Dear Alice,

Could I have the final, definitive, last word on what type of contraception is best to use with a condom?


Dear Unsure,

In this particular case, the "best" contraception to use paired with condoms is the method which works best for you and your partner. A good, quality condom in and of itself is a birth control method with a failure rate of about two percent when used as directed. It also protects against most sexually transmitted infections (STIs) ! However, since condoms are not always used perfectly (when used typically, they have a failure rate of 12 percent) there are several back-up contraceptives that when combined with a condom can offer even greater protection.

Diaphragms, cervical caps, intrauterine devices (IUDs), hormonal contraceptives, and spermicidal foams, creams, or jellies will all contribute to greater pregnancy prevention efficacy when used in combination with a condom. For example, a condom used in conjunction with a spermicidal foam, cream, or jelly provides close to 100 percent protection against pregnancy. As a side note, while they may offer an added layer of protection, spermicides such as nonoxynol-9 have been shown to actually increase the transmission of HIV and infection due the product's abrasiveness. For more information on nonoxynol-9, read Spermicide effectiveness.

The important thing is consistency. Figure out what you and your partner can realistically do every time while still enjoying your sexuality. Here are some questions to consider when choosing a secondary method of protection: Is pregnancy your only concern or do you wish to have protection against STIs as well? Are you or your partner comfortable inserting a diaphragm or cervical cap? Are you in a monogamous relationship or do you have multiple partners? Have you or your partner had past pregnancies? Do you plan to have children in the next five years or ever? How often do you and your partner have vaginal sex?

Speaking with your health care provider may help you and your partner determine which method is best for you. Also, check out the related questions below as well as the Go Ask Alice! Sexual and Reproductive Health archives for more information on different types of contraception.

It's easy to get confused with all the different contraceptives that are available, but it's a good thing to have options! As for a "final, definitive, last word," on the best contraception to use with a condom — that is for you and your partner to decide!


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