All about condom and femidom

History of Condoms

1000 BC

Condom use can be traced back several thousand years. It is known that around 1000 BC the ancient Egyptians used a linen sheath for protection against disease.

100 - 200 AD

The earliest evidence of condom use in Europe comes from scenes in cave paintings at Combarelles in France.

1500's

The first known published description and trials regarding prophylactic condom use were recorded in Italy. Gabrielle Fallopius claimed to have invented a sheath made of linen, and conducted trials amongst 1,100 men using the condom, none of whom became infected with Syphilis. Having been found useful for prevention of infection, it was only later that the usefulness of the condom for the prevention of pregnancy was recognized.

Later in the 1500s one of the first improvements to the condom was made, when the linen cloth sheaths were sometimes soaked in a chemical solution and then allowed to dry prior to use. These were the first spermicides on condoms.

1700's

Condoms made out of animal intestines began to be available. However they were quite expensive and the unfortunate result was that they were often reused.

This type of condom was described at the time as "an armour against pleasure, and a cobweb against infection".

1844

Goodyear and Hancock began to mass produce condoms made out of vulcanized rubber.

Vulcanization is a process which turns crude rubber into a strong elastic material.

1861

The first advertisement for condoms was published in an American newspaper when The New York Times printed an ad. for "Dr. Power's French Preventatives."

1873

The Comstock Law was passed. Named after Anthony Comstock, the Comstock Law made illegal the advertising of any sort of birth control, and it also allowed the postal service to confiscate condoms sold through the mail.

1880's

The first latex condom was produced, although it was to be the 1930s before these were in widespread use.

By 1935 1.5 million condoms were being produced each day in the United States. Latex is made from the sap of a tree mainly found in Asia and Brazil.

1980's and 1990's

During most of the 1980s American manufacturers dominated the American condom market. Then in 1987 a Japanese brand called Kimono became available in the USA. This condom was thinner and well lubricated and it's advertisements emphasized pleasure as well as protection.

Subsequently the 1990s saw the introduction of a large number of different types of condom. Also in the 1990s the first polyurethane condom became available.

By 1993 the annual production of natural latex condoms had reached 8.5 billion.

Using Condoms, Types and Sizes of Condoms

Why do I need to use a condom?

Condoms are the only form of protection which can both help to stop the transmission of viruses such as HIV and prevent pregnancy.

Getting ready, choosing the right condom

A number of different types of condom are now available. What is generally called a condom is the 'male' condom, a sheath or covering which fits over a man's penis, and which is closed at one end.

There is also now a female condom, or vaginal pouch, which is used by a woman and which fits inside her vagina. The rest of this page is about the male condom.

What are condoms made of, and what shapes are there?

Condoms are usually made out of latex or polyurethane. If possible you should use a latex condom as these are the most effective against viruses such as HIV, and in most countries they are the type most readily available.

Condoms come in a variety of shapes. Most have a reservoir tip although some do have a plain tip. Condoms may be regular shaped (with straight sides), form fit (indented just below the glans or "head" of the penis), or they may be flared (wider over the glans).

Ribbed condoms are textured with ribs or bumps, which can increase sensation for both partners. Condoms also come in a variety of colours.

The lubrication on condoms also varies. Some condoms are not lubricated at all, some are lubricated with a silicone substance, and some condoms have a water-based lubricant. The lubrication on condoms aims to make the condom easier to put on and more comfortable to use. Some lubricated condoms are also now available with a spermicide (Nonoxynol 9) added. A spermicidal lubricant also aims to provide an additional level of protection if some semen happens to leak out of the condom. This can help to reduce the likelihood of pregnancy, but regular use of nonoxynol9 can cause an allergic reaction in some people resulting in little sores which can actually make the transmission of HIV more likely. Nonoxynol 9 is a suitable spermicide only for women who are HIV-negative and are at low risk of exposure to HIV or other STI's, and only for vaginal sex.

What shape should I choose? Why are some condoms flavoured?

It's up to you which to choose. All of the differences in shape are designed to suit different personal preferences and enhance pleasure. It is important to communicate with your partner to be sure that you are using condoms that satisfy both of you.

Some condoms are flavoured to make oral sex more enjoyable.

What about the condom size?

Condoms are made in different lengths and widths, and different manufacturers produce varying sizes.

There is no standard length for condoms, though those made from natural rubber will in addition always stretch if necessary to fit the length of the man's erect penis.

The width of a condom can also vary. Some condoms have a slightly smaller width to give a "closer" fit, whereas others will be slightly larger. Condom makers have realised that different lengths and widths are needed and are increasingly broadening their range of sizes.

The brand names will be different in each country, so you will need to do your own investigation of different names. There is no particular best brand of condom.

So, when do you use a condom?

You need to use a new condom every time you have sexual intercourse. Never use the same condom twice. Put the condom on after the penis is erect and before any contact is made between the penis and any part of the partner's body.

If you go from anal intercourse to vaginal intercourse, you should consider changing the condom.

How do you use a condom?

Condoms can deteriorate if not stored properly. They can be affected by both heat and light. So it is best not to use a condom that has been stored in your back pocket, your wallet, or the glove compartment of your car.

Open the condom package at one corner being careful not to tear the condom with your fingernails, your teeth, or through being too rough. Make sure the package and condom appear to be in good condition, and check that if there is an expiry date that the date has not passed.

Push the condom into one side of the package and tear open the other, empty, side of the package. This way you will avoid any possibility to damage the condom.

Place the rolled condom over the tip of the hard penis, and if the condom does not have a reservoir top, pinch the tip of the condom enough to leave a half inch space for semen to collect. If the man is not circumcised, then pull back the foreskin before rolling on the condom.

Pinch the air out of the condom tip with one hand and unroll the condom over the penis with the other hand. Roll the condom all the way down to the base of the penis, and smooth out any air bubbles. (Air bubbles can cause a condom to break).

If you want to use some extra lubrication, put it on the outside of the condom. But always use a water-based lubricant (such as KY Jelly or Liquid Silk) as an oil-based lubricant will cause the latex to break.

The man wearing the condom doesn't always have to be the one putting it on - it can be quite a nice thing for his partner to do.

What do you do if the condom won't unroll?

The condom should unroll smoothly and easily from the rim on the outside. If you have to struggle or if it takes more than a few seconds, it probably means that you are trying to put the condom on upside down. To take off the condom, don't try to roll it back up. Hold it near the rim and slide it off. Then start again with a new condom.

When do you take off the condom?

Pull out before the penis softens, and hold the condom against the base of the penis while you pull out, so that the semen doesn't spill. Then tie a knot in the condom and throw it away. It's not good to flush condoms down the toilet - they're bad for the environment.

What do you do if a condom breaks?

If a condom breaks during sexual intercourse, then pull out quickly and replace the condom. Whilst you are having sex, check the condom from time to time, to make sure it hasn't split or slipped off. If the condom has broken and you feel that semen has come out of the condom during sex, you should consider getting emergency contraception such as the morning after pill.

What condoms should you use for anal intercourse?

With anal intercourse more strain can be placed on the condom, so it is sensible to use stronger condoms and plenty of lubricant. But if you can't get hold of a strong condom, a normal condom is better than no condom.

Is using a condom effective?

If used properly, a condom is very effective at reducing the risk of being infected with HIV during sexual intercourse. Using a condom also provides protection against other sexually transmitted diseases, and protection against pregnancy. In the laboratory, latex condoms are very effective at blocking transmission of HIV because the pores in latex condoms are too small to allow the virus to pass through. However, outside of the laboratory condoms are less effective because people do not always use condoms properly.

What about polyurethane condoms?

Polyurethane condoms are thinner than latex condoms, and so they increase sensitivity and are more agreeable in feel and appearance to some users. They are also helpful to the very small number of people who are allergic to latex. But a disadvantage is that they are slightly more likely to break than latex condoms and they are often more expensive.

How can I persuade my partner that we should use a condom?

It can be difficult to talk about using condoms. But you shouldn't let embarrassment become a health risk. The person you are thinking about having sex with may not agree at first when you say that you want to use a condom when you have sex. These are some comments that might be made and some answers that you could try.

EXCUSE
ANSWER


Don't you trust me?
Trust isn't the point, people can have infections without realising it

I can't feel a thing when I wear a condom
Maybe that way you'll last even longer and that will make up for it

I don't stay hard when I put on a condom
I'll help you put it on, that will help you keep it

I don't have a condom with me
I do

I'm on the pill, you don't need a condom
I'd like to use it anyway. It will help to protect us from infections we may not realise we have.

But I love you
Then you'll help us to protect ourselves.

Just this once
Once is all it takes

Are Condoms Effective? Do Condoms Fail?

Are condoms effective at preventing infection with the virus HIV?

Yes. Studies have shown that if a latex condom is used correctly every time you have sex, this is highly effective in providing protection against HIV.

The evidence for this is clearest in studies of couples in which one person is infected with HIV and the other not. i.e."discordant couples". In a study of discordant couples in Europe, among 123 couples who reported consistent condom use, none of the uninfected partners became infected.(1) In contrast, among the 122 couples who used condoms inconsistently, 12 of the uninfected partners became infected.

In the laboratory, latex condoms are very effective at blocking transmission of HIV because the pores in latex condoms are too small to allow the virus to pass through. However, outside of the laboratory condoms are less effective because people do not always use condoms properly.

How often do condoms fail?

There is no one answer to this, as different studies have shown different results. Many studies of condom effectiveness have counted how often women have become pregnant when their partners have used condoms for birth control. This "failure rate" includes cases where the couple did not use a condom every time they had sex, or they did not use the condom correctly.

Some studies have included the times the condom was torn accidentally by the people using it.

How often do condoms break?

In the United States most studies of breakage caused by defects in the condom itself, have shown the breakage rate is less than 2 out of every 100 condoms, probably less than 1 out of every 100. Studies in other countries have shown a breakage rate ranging from 0% to 7%.

How Are Condoms Tested?

Any possible existence of holes and other defects on the condom are tested electronically. This must be indicated on a package or a family pack. If this is not a case, a condom should not be purchased.

Also, from each batch of condoms, some condoms will be selected randomly and given additional checks. These additional checks will often include a "water leak" test to find holes, and an "air burst" test to check condom strength.


(1)De Vincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. New England Journal of Medicine 1994;331:341-346

Female Condom

What is the Female Condom?

The female condom (often known as the 'Femidom' or by the name 'Reality') is a polyurethane sheath or pouch about 15 cm in length, which is worn by a woman during sex. It entirely lines the vagina and it helps to prevent pregnancy and sexually transmitted diseases.

At each end of the condom there is a flexible ring. At the closed end of the sheath the flexible ring is inserted into the vagina to hold the female condom in place. At the other open end of the sheath the ring stays outside the vulva at the entrance to the vagina. This ring acts as a guide during penetration and it also stops the sheath bunching up inside the vagina.

There is silicone-based lubricant on the inside of the condom, but additional lubrication can be used. The condom does not contain spermicide and it should not be used at the same time as a latex male condom.

The female condom first became available in 1992. Since then more than 18 million have been sold around the world. The female condom is marketed under the name FC in the United States, and Femidom in the United Kingdom.

How do you Use the Female Condom?

Remove the condom from its package and rub the outside of the pouch together to be sure the lubrication is evenly spread within it. Make sure the inner ring is at the bottom closed end of the pouch, and hold the pouch with the open end hanging down.

Squeeze the inner ring with thumb and middle finger, and then insert the inner ring and pouch into the vaginal opening and with the index finger push the inner ring and pouch right the way up into the vagina. (Because the female condom is lubricated it is slippery, so you need to do this slowly and carefully.) Make sure the condom is inserted straight, and is not twisted inside the vagina. The outer ring and about an inch of the pouch will now lie outside the body. The penis should be guided into the condom in order to ensure that the penis does not slip into the vagina outside the condom.

If the condom slips during intercourse, or if it enters the vagina, then you should stop immediately and take the female condom out. Then insert a new one and add extra lubricant to the opening of the pouch or on the penis.

After intercourse, squeeze and twist the outer ring gently and then pull the condom out keeping the sperm inside. Then discard it as you would a male condom. The female condom should not be reused.

What are the Advantages and Disadvantages of the Female Condom?

The advantages of the female condom include the fact that it is the only contraceptive for women that also provides protection against HIV. There are also no side effects and it can be used by people who have a latex sensitivity.

The disadvantages include the fact that it is more expensive than the male condom. The female condom can also be noisy and there may be a slight reduction in sensitivity.

Also, the outer ring may need to be held in place to prevent the condom from slipping into the vagina.

UNAIDS and the Female Condom

UNAIDS has chosen to support the use of the female condom, particularly in the developing world, as a practical means of protecting women from STDs and HIV/AIDS. As a result of the UNAIDS initiative, in excess of 4 million female condoms have been sold in 16 countries in the developing world, including South Africa, Uganda, Zambia and Zimbabwe.

Study Proved Effectiveness

UNAIDS has also supported a study of sex workers in Thailand which compared female and male condom use. This study showed that, in the group of women who were given the choice of using either male or female condoms, the average incidence of sexually transmitted diseases (STDs) decreased by 34% and the number of unprotected sex acts decreased by 25% compared to the group of women who had only the choice of using male condoms.