gynecology and obstetrics
Barrier and Other Pericoital Contraceptives
Condoms
Condom use reliably reduces the risk of Overview of Sexually Transmitted Infections (STIs), including HIV infection. Condoms may be made of latex, polyisoprene, polyurethane, silicone rubber, or lamb intestine. Lamb-intestine condoms are impenetrable to sperm but not to many of the viruses that can cause serious infections (eg, HIV). Thus, latex and synthetic (polyurethane, polyisoprene, and silicone rubber) condoms are preferred. Condoms also protect against Theexternal (male) condomis the only reversible male contraceptive method other than withdrawal, which has higher contraceptive failure rates. The male condom is applied before penetration; the tip is pinched shut and should extend about 1 cm beyond the penis to collect the ejaculate. Theinternal (female) condomis a pouch with an inner and an outer ring; the inner ring is inserted into the vagina, and the outer ring remains outside and covers the perineum. The female condom should be placed no more than 8 hours before intercourse. The penis should be carefully guided through the external ring to make sure that the ejaculate is collected in the pouch. For both types of condoms, care must be taken to avoid spilling condom contents when the penis is removed after intercourse. With the external condom, the penis should be withdrawn immediately after ejaculation while the condom’s rim is held firmly against the base of the penis; this precaution prevents the condom from slipping off and spilling semen. The larger ring of the internal condom should be twisted to prevent semen from spilling. Emergency Contraception should be used if contents spill, the condom slips, or the condom breaks. A new condom should be used for each episode of sexual intercourse. Pregnancy rates at 1 year are External (male) condom: 2% with perfect use and 18% with typical use Internal (female) condom: 5% with perfect use and 21% with typical use 