FSRH | Barrier methods of contraception

This guideline is really just revision and I don’t think anyone has ever come in asking for information about condoms. However, I suppose that if we are being keen, when someone says ‘I’m using condoms’ for contraception, we should be checking that they are aware of the failure rates and, especially in young people, offering them information about safe condom use.

Failure rates with perfect use of male condoms is 2% per year (ie 2 women will fall pregnant a year). With typical use, the failure rate is 18%...

Anal Sex. For anal sex, use of lubricant greatly reduces the chance of breakage (from 21.4% to 3%). If inappropriate lubricant is used, the breakage rate is higher (eg oil based lubricant  7.7%, saliva 10.8%).

Sizing of Condoms. You can also get ‘fitted condoms’. Men can measure themselves and then get ‘fitted condoms’ from the internet. Men are more likely to use condoms if they fit well. Rather amusingly, it has been shown that men with a large penis size using fitted condoms have fewer slippages than men with a medium penis size. Maybe a degree of ‘wishful thinking’ going on?

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton locum chambers, and Pallant Medical Chambers Clinical Guidelines Lead Partner.

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