By Madeleine Castellanos, M.D.
Although condoms are the gold standard for STI prevention, there are several things that cause people to shy away from using condoms. Some of these complaints are decreased sensitivity, difficulty in keeping an erection while using a condom, discomfort in wearing a condom, and irritation during or after using a condom. It may take a little trial and error, but most of these issues can be overcome with some practical information and practice.
Firstly, in order to put on a condom, a man should already have an erection that is satisfactory. If you attempt to put on a condom before a man has a complete erection, the pressure from the condom could actually prevent having sufficient blood filling the penis for a good erection. Once a man has an erection, however, this pressure does not effect the hardness of the erection. Some men, however, find that they start to lose their erection when they put on a condom. This is usually related to their thoughts about condoms which can cause anxiety or negative ideas, or is a combination of those psychological factors combined with physical factors.
If a condom does not fit well, it can result in decreased sensitivity, discomfort or even pain. For most men, finding a condom that has the proper width (yes they vary in how wide they are as well as how long) makes all the difference. If a condom ring is too tight around the shaft of the penis, it may be too uncomfortable to get lost in the moment and really enjoy sex. If the width seems to be ok, but there is still a considerable decrease in sensitivity, try using condoms that have a wider area around the tip, so that there is movement around the most sensitive part of the penis during penetration, which feels more natural. Regardless of what style of male condom you choose, you should leave some extra space at the tip of the condom to give room for the semen to collect after ejaculation. If your erection is a little shorter than the condom, it is better to leave more extra space at the top, since you should be able to unroll the condom completely for comfort and effective use. With practice, you will know just how much to leave for yourself.
If you are finding that male-style condoms are too constricting for comfortable sex, then you may benefit from trying female condoms. They are condoms designed to be inserted into the vagina and stay put with a ring that holds onto the cervix. They are inserted all the way into the vagina with the outer ring covering part of the labia first, then pushing the rest of it up as far as it will go and having the inner ring surround the cervix. The outer ring always stays on the outside and actually provides more coverage of the labia, which can decrease those sexually transmitted infections that are passed on with skin to skin contact (like genital warts and Herpes). Since the female condom is much wider, it doesn't cause the squeezing that is uncomfortable for men who are very wide. The female condom does take some practice to use effectively, and you must ensure that the outer ring doesn't slip into the vagina during penetration (sometimes you may need to adjust it).
One of the great drawbacks of using condoms is that people may experience more irritation during or after sex. It is important to use lubrication on the outside of the condom and should be reapplied regularly during sex. Keeping the lube within arm's reach during sex helps keep the action moving right along. Since condoms are destroyed by oils, choose only water-based lubricants. Also, keep in mind that many people find glycerin to be be irritating to their mucosal tissues, so finding a glycerin-free lube is always best. Never use lotions, creams, or any other type of lube not specifically designed for sex since they may contain oils in them and can be very irritating inside. Stay away from condoms that contain nonoxynol-9 spermicide, since this is particularly irritating.
If you find that latex condoms are the cause of your irritation (or you just don't care for the taste, smell or feel), find yourself condoms made of polyurethane or polyisoprene. Both of these are thinner than latex, so provide a more natural feel. Polyurethane is much less stretchy than polyisoprene (which is a great plus for some people), but transfers body heat pretty well. These are all options to consider when finding the condom that you like the best. By finding the condom that works best with your anatomy and preferences, many of the complaints often heard with condom use can be eliminated for a safe, pleasurable sexual experience.