study in the International Journal of STDs and AIDS. Misconceptions and misunderstandings account at least in part for external condom use mistakes.
The bottom line is that external condoms work. Here are the top 10 facts that illustrate why they should be part of your sexual health routine.
American and imported external condom manufacturers electronically test every external condom for holes and other defects. They also conduct additional testing on random external condoms from each batch, usually involving a water leak test to detect holes and an air burst test to check the strength of the external condom.
The U.S. Food and Drug Administration (FDA) inspects external condom manufacturing facilities periodically and performs random testing to ensure consistent quality.
External condom malfunction can occur if you use a poorly sized external condom. Those that are too tight may be more likely to break, whereas external condoms that are too loose may be more likely to slip off.
However, if an external condom breaks, the size may not be the cause. Instead, it may be that you are using the wrong lubricant, using an expired condom, or storing the external condom at high temperatures (such as in the glove compartment). These things can undermine the integrity of an external condom and increase the risk of bursting.
Check the expiration date before using an external condom, and throw away any external condom that is torn or looks damaged. Never reuse an external condom.
STIs like chlamydia, gonorrhea, hepatitis B, HIV, syphilis, and trichomoniasis are transmitted through genital secretions, including semen. External condoms provide excellent protection against these STIs because they act as barriers.
The current body of research shows that consistent external condom use translates to an overall reduction in the rate of the following STIs:
Gonorrhea: 90%Hepatitis B: 90%Chlamydia: 50% to 90%Trichomoniasis: 90%Syphilis: 50% to 90%HIV: 85%Syphilis: 50% to 71%
While external condoms may not have the same level of efficacy in preventing herpes or HPV compared to, say, HIV or gonorrhea, they can still significantly reduce the risk of infection compared to not using them.
While the benefits of external condoms appear to be lower with HPV among people in the general population, they offer significant protection in those at increased risk of HPV-associated cancers.
According to some of the more recently published studies:
Young women are 50% less likely to acquire HPV if their partner uses an external condom at least 50% of the time. If external condom use is perfect, the risk is reduced by 70%. The majority of cervical cancers today are linked to high-risk HPV strains, typically acquired when one is younger. The consistent use of external condoms in men who have sex with men (MSM) is associated with an 87% decreased risk of infection compared to a matched set of MSM who don’t use external condoms consistently. MSM have the highest risk of acquiring anal cancer due to HPV infection.
Latex Polyurethane Polyisoprene Lambskin
The FDA has approved latex, polyurethane, and polyisoprene external condoms as an effective means to reduce the risk of pregnancy and STIs.
Studies have shown that polyurethane condoms are just as effective in preventing pregnancy and STIs as latex condoms. However, they may be more likely to slip and break due to their reduced elasticity (particularly if they are too tight or too loose).
Polyisoprene external condoms are also as effective as external latex condoms for barrier protection. They gave more elasticity than external polyurethane condoms and are less likely to slip or break.
With typical (real-world) use, external condom efficacy drops to around 85%. Typical use is the term used to describe inconsistent external condom use.
By comparison, the birth control pill (“the pill”) is 99% effective with perfect use. Taking a pill every day can be difficult, however, which is why 9 out of every 100 women on the pill experience unintended pregnancy in a year.
People with latex allergies can safely use polyurethane or polyisoprene external condoms (or external lambskin condoms if the aim is to prevent pregnancy).
Other additives in external condoms may also cause allergy or irritation, such as spermicides and lubricating agents like parabens or glycerin.
If such a reaction occurs, don’t give up on external condoms. Instead, try other brands or types of external condoms. Or, speak with your healthcare provider to pinpoint which specific ingredient you are allergic to.
Never use a lubricant that contains oils, fats, or grease with an external latex condom. These include petroleum-based products like Vaseline, baby oil, hand lotions, cold cream, vegetable shortening, or cooking oil.
Only water-based lubricants, available online and in many drugstores, should be used with external latex condoms. Oil-based lubricants are perfectly fine with polyurethane or polyisoprene external condoms.
Not only should you only use one condom at a time, but an external condom should also not be used with an internal condom for the same reasons.
A 2011 study in Texas Medicine reported that 67% of the 180 college students included in the study failed to apply an external condom correctly when tested with both a questionnaire and external condom demonstration.
When used and sized correctly, external condoms are not only easy and quick to apply but can maintain high levels of sensitivity.
If an external condom is uncomfortable for you, there are different types of condoms you can try. Many external condoms have even extra features (like special tingling lubrication or bumps and bridges) that may actually enhance sexual pleasure.
Another possibility is if a man has a large penis, using a regular or snug-fit condom can be uncomfortable. If that is the case, look for larger condoms, such as Trojan Magnum.
