Contraception

THE CONDOM

Description and mechanism of action

A condom is a sheath made of latex, polyurethane or natural membrane (lambskin) that covers the erected penis. It prevents sperm and bacteria from coming into contact with the partner’s genitals.

A condom costs between 75¢ and $4.

Latex, natural membrane or polyurethane?

• Latex
  Latex condoms are most popular for the following reasons: they are offered in different shapes, sizes, thicknesses, colors and flavours. They are also more resistant and less expensive. Furthermore, they protect against STDs and HIV.
   
• Natural membrane
  Condoms made of natural membrane are offered in one size only and are thinner than most latex condoms; they are strongly lubricated and odorized. These condoms transmit body heat more efficiently, therefore increasing sensations and they can be an alternative for those who are allergic to latex. The degree of protection they offer against STDs is not demonstrated, but it is better to use a natural membrane condom than to use none at all. However, if a person is allergic to lanolin, the use of lambskin condoms must be avoided.
   
• Polyurethane
  A polyurethane condom will soon be available on the Canadian market. It will be more resistant than the latex condom and it will provide improved sensations. It will also be compatible with oil-based lubricants. It will better protect against STDs and HIV and will be suitable for people who are allergic to latex.

Effectiveness

The condom is 99% effective, when used each time there is sexual activity, whatever the timing of the menstrual cycle and when it is worn before any contact between the penis and the vulva or vagina.

Lubrication

Some condoms are pre-lubricated. The lubricant helps penetration, reduces the risk of tearing and improves sensations. If better lubrication is needed, you can use a water-soluble lubricant such as K-Y, Surgilube or Lubafax.

You can also add a spermicide (Ortho-Gynol cream, Delfen foam, Advantage 24), which will increase protection against pregnancy and infections. In rare cases, some are allergic to spermicides or lubricants.

Avoid oil-based lubricants with latex condoms: Vaseline, hand creams, oil of any kind. Be cautious of creams and ovules used for vaginal infections (Vagisil, Monistat, etc.) that may also alter these condoms for up to 72 hours after ending the treatment.

Female condom Reality¬. The female condom is now sold in pharmacies for about $12 for a set of three: there is only one model and one size. It is made of thin, soft polyurethane. It has two flexible rings at each extremity. The inner ring allows for the condom to be inserted and also ensures it stays in place. Reality ¬ is said to be as effective as the male condom and it also protects against STDs and HIV. It lines the vagina and therefore does not compress or constrict the penis. Since polyurethane warms up instantly when in contact with the body, it provides improved and more natural sensations.

Using a condom, anyone can learn!

1. Check the expiry date on the box: choose the latest date (three to five years away).
2. Keep condoms in a cool area and away from light: as much as possible, avoid keeping condoms in a wallet, in tight pant pockets or the car’s glove box. 
3. Plan ahead: always have condoms readily available (on the night table, in a case in your handbag, schoolbag or in your shirt or jacket pocket). 
4. Be assertive: do not hesitate to mix the condom to your sexual encounters and add it to your sex play. 
5. Use a new condom each time you have intercourse. 
6. Carefully open the packaging, avoiding contact with rings, teeth and nails. Remove the condom only when you are ready to use it and do not test it by stretching it, inflating it or by unrolling it. 
7. One partner or the other must put the condom on the penis before any genital, oral or anal contact.
8. Unroll about one centimetre of the condom and pinch the air out of the tip of the condom with your fingertips. 
9. After pulling back the foreskin, unroll the condom all the way to the base of the penis, as far as possible.  
10. After ejaculation, the penis must retire while still erect, firmly holding on to the base of the condom: make sure the condom is in good condition. 
11. Discard the condom in the garbage: it is not biodegradable. 
12. The penis must not touch the vagina as sperm may still flow from it.

Remember!!

• A safe condom must have a batch number and an expiry date. It can be purchased from a pharmacy, a vending machine, a sex-shop, a supermarket or a convenience store. The most expensive condom does not necessarily provide the best protection.
   

• Small drops of transparent liquid that humidify and lubricate the tip of the erected penis may contain spermatozoids that could result in fertilization if they are located at the entrance of the vagina or in the vagina.
   

• Condom tears generally occur as a consequence of abusive or prolonged use, poor storage conditions, a lapsed expiry date or because an inadequate lubricant was used. Condom tears are more frequent during anal intercourse. Condoms may break during unwrapping, when putting it on or removing it. It is important to throw away the condom if it is smelly, if its texture is greasy or if chemical substances have crystallized.

If the condom breaks…

• You can see a doctor to obtain an emergency (morning-after) oral contraceptive or IUD.
• You can use spermicides immediately. This is less effective than the above measure.  
• You can also undergo screening tests for AIDS or other STDs.

A condom for all occasions!

• Un condom pour chacun, pour tous les goûts et pour chaque occasion (Adapted from Turgeon F. Steben M. Les maladies transmissibles sexuellement. Montréal : Les presses de l’Université de Montréal, 1994 : 330-2).
   
• An ordinary condom, for contraception and for preventing AIDS and other STDs
  Lubricated latex condom: Shields Protection¬, Sheik Sensi Cream¬, Ramses Sensitol¬, Trojan-Enz¬, LifeStyles¬.
  Avoid natural membrane condoms. Fourex¬, Naturalamb¬)
  For maximum protection: Ramses Ultra15¬, Trojan-Enz¬, Ultra texture ¬.
   
• A condom that increases sensations
  Add a drop of lubricant (Lubafax¬, K - Y ¬, Surgilube¬) on the glans.
  Thinner condom: Conceptrol Supreme¬, LifeStyles Nuda¬, Sheik Sensi-Thin ¬, Trojan Plus¬, Japanese.
  Ribbed condom: Ramses Basic¬, Titan Ribbed¬, Trojan Naturalube¬.
  Natural membrane condom: Trojan Kling-Tite¬, Naturalamb¬.
   

• A condom for oral relations
  Non-lubricated condom: Ramses Basic¬, Sheik Basic ¬, Trojan Basic¬.
   

• A condom for anal intercourse
  Adjusted condom: Ramses Extra Strength¬, Shields Protection X¬. Add a water-soluble lubricant: Lubafax¬, K-Y ¬, Surgilube¬.
   

• A condom for a smaller penis
  Conceptrol Supreme¬. Use Ortho condoms, they are generally smaller.
   

• A condom for a larger penis
  Condoms made by Julius Schmid (Ramses¬, Sheik¬, Trojan¬).
   

• A safe "gadget" condom to offset monotony
  Ramses Ribbed¬, Sheik Excita Sensi-Ribbed¬, Fruty¬, Trojan Naturalube¬, Titan Ribbed¬ and LifeStyles¬, various colours. Avoid sex-shop condoms if they do not have a batch number or expiry date.
   

• To avoid condom tear
  Ramses Ultra¬ Ortho Shield Protection¬. Add lubricant. Re-examine the way the condom is used during sexual intercourse.
   

• To avoid premature ejaculation
  Avoid ultra-thin condoms or natural membrane condoms. Lubricate well.
   

• If the condom slips
  There is too much lubricant. Hold the condom or put it back in place.
   

• In case of vaginal or glans irritation
  Choose a non-lubricated condom and add a water-soluble lubricant such as K-Y¬, Lubafax¬, Surgilube¬. Change brand of lubricated condom.
   

• If distasteful
  Use a water-soluble lubricant. Change brand of condom.
   

• In case of allergy to latex
  Choose a polyurethane or natural membrane condom.
   

• If sensation is lessened and it is more difficult to maintain erection because the condom hinders sexual intercourse
  Include the condom in sex play. Use humour and creativity. Use a thinner condom, a natural membrane or Japanese condom.
   

• If it is difficult to put on the condom
  Practice alone or with your partner, by unrolling it on a banana, etc.
   

• When condoms are not available
  Make sure you have some on you and keep condoms in the house and in other location.

The above is translated from an excellent text produced by the family planning team at the Centre hospitalier régional de Rimouski.
http://www.planningchrr.com/

www.jcapote.com