A condom sealed in typical packaging

A condom is a device, usually made of latex, that covers a man's penis during sexual intercourse to reduce the risk of pregnancy and/or sexually transmitted diseases (STD) such as gonorrhea, syphilis and HIV. Condoms do not protect against all forms of STDs. They are also known as prophylactics, as well as a number of colloquial or slang terms, such as rubbers.

Folk etymology claims, without basis, that the word "condom" is derived from a purported "Dr. Condom" or "Quondam", who made the devices for King Charles II of England. There is no evidence that any such "Dr. Condom" existed.

Overview

A condom made from animal hide around 1900

The first efforts at making condoms involved the use of woven fabrics. These were obviously not effective. The earliest effective condoms were made of sheep gut or other animal membrane. These are still available today because of their greater ability to transmit body warmth and tactile sensation, when compared to synthetic condoms, but they are not as effective in preventing pregnancy and disease. Mass production of condoms started in mid-19th century, shortly after the invention of the rubber vulcanization process. Until the 1930s, condoms were made from rubber; they were still quite uncomfortable and expensive (though reusable) and thus only available to small part of population. When latex condoms at last became available in late 1930s, it was a leap forward in effectiveness and affordability. However, before the middle of the 20th century, many places outlawed the sale of condoms, and many subsequently allowed their sale "only for the prevention of disease". During this ban, they come under many aliases such as "rubber sponges". One of the early condom brands was called "Merry Widows".

An unrolled latex condom

Latex condoms are packaged in a rolled-up form, and are designed to be applied to the tip of the penis and then rolled over the erect penis. They have a "right side" and a "wrong side" when rolled up, and the first thing the user must do is to determine which side is which before attempting to apply them. Any touching of the penis to the "wrong side" of the rolled-up condom before application potentially "contaminates" the outside with bodily fluid, defeating the condom's purpose.

Early latex condoms were very similar, but later some came to have reservoir tips to contain ejaculated semen. One relatively early innovation, the 'short cap', only covered the head of the penis. These were not useful condoms, as there was still contact between the partners' genitals, and bodily fluids could easily spill out of the cap.

In recent decades, however, condom makers have diversified in colors, sizes and shapes. Flavors or designs thought to have stimulating properties are sometimes added. Such stimulating properties include enlarged tips or pouches to more fit the glans penis better and textured surfaces such as ribbing or studs (small bumps). Many condoms have spermicidal lubricant added, but it is not an effective substitute for separate spermicide use.

Condoms made from natural materials (such as those labeled "lambskin", made from lamb intestines) are not as effective at preventing disease. A few companies are today also making condoms from polyethylene and polyurethane, expected to be as effective as, but less tested than, latex. These condoms have the advantage of being compatible with oil-based lubricants. They can also be used by people who have a latex allergy.

As a method of contraception, condoms have the advantage of being easy to use, having few side-effects, and of offering protection against sexually transmitted diseases. There is a paradox in contraceptive use of condoms: their theoretical effectiveness is relatively high, but their actual effectiveness is relatively low. This is because many people fail to follow rigorously the proper procedures for condom usage. Even touching the female genitalia with the same (unwashed) hand that removed the condom can potentially cause pregnancy. Furthermore, surveys have shown that many users do not know how to put them on correctly, resulting in bursts and slippages.

Therefore, of themselves, condoms are only moderately reliable as a contraceptive method, but when combined with a spermicide their reliability is comparable to other methods. But even when condom use is combined with another method of contraceptives (such as spermicide or birth control pills), pregnancy is still possible.

Among their disadvantages, people list that putting them on can interrupt foreplay and lovemaking. (Others who have integrated wearing a condom as part of the entire process for sexual activity, however, do not consider this bothersome.) Because of an obvious barrier of the skins, sensory stimulation is sacrificed, causing some people to dismiss condoms as limiting their pleasure (though this effect can be largely overcome by properly applying lubricants internally and externally). However, a woman can partially solve this problem by training her vaginal muscles, specifically the pubococcygeus. These drawbacks of condoms, among others, are often cited as reasons by those who decide not to use them.

Condom failure

Most condom failures are due to misuse. This has led some researchers to suggest age-appropriate sex education that includes how to use a condom properly. A 1994 FHI study showed that most condom users rarely experience condom breakage or slippage. [1] According to the World Health Organization [2], condoms currently have a failure rate of three percent at twelve months, when used properly and consistently.

Another possible, though rare, cause of condom failure is outright sabotage. One motive is to have a child against a partner's wishes, known to be done by men and women alike. Saboteurs usually pierce the condom's tip multiple times before intercourse. As this can result in pregnancies unwanted by one of the participants, it is generally seen as a deceitful and unethical act. However, at least one website is set up to provide advice on sabotage to women who want a child against their male partner's wishes. Sabotage as a teen prank has also been portrayed (in passing) in the Japanese film Pikanchi.

One method of testing condoms for microscopic holes involves placing the condom being tested over one conducting form with another on the other side of the condom. If the condom does not prevent an electric current from flowing between the two conducting forms, it fails the test. Holes in condoms are unlikely if proper handling conditions (see below) are followed.

Proper use

The use of male condoms involves the following:

• Condoms should never be stored in hot places like car glove-compartments or wallets kept in pockets close to the body, as prolonged exposure to heat damages latex.
• Sharp fingernails can damage condoms.
• Condoms are best put on the erect penis as soon as an erection is achieved and before any contact with the other person's body, and should always be put on before contact with a vagina or anus.
• Retracting the foreskin before putting on a condom maximizes mobility and reduces the risk of breakage during intercourse.
• Room needs to be left at the tip of a condom to hold semen. Most condoms have a reservoir tip that should be pinched while applying the condom to avoid trapping an air bubble which could burst later.
• Water-based sexual lubricants, such as KY Jelly, are safe for use with condoms, but oil-based lubricants weaken latex and may cause it to tear or develop holes. Lubrication can be used to reduce the abrasion on the condom during vaginal sex, and is virtually essential for anal sex.
• Some condoms are designed specifically for anal sex. The material is slightly thicker, making these condoms less likely to tear than those designed for vaginal sex.
• Condoms should be discarded after the expiration date on the package. Even ones that seem fine past that date may be more likely to burst later.
• The penis should be withdrawn immediately after ejaculation, even if the erection can be maintained; leaving it in leads to needless risk.
• The base of the condom should be held during withdrawal to prevent the condom from slipping off.
• One's hands and penis should be washed before further physical contact with another person (including the sexual partner).
• Condoms are for single use only, and should never be reused.
• Condoms are available in special sizes for people who require larger or smaller ones.
• Practicing applying condoms alone in a well lighted place can help a man learn to apply it correctly before using them for sex.

General instructions for putting on a male condom are as follows:

1. Check the expiry date on the condom wrapper - Condoms have a printed expiry date and batch number. Do not use out of date condoms.
2. Gently apply pressure to the condom wrapper to make sure it has a slight pillow-like quality to it, indicating air inside and proper and unbroken sealing. Otherwise air may have escaped from tear or punctures and the condom itself may be damaged as well.
3. Exercising caution, open the foil (or plastic) wrapper along one side. Be careful not to damage the condom with sharp objects.
4. If the condom is sticky or brittle, discard it and use another one.
5. Press firmly together the tip of the condom to expel air that may be trapped inside the condom. Air pockets can cause the condom to burst. This tip is there to contain the discharge in ejaculation.
6. Ensure that the penis is fully erect — a condom may fall off the penis which is only partially erect.
7. Check that the condom is in the right direction to unroll down the penis and before unrolling put it on the tip of the penis. If you accidentally try to put it on the wrong way, discard it and start over with a new condom. Touching the wrong side of the condom with the penis can transfer bodily fluids, defeating its purpose.
8. Unroll the condom over the shaft of the penis. Unroll it all the way. If it does not unroll, it is on the wrong way and you must start over with a new condom.
9. Make sure the condom isn't loose or or at risk of coming off.
10. Do not allow the penis to go flaccid at any time while wearing or putting on the condom; You will have to discard the condom otherwise.

All 12-packs of condoms come with these or similar instructions, and may contain additional information; be sure to read these instructions if you have never used a condom before.

Some men who feel a particular size condom is hard to put on because it is too small have reported that they partly unroll the condom, stretch it with both index fingers, insert the penis (asking their partner to expel air from the tip), remove fingers and unroll. This procedure is not recommended as one's fingernails can come in contact with the condom. Consider buying a larger condom, or practising the approved method above.

Prevalence of condoms

Condoms are most accessible in developed countries. In various cultures, a number of social or economic factors make access to condoms prohibitive. In some cases, cultural beliefs may cause some persons to shun condoms deliberately even when they are available. [3]

Furthermore, regardless of culture and availability, many men shun condoms simply because they dislike using them. This dislike may be due either to a belief that condoms reduce sexual pleasure or to practical problems, e.g. difficulty in sustaining an erection hard enough for effective condom use. Embarrassment about actually purchasing condoms in the first place also occurs, but such privacy concernes are answered when condoms can be sold in vending machines in public toilets, and later through the Internet.

Female condoms

Recently "female condoms" or "femidoms" (not to be confused with femdoms) have become available. They are larger than male condoms and have a stiffened ring-shaped opening, and are designed to be inserted into the vagina. The female condom also contains an inner ring which keeps the condom in place inside the vagina - inserting the female condom requires squeezing this ring. Sales of these have been disappointing in developed countries, though increasingly developing countries are using them to complement already existing family planning and HIV/AIDS programming. Probable causes for poor sales are that inserting the female condom is a skill that has to be learned and that female condoms can be significantly more expensive than male condoms (upwards of 2 or 3 times the cost). Also, reported "rustling" sounds during intercourse turn off some potential users, as does the visibility of the outer ring which remains outside the vagina. This type of condom is made from polyurethane, though newer iterations are made from nitrile.

These condoms have the advantage of being compatible with oil-based lubricants as they are not made of latex. The external genitals of the wearer and the base of the penis of the inserting partner are more protected than when the male condom is used. Inserting a female condom does not require male erection. (Boston Women's Healthbook Collective, 2005: 336-337)

The instructions for use of female condoms are of necessity different from those of male condoms, since they are inserted rather than worn, and designed to drape around the penis, rather than to fit tightly over it. They are as follows:

• The condom should be removed carefully from the packaging;
• The small inner ring should be squeezed closed;
• The inner ring should be pushed into the vagina, the outer ring remaining outside;
• The penis should be guided through the outer ring to ensure that it is not pushed aside.
• Before removing the condom, the outer ring should be squeezed and twisted (while the wearer is still lying down, if applicable) to ensure that semen does not leak out of the pouch. Pull to remove the condom.
• Any "rustling" can be counteracted by applying extra lubricant to the inside of the condom; this is also the course of action to take if the outer ring is pulled into the vagina during intercourse. (Boston Women's Health Book Collective, 2005: 337-338)

A new, updated female condom is being developed by PATH, a medical technologies NGO, that would be easier to put in as well as less awkward to use. [4] A second iteration of the original female condom is also in development by the Female Health Company that would be cheaper and easier to use.[5]

Religious attitudes towards use of condoms

Main article: Birth control#Religious and cultural attitudes toward birth control

Condoms and other mechanisms of contraception, along with abortion, are prohibited by the Roman Catholic Church for Catholic couples in canonically valid marriages, and condemned by some conservative Protestants for moral reasons. Opinions of Orthodox Christian bishops vary on the matter. Some other religious authorities, however, view contraception from the angle of stewardship of Earth. Overpopulation abatement is part of good stewardship and contraception (including limiting sexual activity) serves this purpose.

Teens participating in sexual activities contribute to the vast majority of condom failures. Those who assert that teens should be taught to use condoms properly often face opposition by religious and other groups that oppose any sex outside marriage. They consider teaching contraception to youth tantamount to encouraging teen sex. However, some studies suggest sexual abstinence-only programs actually increase instances of teen pregnancy. [6]

One quote about contraception from a religious source that specifically mentions condoms is as follows:

"It is permissible to use condoms so long as this does not cause any harm and so long as both husband and wife consent to their use, because this is similar to ‘azl (coitus interruptus or “withdrawal�). But it reduces the sensation of pleasure, which is the right of both partners, and reduces the chance of conception, which is also the right of both partners. Neither one of them is allowed to deprive the other of these rights. And Allaah is the course of strength." - islamic-paths.org, Sex and Sexuality in Islam - Condoms (2005) [7]

Likewise, others have criticized opponents of condom use as being to some degree responsible for overpopulation and the proliferation of sexually transmitted diseases.