Dear Dr G,

I am a firm believer in safe sex. Not that I am promiscuous or worried about sexually transmitted infections but my primary concern is contraception and avoiding unwanted pregnancies.

My wife and I, both in our early 30s, enjoy our sex life but constantly worry about who should take responsibility for family planning. As a man, I volunteer to shoulder this responsibility. However, I often find that using barrier protection dampens sensation.

While I appreciate that condoms are one of the most used forms of contraception, I still have some reservations about this barrier method. Despite multiple attempts to use condoms during intercourse, I find them cumbersome and limiting in terms of physical contact. My wife shares this sentiment, describing it as “eating candy with the wrappers on.”

Even though there is no real need for STI protection in our marriage, I still fear that “unwrapping the candies” could lead to an unwanted pregnancy. Therefore, I would like to ask Dr. G about the importance of condoms. What proportion of couples use condoms for contraception? What are the risks of unwanted pregnancy? Is there any way to maintain sensitivity while using them?

Regards,

Wrapped-up Wyatt

A male condom is a sheath-shaped barrier device rolled onto an erect penis during penetrative intercourse. Lamb intestine condoms have been used for disease prevention since at least 1564 in China. “Lambskin” condoms made from sheep intestine are still used today, offering a more natural sensation. As a barrier method, condoms reduce the probability of pregnancy and sexually transmitted infections (STIs). Modern male condoms are typically made from latex, and less commonly from polyurethane.

The protective efficacy of most condoms is ensured by rigorous scrutiny from the FDA. All latex and polyurethane condoms are subjected to the highest quality testing standards, with manufacturers undergoing random spot-checks to ensure at least 996 out of every 1,000 condoms pass the water leak test before being deemed safe for use.

Condoms are designed to be rolled onto an erect penis before sexual intercourse, providing a physical barrier that blocks the transfer of semen. Male condoms are among the safest and most effective forms of birth control, with a 98% success rate in preventing pregnancy when used correctly. However, typical use, including incorrect use, slippage (0.4-2.3%), and breakage (0.6-1.3%), can result in pregnancy rates ranging from 10% to 18% per year.

Condoms also protect against sexually transmitted infections through bodily fluids, including semen, vaginal secretions, and blood. This barrier method is proven to prevent the spread of gonorrhoea, chlamydia, HIV, and syphilis, reducing risks by 80-95%.

Globally, around 21% of those using birth control rely on condoms, making it the second most common method after female sterilisation at 24%. The highest usage rates are in East Asia, Europe, and North America, with Japan recording usage of up to 80%. Six to nine billion condoms are sold annually, making them part of the World Health Organization’s list of Essential Medicines.

The male barrier method creates a mechanical barrier between sex partners, limiting physical contact, reducing tactile sensation, and attenuating heat transfer during sex. This reduction in sexual pleasure, compared to natural unprotected methods, is a common reason people cite for avoiding condom use. Descriptions like “using a condom is like taking a shower with a raincoat on” or “eating candy with the wrapper on” typically express the feelings of those who dislike condoms.

Manufacturers are constantly researching ways to provide condoms that are both safe and pleasurable. Textured, bumpy, ribbed, and studded condoms are some of the creative designs that aim to transform bedroom sparks into fireworks, despite the diminished tactile contact.

There is little doubt that the use of condoms alters the natural feel of sex, potentially dampening the experience. However, as the most effective and safe method for contraception and disease prevention, the proper use of this barrier is crucial despite any reduction in pleasure. In reality, there are many types of condoms that couples can choose from to ensure safety without compromising on pleasure.