Talking to your kids about sex can be daunting, no matter how close you are. But discussing issues like abstinence, sexually transmitted diseases (STDs), and birth control can help lower teens' risk of an unintended pregnancy or contracting an STD.

The American Academy of Pediatrics (AAP) supports sex education that includes information about both abstinence and birth control. Research has shown that this information doesn't increase kids' level of sexual activity, but actually promotes and increases the proper use of birth control methods among sexually active teens.

How and when you discuss sex and birth control is up to you. Providing the facts is vital, but it's also wise to tell your kids where you stand. Remember, by approaching these issues like any other health topics, not as something dirty or embarrassing, you increase the odds that your kids will feel comfortable coming to you with any questions and problems. As awkward as it might feel, answer questions honestly. And if you don't know the answers, it's OK to say so, then find out and get back to your kids.

If you have questions about how to talk with your son or daughter about sex, consider consulting your child's doctor. Lots of parents find this tough to tackle, and a doctor may offer some helpful perspective.

What Are Condoms?

Condoms are considered a barrier method of contraception. There are male condoms and female condoms. A male condom is a thin sheath (usually made of latex, a type of rubber) that is worn on the penis. A female condom is a polyurethane sheath with a flexible ring at either end. One end is closed and inserted into the vagina; the other end is open and the ring sits outside the opening of the vagina. The male condom, sometimes called a "rubber" or "prophylactic," is far more commonly used.

How Do Condoms Work?

Condoms work by keeping semen (the fluid that contains sperm) from entering the vagina. The male condom is placed on the penis when it becomes erect. It is unrolled all the way to the base of the penis while holding the tip of the condom to leave some extra room at the end. This creates a space for semen after ejaculation and makes it less likely that the condom will break.

After the male ejaculates, he should hold the condom at the base of the penis as he pulls out of the vagina. He must do this while the penis is still erect to prevent the condom from slipping off when he gets soft. If this happens, sperm could enter the vagina.

The female condom is inserted into the vagina using the closed-end ring. The other ring creates the open end of the condom. The sheath then lines the walls of the vagina, creating a barrier between the sperm and the cervix. The female condom can be inserted up to 8 hours prior to intercourse. It should be removed immediately after sex before standing up.

The male and female condoms should not be used at the same time because friction can cause them to break up, or they can get stuck together and cause one or the other to slip during intercourse, making them ineffective.

A used condom should be thrown in the garbage, not down the toilet. Once a condom is used, it cannot be reused. A new condom should be used each time a couple has sex and it must be used from start to finish each time to protect against pregnancy and STDs. It's important to never use oil-based lubricants (such as mineral oil, petroleum jelly, or baby oil) with condoms because they can break down the rubber.

And a condom that seems dry, sticky, or stiff when it comes out of the package, or is past its expiration date, should be thrown away and a new one used instead. It's wise to have several condoms on hand in case there's a problem with one. It's best to store unused condoms in a cool, dry place.

How Well do Condoms Work?

Over the course of a year, 15 out of 100 typical couples who rely on male condoms alone to prevent pregnancy will have an accidental pregnancy. The use of the female condom is a little less reliable and 21 out of 100 couples will have an unintended pregnancy. Of course, these are average figures and the chance of getting pregnant depends on whether the method is used correctly every time. In fact, studies show that although it's possible for condoms to break or slip during intercourse, the most common reason that condoms "fail" is that the couple didn't use one at all.

Experts used to think that using spermicide with a condom would not only decrease the pregnancy rate, but also help fight against STDs. However, more recent information indicates that this is not true and that spermicide can cause irritation, which can make HIV transmission more likely.

Protection Against STDs

Most male condoms are made of latex. Those made of lambskin may offer less protection against some STDs, including HIV/AIDS, so use of latex condoms is recommended. For people who may have an allergic skin reaction to latex, both male and female condoms made of polyurethane are available.

When properly used, latex and plastic condoms are effective against most STDs. Condoms do not protect against infections spread from sores on the skin not covered by a condom (such as the base of the penis or scrotum). Couples having sex must always use condoms to protect against STDs even when using another method of birth control.

Abstinence (not having sex) is the only method that always prevents pregnancy and STDs.

Possible Side Effects

Most men and women have no problems using condoms. The side effects that can occasionally occur include:

• allergy to latex condoms
• irritation of the penis or the vagina from spermicides or lubricants that some condoms are treated with

Who Uses Condoms?

Couples who are responsible enough to stop and put a condom on each time before sex and people who want protection against STDs use condoms. Because condoms are the only method of birth control currently available for men, they allow the male to take responsibility for birth control and STD protection. Condoms are also a good choice for people who do not have a lot of money to spend on birth control.

Where are Condoms Available?

Condoms are available without a prescription and are sold in drugstores, supermarkets, and even vending machines. (In some stores, they're in the "Family Planning" aisle.) Condoms come in different sizes, textures, and colors.

How Much Do They Cost?

Condoms are the least expensive and most available method of birth control — other than abstinence, of course. Male condoms cost about $0.50 to $1 each and are less expensive when they are bought in boxes that contain several condoms. In addition, many health centers and family planning clinics (such as Planned Parenthood) and some schools distribute them free of charge. Female condoms are a little more expensive and cost about $2 to $4 per condom.

Reviewed by: Larissa Hirsch, MD
Date reviewed: September 2009