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your guide to male and female condoms Helping you choose the method of contraception that is best for you and male condoms female and female condom con dom male and female male an ale and female condoms condoms male and condoms female condom male and female condoms and female male and fe male and female male and female cond male and oms male and fema male and fe

2 3 Male and female condoms Male and female condoms are barrier methods of contraception. They stop sperm meeting an egg. A male condom fits over a man s erect penis and is made of very thin latex (rubber) or polyurethane (plastic). A female condom is made of polyurethane. It is put in the vagina and loosely lines it. How effective are condoms? How effective any contraceptive is depends on how old you are, how often you have sex and whether you follow the instructions. If 100 sexually active women don t use any contraception, 80 to 90 will become pregnant in a year. Male condom If used according to instructions it is 98 per cent effective. This means that two women in 100 will get pregnant in a year. If it is not used according to instructions, more women will become pregnant. Contents How effective are condoms?...3 Can anything make condoms less effective?...4 Where can I get condoms?...5 What are the advantages of condoms?...5 What are the disadvantages of condoms?...5 Can anyone use condoms?...6 When should I use lubricants with a condom?...6 Do I need to use spermicide?...7 I ve just had a baby, can I use condoms?...7 Can I use condoms after a miscarriage or abortion?...7 Which condoms are best for oral sex?...7 Which condoms are best for anal sex?...8 Can sperm travel through pores in the condom?...8 How are condoms tested to make sure they will work?...8 Are there different types of condom?...8 Going on holiday?...10 How do I use a male condom?...10 How do I use a female condom?...11 Where should I keep condoms?...13 How do I find out about contraception services?...13 Emergency contraception...14 Sexually transmitted infections...15 A final word...16

4 5 Female condom If used according to instructions it is 95 per cent effective. This means that five women in 100 will get pregnant in a year. If it is not used according to instructions, more women will become pregnant. Some novelty male condoms are designed purely for fun, and should not be used for contraception. Where can I get condoms? Male and female condoms are free from contraception and sexual health clinics and young people s services, and some general practices and genitourinary medicine (GUM) clinics. You can buy them from a pharmacy, by mail order or online as well as from vending machines, supermarkets, garages and other shops. Can anything make condoms less effective? Sperm can get into the vagina during sex, even if you use a This may happen if: O the penis touches the area around the vagina before a condom is put on (pre-ejaculation fluid, which leaks out of the penis before ejaculation, may contain sperm) O the condom splits O you use the wrong type or size of condom O you don t use the condom correctly O the male condom slips off O the female condom gets pushed into the vagina O the penis enters the vagina outside the female condom by mistake O the condom gets damaged, for example by sharp fingernails or jewellery O you use too much or too little lubricant O you use oil-based products (such as body lotions) with latex condoms. These damage the If any of these happen, or if you have had sex without using contraception, you can get advice about emergency contraception (see page 14). What are the advantages of condoms? O You only need to use them when you have sex. O They help to protect both partners from some sexually transmitted infections, including HIV. O There are no serious side-effects from using condoms. O Male condoms come in a variety of shapes and sizes. O Male condoms are easily available. O A female condom can be put in any time before sex. What are the disadvantages of condoms? O A male condom can sometimes slip off or split. O Some people are sensitive to latex condoms, though this is rare. O When using a male condom, the man has to pull out after he has ejaculated, and before the penis goes soft, holding the condom firmly in place. O When using a female condom, you need to make sure the penis is in the condom and not between the condom and vagina and that the open end of the condom stays outside the vagina. O Female condoms can slip out or get pushed into the vagina.

6 7 Can anyone use condoms? Yes, male and female condoms are suitable for most people. Some men and women are sensitive to the latex in male condoms. If this is a problem you can use male polyurethane condoms or female condoms. Men who do not always keep their erection during sex may find it difficult to use a male Female condoms may not be suitable for women who do not feel comfortable touching their genital area. When should I use lubricants with a condom? Most male condoms come ready lubricated to make them easier to use. Some people also like to use additional lubrication. Any lubricant can be used with male polyurethane condoms. However, if you are using a male latex condom you should never use oil-based products such as body oils, creams, lotions or petroleum jelly as a lubricant. This is because they can damage the latex and make the condom more likely to split. Some ointments can also damage latex. If you are using medication in the genital area for example, creams, pessaries, or suppositories ask your doctor, nurse or pharmacist if it will affect latex condoms. You can check the condom packaging to find out whether a condom is made from latex or polyurethane. Some condoms don t have any lubricant on them so that you can choose not to use lubricant, or to use a lubricant of your own choice. Female condoms come ready lubricated to make them easier to use. Some people also like to use additional lubrication. Any lubricant can be used with female condoms as they are made of polyurethane. This includes body oils, creams, lotions or petroleum jelly. If you are using medication in the genital area, for example, creams, suppositories or pessaries, you can still use female condoms. Do I need to use spermicide? No. If used correctly, condoms are an effective method of contraception and you do not need additional spermicide a chemical that kills sperm. Some male condoms are lubricated with spermicide. These types of condom are being phased out. Research shows that spermicide which contains Nonoxinol 9 does not protect against sexually transmitted infections. It may even increase the risk of infection. If you can, avoid using spermicidally lubricated condoms and don t use additional spermicide as a lubricant. I ve just had a baby, can I use condoms? You can use condoms immediately after you have had a baby using an additional lubricant can help to make sex more comfortable. Can I use condoms after a miscarriage or abortion? You can use condoms immediately after having a miscarriage or abortion. Which condoms are best for oral sex? Any condoms can be used for oral sex. However, flavoured condoms are a good option because they re not lubricated and come in a range of flavours to suit most people s tastes.

8 9 Which condoms are best for anal sex? Standard condoms are suitable for anal sex there is no evidence that stronger or thicker condoms are better or safer. It s very important that you use extra lubrication for anal sex to reduce the risk of the condom breaking. Can sperm travel through pores in the condom? No. Neither latex nor polyurethane condoms have pores. How are condoms tested to make sure they will work? Condoms go through several different tests to check they are free from holes, the strength and stretch of the latex, the air pressure needed to burst one and the safety of the packaging. Are there different types of condoms? There are many different types of male condoms to choose from including regular, larger, trim, stimulating and fun. Regular condoms These are made from latex or polyurethane. They are an average length and width to suit most men and are straight sided with a round or teated end. Adult penis sizes do vary, but not by much. However, you may feel more comfortable with a larger or smaller comfort and to make them easier to put on. Smaller condom Often known as trim condoms, small condoms are designed for a thinner or shorter penis. Made-to-measure condoms Custom-made condoms are available for those who cannot find a condom that is the right size or comfortable. Ejaculation delayers Most ejaculation delayer condoms contain benzocaine. Benzocaine is a low strength local anaesthetic, similar to that used in throat lozenges. It is put in the condom lubricant or teat and works by temporarily numbing the nerve endings of the penis. Heightened stimulation condoms Some contain a special lubricant that creates a warm or tingling sensation for both partners. Others contain extra lubricant to increase sensation. All brands now have at least one style of condom that is textured ribbed, dotted, and/ or studded which aims to increase sensation during sex. Fun condoms Coloured, flavoured, glow-in-the-dark and novelty condoms are all aimed to make sex more fun. Check the packaging to make sure that they can be used to protect against pregnancy and sexually transmitted infections. Larger condoms These are condoms designed to fit a larger penis. They vary in shape and some are flared to improve Strong condoms These condoms are slightly thicker and sometimes have additional lubricant. They are usually made of

10 11 latex. Strong condoms are not less likely to break. Thin condoms These condoms are thinner than a regular condom, providing greater sensitivity for both partners. Vegan condoms Many latex condoms contain a milk protein called casein. Vegan condoms are free from all animal products. Going on holiday? It is always a good idea to pack condoms even if it s just in case. If you are going abroad, take your favourite brand from the UK. That way you won t have to rely on a local brand which could be packaged in a foreign language or which may not have been produced to the same standards. How do I use a male condom? You will find instructions on the condom packet or in a leaflet inside the pack. You can also ask your doctor, nurse or pharmacist. Use a new condom each time you have sex. Check the use by date on the packet. Be careful how you take the condom out of the packet sharp fingernails and jewellery can tear the Find the teat or closed end and squeeze it to get rid of air. This will also help you roll the condom on the right way round. Put the condom on when the penis is fully erect and before it touches the vagina or genital area. Still holding the end, roll the condom all the way down the penis. If it won t roll down then it s probably on inside out. If so, start again with a new condom as sperm could now be on the first one. If you have foreskin, you may find it easier and more comfortable to put the condom on if the foreskin is pulled back. This lets the foreskin move freely and reduces the risk of the condom tearing or slipping off. As soon as the man has ejaculated, and before the penis goes soft, hold the condom firmly in place while pulling out. Do this slowly and carefully so you do not spill any semen (the ejaculation fluid that contains sperm). Take off the condom, wrap it and put it in a bin. Do not put it down the toilet. Make sure the penis does not touch the genital area again, and if you have sex again, use a new How do I use a female condom? The packet contains instructions. Use a new condom every time you have sex. Check the use by date on the packet. You can put the condom in any time before sex, but always before the penis touches the vagina or genital area. You can put the condom in when you are lying down, squatting or with one leg on a chair. Find the position that suits you best. Be careful how you take the condom out of

12 13 the packet sharp fingernails and jewellery can tear the Hold the closed end of the condom and squeeze the inner ring between your thumb and middle finger. Keeping your index finger on the inner ring helps you to insert the condom into the vagina. With your other hand, separate the labia (folds of skin) around your vagina. Put the squeezed ring into the vagina and push it up as far as you can. Now put your index or middle finger, or both, inside the open end of the condom, until you can feel the inner ring. Push the inner ring as far back into the vagina as it will go. It will then be lying just above your pubic bone. (You can feel your pubic bone by inserting your index or middle finger into your vagina and curving it forward slightly.) Make sure that the outer ring lies close against the area outside your vagina (vulva). It is a good idea to guide the penis into the condom to make sure it does not enter the vagina outside the Holding the outer ring in place, outside the vagina, also helps to stop the entire condom being accidentally pushed right into the vagina. As the female condom is loosefitting, it will move during sex. But you will still be protected as long as the penis stays inside the To remove the condom, simply twist the outer ring to keep the semen inside. Then pull the condom out gently. Wrap the condom and put it in a bin. Do not put it down the toilet. Make sure the penis does not touch the genital area again, and if you have sex again, use a new Where should I keep condoms? Always keep packets of condoms and individual condoms where they cannot be damaged by strong heat, sharp objects, light or damp. How do I find out about contraception services? The Sexual Health Information Line provides confidential advice and information on all aspects of sexual health. The number is 0800 567 123 and the service is available from Monday to Friday from 9am - 8pm and at weekends from 11am 4pm. For additional information on sexual health visit www.fpa.org.uk Information for young people can be found at www.brook.org.uk

14 15 Clinics To locate your closest clinic you can: O Use Find a Clinic at www.fpa.org.uk/clinics O Download FPA s Find a Clinic app for iphone or Android. You can find details of general practices and pharmacies in England at www.nhs.uk and in Wales at www.nhsdirect.wales.nhs.uk. In Scotland you can find details of general practices at www.nhs.24.com and in Northern Ireland at www.hscni.net Emergency contraception If you have had sex without contraception, or think your method might have failed, there are different types of emergency contraception you can use. O The emergency contraceptive pill, Levonelle - can be taken up to three days (72 hours) after sex. It is more effective the earlier it is taken after sex. It is available with a prescription or to buy from a pharmacy. O The emergency contraceptive pill, ellaone - can be taken up to five days (120 hours) after sex. It is only available with a prescription. O An IUD - can be fitted up to five days after sex, or up to five days after the earliest time you could have released an egg (ovulation). Sexually transmitted infections Most methods of contraception do not protect you from sexually transmitted infections. Male and female condoms, when used correctly and consistently, can help protect against sexually transmitted infections. If you can, avoid using spermicidally lubricated condoms. The spermicide commonly contains a chemical called Nonoxinol 9, which does not protect against HIV and may even increase the risk of infection. Ask your doctor, nurse or pharmacist about getting emergency pills in advance, just in case you need them.

A final word This booklet can only give you general information. The information is based on evidence-guided research from the World Health Organisation and The Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists. All methods of contraception come with a Patient Information Leaflet which provides detailed information about the method. Remember - contact your doctor, practice nurse or a sexual health clinic if you are worried or unsure about anything. www.fpa.org.uk The Sexual Health Line is provided by the Department of Health. This booklet is produced by the sexual health charity FPA, registered charity number 250187. Limited liability company registered in England, number 887632. Supported by the Department of Health. FPA does not run the Sexual Health Line. FPA printed January 2014 ISBN 978-1-908249-54-8 The information in this booklet was accurate at the time of going to print. Booklets are reviewed regularly. Next edition available in 2015. If you would like the information on the evidence used to produce this booklet or would like to provide us with feedback about this booklet email feedback@fpa.org.uk Ref: 1010