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What size condom do you wear? Large? Extra large? Massive?

July 31st, 2006

Dr Petra

Today the Family Planning Association (FPA) has announced a call for the NHS to provide a wider range of condoms with more sizes and shapes on offer. Their request is in advance of Sexual Health Week (7-13 August) and is aimed at persuading health professionals to tackle people’s questions about condom size.

There’s a good reason for this approach. A condom that is too small may split or tear, whilst a condom that doesn’t provide a snug fit could slip off or leak – both of which can lead to condoms being ineffective. Which means they would cease to prevent pregnancy or against STIs.

Existing anecdotal evidence suggests that people do have problems with condoms – and often if people encounter problems or discomfort this leads to avoiding condom use. In particular for a young man who tries on a condom the first time he has sex, if it’s tricky to use the condom or if the condom fails he may well be unlikely to try with a condom in the future.

To investigate this further the FPA commissioned research to investigate this with a polling company interviewing 497 adults aged 18-35 across the UK in June 2006. It isn’t clear from their release how many of these adults were male or female, gay or straight. It’s also not clear whether ‘interview’ means ‘questionnaire’ or a more in-depth qualitative study (my guess is on the former). Predictably this is a ‘rough and ready’ study completed, analysed and reported within the space of a couple of months, so perhaps not as robust as it could be.

However I’m willing to be a little less snooty about this research-for-publicity exercise, since on this occasion it is in a good cause. And it does raise some interesting outcomes.

35% of current or past condom users had experienced a condom that either split or slipped off. Of that group 64% didn’t know why the problem had occurred.

25% of those questions didn’t know that condoms were available in different widths and lengths. This I can believe since often when you talk to people about condoms – particularly young men, they tell you how condoms don’t fit, are too thick, and are uncomfortable. Which simply isn’t true of modern condoms where frankly we’re getting spoilt for choice. One stockist sells a range of 70 different size condoms – and that’s before we get onto different colours, flavours and textures.

43% of participants agreed both men and women are embarrassed to discuss condoms – seemingly because it means alluding to penis size that doesn’t make for a comfortable conversation.

The FPA’s director of information Toni Belfield said: “Men come in different shapes and sizes and so do condoms. Poor use of condoms can have devastating consequences on people’s sexual health. Recent new figures showed the UK has the highest ever number of new cases of chlamydia and continued high rates of unwanted pregnancies.”

She continued to comment: “the NHS is the largest distributor of free condoms in the UK. FPA would like to see a much wider variety of condoms made available so people can chose a fit that is right for them from a good selection. We would also like to see health professionals talk to clients about condoms during consultations and tackle some of the embarrassment that exists around condom use. Problems such as condoms splitting or coming off are directly related to people choosing the wrong size and shape or not using them correctly. When this happens, people lose trust and confidence in the method. As a direct consequence, people are then far more likely to use condoms erratically or stop using them altogether.”

I agree that health professionals could do their bit, but this is also about money. The NHS is already strapped for cash and we’ve found increasingly that money earmarked for sexual health is being spent on other areas by some Primary Care Trusts. In the past free condoms have been made available but weren’t particularly attractive, sexy or high quality. Providing a range of condoms at cost price would help – as would condom manufacturers being willing to reduce their prices to reach a wider customer base.

The media also has a responsibility here to inform people that condoms aren’t the uncomfortable equivalent of wearing your socks in the shower. Instead they can be the equivalent of a wearable sex toy – that has the advantage of protecting against STIs and pregnancy.

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