Condoms: How to use them and how effective are they?

What are condoms?

Condoms are a non-hormonal, barrier birth control option. The external or male condom (the one we’re mainly going to cover in this article) is the most commonly used. There’s also another kind called the internal condom. You can buy condoms as an over-the-counter birth control method in supermarkets, drug stores, and pharmacies. As well as a means of preventing pregnancy, condoms are also useful for preventing the spread of sexually transmitted infections (STIs). 

How do condoms work?

When used as a birth control, external condoms are worn on the penis during vaginal penetrative sex to prevent pregnancy. Essentially, condoms work by acting as a barrier so that sperm can’t enter the vagina, meaning they stop the male sperm cell and female egg cell from meeting. 

Because condoms prevent bodily fluids from meeting, they are the only method of birth control that also protects against STIs. [1] Even if you’re using another contraceptive method to prevent pregnancy, you should consider using a condom if you’re at risk. They can also be used during anal or oral sex.

What are condoms made of?

The most common material used to make male condoms is a kind of rubber called latex. Not everyone can use condoms made of latex, but the good news is there are also other options available. Condoms made of polyurethane (a type of soft plastic) or polyisoprene (synthetic rubber) can be a better option for people who are sensitive or allergic to latex.

Condoms have been around for thousands of years, and some of the first condoms were made from animal intestines. [2] For those who prefer natural materials, lambskin condoms are still available to this day (they are actually still made from lamb intestines and not skin). However, while they can be an option for those who are looking to prevent pregnancy and are allergic to latex, it’s good to know that condoms made from natural materials don’t protect from STIs. [3]

How effective are condoms?

We often talk about birth control effectiveness in terms of typical and perfect use. Typical use reflects how a method is used in real life; it accounts for user error, as well as the method failing because of its own drawbacks. Perfect use, on the other hand, reflects how a method is used in an ideal scenario. Since condoms require action from those using them, they have lower typical use than perfect use effectiveness.

So, how effective are condoms? If we look first at typical use, condoms are 87% effective. This number reflects couples who don’t always follow the instructions or sometimes forget to use condoms altogether. It also includes the condom itself failing, for example, if it breaks or tears. 

With perfect use, condoms are 98% effective, and this number only reflects the effectiveness when a condom is used, well, perfectly… That means if it fails, it’s purely because there was a problem with the condom itself, not how it was being used.

Can you get pregnant when using condoms?

The short answer is: yes, you can get pregnant even if you’re using a condom. So far, we’ve talked about how effective they are in terms of percentages, so let’s put the failure rate of condoms into context by looking at something called the Pearl Index. A birth control method’s Pearl Index reflects how many women out of 100 who use the method over the course of a year become pregnant. 

If we take the typical use of the condom — that’s 87% — this means that out of 100 women using the method for a year, 13 of them got pregnant. 

What’s the most common reason why condoms fail?

Condoms most often fail because of how they are used. This can include putting condoms on incorrectly, putting them on after penetration, using them beyond their sell-by date, or not storing them correctly. It’s also important to note that the typical use failure rate of the condom also reflects couples who usually use this method forgetting to do so. 

In Europe and the U.S., condoms have to be rigorously tested and cleared by regulators. Before being packaged and sold, each individual condom is subject to testing — if a flaw is found with that condom, then the whole batch is discarded. Therefore, while possible, it’s highly unlikely that condoms break because of manufacturing. 

If a condom does break, it’s usually because it comes into contact with something sharp (like fingernails, piercings, or teeth) or because of friction if there isn’t enough lubrication during intercourse. In fact, using lube is actually a great way of reducing the risk of condom tearing — just make sure you pick the right kind of lube for the condom you’re using (oil-based lube shouldn’t be used with latex condoms). [4] 

If a condom breaks, you may need to consider emergency birth control options. These can work up to five days after unprotected sex. 

Can condoms fail without breaking?

While breaking might be the most obvious way for a condom to fail, there are more things that can stop this method from working, such as:

• Leaking or slipping off: If the condom isn’t the right size, it may slip off the penis during intercourse, or sperm may leak into the vagina. Condoms come in different sizes and shapes, so take some time to find one that works for you!
• Wearing it incorrectly: For condoms to be effective, they need to be put on correctly. This includes making sure it’s rolled all the way to the base of the penis and leaving a bit of space at the tip to make room for the ejaculate. Never wear more than one condom at once or use an external and internal condom at the same time — that increases the risk of it tearing.
• Not using it the whole time: It’s possible to become pregnant from pre-cum since it may contain some sperm cells, so it’s important to wear a condom the whole time you’re having sex to prevent pregnancy. [5]
• Not wearing a condom at all: Anyone can forget things in the heat of the moment, and forgetting the condom altogether is included in the typical use effectiveness of condoms. Sharing the responsibility of reminding each other and keeping condoms close to hand when you need them can help with remembering!
• Using condoms with Natural Cycles

When using Natural Cycles as birth control, you’re recommended to use condoms if you have sex during your fertile days. On non-fertile days on the other hand, you don’t need to use protection. So, if you’re already a condom user, switching to Natural Cycles can mean using fewer condoms. When it comes to effectiveness, Natural Cycles’ effectiveness rates (93% with typical use and 98% with perfect use) include pregnancies that happen due to the condom breaking. [6] 

How effective are condoms against STIs?

External condoms are the most effective contraceptive method available when it comes to protecting against STIs. They are over 90% effective against HIV, Hepatitis B, and gonorrhea, and also significantly lower the risk of getting several other infections like chlamydia and syphilis. However, there are a couple of STIs which condoms are less effective against. For example, while condoms do offer some protection against genital herpes and HPV, these may spread by skin contact with parts that aren’t covered by the condom. [7] It’s always a good idea to speak with your healthcare professional if you’re concerned about an STI. 

Different types of condoms

Most of us tend to refer to the external condom when talking about condoms, but what kinds are there? While there are lots of brands and models, these are the main types of condoms:

• External (male) condom: the most common type, external condoms come in the form of a sheath that’s placed over the penis. They work by stopping semen from entering the vagina or as a barrier for STIs during vaginal, anal or oral penetration.
• Internal condom: also called female condoms. These are placed inside the vagina before sex and work by stopping semen from entering the vagina.
• Dental dams: thin sheets made of latex or polyurethane that can be used during oral sex as a barrier between the genitals and mouth to protect from STIs.
• Finger condoms: a type of condom that can be worn on the fingers to reduce the risk of STIs during fingering.

As well as protecting against STIs and pregnancy, condoms can also add an extra layer of excitement to your sex life. External condoms come in all shapes, sizes, colors, and flavors. You can buy condoms that are ribbed to enhance pleasure, or condoms with lubricants that can help make sex last longer. 

How long do condoms last? 

Condoms have an expiration date, and you shouldn’t use condoms that have expired since they may be less effective. They usually last between one and five years, but it depends on the material. Make sure to always check the expiration date before using them!

It’s also important to store condoms correctly so that they last as long as intended. Usually, this means keeping them in a cool and dry place and away from sunlight. While it might be handy, be wary about storing condoms in your wallet – they shouldn’t be kept there for longer periods of time.

How do you put on a condom?

Now that we’ve talked about how important it is to use condoms correctly to prevent pregnancy, let’s go over how to put them on. Some couples find that putting on a condom disrupts the mood, and it may also take some practice in the beginning before you get the hang of it. But don’t worry, communicating openly with your partner can even make it an exciting and intimate moment!

1. Open the wrapper carefully so the condom isn’t damaged (don’t use your teeth).
2. Check that the condom is the right way around before you start putting it on.
3. Pinch the tip of the condom and place it on the erect penis — there should be a little room for semen.
4. Unroll the condom all the way to the base of the penis.
5. After sex, hold the condom in place while pulling out, and then take the condom off. 

Pros and cons of using condoms

Now we’ve covered how condoms work, how effective they are, and other reasons you might choose to use them besides preventing pregnancy. Let's recap some of the advantages and disadvantages of using this method.

Pros of using condoms

• They protect against STIs during vaginal, oral, and anal sex
• They are highly effective at preventing pregnancy when used correctly 
• No prescription is needed to use condoms, and they’re easy to get hold of
• Condoms are an affordable method and can even be free in some cases
• They can be used with most other methods of birth control for extra protection
• Different varieties of condoms are available to suit individual needs and preferences 

Cons of using condoms 

• A new condom must be used every time you have unprotected sex
• Some couples find putting on a condom interrupts sex, and others find sex with a condom to be less pleasurable
• There is always a risk that a condom may break or leak
• In the long run, they may end up being more costly than long-acting birth control options
• They are less effective than the birth control pill or long-acting birth control methods such as the IUD

Prevent pregnancy hormone-free with Natural Cycles

Here at Natural Cycles, we’re dedicated to broadening knowledge and breaking stigmas around reproductive health. We hope you’ve learned lots about condom effectiveness and how to use them to prevent pregnancy and protect against STIs. The first FDA Cleared birth control app, Natural Cycles, helps you learn about your unique cycle in addition to helping you prevent pregnancy naturally. Why not check out if it could be right for you?