Best contraception with a condom?

Dear Unsure,

It's easy to get confused with the many contraceptives that are available, so kudos to you for seeking out more info on the different options. In this particular case, the "best" contraception to use with condoms is the method that works best for you and your partner(s). External and internal condoms have a failure rate of about two and five percent respectively when used correctly and consistently. As an added bonus, they also reduce the risk of most sexually transmitted infections (STIs)! However, since condoms aren’t always used perfectly, they're about 85 percent effective at preventing pregnancy with typical use. Luckily, there are several contraceptives that offer even more protection when combined with a condom.

Other barrier and hormonal methods of contraception can be used to supplement condom usage for pregnancy prevention. Diaphragms, cervical caps, intrauterine devices (IUDs), birth control pills, sponges, the implant, the birth control shot, the patch, and spermicidal foams, creams, or jellies all help to provide greater pregnancy prevention effectiveness when used with a condom. However, as a side note, while spermicides such as nonoxynol-9 may offer an added layer of protection against pregnancy, they've been shown to actually increase the transmission of human immunodeficiency virus (HIV) and infection due the product's abrasiveness. For more permanent methods, a vasectomy or tubal ligation are also options. As these are more permanent forms of pregnancy prevention, condoms would primarily reduce the risk of STI transmission.

Using contraceptives consistently and correctly will provide the most protection against pregnancy and STIs. Figuring out what you and your partner(s) can realistically maintain while still enjoying your sexuality and considering potential side effects is key to determining which contraceptives are best for you. Here are some questions to consider when choosing a secondary method of protection: Are you comfortable inserting a diaphragm or cervical cap? Are you in a monogamous relationship or do you have multiple partners? Have you or a partner had past pregnancies? Do you plan to have children in the next five years — or ever? Would you like to use contraception to alleviate menstrual pain? Do you want something that you would use each time or would you prefer something longer term? Do you (or your partner) prefer or need to use hormone-free contraception? Reflecting on these questions can help you narrow down what’s best for you. In the meantime, check out the Sexual & Reproductive Health section of the Go Ask Alice! archives or Planned Parenthood for additional information about these options. You could also reach out to a health promotion specialist to speak about these options further.

It may also be a good idea to speak with your health care provider to ensure there aren’t any medical conditions to consider when deciding on your additional contraception. As for the best one to use with a condom — that's for you to decide!