The Male Health Center

What You Should Know About Condoms

It's been almost 20 years since condoms started coming out from behind pharmacy counters. But who would have guessed back then that they'd find their way onto convenience store racks up there with the auto air fresheners and the photographic film?

Ready availability of condoms is good news, but other trends worry me. Condoms sales in 1992 were actually about the same as 1990, when they peaked. Yet up to two-thirds of heterosexuals with multiple sex partners don't use them. At the same time, I hear too many people who do use condoms putting too much faith in them.

As disease preventives or birth control devices, condoms are far from perfect. Not that they break often: All non-novelty condoms are manufactured to exacting standards, and every one is electrically tested for leaks. Some go through even more rigorous quality control measures—everything from being inflated with more than six gallons of air to simulated intercourse on a machine. Condom problems almost always result from failure to follow instructions.

For example, far too many people don't know that a "natural" condom doesn't protect against all sexually transmitted diseases. And even a latex condom provides little protection if it's not put on before any genital contact. Even used with great care, condoms protect only a limited part of the genitals, leaving other areas exposed to infection. Herpes and genital warts, for example, don't restrict themselves to the penis or vagina.

As birth control devices, condoms could be as much as 98 percent effective if used correctly. But in actual practice, between 10 and 20 couples who depend on them will become pregnant in a year—about the same degree of effectiveness as other barrier contraceptives but far, far better than withdrawal or rhythm. If you really don't want to have a baby, look to the pill or permanent birth control.

Don't get me wrong; I'm a condom advocate. But I also want people to know what they can and can't do. A condom is far better than no protection—especially if you use them correctly, as I'll discuss in a future column—but there's only one fail-safe method of contraception and disease prevention.

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