The Female Condom
A female condom (pictured to the right) is a hollow tube capped at one end consisting containing two flexible rings at each end. The device is inserted into the vaginal canal and covers the external genitalia forming a continuous barrier along the vagina. This barrier protection when correctly used can prevent transmission of STIs and unwanted pregnancy. This device is not commonly used for several reasons. When used correctly there is still a 5% chance of unwanted pregnancy and STI transmission whereas correctly used male condoms boast only a 2% chance (discussed in more detail below). Additionally they are more expensive than male condoms, can tear, need extensive lubrication and lessen feeling between partners.
However there are several advantages to female condoms. They boast reduced risk of genital warts and herpes transmission as external labia are covered. They give the woman control over contraception, potentially reducing risk taking procedures where the male may not want to use a condom. Furthermore there is some suggestion that when inserted anally they provide protection during anal sex, though more research is needed in this area.
More information about use can be found here and here.
The Dental Dam
The dental dam is placed over the vagina or anus during cunnilingus or analingus, respectively. It provides protection from transmission of contact STIs such as herpes viridae infection and genital warts. It is not widely used as risk is not often attributed to oral sex and use is often not socially acceptable. Thus in order to get the full advantage of the dental dam people must be educated to the dangers of oral sex and it's use de-stigmatised.
More information here.
The Male Condom
The male condom, usually referred to simply as the condom, is the most commonly used barrier protection device. They're cheap easily available and when used correctly they are 98% effective at preventing unwanted pregnancies and STI transmission. They work by preventing transmission of bodily fluids, preventing transmission of STIs like HIV and hepatitis. They also directly impedes the sperm's path to the vagina, stopping potential pregnancies. Unfortunately it doesn't fully protect against some contact STIs like herpes, genital warts and syphilis.For a lighthearted look at this contraceptive method I suggest checking out these animations from Loop De Loop, or at least indulge me by having a quick look at my favourite one by sarah and lachlan.
Condoms are only effective when used correctly. No worries, everyone knows how to use a condom properly right? Wrong. There are a huge amount of basic errors people make in putting on and using condoms. Before we take a look at what people do wrong lets quickly revise correct technique.
Putting on a Condom
Firstly there is no shortage of literature on the internet suggesting correct ways to put on a condom. Although some articles like '25 Sexy Ways to Put on a Condom,' by Cosmopolitan magazine may be tempting, the methods suggested are likely to lead to condom usage errors and pussy genitals aren't so sexy (at least for most people). I suggest getting information from less saucy government sites or this guide from durex is pretty easily digestible.
There are essentially 3 steps to remember:
1. Opening the Packet
Before the packet is opened two checks should be performed. Firstly is it within date? If it is out of date the lubricant may have degraded increasing the chance of the condom ripping. If it is out of date discard the condom.
Is it still air sealed? To check this push one side of the packet, if the other side bulges then the packet is still sealed if not then the condom may have been tampered with. If no air seal is present, discard the condom.
The condom packet should be opened by pushing the condom to one side of the packet. The packet should then be torn from the opposite to the condom BY HAND. Not using teeth, scissors or any other sharp implement as these can damage the condom.
2. Putting it on
Firstly you have to determine the condom's orientation, it will only unroll one way. The teat of the condom should be facing upwards, resembling a sombrero (shown to the right). This allows it roll down the penis nicely.
Next squeeze the teat to remove air in it and place it on the head of the penis. This provides a space for the semen to travel into upon ejaculation. If this teat is full of air on application the condom may rip upon ejaculation due to built up pressure.
Using the your other hand roll the condom down the length of the penis to the base. Don't stretch and pull the condom down. If you find that you have placed it on the penis in an incorrect orientation don't change the orientation and reuse it. This condom has been exposed to the bodily fluids and turning the condom inside out directly exposes your partner to these. Additionally in the incorrect rolling the condom may have been stretched a weakened. Get a new condom and start from step 1 again.
3. Taking it off
Hold the condom at the base and slide it off the penis. Tie it off so the sperm doesn't flow out and bin it. DO NOT put it in the toilet. Condoms can block toilets leading to an expensive (and awkward) visit from a plumber.
(4.) Lubrication
Lubrication is often overlooked however the un-lubricated condom is prone to ripping, negating it's efficacy. Only WATER-BASED lubricants should be used. Other petroleum based lubricants (like Vasoline) should not be used as these can degrade the condom and lead to leakage. Spit is not an acceptable water-based lubricant, gels like KY jelly are recommended.
Condom Usage Errors
A 2012 review by Milhausen et al in Sexual Health aimed to discover the frequency of condom use errors world wide. 'Condom use errors and problems: a global view' looked at 50 different studies from 14 different countries and found widespread basic condom use errors were prevalent globally. The major errors are discussed here.
Application errors were the most common error found. Late application of condoms happened in 1.5% to 24.8% of all sexual encounters in which condoms were used. In this instance STIs may have been transferred before the condom was applied. Early removal happened in 1.4% to 26.9% of all sexual events with condom use meaning that these individuals were unprotected from both STIs and unwanted pregnancy.
Other errors included included incomplete unrolling (1.4% to 26.9%), not leaving space at the tip (24.3% to 45.7%) with the air not being squeezed out in 44.6% of all cases. 4% to 30.4%
of people initially put the condom on inside out before turning it around and putting it on again. 2.1-11.2% of participants exposed the condom to sharp objects before use. Astonishingly 74.5% of
men and 82.7% of females were found to not inspect the condom for damage before use.
These errors were more common than cases of condom failure such as leakage, tearing and slippage. The silver lining here is that if user error is what leads to incomplete protection from condom use then these errors can be corrected by education. It is often assumed that adults know how to use condoms correctly. This data shows this is not so.
Summary
Barrier protection methods can provide people engaged in sexual activity protection from transmission of STIs and unwanted pregnancies. However these devices are only effective when used properly. Unfortunately they are often used incorrectly and thus education on correct use is essential for these methods to be effective. Furthermore there are many differing attitudes around contraceptive use in differing situations. Particularly the use of contraception must be normalised for oral-genital as well as genital-genital sex to stop increase in oral STIs.
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