Top 10 External Condom Facts

External condoms are an effective means of birth control and can help protect you from sexually transmitted infections (STIs) like HIV. But, you need to use external condoms correctly and consistently for them to work.

The simple truth is that many people don't use external condoms correctly or consistently, particularly young adults, 55% of whom use external condoms, according to a 2015 study in the International Journal of STDs and AIDS. Misconceptions and misunderstandings account at least in part for external condom use mistakes.

The bottom line is that external condoms work. Here are the top 10 facts that illustrate why they should be part of your sexual health routine.

1

External condom quality is strictly regulated.

A young woman is sitting on the bed holding a condom in her hands.
Boy_Anupong / Getty Images

External condom types can vary, but for an external condom to be sold in the United States, it needs to meet strict quality standards.

American and imported external condom manufacturers electronically test every external condom for holes and other defects. They also conduct additional testing on random external condoms from each batch, usually involving a water leak test to detect holes and an air burst test to check the strength of the external condom.

The U.S. Food and Drug Administration (FDA) inspects external condom manufacturing facilities periodically and performs random testing to ensure consistent quality.

Condoms are class II medical devices. Manufacturing requirements are strictly regulated, so external condoms must meet industry standards designated by the FDA in order to be sold.

2

External condoms are sized to fit.

Young couple looking at condoms in store

 Fancy / Veer / Corbis / Getty Images

When it comes to using external condoms, size does matter. Since penis size can vary, using the correctly sized external condom is important to ensuring both comfort and protection.

External condom malfunction can occur if you use a poorly sized external condom. Those that are too tight may be more likely to break, whereas external condoms that are too loose may be more likely to slip off.

However, if an external condom breaks, the size may not be the cause. Instead, it may be that you are using the wrong lubricant, using an expired condom, or storing the external condom at high temperatures (such as in the glove compartment). These things can undermine the integrity of an external condom and increase the risk of bursting.

Check the expiration date before using an external condom, and throw away any external condom that is torn or looks damaged. Never reuse an external condom.

3

External condoms are effective against most STIs.

Chlamydia screening smear test paperwork with lap sample

Peter Dazeley / Getty Images

External condoms are one of the most effective means for preventing STIs. The only "better" method is abstinence.

STIs like chlamydia, gonorrhea, hepatitis B, HIV, syphilis, and trichomoniasis are transmitted through genital secretions, including semen. External condoms provide excellent protection against these STIs because they act as barriers.

The current body of research shows that consistent external condom use translates to an overall reduction in the rate of the following STIs:

  • Gonorrhea: 90%
  • Hepatitis B: 90%
  • Chlamydia: 50% to 90%
  • Trichomoniasis: 90%
  • Syphilis: 50% to 90%
  • HIV: 85%
  • Syphilis: 50% to 71%
4

External condoms can reduce the risk of HPV and Herpes.

A man and a woman's feet intertwined in bed

Alexander Nicholson / Getty Images

STIs like genital herpes or human papillomavirus (HPV) are transmitted through skin-to-skin contact. So despite what some people might tell you, external condoms can reduce the risk of these infections if it covers the infected skin.

While external condoms may not have the same level of efficacy in preventing herpes or HPV compared to, say, HIV or gonorrhea, they can still significantly reduce the risk of infection compared to not using them.

Studies suggest that the consistent use of external condoms can reduce the risk of genital herpes by 30%.

While the benefits of external condoms appear to be lower with HPV among people in the general population, they offer significant protection in those at increased risk of HPV-associated cancers.

According to some of the more recently published studies:

  • Young women are 50% less likely to acquire HPV if their partner uses an external condom at least 50% of the time. If external condom use is perfect, the risk is reduced by 70%. The majority of cervical cancers today are linked to high-risk HPV strains, typically acquired when one is younger.
  • The consistent use of external condoms in men who have sex with men (MSM) is associated with an 87% decreased risk of infection compared to a matched set of MSM who don't use external condoms consistently. MSM have the highest risk of acquiring anal cancer due to HPV infection.
5

Certain condoms are better for preventing STDs.

Close up of young man's hand holding a condom from wallet
Karl Tapales / Getty Images

There are four types of external condoms approved for use in the United States that are made with different materials:

The FDA has approved latex, polyurethane, and polyisoprene external condoms as an effective means to reduce the risk of pregnancy and STIs.

Studies have shown that polyurethane condoms are just as effective in preventing pregnancy and STIs as latex condoms. However, they may be more likely to slip and break due to their reduced elasticity (particularly if they are too tight or too loose).

Polyisoprene external condoms are also as effective as external latex condoms for barrier protection. They gave more elasticity than external polyurethane condoms and are less likely to slip or break.

External lambskin condoms contain tiny pores that too small for sperm to get through, so they are effective at preventing pregnancy. However, bacteria or viruses can pass through the pores, so they offer no protection against STIs.

6

External condoms are nearly as effective as the pill.

Woman pregnant sitting on chair with hands on belly

Sot / Getty Images

When used correctly and consistently, external condoms are 98% effective in preventing pregnancy. This means that 2 out of every 100 women whose partners consistently use external condoms will become pregnant during the first year of external condom use.

With typical (real-world) use, external condom efficacy drops to around 85%. Typical use is the term used to describe inconsistent external condom use.

By comparison, the birth control pill ("the pill") is 99% effective with perfect use. Taking a pill every day can be difficult, however, which is why 9 out of every 100 women on the pill experience unintended pregnancy in a year.

For people who find it difficult to adhere to daily birth control pills, the consistent, on-demand use of external condoms provides an effective means of preventing pregnancy—either on their own or paired with another form of birth control.

7

There are external condoms for people with allergies.

pile of colorful condoms

CatLane / Getty Images

Studies suggest that around 4% of the general population has a latex allergy and, therefore, cannot use external latex condoms. But, this doesn't mean they should avoid external condoms; there are alternatives.

People with latex allergies can safely use polyurethane or polyisoprene external condoms (or external lambskin condoms if the aim is to prevent pregnancy).

Other additives in external condoms may also cause allergy or irritation, such as spermicides and lubricating agents like parabens or glycerin.

If such a reaction occurs, don't give up on external condoms. Instead, try other brands or types of external condoms. Or, speak with your healthcare provider to pinpoint which specific ingredient you are allergic to.

8

The choice of lubricant matters.

A bottle of personal lubricant

Ulrich Baumgarten / Getty Images

When it comes to external condom lubricants, there are right and wrong choices. Oil-based lubricants can quickly break down the structure of latex and increase the risk of breakage.

Never use a lubricant that contains oils, fats, or grease with an external latex condom. These include petroleum-based products like Vaseline, baby oil, hand lotions, cold cream, vegetable shortening, or cooking oil.

Only water-based lubricants, available online and in many drugstores, should be used with external latex condoms. Oil-based lubricants are perfectly fine with polyurethane or polyisoprene external condoms.

9

"Double bagging" reduces external condom effectiveness.

Two yellow condom packets on a bedsheet

Suparat Malipoom / EyeEm / Getty Images

Although it may seem to make sense, “double-bagging” external condoms does not equal more protection. In fact, this practice may actually make external condoms less effective. When two external condoms are used together, more friction can occur between them; this makes it more likely that one or both of them will tear.

Not only should you only use one condom at a time, but an external condom should also not be used with an internal condom for the same reasons.

10

Correct external condom use increases pleasure.

smiling man opening condom with blurry woman in the background

Moodboard / Getty Images

Many people claim they avoid external condoms because they are either uncomfortable, burdensome, reduce sensitivity, or "interrupt passion." In many cases, these concerns can be overcome by learning how to use external condoms correctly.

A 2011 study in Texas Medicine reported that 67% of the 180 college students included in the study failed to apply an external condom correctly when tested with both a questionnaire and external condom demonstration.

When used and sized correctly, external condoms are not only easy and quick to apply but can maintain high levels of sensitivity.

If an external condom is uncomfortable for you, there are different types of condoms you can try. Many external condoms have even extra features (like special tingling lubrication or bumps and bridges) that may actually enhance sexual pleasure.

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12 Sources
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