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How well will condoms really work?

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Lary2211 asks:

I'm 19 years old. My boyfriend and I want to have sex. He is not a virgin, but I am. The only thing that I'm scared of is getting pregnant. We will use condoms for sure and as my boyfriend has had intercourse before, I'm assuming he knows how to use them. How effective can the condom be to prevent me from getting pregnant since I will be having sex for the first time?

Another issue that is freaking me out is what if the condom tears or comes off? Can I guarantee 100% protection and rely on my boyfriend's experience with condoms? I'm worrying a little bit too much, but I really want to experience sexual intercourse with someone I really love. I would really appreciate your help and advice because I'm in need of some.

Heather Corinna replies:

There are a bunch of things you can know and do that I think are going to help you feel a lot better.

When we talk about the effectiveness of any kind of contraception, including condoms, we reference two different groups of figures. One is perfect use: that means a person always uses their method and always uses it correctly. These results are often figured via lab studies, where perfect use can be verified. The other is typical use: how your average person generally uses a method. For instance, it's typical use for women to take a birth control pill late or miss one now and then, have a patch slip off, or only put a condom on after intercourse has already begun. Typical use rates also include not using a given method at all. In other words, the typical use rate for condoms is about people who, when asked what method of birth control they use, say condoms, even if they only use a condom one out of every three times they have intercourse.

In typical use, condoms are around 85% effective, or present a 15% risk of pregnancy. But in perfect use, they're about 98% effective, or present about a 2% risk of pregnancy. That's the case whether it's the first time someone is having sex or the 201st: what sexual experience you have or have not had does not change the effectiveness rate of a contraceptive.

To give you a couple methods to compare that to, spermicides are 85% effective in perfect use and 71% effective in typical use. The birth control pill is 99.7% effective in perfect use and 92% effective in typical use. An IUD is over 99% effective in both typical and perfect use.

No one method is 100% effective in perfect or typical use over time. If you want 100% protection from pregnancy, the only way to get that is by not having the kinds of sex (genital intercourse or other direct genital-to-genital contact) that present risks of pregnancy.

But both kinds of effectiveness statistics for methods are about effectiveness of use over one year: that means that in single incidents of sex, condoms absolutely can be 100% effective. After all, we either become pregnant or we don't: it's not like we can become only 13% pregnant. If we use a condom as contraception when we have sex, and we don't become pregnant, then that condom was 100% effective.

It might help to know that young women who use NO method of contraception have about a 90% chance of becoming pregnant in one year. Once more with feeling, women using condoms have only a 15% chance at a maximum. As you can see, using condoms and/or other methods of contraception makes a huge difference, even just in typical use, but all the better with perfect use, when that risk is only around 2%.

In case someone's filled your head with the idea that even when used properly, condoms are highly likely to fail, know that's just not true. According to the CDC (via Avert) "in the United States, most studies of breakage caused by fault in the condom itself have shown breakage rate is less than 2 condoms out of every 100 condoms. Studies also indicate that condoms slip off the penis in about 1-5% of acts of vaginal intercourse." When condoms break or slip off, it's usually because they weren't put on, used, taken off or stored properly. Condom failure is usually due to user error.

And while we're at it, as the CDC also explains, "laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens." Condoms are also very highly effective at preventing STIs, which is just as important as preventing unwanted pregnancy.

Seeing all those figures, it's probably obvious that using condoms consistently and correctly makes a world of difference.

You don't need to just assume or guess your partner knows how to use condoms correctly: this is something that you both can talk about with him, and should be talking about, all the more if condoms are going to be your only or primary method of birth control. So, check in. Make sure you're both on the same page that you're always going to use a condom, from start to finish. Ask if he feels like he has condom use down, and review, together, what correct use is and is not. Make sure you know for yourself how to use condoms properly, and see with other sexual activities you might already be engaging in, like oral sex, if you both DO know how to use them properly. Both of you should know how to put on and remove a condom, after all, not just him. You both knowing that not only will help assure condoms are always used and used properly, but sometimes you'll find it's simply more convenient, depending on whose hands are where doing what, for you to put the condom on him than it is for him to do it. Some couples also find that makes condom use more exciting for them.

Some STIs are just as big a deal as pregnancy, but assuring you two know how to use a condom correctly when only one of those things are on the line, rather than both, is smart. You can take some turns putting the condom on him with the activities you're doing now that do pose risks of STIs (which you should be doing anyway), but not of pregnancy, to be sure you both know how to use them right before you have intercourse, rather than relying on him being the only one who knows how, or finding out if he is or isn't an ace at it later on.

You also don't have to only use condoms for intercourse if you want more protection from unwanted pregnancy than condoms offer. When we pair up any two methods together, even if we don't use EITHER perfectly, you'll have no less than 92% effectiveness. When we pair any two and use them perfectly, no two methods combined offer less than 97% effectiveness, and most combined with perfect use offer over 99% protection.

You have many options for second methods. You can talk to your doctor about getting a prescription for a hormonal method, like the pill or Nuvaring, you could ask about cervical barriers if you want something non-hormonal, or could add a second method that doesn't require consulting with a healthcare provider at all, like natural family planning, withdrawal or spermicides.

You also always have the option of getting yourself a pack of Plan B to have around just in case a condom should slip off or break. If a condom does break or slip into your vagina, that's something you can use to help prevent a pregnancy when a condom has failed. You can go to a pharmacy and get it after-the-fact, it's just more convenient and can give you more peace of mind to already have a pack handy. That way, you can take it right away so it can be most effective. and you also don't have to run yourself ragged trying to find it if and when you're in the time crunch of needing it pronto.

I'd also like to mention that sometimes when we find ourselves really freaking out about this stuff, it can be because while we want to do something, we need more time to prepare, assess our readiness, to be in a relationship or talk through all of this stuff with a partner, friends, family or someone else we trust and get good support from.

So, even if knowing what I've told you about condoms, assuring you both know how to use them, and/or adding a second method still leaves you feeling really scared, you can always hold off on intercourse until that's less scary for you, and you feel more prepared to handle it as a possible outcome. Even if your boyfriend isn't scared the way you are, if you're still feeling this scared, and this is someone who loves you and cares for you, he should have no problem holding off until you feel more ready. Any partner who pushes when their partner says they don't feel totally okay with sex and all it can entail yet, or who even likes the idea of having sex with someone who is scared is someone to steer clear of if you want to assure healthy sexual partnerships.

On top of the emotional and interpersonal toll it can take on you, feeling scared or panicked also doesn't tend to result in great sex for anyone. Stress and anxiety usually keep our bodies and minds from becoming fully aroused, and make it much harder to experience pleasure and to reach orgasm. Plus, I always hope that anyone who is sexually active is feeling just as good after sex as they did during: if afterwards, you think you're going to be sweating bullets until your next period arrives, I'd suggest you give some thought to if now is really the best time for you to add intercourse to your life.

If you're feeling that way, what you might want to do before intercourse is some more of your own thinking, then talk with your partner about an unwanted pregnancy. What do you think you'd want to do if that happened? While our ideas about what we might do in the abstract aren't always the same as when we're actually pregnant at any given time, you certainly can get some sense of what choice you think would be best for you. How would he feel about it? Does he feel like he'd be able to be supportive, including of what reproductive choice you think you'd want to make? Talk about what you feel like you need to feel comfortable with any risk of pregnancy, and you can work together to get there.

I'll leave you with a few extra links for all of this, including our system to help users find out what methods of contraception will likely be best for them, a page that can show you the effectiveness rates when you combine methods as well as instructions on how to use condoms properly, and so that they feel best for both of you.

written 01 Oct 2009 . updated 27 Jan 2014

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