I am working in a part of the city where bacterial sexually transmitted infections (STIs) are unfortunately endemic. They are easily prevented by condom use, yet for a wide variety of social reasons, the majority of my patients who are at risk for STIs report to me that they use condoms sometimes or never. These same patients often present to the office not only to be tested for STIs but also to report bothersome vaginal discharge that may or may not be related to STIs. Condoms are readily available in my office — in a basket in each exam room, or in paper bags of 15 of them that we can give out, or even by prescription at the pharmacy on site.
I want to share my top five reasons I encourage condom use for my patients and others who are at risk for either STIs like chlamydia or gonorrhea but also for this bothersome discharge known as bacterial vaginosis.
Starting with the most obvious/boring/basic/duh. If you have sex with someone who has one of these infections, or HIV, or even HPV, you greatly reduce your risk of being exposed to their infections by correctly and consistently using condoms with those partners. Great for casual encounters, someone you don’t want to or can’t talk to about their risk factors for STIs, or someone known to have these infections.
2. Less Mess!
Let’s face it, male-bodied people are messy when it comes to sex. Their ejaculate can get all over you if they pull out or if they come in you or during other sexual play. It’s nice when you wrap it up that if you/he removes the condom appropriately after coming, that mess stays put in that condom and not all over you/your sheets/car/bathroom/couch/wherever you are.
3. (Added) Contraception
If you are trying to avoid pregnancy and have sex with a male bodied person, using condoms for penis-in-vagina sex is a great primary or secondary family planning/contraceptive method. If you *always* use condoms correctly, this method is 98% effective — meaning that if 100 women are using this method correctly all of the time, only 2 of them will get pregnant. Of course, not using it correctly every time is less effective — but still 82% effective. This is great added protection from pregnancy if you use another method, like the pill, the patch, the ring, or the shot.
4. Fewer vaginal infections
That thin, white, fishy smelling discharge known as bacterial vaginosis can be prevented with good vaginal hygiene and by using condoms. This helps keep the environment of the vagina nice and acidic. Your vagina has this lovely acid-producing bacteria (the “good” bacteria) that can get disrupted by semen/cum, which is very basic (going back to some chemistry here…). If the semen isn’t hanging out in the vagina, it doesn’t have a chance to change the vaginal environment, so you can keep it acidic in there. (Then, don’t douche or use those other “feminine” products…more on that later!)
5. It involves your dude!
Unlike most birth control methods or things women/female bodied people do to keep ourselves safe and free from pregnancy, etc., condom use directly involves your guy. This may not always be possible, if he hurts you or wants you to get pregnant when you don’t, or he wants to have other control over you. But in a safe and healthy relationship, talking about condom use and safety can add intimacy and a shared commitment to your safety.
Now…the HOW of condom use is another thing. If it were as easy as telling people WHY we probably wouldn’t have such high rates of STIs and unplanned pregnancies. So, that’s for another day.