Last updated: May 17, 2008
couple-condom-sex
Responsibility for pregnancy or an STD is easy to place on a "bad" rubber.
Masterfile
In theory, condoms are 97% effective for preventing pregnancy—that's almost as effective as the Pill. But under real-life circumstances, so many people use them incorrectly or avoid them for one reason or another that theeffectiveness of condoms drops to 86%.


A 2002 study of college students documented typical condom misuse, slippage, and breakage. Of the men surveyed, 40% said that they had failed to leave space for ejaculate at the tip of a condom, for instance, and 15% had taken the condom off before completing intercourse.

Then there are the couples who "use condoms" but only now and then, and those who don't unroll one until intercourse is already under way.
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"A couple may not put on a condom until the last minute," posits Paul Fine, MD, associate professor of gynecology at Baylor College of Medicine in Houston, Texas, "and in the heat of passion, he might not have the control he usually has, so that's never foolproof." Besides, you can get pregnant before ejaculation; so-called pre-ejaculate is "loaded with sperm," says Dr. Fine.

The only genuinely safe option is not to let the penis enter the vagina at all without covering it first with a condom. (This is the best strategy for preventing most STDs, as well.)


Handle with care
The latest generation of condoms is less prone to breakage. It does happen, but human error is still usually to blame. "If you tear a condom package open with your teeth," says Dr. Fine, "it can leave a tiny tear in the condom." And if a condom is too large or too small, or if there's not enough lubrication—whether from body fluids or from water-based gels—it can break or come off during intercourse.

It's good policy to carry around a condom in order to be safe during those unanticipated moments, but too much travel can wear on a condom. "When men keep them in their wallet, for instance, if the package in any way gets torn or is opened, the condom can dry out, and dried latex is more prone to failure," says Dr. Fine.

On the other hand, the actual condom breakage rate is low—two or three out of every 100 uses—despite the high frequency of that complaint.

Make sure you have a backup plan
If for some reason you do have a condom misstep, women hoping to avoid pregnancy should keep Plan B in their medicine cabinets. Plan B, also known as the "morning after" pill,, can keep you from getting pregnant if you take it up to 72 hours after sex—though it's most effective when taken within 24 hours—and it's available over-the-counter now. According to Dr. Fine. "Plan B is as safe on your body as aspirin." If you're worried about HIV as well, ask your doctor about the "morning after" treatment called PEP (postexposureprophylaxis).