What to do if a condom breaks?

Options for emergency contraception

When used as a contraceptive, condoms are 98% effective but when a condom breaks, not only can it ruin the moment, it can cause a whole new world of concern in terms of worry about unwanted pregnancy and sexually transmitted diseases. We are going to look at how real those concerns are but firstly, let's look at the ways to reduce the chance of a condom breaking in the first place. There are some very basic precautions that should be taken.

 

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Minimising the chance of a condom break!

There are some basic rules about the care and use of condoms to ensure that they are at their peak condition and so minimising the chance of breakage.

  • Read the expiry date - whilst this may be the last thing on your mind at the height of passion but condoms have an expiry date for a very good reason and that is that the material they are made of will begin to degrade, becoming less robust and more vulnerable to damage.

  • Is the storage of condoms important? - leaving condoms in hot places such as the glove box or a car or storing them in direct sunlight has a similar effect to that of aging in that heat and sunlight will accelerate the process of breakdown of the material and as with age, the material will be more susceptible to damage.

  • Can lubrication prevent breaks? - if natural lubrication is slow to appear and the genitals are quite dry, not only is it likely to be uncomfortable but it will also put more strain on the condom making it more likely to break. It is correct that lubrication can prevent tears and condoms can be purchased that are already lubricated.; alternatively, a separate lubricant can be used.

It is important, however, particularly if using latex condoms, not to use petroleum jelly as a lubricant as it is incompatible with latex products and so will weaken the condom.

  • Which type of condom is best? - it is not about one particular type of condom being the best, it is about ensuring that you choose the correct size for you as well as the correct type.

It is important that the condom fits correctly and so comfortably. If the condom is too tight it is more likely to split. However, the condom does need to be tight enough to stop it from falling off and you may need to try several types in order to find the one which fits best.

  • Be careful when unwrapping the condom - it is really important that you are careful with long nails and jewellery when you are opening a condom packet; they are not good around condoms! Especially, do not open the packet with your teeth!

  • Putting the condom on - it is important that a condom is fitted correctly and so it is advisable to take your time.

When putting a condom on, first squeeze the tip with the forefinger and thumb to ensure that any air is expelled. Then continue by rolling the condom down the shaft of the penis using the other hand.

Just a note, it is important to leave some space (without air in it) at the tip in order that there is somewhere for the semen to go. If the condom has to stretch a create a balloon to accommodate the semen it is more likely to split.

Now that we have explained how best to prevent breakage of a condom, what do we do if it splits anyway? Condoms are a barrier method of contraception and protection against STI’s; as we have already mentioned, breakage of a condom leaves us open to unwanted pregnancy and sexually transmitted infections. What options do we have?

 

Unwanted pregnancy

We would first look to emergency contraception. These are types of contraception that can be used after sex but within a certain amount of time and they prevent the pregnancy from occurring as opposed to terminating an existing pregnancy.

  • The morning after pill -  this can be obtained from your GP or over the counter; there are two types available
    • Levonelle (levonorgestrel which can be taken up to 3 days after unprotected sex but it is more effective if it is taken in the first 12 hours

    • EllaOne (ulipristal acetate) which can be taken up to 5 days after unprotected sex

    • Birth control pills that contain oestrogen and progesterone can be taken as emergency contraception if taken at a higher dose within 3 - 5 days of unprotected sex.  Whilst this does work it is less effective than other forms of contraception

The morning after pill works by stopping or delaying the release of an egg from the ovary (ovulation). Ellaone has another weapon in the prevention of pregnancy and that is the fact that it changes the lining of the uterus so that if an egg is released it is less likely to implant.

Efficacy of the morning after pill is listed below:

  • If taken within 24 hours - 95% effective
  • If taken within 48 hours - 85% effective
  • If taken within 72 hours - 58% effective

EllaOne however maintains the 95% efficacy of the first 24 hours for 5 days.

There are a number of side effects associated with the morning after pill.  These include:

  • Nausea or vomiting
  • Dizziness
  • Fatigue
  • Headache
  • Breast tenderness
  • Bleeding between periods or heavier menstrual bleeding
  • Lower abdominal pain or cramps

 

Other forms of emergency contraception

Fitting the emergency coil (IUD) is the most effective form of emergency contraception at 99% effective if fitted within 5 days of unprotected sex.  This needs to be fitted by a health professional at a GP surgery or family planning clinic.

It has the added bonus of also operating as a form of long-term contraception as it can remain in place for 5-10 years.

 

Transmission of sexually transmitted infection

If a condom breaks it leaves you open to contracting a sexually contracted disease so it is imperative that you are  screened for any possible infection 

If left undiagnosed, some STI’s such as gonorrhoea and chlamydia can have some serious long-term effects on your health.

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