As we've explained in the past, like here, with proper use, condoms actually break very rarely. The common mythology that condoms are flimsy and break all the time is just that: mythology, not reality. Different studies on latex condom breakage tend to reflect a breakage rate of around .4%, or only 4 breaks in every 1,000 uses. So, if you're having condoms break often, especially before you've even used them a few hundred times, it's not likely something is wrong with condoms, but that something is wrong with the way you're using them. That's not surprising, since a lot of people don't get good information about how to use condoms correctly, or ever see clear, slow demonstrations of proper use where they also get the chance to ask questions.
Since we've been having some users lately reporting patterns of breakage, we thought we'd take a few minutes to walk you through a review of some common issues that tend to make breakage more likely, so that those of you using condoms can avoid breaks and have them provide you the high level of effectiveness in preventing pregnancy and STIs you are using them for.
Have you checked the expiration date? Condoms past their expiry date are much more likely to break, because the latex can start to break down. If they're past the expiry date, they also may have been shuffled around for a long time. The expiry date put on a condom -- which you can always find right on the package of every individual condom -- is usually for around five years after it's been manufactured, so you've got a pretty good time window. Our advice? Make sure a condom is not only within its expiry date, but around six months ahead of it, the time when a lot of condom resellers dump a batch instead of continuing to sell them. Don't use condoms past their expiry dates: toss them out and get yourself new ones.
Are you or your partners storing them properly? Sometimes people carry around what we'll call the "wishful thinking" condom. That one condom they keep in their wallet from the dawn of time, thinking if they have that one condom, they'll be more likely to have an opportunity for sex. Or maybe you just think that will assure you'll never be without a condom when you need one, which would be great if the condom you had had been stored properly.
Condoms need to be stored somewhere that doesn't get too hot or cold, where they're not directly exposed to sun or fluorescent light, and where they don't get bumped around a lot. Back pockets, wallets, the bottom of a purse or inside a car dashboard compartment are not sound places to store condoms. If you want to carry a condom or two around with you, find something you can put them in that protects them, like a pencil case, or in the box they came in if you bought a whole box. There are also cases made expressly for storing condoms, and sometimes when you buy condoms, you might find some already specially packaged in a storage case.
Condom storage is also something to think about before you even have the condom yourself. Some places that sell or dispense condoms don't store them properly, potentially screwing them up before you even get them. That's why machines that dispense them aren't such a great place to get them, nor are places like gas stations, which often keep them near the front windows, where it can get hot or sunny. When purchasing condoms, look for them to be in a spot where temperatures are moderate and they're not in direct sunlight. You also want to avoid hand-me-down condoms, too, however well-intentioned the person who gave them to you may be. Who knows how that person stored them.
Leaving room in the tip? You don't put condoms on like you put on a sock or stocking, where you pull them all the way on so that they're snug at the tip. Instead, we need to leave a little bit of room -- around a half inch or so, or the width of two fingers, if that's easier -- at the tip for ejaculate and so the condom can move around a little bit. That makes them feel more comfortable, too.
Using enough lubricant? Plenty of condoms come pre-lubricated, but that's only a smidgen of lube. More times than not, especially for intercourse that goes on for a while -- and more so with anal intercourse than vaginal, since the anus doesn't produce its own lubricant -- you'll need some extra lube right from the start, or to add lube during sex. Even with vaginal intercourse, while the vagina often produces its own lubrication when the person with the vagina is aroused, lube is often still needed. It's pretty common for younger people to feel nervous or have issues with arousal, so not being as lubed up on your own as you might be otherwise is typical. Too, if you're using a hormonal birth control method like the pill, one common side effect is a drier vagina. While we don't endorse mixing sex with drugs or booze, being wasted also tends to impact lubrication, especially with alcohol. By all means, drinking impairs our judgment no matter what, making it a lot harder to use condoms at all, let alone properly, but it also often inhibits parts of the sexual response cycle. Whatever the reason, chances are awfully good that you need more lube than a condom itself offers. Plus, putting a drop or two of lube inside the condom, as well as more liberally on the outside, makes condoms feel a lot better, too.
Feeling funny about using lube? Don't, seriously. People have used lubricants for as far back as we know, and if you ask us, beautifully engineered, clean lube in a bottle or tube is a serious improvement over animal guts or blubber, something we know people way back in the day used as lube. The idea that a body creating enough lubricant on its own gives a person some kind of sexual status, and that not being lubed up enough on your own means something is terribly wrong, are both really problematic ideas. Lube makes things feel better most of the time, and it helps condoms be more effective. We can probably agree that there's no status in sex feeling less than as good as it can, or in a condom failure.
Remember, what you use as lube with latex condoms matters a lot. When buying lube, look for the tube bottle or packet to make clear a lube can be used with condoms. Oil-based lubes or oils, lotions or vaseline are NOT okay to use with latex condoms.
One condom per customer. If you have the idea that two condoms at a time are better than one, ditch it, and fast. That only increases friction, which increases the possibility of breakage. Only use one condom at a time.
Same goes for thinking thinner condoms will be more likely to break: that's not true. Thinner condoms often feel better and are just as effective as thicker ones.
Does the condom fit? Condoms really aren't one size fits all. Sure, most brands will fit a lot of people just fine. But some brands or styles don't work for plenty of folks. So, if a condom is really tough to get on or off, hard to roll down, won't roll down all the way, or feels uncomfortable, try out some different sizes or brands. If we have to struggle with condoms, we're more likely to put them on wrong or just ditch them altogether. And with so many options in condoms, there's no reason anyone should have to use a size or style that doesn't work for them. The right condom usually feels great and works just as well. Even if you're getting condoms for free from a clinic or school, you'll often have more than one option, so snag a few different ones when you can.
Carrying condoms when you're not the one wearing them? If so, see if you can't buy variety packs, so you have more than one style or size around in case another just doesn't work out. Most condom manufacturers sell combination boxes of a couple different styles or fits, sold right where you can get boxes of only one style or size. If you feel funny about having a variety and worry about judgment from a partner, remember that what you're doing is having an assortment so they're most likely to have a condom that feels good for them. Every partner is going to appreciate that.
Are you or your partner hanging around after ejaculation or starting intercourse again without changing condoms? Male condoms are manufactured and designed for a single use: in other words, for only one session of intercourse or one ejaculation. After ejaculation happens, it's really important the person wearing the condom withdraws pretty immediately. If you want to continue that sexual activity or start again, you need to put on a new condom.
Breaking during oral sex use? That's even more unusual than breaks during intercourse, but if it's happening, we've got one word for you: teeth. You've got'em, and they're sharper than you think (just ask your lunch). If condoms are breaking during oral sex, and they were put on properly, stored properly, and are within the expiry date, teeth are probably the issue here. Remember that during oral sex, you've got to watch those little sharpies, both for a partner's comfort, but also when using condoms.
While we're talking about teeth, don't forget that they're not what you want to use to open a condom. That can easily rip or tear the condom. You want to use your hands to open a condom, not your mouth.
Practice makes perfect. So does patience. If you're racing around in a big hurry to put a condom on, it's a lot easier to make mistakes. And when everyone is turned on, they can be a lot tougher to notice. So, if you aren't already an expert with putting condoms on -- whether you're the person who wears them or not -- practice. If you are the person wearing them, practice during masturbation, where you don't have the pressures we can all feel when there's a partner there. If you aren't the person wearing them, get some condoms and find something suitable to practice on: the age-old banana is always an option, and one of our users today said she practiced using a deodorant can.
Remember that it's ideal for everyone involved with condom use to know the right way to use them and how to put them on. Not only can putting them on for a partner make condoms feel like part of sexual activity, rather than an interruption, we all have different levels of experience and skill with condoms, as well as different levels of condom education. So, if both people know how, and one person is doing something wrong, rather than finding out the hard way, the other person can easily make a correction so condoms work as well as you want them to, every time.
Don't forget about the female condom! If no matter what you do, male condoms (and we know, this female/male language doesn't make a lot of sense, and certainly isn't very inclusive, but it's what they're called right now) don't seem to work out for you, try a female condom to see if that works better. Female condoms are non-latex, and far roomier at the base and through the shaft than male condoms are, and they can also be inserted well in advance of intercourse to help you avoid game-time fumbles. As well, if you or a partner prefer not to withdraw soon after intercourse, that's okay with female condoms in a way it isn't with male condoms, which are more likely to break or slip off when withdrawal doesn't happen soon, or if intercourse is something you continue after ejaculation. Female condoms can be a bit tougher to find, so if you want to try them and are having a hard time finding them, check in with your local sexual health or family planning clinic.
Have questions or want someone to walk you through all the steps of proper condom use so you can be sure you're doing it right? We've got your back: come on over to the message boards, or use our text service. We're happy to talk with you one-on-one.
P.S. We just got a helpful addition to this list from Scarleteen reader and peer sex educator Katarina Albrecht. She said, "Another important point: Do NOT poke your finger carelessly into the tip to correct the direction for rolling them off! We teach people to blow into the tip to change the direction or be reeeally careful with their nails. We've been seeing so. many. girls (and boys) do this with their long, sharp, nicely manicured fingernails." Thanks, Katarina!
I'm 20 and have been with my partner for about two and a half years. We have a great relationship and are happy together. However, two years ago, when we first started sleeping together, I contracted genital herpes, even though we used condoms. I was a virgin before I slept with him so I knew it had come from him. I was angry and upset but he kept telling me he had tested clean at his last STI check and couldn't understand that he must have it. When we went to the GUM clinic (together) they confirmed that I had herpes but told me that they don't test for herpes unless there are symptoms present. Therefore when my boyfriend had his previous check-up (symptom free) he tested clean for everything they test for and then went on to sleep with me. My boyfriend was upset that I was blaming him and was tested again for everything they test for to prove to me he wasn't lying when he told me he was clean. He was negative for everything they tested him for....except like last time, they didn't test for Herpes and told him they didn't test for it unless there were symptoms, which there wasn't. He says he doesn't remember ever having symptoms hence why he's never had a physical check for it. I KNOW I didn't do anything wrong, and neither did my boyfriend, but I feel so bad about myself. I feel like I should have done something before we slept together, but I don't know what. I asked him to make sure he was clean: he did. We had no idea that they didn't do standard tests for herpes.
How do I stop feeling dirty and like I was irresponsible?
I'm and 18 years old and have been having sex for a year and been on the pill for about a year. I take my birth control like a ritual at the same time every day (the combination pill). Sometime my boyfriend and I don't use a condom in the beginning to get him hard then we always put one on. My question is, when on the pill do you absolutely have to use condoms? They say that every time you have sex you NEED to use a condom. I know it is the most effective way, but I thought that the one of the points of the pill is so you don't need to use a condom.
I'm unclear on how condoms are supposed to be effective in preventing female-to-male contamination during "plain" sex, I mean insertion of the penis into the vagina. Let me explain.
Latex is an effective barrier to virii and germs. I get that. As far as protecting the woman is concerned, I've no trouble believing it works. The STD virii or germs are present in the semen and/or pre-cum; these are "emprisoned" by the condom, don't get out, and don't get into contact with any part of the anatomy of the woman. She's protected. The sweat of the man does not contain these virii or germs and thus no risk with the rest of the skin-to-skin contact. But in the other direction, I don't quite get it.
That's the verbatim response to the question "What if I want to have sex before I get married?" in "No Second Chance," a film that is part of Sex Respect, an abstinence-only program. Sex Respect has a host of other special and oh-so-factual messages for you in their student workbook, including such sparkly gems as:
"A young man's natural desire for sex is already strong due to testosterone...females are becoming culturally conditioned to fantasize about sex as well." (p. 11) Did you know that without cultural conditioning, women don't have any desire for sex? Of course you did. Did you know that women don't have any testosterone in our bodies, too? Note: neither of these things are true. But you knew that already.
"A guy who wants to respect girls is distracted by sexy clothes and remembers her for one thing. Is it fair that guys are turned on by their senses and women by their hearts?" (p. 94) So, when it comes to sex, men don't have emotions and women don't have any of our five senses. Fascinating. And no: that's totally not fair, but then gender stereotypes rarely are.
"These are simply natural consequences. For example, if you eat spoiled food, you will get sick. If you jump from a tall building, you will be hurt or killed. If you spend more money than you make, your enslavement to debt affects you and those whom you love. If you have sex outside of marriage, there are consequences for you, your partner and society." (p. 11) Including the not-to-be-missed consequence of having to pay over a billion in U.S. tax dollars to fund stellar education just like this.
But this particular message in the video, that sex (and only sex outside of heterosexual marriage) equals death is a common thread in many, if not most, abstinence-only curricula and programs. I figured it was high time we just unpack it, take a good look at the real deal, and be done with it.
I'm pretty familiar with common causes of death, but I thought I'd channel my inner goth and do some homework on death anyway. I even -- though most of me knew better -- prepared myself to discover that sex INDEED posed far larger risks of death than I thought, and prepared myself to share that information if I discovered it. After all, if I had any agenda or educational model that required my not being truthful about any part of sexuality or sexual health, then as far as I'm concerned, the impetus would be on me not to lie or misrepresent that information but to adjust that agenda or the way I educated. Clearly, this is a way of thinking lost on some folks.
I'm keeping this to the U.S. for a few reasons. One biggie is that if I were to pull international statistics, I'd be including nations where ultimately, very serious lack of access to healthcare or basic, healthy living conditions was often the real cause of death: where what someone died from often would have been preventable with care and a better environment. That's hardly a non-issue here in the States, but it's not the kind of issue it is here as it is in much of Africa or some areas in Asia. I'm also being kind to the ab-onlies in sticking to the U.S. If I included, for instance, HIV-related deaths from the least developed nations, I'd be showing up even more clear evidence than we have in the States that marriage doesn't prevent sexually transmitted infections. "In Rwanda and Zambia, for example, an estimated 55-93% of new infections occur within marriage or in cohabiting relationships." Same goes for deaths for pregnant women. We have to include those if we're addressing death related to sex, but while maternal death rates for the U.S. are high for a developed nation, they're peanuts in comparison to those of third world nations. Conversely, the rate of abortion-related deaths is also far, far higher in areas where abortion is illegal.
Let's go ahead and look at some current death statistics. According to the CDC, in 2006 there were 2,426,264 deaths in the United States. The top 15 leading causes of death, and how many deaths for each of those causes there were, is as follows:
It's perhaps worth noting that in 2006, there were "30,896 gun deaths in the U.S: 12,791 homicides (41% of total deaths), 16,883 suicides (55% of total deaths), 642 unintentional shootings (2% of total deaths), 360 from legal intervention (1.2% of total deaths) and 220 from undetermined intent (.8% of total deaths)." In that same vein, here is a list of U.S. military deaths in Iraq for 2006: there were 920 U.S. Military deaths (during active duty) for 2006, total. If it seems silly to mention such a relatively small number, keep reading.
You'll notice that STIs and pregnancy (including labor/delivery or abortion) aren't on that list at all: they don't even make the top 15, which might be pretty surprising when someone is making it sound like if you have sex (oh, sorry: premarital sex) you're not only going to drop dead, you're going to drag everyone else you know to the grave with you.
Of course, some of the deaths in some of those groups may have been related to sex. For instance, three leading causes of death for pregnant women are heart disease, homicide (often directly related to being pregnant) and vehicular accidents. Septicemia can also occur due to miscarriage. Similarly, those who died from HIV/AIDS may have actually died of pneumonia or influenza. And sometimes people (though not usually people your age) really do have strokes during sex. I should also mention that some of those homicides would have included hate crimes: assaults to those who were of a gender or sexual orientations others didn't like, though that's not really about how sex itself can kill you, but how people who are deeply screwed up about sex, gender and sexuality issues can.
To pick up some of those gaps, "The rate of maternal mortality in the United States declined dramatically over the last century; however, an increase in the rate has become evident in the past several decades. In 2006, the maternal mortality rate was 13.3 deaths per 100,000 live births, compared to a low of 6.6 in 1987. In 2006, there were a total of 569 maternal deaths (those resulting from complications during pregnancy, childbirth, or direct or indirect obstetric causes up to 42 days after delivery or termination of pregnancy)." That rate includes deaths due to abortions, but is mostly deaths due to sustaining a pregnancy or to labor or delivery. The rate of death for abortion overall is far lower than for that of sustained pregnancy: it's "one death for every one million abortions at or before eight weeks to one per 29,000 at 16–20 weeks—and one per 11,000 at 21 or more weeks." And only 1.4% of abortions in the U.S. occur after 21 weeks, the majority of which are performed due to serious complications of pregnancy which can include serious health risks for those pregnant women.
In 2006, the estimated number of deaths of persons due to HIV/AIDS in the United States and dependent areas was 12,113. In other words, while most deaths due to HIV/AIDS are included in the death statistics for other direct causes, this is exactly how many HIV/AIDS-related deaths we had in 2006. Sparing any deaths from cervical cancer related to HPV, and Hepatitis-related deaths (which often is acquired nonsexually), most other STIs do not result in death at all, let alone make the grade for leading causes of death.
This article (Sexually Transmitted Infections 2005;81:38-40) lists deaths directly related to sex, though for 1998, not 2006. That's important because some of these rates are different than they are now: for instance, our maternal death rate has increased and our HIV-related death rate has decreased by nearly half). Would that we had the same study for 2006, but this is the only thing like this I can find anywhere:
As part of an analysis of the burden of disease and injury in the United States, we identified and quantified the incidence of adverse health events, deaths, and disability adjusted life years (DALY) attributed to sexual behaviour. In 1998... 29,782 such deaths (1.3% of all US deaths) occurred... Viral infections and their sequelae accounted for nearly all sexual behaviour related deaths—mostly HIV/AIDS.
The table of data for that piece shows the vast majority of those deaths were HIV-related (22,455), and again, that's almost twice the rate of HIV-related deaths as we see in the states currently, primarily due to advances in HIV medical care and treatment. The next highest group was cervical cancer likely due to HPV (4,921) -- which would be included in the total rate for all cancers -- and the next rung was from Hepatitis B and C, which may or may not even have been acquired sexually. The same is likely true for some (but not the majority) of those HIV/AIDS deaths; a minority of those cases may have been due to IV-drug use, for instance. This data apparently also only included deaths related to unwanted, not wanted, pregnancy. That leaves only 414 deaths from other STIs or from unwanted pregnancy death outcomes.
Now that we've got all that sorted: by all means, having sex can result in some health issues or conditions (and some of them certainly are or can become serious) and can be related directly to a death. Comprehensive sex educators and organizations like Scarleteen want you to know that, it's something we mention (and always have) when it's relevant, and we want you to know how -- which is why we do that funny thing where we tell you how -- you can protect yourself as best you can from death and other unwanted health outcomes from sex, either by abstaining from partnered sex or by utilizing safer sex practices if and when you choose to engage in partnered sex (whether you're married or not). In other words, someone saying sex could result in death isn't lying. It can.
But. You are much less likely to die from sex than you are from a whole host of other behaviours or circumstances, some of which the same folks would not warn you about with anything close to the same urgency or intensity. I just don't see driver's ed teachers telling you that if you get in a car at all, you need to be "prepared to die," even though more people die in car accidents than those who die as a result of having any kind of sex. (I also don't imagine they say that wearing a seatbelt when you are in a car is playing "Russian roulette.") I don't see them telling that to a class about enlisting in the military. I don't see them saying that to nearly everyone eating things in the lunchroom every day which could put them at risk for the most common cause of death. "Time for lunch, everyone! Prepare to die!"
Anyone who is stating or making it sound like sex or premarital sex is something more likely to kill you than anything else is being baldly dishonest. Whether you have sex with a partner in or out of marriage, with a partner of any given gender, at any given age and even IF (though we don't advise it) you take risks with your health and don't have sex safely, it is not, by any stretch, highly likely to kill you, and you do NOT have to "be prepared to die" if you choose to be sexually active. Not any more than you need to be prepared to die because we're all going to freaking die at some point no matter what we do, anyway.
And unless the same people telling you that if you have sex YOU WILL DIE are also telling you, with the same hysteria, force and fury that YOU WILL DIE if:
...then those folks are being particularly dishonest, especially if they're telling you that they're trying to scare the crap out of you expressly out of concern for your health, rather than because they want you to conform to their own personal set of values. Because doing any or all of the things in that list are directly related to or causes of the ACTUAL leading causes of death: the real ways you are most likely to die.
Since you're here at Scarleteen, I know I don't have to tell you that if you're going to have sex with other people, we think it's a wise idea to have sex safely and responsibly (in ways which have been soundly and scientifically proven, over time, to protect your life and health, something public health agencies all agree on). I know I don't have to tell you that if you and/or any partner aren't ready to do that, we think it's a good idea to put sex on hold until you are all ready, willing and able to have sex safely and responsibly. Not just until you're married, if marriage is even an option for you or something you want to do at all. One of the reasons we think that is because some kinds of sex (most primarily vaginal or anal intercourse) sometimes can pose a risk of death, and another, the more pressing, is because far more often, some kinds of sex can pose risks to your health and the quality of your life.
But we also think that just like you choose to go ahead and drive in that car even though it's one of the most common causes of death; just like you choose to leave your home at any time even though it may expose you to things like flu viruses or people who might shoot you, that you're capable of -- and absolutely entitled to -- making choices about what possible risks in your life you want to take for the possible benefits those same actions or behaviors might offer. Because that's simply a part of living your life, the life that, by virtue of merely being alive, is going to kill you some day whether you have sex or not.
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