By Elizabeth Akincilar, MSPT, Cofounder, PHRC Merrimack
This week we’re celebrating National Condom Week; which gives us the perfect excuse to educate our community about the correct use of and important precautions to consider when using condoms to prevent sexually transmitted diseases and unwanted pregnancies.
Condoms, aka male sheath, johnny, rubber, raincoat, cock sock, or the English riding coat; whatever you prefer to call them, if you’re having sex, you need to be well famiilar with them.
A little history
The first documented condom was in Europe in 1564 by the anatomist, Fallopia (also namesake to fallopian tubes). They were primarily used to prevent STDs in the 16th century as diseases like Syphilis were often fatal and ran rampant through Europe for hundreds of years. By the 17th century and the discovery of spermatozoa, the Catholic Church realized that condoms were impeding pregnancy and therefore bad. In fact, the Catholic Church only grudgingly accepted the use of condoms in 2010 and then only to prevent the spread of serious diseases, such as HIV. By the 18th century, in the eyes of medical professionals, condoms were only used by prostitutes and immoral people. During this time condoms were made from all sorts of materials such as animal intestines, leather, and tortoise shell. It wasn’t until Charles Goodyear discovered vulcanized rubber that the more modern condom was available to the masses in 1839.
Even more impressive, the first female condom, or internal condom, is said to have been first used over 2000 years ago in ancient Greece. The story goes, as a result of a curse, King Minos ejaculated snakes and scorpions which usually killed his lovers. His physician came up with the idea of inserting the bladder of a goat into his lovers which caught the poisonous creatures before they could cause harm. Whether you believe this story or not, what we know to be true is Marie Stopes, a 20th century birth control activist and supporter of positive eugenics, promoted the first female condom in 1923. It was made of thick vulcanized rubber with a steel coil rim. The first modern female condom wasn’t released until 1993 and was not well accepted by its audience. Women found it difficult to insert and overall unpleasant.
However, in the 21st century both the internal (female) condom and the external (male) condom are going through a revolution. The internal condom market has suddenly become competitive which means there will likely be more options in the near future. Interestingly, the Bill and Melinda Gates Foundation, apparently tired of the same old condom design, gave 11 condom designers $100,000 each to design something new!
For those readers who were unfamiliar with internal condoms until now, they are a long plastic pouch, usually made of nitrile, a man made latex-free rubber. The pouch is placed inside the body prior to intercourse. It can be used for vaginal or anal intercourse. Flexible rings on both ends hold it in place. The condom lines the walls of the vagina or rectum, collecting semen and other fluids. It can be tricky to insert at first, it just takes a bit of practice.
Effectiveness
- When external (male) condoms are used perfectly they are 98% effective at preventing pregnancy. However, people are not perfect. In reality, condoms are about 85% effective in preventing pregnancy.
- When internal (female) condoms are used perfectly they are approximately 95% effective at preventing pregnancy. However, in reality, they are roughly 79% effective.
- In general, external condoms used correctly are very effective in preventing sexually transmitted diseases (STDs). Internal condoms don’t eliminate the risk of getting a STD, but they greatly reduce the chances.
- Lambskin and other animal membrane condoms will protect against pregnancy but will not protect against HIV and other STDs.
Helpful pointers for correct use
- Always check the expiration date printed on the wrapper or box.
- Don’t use the condom if the packaging has holes in it or the condom feels dry, stiff, or sticky.
- Open condoms carefully so you don’t damage them, i.e. don’t use your teeth or scissors to open them!
- Store condoms in a cool dry place away from direct sunlight and sharp objects. Don’t store them in your car, pocket or bathroom for long periods of time (greater than one month) as exposure to heat and/or moisture can damage them.
- Be sure to put the condom on or insert the condom correctly. Incorrect placement of a condom decreases its effectiveness significantly as it can move out of place or break during sex.
- Carefully remove the condom after sex so semen and other fluids don’t spill onto your partner.
- Do not reuse condoms. A new condom should be used with any type of sex (vaginal, anal, oral) or if switching from one type of sex to another.
- Don’t double bag. They are designed to be used on their own. One condom used correctly is all the protection you need.
- Dispose of the condom in the garbage, not in the toilet as condoms can clog pipes.
Precautions
- Don’t use anything that has oil in it with latex condoms, like petroleum jelly (Vaseline), lotion, baby oil, butter or cooking oils. Oil damages latex condoms and may cause them to leak or break. Water based or silicone based lubricants are safe to use and can reduce discomfort with intercourse especially for someone suffering from pelvic pain. Check out this PHRC post for more information on the best lubricants.
- Allergic to latex? Most condoms are made of latex, but there are also condoms made of soft plastics like polyurethane, polyisoprene, and nitrile if you’re allergic to latex. Check out this PHRC blog post to learn more about latex alternative condoms that may be a better fit for you.
- If you’re using vaginal medications for a yeast or bacterial infection, many of these medications have fatty excipients (stabilizers often used in these kinds of medications) such as glycerin, paraffin, or petroleum, which can damage latex condoms. This includes medications such as boric acid suppositories, Lotrimin, Monistat, and metronidazole.
- Avoid using latex condoms for up to 72 hours after using estrogen vaginal creams and/or suppositories. Certain estrogen products contain oils that can damage latex causing condoms to break or leak. Be sure to check with your healthcare provider if the estrogen product you’re using is safe to use with latex condoms.
Where to get condoms
Condoms are available at drugstores, Planned Parenthood health centers, community health centers, doctor’s offices, supermarkets, convenience stores, online and even in vending machines. You don’t need a prescription and there are no age restrictions.
You can also get them for FREE at these places
- Your school nurse’s office
- Your college’s health center
- Your college dormitory
- Pretty much anywhere on a college campus
- Your doctor’s office
- Planned Parenthood health centers
- Your local health department
- CondomFinder.org, type in your zip code and it’ll show you the closest place to find free condoms!
Whichever type of condom you use, be sure to use it correctly and consistently to protect yourself and your partner from STDs and/or an unwanted pregnancy. Happy National Condom Week!
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.