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Study shows condom fit impacts its usage
The last time your teen-age male patient came to the adolescent clinic, he left with a bag of male condoms. However, when he returns to be tested for sexually transmitted diseases (STDs), he tells you he hasn't used the condoms. Why?
If the condoms provided aren't a comfortable fit, chances are your patient won't use them consistently and correctly. Results of a new study indicate that men who report wearing poorly fitting condoms are more likely to remove condoms before penile–vaginal sex.1
The research was conducted using a convenience sample of men recruited through advertisements and through a condom web site. The participants then completed a survey on The Kinsey Institute web site.
In the study, men who reported wearing ill-fitting condoms also reported a number of related problems. Compared with men who did not have condom fit problems, those who did had more breakage, more slippage, and were more likely to report irritation of the penis. They also were more likely to report reduced sexual pleasure, plus more difficulty reaching orgasm, both for themselves and for their sexual partner. Men with ill-fitting condoms said that the condoms interfered with their erection and contributed to dryness during intercourse.1
Give them choices
What can clinicians do to work with patients toward improved use of condoms?
Health care providers are in an ideal position to educate patients about condom "fit and feel" and then provide them with a variety of high-quality condoms in various sizes, says Richard Crosby, PhD, professor of health behavior at the Lexington-based University of Kentucky and lead author of the current research. Failure to do so might best be described by the old adage "penny-wise and pound foolish," Crosby notes.
When counseling on condom use, ask questions such as "Does this particular condom pinch or feel uncomfortable?" "Does it break?" and "Does it slip off?" advises study co-author William Yarber, HSD, professor in the departments of Applied Health Science and Gender Studies at Indiana University and senior research fellow at The Kinsey Institute. Previous research conducted by the research group shows that when condoms are ill-fitting, the risks for condom error increase.2
Offer patients two or more types of condoms, suggests Yarber. Encourage them to practice using them to determine which one feels better, he advises. While earlier research on condoms centered on parameters such as breakage and slippage, less attention has been focused on the eroticism and pleasure aspects, says Yarber. If patients encounter problems with the fit and feel of condoms, they are not going to use them, he states.
Encourage use of water-based lubricants, such as K-Y Jelly, Astroglide, and AquaLube. Such lubricants do not degrade the condom material and help to increase sensation. Advise against use of oil-based lubricants, such as petroleum jelly, which reduce condom integrity and might facilitate breakage.3
Science eyes scale
Discussing penis size or condom issues might be challenging for some patients.
To help clinicians engage men in discussion of condom fit and feel, researchers at the Sexual Health Research Working Group at Indiana University Bloomington have developed a questionnaire, the "Condom Fit and Feel Scale."4 The questionnaire includes such statements as "Condoms feel too loose on my penis," "Condoms feel too tight along the shaft of my penis," and "Condoms feel too tight on the head of my penis." Answers cover a range from "always applies" to "never applies." The condom scale offers a way for men to express in a confidential way their condom concerns related to length, width, tightness, or looseness.
The group's research shows that one size doesn't fit all when it comes to condoms. In the study, 21% reported that condoms felt too tight, while 18% said their condoms felt too short. Ten percent of men said their condoms felt too loose, and 7% reported that condoms felt too long.5
Problems with condom fit aren't just confined to the United States. The Indiana researchers posed questions to men in five European countries (France, Germany, the Netherlands, Slovenia, and Spain) regarding condom fit. Data indicates those surveyed reported a wide variety of problems associated with condom fit and feel.6 Men in the Netherlands were least likely to report that condoms fit fine and were most likely to report that condoms were too short and too tight. Men in Spain were most likely to report that condoms were too long, the analysis suggests.6