Condoms and other barrier methods

If a condom splits or slips during sex, contact a pharmacist or sexual health service soon. You may need emergency contraception or an STI test. Condoms help prevent pregnancy and lower the risk of STIs. Diaphragms and caps don’t protect against STIs.

External and internal condoms

An external condom goes over the penis before vaginal, anal or oral sex. It helps prevent pregnancy and lowers the risk of sexually transmitted infections (STIs). An internal condom goes inside the vagina, with its outer ring staying outside. During sex, the penis needs to go inside the condom, not between the condom and the wall of the vagina.

Use a new condom every time and follow the instructions on the packet. Check the expiry date before you open it. Put an external condom on before the penis touches the vagina or anus. When pulling out after sex, hold the base of the condom so it doesn’t come off.

Don’t use an internal and an external condom together, or wear two condoms at once. The NHS warns that this can make them split. There isn’t much evidence on whether internal condoms protect against STIs during anal sex. The NHS says they may help, but it’s not clear how much.

Choose lubricant and material together

With latex condoms, use water-based or silicone-based lubricant. Oil-based lubricant isn’t suitable. Check the material on the packet. If you have a latex allergy, you can get latex-free condoms. Some internal condoms contain latex too, so check those as well.

According to CDC, lambskin condoms help prevent pregnancy but may not protect against STIs, including HIV. A “latex-free” label on its own doesn’t tell you how well a product protects against STIs. Check the material and the packet information.

If you are using an antifungal medicine around your genitals or anus, ask a pharmacist which barrier method is suitable. NHS advice is not to use latex condoms in this case. Take the name of the medicine and the condom packet with you.

What a diaphragm or cap involves

A diaphragm or cap covers the cervix (the entrance to the womb) to stop sperm getting in. You put it inside your vagina before sex, and it needs spermicide (a gel that kills sperm). These methods don’t protect against STIs. A clinician checks that it fits and shows you how to put it in and take it out.

Follow the instructions for both the device and the spermicide. They tell you how long to leave it in after sex and when you must take it out. Check it for holes before each use. After giving birth, a miscarriage or an abortion, ask the clinic to check the fit again, as you may need a different size.

Toxic shock syndrome (TSS) is a rare but life-threatening infection that can happen with a diaphragm or cap. Symptoms can come on quickly.

Comparing effectiveness figures

The NHS says external condoms are up to 98% effective if you use them correctly every time, and 82% effective if you don’t. For internal condoms, its figures are up to 95% and 79%. These numbers are about preventing pregnancy. They don’t measure protection against STIs.

US figures are different. The FDA says that out of 100 women whose partners use external condoms, 13 may get pregnant in a year. This describes real-life use, including times when condoms are used wrongly or not every time. When you compare figures, check who published them. Also check whether they describe correct use or real-life use.

Getting supplies and help

In the UK, external condoms are free from sexual health clinics and some GP surgeries and pharmacies. In the US, the FDA says you can buy external condoms over the counter or online. To get a diaphragm or cap fitted, contact a sexual health clinic or GP in the UK, or your healthcare provider in the US and elsewhere.

If a condom splits, slips or leaks, contact someone today. In the UK, that’s a pharmacist, sexual health clinic or GP. In the US and elsewhere, it’s a pharmacist or sexual health service. Ask for advice too if you find a hole in a diaphragm or cap after sex. Explain what happened and when.

Call 999 now (UK) or 911 (US), or your local emergency number, for confusion or difficulty breathing.

Get urgent help now from NHS 111 (UK), or an urgent medical service (US and elsewhere), if you get a high temperature with vomiting, diarrhoea, muscle aches or a rough rash while using a diaphragm or cap. Tell them you are using a diaphragm or cap.