Talk:Condom

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[edit] ADD SK version

sk:Prezervatív

Add [SK] .. it isn't included in multi-lng list

—The preceding unsigned comment was added by 147.229.220.155 (talk) 01:00, 11 February 2007 (UTC).

[edit] Archives

[edit] Advertisement

the section on preventing STDs includes what is most likely just an ad, "An article in The American Journal of Gynecologic Health[19] showed that "all women who correctly and consistently used Reality® were protected from Trichomonas vaginalis" (referring to a particular brand of female condom)."

[edit] Lubricated condoms

Umm, is the lubricated side of the condom supposed to be inside the condom or outside the condom? Meaning, dry inside, wet out, or wet inside, dry out? I would REALLY appreciate it if someone answer this soon.

-G —The preceding unsigned comment was added by 134.117.157.7 (talk • contribs).

Your best bet for questions is usually Wikipedia:Reference desk. The key to determine the orientation of the condom is which way it rolls, not which side has more lubrication. When placed over the penis, the roll of latex should not be covered by the rest of the condom. Notice how this image (worksafe) shows the tip coming from the bottom of the roll--this is the correct orientation, it rolls onto the penis. If you find you put the condom on the wrong direction, your best bet is to discard it and get a new one. As for lubrication, it is primarily applied to the outside of a condom--be sure to use water-based lubricants. Apply more if you don't think there is enough. See the image in the article for more detail on how to put on a condom. --TeaDrinker 08:46, 10 January 2007 (UTC)

[edit] Causes of condom failure

I removed the the following passage from the causes of failure section as non-use is in no way, shape, or form a failure of the condom. Passage follows:

  • Among couples that use condoms for birth control, pregnancy may occur when the couple does not use a condom. The couple may have run out of condoms, or be traveling and not have a condom with them, or simply dislike the feel of condoms and decide to "take a chance."

Again there is no mention of a condom failing in that passage. L0b0t 23:12, 24 August 2006 (UTC)

How do you respond to Lyrl's initial explanation in his edit summary, that these so-called failure modes of non-use are being included in the statistics on typical-use failure rates, and therefore deserve discussion to avoid misrepresentation? I mean, I for one would agree with you that non-use should never be considered a failure mode, but perhaps the eggheads who decided which failure modes should be included in the typical-use guideline felt differently. If that is the case, then we should either a.) include Lyrl's section or b.) take the time to point out that the "typical use" stats are based on the inclusion of non-use as a "failure mode" (so our readers will understand the stats are slightly crocked). Which do you think is best? Kasreyn 01:17, 25 August 2006 (UTC)
As pointed out to me in a previous discussion, it depends on your definition of failure. If you define failure as breakage or slippage, then no, non-use is not a failure. If you define failure as pregnancy amoung condom users, however (and this is how it is defined in the typical use failure statistics) then non-use certainly is a failure. Lyrl Talk Contribs 02:21, 26 August 2006 (UTC)
I stand corrected. I was unaware of the inclusion of non-use in statistics. I would posit however that the malleability of statistical sampling makes it very dodgy and unreliable. One would also have to define condom user. Being a "condom user" would seem to preclude any non-use as one would be using a condom. Perhaps "test subjects that reported regular condom usage" or "habitual condom users"?L0b0t 06:21, 26 August 2006 (UTC)
Indeed. It appears the researchers really didn't think carefully about this... which would tend to lead one to suspect the quality of their measurements and results as well. Can a different study be found, by researchers who have a better grasp of the initial premises involved in such a study? Kasreyn 08:09, 26 August 2006 (UTC)

People who intend to use a single contraceptive method as their form of birth control are considered "users" of that method. In withdrawal, for example, men who intend to withdraw - but don't always manage to pull out in time - are included in the typical failure rate of withdrawal. Similarly, with oral contraceptives, women who forget to take the pills are included in typical failure rate of the pill. Somewhat obviously, the pregnancy rate amoung forgetful pill-users is significantly lower than that amoung forgetful withdrawal-users.

The inclusion of such people in calculating typical failure rates allows people to compare the difficulty of using a method, and whether it still offers any protection if they sometimes forget to use it (hormones still offer some protection if not taken for a day, while things like withdrawal and barriers do not). Lyrl Talk Contribs 13:24, 26 August 2006 (UTC)

I see your point I just feel some other name should be given for those people. If you are a condom user you are using a condom, if you don't use a condom you cease to be a condom user by definition.L0b0t 18:04, 26 August 2006 (UTC)
Is a heroin user only a heroin user on the days he is able to find a fix? I'm not sure the rule you are suggesting is actually the way "user" is generally defined. The various terms "x user" are often construed to mean that the person is, generally speaking, a user-of-x-type person even when not specifically engaged in use of x. Ie., "heroin user" describes a fairly well-accepted set of precepts about the person's likely behavior, the most important of which is "frequently uses heroin", but there are others as well, such as "more likely to be a criminal", "more likely to die of a heart attack", etc. Kasreyn 08:28, 27 August 2006 (UTC)

[edit] Protecting Rifle Barrels

Stephen Ambrose's book D-Day has interviews with a couple of soldiers who talk about using condoms to protect rifle barrels from water and debris. I've read it in a couple other places since, but that was the first place I saw it. I was about nineteen and it seemed the funniest thing in the world to me. 71.199.115.160 06:03, 25 September 2006 (UTC)Tom Miller

[edit] Condoms as gloves

I removed the following from the article:

  • British SAS troops are also reported to use condoms as make-shift gloves during emergency surgery on the field of battle: five condoms, one over each finger, can help prevent contamination from blood during the operation or application of dressings.{{dubious}}

As the edit adding the "dubious" tag noted, condoms would be quit ill fitting and difficult to use. With all due resepct to the ledgend of James Bond and the British, I can hardly imagine anyone going into battle with ten condoms per person. I am removing it pending citation. --19:44, 18 November 2006 (UTC)

A "condom" over each finger is possible provided it was one of those "finger cots" see http://en.wikipedia.org/wiki/Finger_cot but that doesn't prevent contamination from reaching the palm of the hand or up the wrists as would a surgical glove. A standard condom would obviously be too large for a finger, and covering the whole hand would obviously be impractical. --Greenbomb101 14:57, 21 January 2007 (UTC)

[edit] Weight gain

Why is that listed in the info box? Is weight gain a purported side effect of condoms? —The preceding unsigned comment was added by 74.12.162.53 (talk • contribs) .

No, the box is a standard template for birth control methods. Weight gain can be associated with certain hormonal contraceptives, so it was incorporated into the template. Here it is a bit excessive, however, I agree. There is, unfortunately, no way to remove it without changing the template. --TeaDrinker 23:27, 19 November 2006 (UTC)
Ah, thank you for clearing that up! I thought it might've been some kind of weird joke.

[edit] Vandalism

I noticed a passage under the "Invisible" condom section that is clearly vandalism, but cannot find it in any of the edit pages to remove it. Maybe someone else knows how this was done?74.64.60.85 22:39, 26 November 2006 (UTC)

It was pretty slick, but I got rid of it. Selected the blank area at the end of the real text and deleted it. Poof! It's sad that someone would go to the trouble to add something so stupid in such a clever fashion.

There was also a bit about some guy using anal condoms, and his details such as address and phone number were given too. It was pretty ridiculous, I was gonna remove it but someone beat me to it haha.

--Littmann 07:45, 20 December 2006 (UTC)

[edit] Pope vs. condoms

The referenced article in the Independent is a good example of a widespread urban legend which should be addressed here. The logic of it is very simple. The Catholic condemnation of condom use as 'sinful' is based on their use as contraceptive devices; which, in the Church's opinion, trumps their use as barriers to the transmission of STD's. These objections do not apply, ipso facto, in the case of homosexual relations.

The Catholic birth control vs. STD protection issue is not only relevent to homosexual couples. There has been one Cardinal (though I could not find it in a quick Google search) who promoted condom usage amoung prostitutes. I did find an article mentioning a Cardinal promoting condom use by people known to have HIV. Lyrl Talk Contribs 01:36, 29 November 2006 (UTC)

[edit] Spray-on Condom

I removed a reference to a German scientisit creating a "spray-on" condom. It sounded fishy and was unsourced. If it is legitimate and you would like to add it back please give a source.--Eric 23:36, 7 December 2006 (UTC)--69.138.54.21 23:35, 7 December 2006 (UTC)

Unsourced??? What are you talking about? The source was linked to right in the article. There was both an html page and streaming video to the actual news article mentioned. Of course I am putting it back. CyberAnth 23:23, 8 December 2006 (UTC)
Ah, my apologies, I now see you are speaking of someone else's addition about it, which I would have removed on site as well. CyberAnth 03:32, 9 December 2006 (UTC)

[edit] Questions about the article

Shouldn't polyurethane condoms get their own section, if they're not latex?

Should the question of getting the right sized condom get more coverage? Xiner 21:54, 8 December 2006 (UTC)

I've fixed the polyurethane section.
If you can find sources for a discussion of condom sizing, that information might improve the article. It's a topic I would be hesitant to leave in without references, though. Lyrl Talk Contribs 23:02, 8 December 2006 (UTC)

[edit] Usage picture?

Image:CondomUse2 alternative.jpg has been in this article for some time. Recently, an anonymous editor has replaced it (twice) with Image:Posecondom.jpg. I prefer the first picture. What are other's opinions? Lyrl Talk Contribs 22:31, 12 December 2006 (UTC)

Image:Posecondom.jpg appears much more clear. CyberAnth 04:07, 13 December 2006 (UTC)
I agree. The second image is simply beter. Chavmusiksux 19:56, 18 December 2006 (UTC)

The posecondom one shows the wrong use of condoms. You should always squeeze out the air from the tip. Although the user holds the condom by the tip, he should have contineued to hold on the tip as he rolled the condom on. Ole-p 21:45, 19 March 2007 (UTC)

Well, from here:
For example, many condom instructions tell users to hold the tip of a nipple-ended condom or to squeeze the air out of the tip. There is no evidence that this helps avoid breaks (189). (Holding the nipple, however, guarantees that the condom is in the right position to unroll easily.)
So maybe squeezing air out isn't as important as we thought. Although this article just says squeezing air out of the tip "hasn't been studied". Lyrl Talk C 22:43, 19 March 2007 (UTC)

[edit] Etymology

I have seen in this and many dictionaries that the origin of the word "condom" is not known. It seems to me very likely that it is derived from one of the first discoverers of Latex, Charles-Marie La Condamine, a French scientis and explorer who discovered latex in Peru in 1735. See this link: http://www.iisrp.com/WebPolymers/00Rubber_Intro.pdf

It seems quite reasonable that tubes made of latex could have found general use and might have been called condoms from his name. It would be a small leap from there to the devices we now have for contraception. I am surprised that no connection to La Condamine seeem to hav ebeen made relative to the term condom.

68.21.231.254 23:38, 13 December 2006 (UTC) Tom Hayden

The problem with that is that sheepskin condoms existed for at least a hundred years before the discovery of rubber by Europeans. And rubber condoms were not made for over a hundred years after that. Lyrl Talk Contribs 00:56, 14 December 2006 (UTC)

[edit] Indian size study

Despite its widespread reporting on MSN, Yahoo!, BBC, and others, I believe this news story is a hoax. Primarily, the organization that supposedly conducted this study, the Indian Council of Medical Research, has no mention of the study on its website. Secondly, the report gave data only for penis length, which has nothing to do with sizing (nobody unrolls a condom all the way). Actual condom sizes vary in diameter - which apparently wasn't measured in this supposed study. Unless more convincing evidence of this study is presented (like a PubMed citation, or a link associated with the ICMR), I'm removing the reference to it from this article. Lyrl Talk Contribs 00:57, 15 December 2006 (UTC)

The report was originally published in The Times of India, here:
http://timesofindia.indiatimes.com/Condoms_now_in_market_oversized_for_Indian_men/articleshow/738916.cms
The article states the Indian Medical Council will publish the findings in 2007. This explains the absence at the site.
As much as I find the study offensive, as its agenda is probably a roundabout way to drum up more support for retention of the caste system in India, I think the study is worth noting, even if for its oddity. I believe it is certainly no hoax.
CyberAnth 02:37, 16 December 2006 (UTC)
Thank you, that article addresses both the lack of information from the IMCR and also the issue with length vs. girth (girth actually was measured). The IndiaTimes article also lends less credibility to the too-large condom claim, though, as that appears to be from unofficial "sources" reporting on "a smaller exploratory study", not from any official IMCR finding. Other editors seem to also be skeptical of this conclusion: Human penis size#Indians. Lyrl Talk Contribs 03:27, 16 December 2006 (UTC)
No doubt it is a political study more than anything else, or at least how it has been reported. And let us just be real clear and spell out what it is "saying", politically: "Another way the Indian men of higher castes are better is that they have larger penises."
Note the order in which it placed the correlations: "The Indian Council of Medical Research (ICMR) study has correlated penis size with socio-economic status, geographical location and the overall dimensions of the male."
"Socio-economic status" - a euphemism for "caste" in India. The study "has correlated penis size and caste"!
Sheesh...if how I am reading this report is right, this is some VERY racist stuff, I think we'd agree, like with the idea that people of Black African descent are less intelligent because of larger penis size.
Gotta run. Gotta go puke....
CyberAnth 03:55, 16 December 2006 (UTC)
At any rate, I think the info should be retained in the article - just one sentence mentioning it. At the least, that will remind us to actually read the ISMR study when it comes out in 2007 to see what it was for sure saying. CyberAnth 04:11, 16 December 2006 (UTC)
Hey, am just saying I like how it reads now in the article. When I edited it to include the wiki link to the IMRC I felt like it needed to be rephrased but didn't have the time/inclination. Nice to see it is better now when I came to take a look at it again. Good work guys. Mathmo Talk 07:47, 16 December 2006 (UTC)

[edit] Condom use in Decompression of Tension Pnumothorax

i added a citation. —The preceding unsigned comment was added by 24.14.94.230 (talk • contribs) 16:36, 27 December 2006 (UTC)

[edit] "pregnancy rate" rather than "failure rate"

Note discussion at Talk:Birth control#"pregnancy rate" rather than "failure rate" re replacing occurrences of "failure rate" with "pregnancy rate". I would also like to see the same change on this page. Please make any comments there. --Coppertwig 04:02, 8 January 2007 (UTC)

Please note ongoing discussion on this at the above-mentioned talk page, specifically mentioning the Condom page. --Coppertwig 00:03, 5 February 2007 (UTC)

[edit] Lambskin

Is there any info on the pregnancy rate/whatever of lambskin condoms? Or at least the risks of failure (slpping, breaking). As the pores are too small for sperm, they should in theory be as effective as latex condoms for birth control but it depends greatly on the various failure factors. Obviously if there is some info, it should be added 203.109.240.93 12:47, 23 January 2007 (UTC)

lambskin condoms are really expensive if you look at them they should make them a little bit cheaper so they can keep people safe some people will have sex because of stupidity especially if there is no cheaper way to prevent pregnancy. Yes the lambskin is a good idea for people allergic to latex but then again the prices are way too high. I am not too sure how affective they will be in the end. Shebbykz 01:45, 10 February 2007 (UTC)

[edit] Pregnancy from correct use

The article currently has a sentence Condoms may fail due to faulty methods of application or physical damage (such as tears caused when opening the package), bursting caused by latex degradation (typically from being past the expiration date or being stored improperly), and from slipping off the penis during intercourse or after ejaculation. Sometimes pregnancy may result even without an obvious failure at the time of use. The last sentence - that pregnancy may occur even if the condom does not fall off or noticeably tear - I thought was obvious (factory defects, or a tear or break too small to notice), but it has been fact tagged.

Doing Google searches for a source for that statement, I find a number of cites that claim 97%-98% effectiveness "if the condom does not break" (one example, scroll down to "condoms"). I don't think this statement is technically accurate, though. If I understand correctly the "correct use" failure rate does include some level of breakage and slippage. While incorrect use increases the risk of breaking and slipping, these things happen to even the "perfect" users tracked by the "correct use" failure rate. So I'm hesitant to use these sites as sources. But I haven't come up with anything else so far. Any suggestions? Lyrl Talk C 04:01, 3 February 2007 (UTC)

On further reflection, I think the tagging editor was confused by the terminology of "no failure" (meaning no noticeable breakage or slippage) resulting in "pregnancy" (condom failure). Perhaps I'll just reword that sentence to be less confusing, and remove the tag as obvious. Lyrl Talk C 02:21, 10 February 2007 (UTC)
I think you're talking about this sentence: "Sometimes pregnancy may result even without an obvious failure at the time of use.[citation needed]" I think it needs a citation and that the tag should remain until the citation is found. If it's "obvious", it can simply be deleted since the reader already knows it. See Wikipedia:Verifiability. --Coppertwig 02:36, 10 February 2007 (UTC)
So you believe that, if a couple does not notice any breaks or tears, and the condom does not fall off, that they have a 0% chance of pregnancy? Lyrl Talk C 14:30, 10 February 2007 (UTC)
No, I believe that the citation tag should remain until either a citation is found or the sentence is deleted. Wikipedia is supposed to be based on reliable sources, not on the beliefs of Wikipedian editors. --Coppertwig 15:48, 10 February 2007 (UTC)

From WP:V: Editors should provide a reliable source for material that is challenged or likely to be challenged. and Any material that is challenged or likely to be challenged needs a reliable source. and Sources should be appropriate to the claims made: exceptional claims require stronger sources. This strongly implies that material that is unlikely to be challenged, and that is unexceptional in nature, do not need sources. Nowhere in WP:V does it state that every sentence in an article needs to be cited.

Placement of a fact tag is generally to be taken as a challenge to said material. In this case, however, as explained above, I believe the tag placement was caused by a misunderstanding of what the sentence said, and indicates need for rewriting the sentence rather than need for a source. Does that make sense?

In this particular case, my concern is that the claim is so obvious that the best (scientific) sources don't bother to mention it. I can certainly find a number of unscientific sources for the claim (one example in my first post in this section). So, I see three ways we could proceed:

  • Use one of the sites I can find through Google searching as a source
  • Decide the sentence does not help any readers, and is not worth bothering to source, so delete it
  • Reword the sentence to avoid the confusion between different types of failure (probably leave the word "failure" out altogether) and delete the fact tag

Lyrl Talk C 22:49, 10 February 2007 (UTC)

Even better would be to find more useful information to add to the article, such as the percentage of pregnancies for which there is or is not an obvious failure at the time of use, or mentioning the main reasons for failures that are not obvious at the time of use, or stating that it is not known what the most common causes are, if that is the state of the science.
The citation-needed tag was added on 06:53, 2 February 2007 by Grandmasterka, who is still very active in Wikipedia. I suggest you reword the sentence and then put a message on the user's talk page asking whether the user still thinks a citation is needed. If that user says it's OK and no one else objects, I don't object to the removal of the citation tag.
Deleting the sentence seems to me probably not the best option. If you can find a reputable organization whose website makes a statement like this, the sentence can be changed to "according to the <name of organization>, sometimes ..." with a link to the website and then the citation tag can be removed.
Thank you for your patience and for taking the time to look for solutions and to search for citations. --Coppertwig 00:36, 11 February 2007 (UTC)
Re your most recent edit: Well done. I think your wording flows more smoothly than the previous version. I inserted "sometimes" to make it clearer that condoms are not totally useless.
This sentence contains weasel words: "It is believed that instruction in proper condom use also reduces failure rates." It needs at least a citation and perhaps rewording. E.g. a link to a reputable organization which believes this. --Coppertwig 13:14, 11 February 2007 (UTC)

Hi there guys.

The issue at hand with the sentence I tagged ("Among couples that intend condoms to be their form of birth control, pregnancy may sometimes occur even if they do not notice slippage or breakage at the time of use") is this: Other than deliberate sabotage, which is mentioned elsewhere in the article, it is not obvious to me how a pregnancy might result after using a condom properly without any obvious signs of problems. (I hate to admit it, but I have yet to use one for intercourse.) Wouldn't there be some visible breakage, slippage or overflow? I feel that the sentence should be expanded to show how this might happen, and cited if it's not based on something mentioned elsewhere in the article, or it should be removed entirely. Wikipedia should not be pushing an abstinence-only POV (or any other POV) by saying "well, this might not work even if it looks like there are no problems" without further explanation and/or citation. Other than that, I am very pleased with this article. I suspect some people out there are counting on this article's quality. :-) Grandmasterka 01:07, 12 February 2007 (UTC)

I agree with Grandmasterka. And I congratulate Lyrl for extensive work on this and related pages -- and all the other contributors. --Coppertwig 10:49, 12 February 2007 (UTC)
This study found for experienced users (had used a condom more than 15 times), male condoms broke or slipped off 2.3% of the time. For new users (up to 15 uses of a condom), the rate was 9%. This study found that male condoms broke or slipped off 8.8% of the time, though it seems like there were a lot of new users in the study group, and it references other studies that have found breakage/slippage rates anywhere from 1% to 12%. This study reports that for experienced users slippage/breakage rates are between 1.0 and 3.6%. Personally, I've used condoms hundreds of times and never had any issues, so am surprised to see rates that high. Breakage and slippage does seem to account for much or most of the 2% annual perfect-use failure rate.
However, many (I would think most) couples do not inspect the condom after intercourse. A small tear - sperm are microscopic, it would only take a tiny tear - is likely to go unnoticed. Or the shrinkage of the penis afterwards may change the shape of the condom so that a small tear is not visible. This is actually what people who sabotage condoms rely on - small punctures are unlikely to be noticed by their partner, so the partner has no reason to suspect sabotage. Reading stories of observant Catholic who have used punctured collection condoms to get a semen sample, they do not mention any noticeable spillage. Anecdotally, I have seen a few women post on the internet who used condoms, did not notice any breaking or slipping, and became pregnant. All of this makes me firmly believe that it is possible (though very, very unlikely) to get pregnant after using a condom with no noticed problems. However, none of it can be used as sources for Wikipedia.
In my reading about condom effectiveness, the research effort seems to be focused on a)getting people to actually use the things and b)preventing breaking and slipping. The tiny fraction of users who get pregnant despite using a condom, without any noticed breaks or slips, gets no attention. The closest I have found is here, which states "The authors of a study investigating leak-age concluded that if a condom does not break, it provides 10,000 times more protection than no condom at all." This means that unbroken condoms provide excellent but not foolproof protection (which I believe supports my position), but it's talking about HIV, not pregnancy. Anyway, I'm not able to find a source for the statement, and other editors have so far not shown interest. I (obviously) support leaving it in, but for now it's going to have to stay fact tagged or be removed. Lyrl Talk C 03:20, 13 February 2007 (UTC)
I see what you're saying. That's an interesting PDF. HIV is obviously a lot smaller than sperm but one would think that a tiny tear would still allow both through... I really would want to know how they got the "10,000" figure. Nevertheless, I'm going to go ahead and remove that sentence. Right now, on its own, I think it gives the wrong idea, and we can always put it back when someone finds a proper source. Grandmasterka 10:04, 13 February 2007 (UTC)
Thanks for taking the time to look for sources, Lyrl. I agree with Grandmasterka re removing the sentence for now. If the instructions with the condom say to inspect it after use and people don't, then that doesn't count as perfect-use. If there's an instruction that many people are ignoring, I think it would be good to talk about that in the article: maybe something like "perfect-use pregnancy rates are x%, but that assumes people are following all the instructions, such as to inspect the condom after use." --Coppertwig 12:19, 13 February 2007 (UTC)

[edit] Effectiveness, a better way to say it?

In the effectiveness section it states "... Actual effectiveness is the proportion of couples who intended that method as their sole form of birth control and do not become pregnant; it includes couples who sometimes use the method incorrectly, or sometimes not at all. Rates are generally presented for the first year of use. "

This section used to be worded much better, imo. I would word the entire beginning "Perfect use rates describe the pregnancy rates of people who use condoms properly and consistently. Actual effectiveness rates describe the pregnancy rates of all people, inlcuding those who either use condoms improperly or inconsistently." I'll hold off on making such a change until I hear some other input (or until I hear no counter argument)DanielZimmerman 14:48, 13 February 2007 (UTC)

I agree with your proposed change. Sounds much smoother and easier to understand, and quite accurate -- except "all people" could be misinterpreted; how about "all users" or "all condom users" or "all users of this method" or "all couples using condoms for birth control" or something -- otherwise it might seem to include everyone even those who have no intention of using condoms. --Coppertwig 15:06, 13 February 2007 (UTC)
Both actual and perfect-use effectiveness rates are lower for long-term users than for newer users. Couples who have been using condoms for several years can reasonably expect their pregnancy risk to be lower than what is listed in this article. So I think something about "first year of use" is relevant to have in there.
I think where the numbers come from is also relevant, thus the links to Pearl Index and decrement tables. If it's felt both links make for too much technical information, we could just link to the most common one (Pearl Index), which has a comparison to decrement tables.
Both "perfect use" and "method" are used to describe the pregnancy rates of couples who always use condoms, and use them correctly. I feel the term "perfect" implies average people can't hope to achieve that effectiveness, but that correct and consistent use is actually attainable for the vast majority of people. So I prefer the term "method" which doesn't have the connotation of "unreachable" that I associate with "perfect". "Method" also appears to be the more common term, with 1200 Google hits excluding Wikipedia [1], compared to 400 hits for "perfect use" [2].
I agree that "improperly or inconsistently" reads more smoothly than "incorrectly, or sometimes not at all". Lyrl Talk C 00:04, 14 February 2007 (UTC)
Almost the entire section on effectiveness re pregnancy is about definitions of method effectiveness etc.; only the last sentence is about condoms at all. There's even stuff about oral contraceptives in there. Maybe the examples re oral contraceptives could be replaced with condom examples.
Is the 2% method pregnancy rate for people using plain condoms? Or condoms which come with spermicide on them? Or using condoms and also using some spermicidal gel or something? Are they sure the people in this study aren't also avoiding intercourse during the most fertile times of the month? I mean, they can't be completely sure, but was advice about avoiding intercourse at certain times handed out with the condoms when the study was done? Could using spermicidal gel be considered to be simply following the directions that came with the condoms? --Coppertwig 03:34, 14 February 2007 (UTC)
The examples of "user failure" should probably be converted from oral contraceptives to condom-specific.
Do others think the definition of contraceptive effectiveness is not relevant to this article? Or that parts of the definition add more difficulty to the article's readability than they add information?
Method failure is for one single method, used alone, not in conjunction with other methods. Using both a condom and separately applied spermicide would be two methods. Using a condom on less fertile days and abstaining on more fertile days would also be using two methods. The failure rate of condoms spermicidally lubricated by the manufacturer has never been studied, but they are more likely to break than regular condoms, so they are not currently recommended. Does that help? Lyrl Talk C 02:28, 15 February 2007 (UTC)
I think the definition of contraceptive effectiveness is relevant to this article. However, that particular section is not well-balanced. Perhaps it needs to be renamed to "definition of contraceptive effectiveness" or something and the last paragraph moved to a different section. Or, perhaps a shorter version of the definition could be given along with a link to a page with a more in-depth definition. Above all, I'd like to see more information about the actual condom effectiveness. For example, what you just told me above could be included: that these rates apply to plain, not spermicidally-lubricated condoms. (If that information can be verified.) Currently the section contains only one very brief paragraph addressing the topic its heading suggests it's about, and the reader has to wade through the whole section to get to that one paragraph. --Coppertwig 01:26, 16 February 2007 (UTC)

Sounds reasonable. You might find current footnote numbers 2, 6, and 7 helpful in the rewrite. Lyrl Talk C 22:01, 16 February 2007 (UTC)

Thanks. I've added it to my growing to-do list :-) --Coppertwig 01:23, 17 February 2007 (UTC)
Is there a reason to use "perfect" instead of "method"? My reasons for preferring "method" were explained above, and I didn't see any objections.
Are the examples of actual-use failure modes so unhelpful they should be completely deleted? Coppertwig had suggested moving the section or linking to a page with a more in-depth definition, but I hadn't seen consensus to delete it outright. For now, I've moved it to the end of the section where it hopefully will be less in the way for people after just the numbers and no explanation. Lyrl Talk C 23:39, 19 February 2007 (UTC)
"method" is probably better than "perfect", in my opinion. I don't suggest deleting information; only moving it or replacing it with condom-specific information. --Coppertwig 12:56, 20 February 2007 (UTC)
most of the research I have done on this topic has used the terms "perfect use" and not "method use". How about we include both? Say something like ".... perfect (or method) use is..."

http://www.engenderhealth.org/wh/fp/ccon2.html uses the terms "perfect use" and "typical use" (words I included when I first contributed to the article months ago) And they refer to the "method" as what you are using (ie condom, female condom, etc). http://www.infoforhealth.org/pr/h9/h9chap4.shtml again, "perfect use" and "typical use" http://www.goaskalice.columbia.edu/2219.html ditto http://www.who.int/mediacentre/factsheets/fs243/en/ this is the "WHO" using the terms "perfect use" and "typical use". I think if the WHO is calling them "perfect use" and "typical use", as well as many other experts, that we should also be using those terms in order to be consistant with terminology. http://www.swimmingkangaroo.com/blog/2006/03/failure-of-abstinence-only.html " There are two ways to look at the effectiveness of all birth control methods – perfect use and typical use. " http://209.85.165.104/search?q=cache:gf7W1NQeOdUJ:www.umass.edu/uhs/uploads/basicContentWidget/10209/Effectiveness.pdf+condom+%22perfect+use%22&hl=en&ct=clnk&cd=11&gl=us A university using "perfect use" and "typical use"

Googling condom "failure rates" "perfect use" gives 11,000+ hits. Googling condom "failure rates" "method use" gives < 1000... and that includes sentances like "If a condom does break and you are using no other birth control method, use emergency contraception to prevent pregnancy."

I think it is pretty clear that the proper terms are "pefect use" and "typical use". I shall follow what wikipedia says and "be bold" in changing it to those proper terms. DanielZimmerman 19:57, 21 February 2007 (UTC)

WP:BOLD pretty specifically refers to issues that have not been discussed on the Talk page. Making changes while discussion on the Talk page is still active, without allowing consensus to form, is not encouraged.
There are a number of issues I have with these edits by DanielZimmerman.
  • It reinserts language referring to the pregnancy rate among condom users as the failure rate. With condoms, "failure" is also commonly used to refer to breakage and slippage. To avoid confusion, and per extensive discussion initiated by Coppertwig (#"pregnancy rate" rather than "failure rate"), changes to this page have been made to specify "breakage and slippage" when that is being talked about, to specify "pregnancy" when that is being talked about, and to avoid the word "failure" in the text as much as possible.
  • It deleted a citation of the Guttmacher Institute for a typical or actual pregnancy rate of 18% per year. The reasoning behind deleting a cited fact from a reliable source is not something I'm grasping.
  • It puts descriptions of pregnancy rate types in quotes. This may be interpreted as detracting from the meaning of the word - "perfect" results may not actually be perfect, and "typical" results may not actually be typical. I see no reason to use quotes like this. Quotes may also be used to distinguish a phrase unfamiliar to many readers from the rest of the text; if this is the intent, I would suggest using italics instead.
  • Not only was perfect changed to method (which at least had been introduced as a topic on the Talk page) but actual was changed to typical with no discussion at all!
As far as Google searches, the phrase method use is (as Daniel showed) almost never used to refer to pregnancy rates. Notice that I did not add the phrase method use in this edit, instead using method effectiveness and method pregnancy rate. Results from more relevant searches (the word condom was included in all searches):
If we're going for prominent organizations, among those on the first page of Google results for the method searches above are the Guttmacher Institute, Family Health International, the Centers for Disease Control and Prevention, the Food and Drug Administration, as well as a webpage from the University of Illinois McKinley Health Center.
Obviously phrase choice and placement of quotes may heavily influence hit counts. But from the searches I've been able to think of, method seems to overall be a more popular word choice than perfect when describing pregnancy rates of contraceptors. As stated above, I was previously aware that the phrase method use is never or almost never used to refer to pregnancy rates, and so my opinion is not swayed by the low Google hits for that phrase.
Actual versus typical is not something I have an opinion on. But again, making changes related to an active Talk page discussion before consensus had formed is discouraged. Lyrl Talk C 00:22, 23 February 2007 (UTC)
  • The problem I have with the term "method" is this. Method, in many of the articles cited, refers to the method used to protect yourself. So the method in this case is using a condom. Perfect use is following the directions of the condom exactly and consistently. Typical use is not following the directions, using consistantly, etc. See this site as an example.
" Effectiveness rates are expressed in terms of how many women experience pregnancies during their first year of using the method. Perfect use reflects correct and consistent use, according to specified instructions, with every sex act. Typical use reflects the fact that most couples do not use their contraceptive methods correctly or consistently with every sex act; this rate, therefore, is considered more accurate than perfect use."(emphasis mine)
Saying "method use" does not state how well the user is using that method. You have people who use the method perfectly (perfect use) and people who dont (typical use).
And back to the "google proof".
Googling condom "perfect use" yeilds 27,900 hits (your use of quotes severely restricted the hits on perfect use).
Googling condom "method effectiveness" yeilds 760 hits. I think it is fairly clear that "perfect use" is the term that is prefered ofer "method effectiveness".... and in some of those articles the "method" referred to may be using more than one form of contraception.
  • On the use of "pregnancy rate" vs "failure rate", what do you think the 2-5% under the "perfect use" category is? It is the chance that those condoms will fail... it is "breakage and slippage" that can occur. In fact, for both categories there is an inclusion of the chance of the woman getting pregnant because the condom itself failed. Perhaps a statement on that should be placed that says Included in both rates are the chance that the condom itself may fail (or something like that). The section is already labeled "effectiveness in preventing pregnancy".... so when the use does not prevent someone from getting pregnant, it is a failure. I can agree that there are circumstances where one term may be better than the other. In this case, because the section states that it is a section on the effectiveness in preventing pregnancy and because of the fact that the rates are partially caused by the condom not working (and not user error) that "failure rate" is the proper term.
  • On the issue of putting terms in quotes, i believe it is proper when directly quoting a source, and not paraphrasing, to put quotation marks around those terms that are directly quoted. "Perfect use" and "Typical use" are direct quotes from the source that I cited. If I say that the sky is blue, and someone interprets that as the sky being sad, should I not have said the sky is blue?
  • On the issue of removing a source, it was not something that was purposefully done and I would have no problem changing the 15 to an 18 (or even 21... see below) and including other references as sources for the information.
  • Actual was changed to typical because typical seems to be the term that is used. Stating actual seems to say that this is what will happen. To state that it is typical says that this is the failure rate that MOST people see. Typical implies that some failure rates may be higher and some might be lower (which is more realistic), actual does not. typical use is used by the FDA, Planned Parenthood, NSRC, the WHO, UMASS, Americanpregnancy.org, The paolo alto medical foundation (pamf), Stanford (who actually lists a typical use failure rate of 21%!). actual use does have the same number of hits, but the information linked to in the typical use search in the first page of hits tend to be more relevent to the discussion of failure rates then the "actual use" search (which comes up with some information that is relevent but others that are not). For example, this article has the term "actual use" but it is not what we are discussing (an example of the fda being a "hit" in the terms of it matching keywords but not an actual hit for the purposes of this discussion). It is clear that "typical use" is the correct term. I would also point out that when I made the change last year that there was no objection to the use of the term "typical use" back then. DanielZimmerman 15:47, 23 February 2007 (UTC)

[edit] Method effectiveness versus Perfect use effectiveness

Failures that are caused by user error are user failures. Failures that are inherent in the method itself are method failures. Typical failure includes the entire study population, both user and method failures. Does that make sense?

I agree that in a stand-alone context people are more likely to correctly interpret perfect use than method effectiveness. But in the effectiveness section, the definition of the term is right there in the second sentence. To me, that makes the danger of misinterpretation negligible.

Back to Google, there are 19,000 hits from condom "method failure". Regarding the results from the perfect use search, I see that most sources on Google use a prose style to describe failure rates. Meaning, the phrase perfect use is separated from words like failure, pregnancy, or effectiveness. I think the ability to separate the perfect use phrase from the word it is describing (failure, pregnancy, etc.) makes it grammatically easier to work with than method, and may entirely account for the extra 9,000 Google hits. I think "method" is a technically better term, though, despite being more difficult to use when writing. To support this view, I offer the results from searches on PubMed, which catalogs all the articles from a large number of medical magazines. 18 hits for condom "perfect use" versus 21 hits for condom "method failure", and an additional five hits for condom "method effectiveness". Pretty even results, but a slight edge for method. Something similar is seen in a Google Books search, with 100 results from condom "perfect use", 100 from condom "method failure" and an additional 55 from condom "method effectiveness". Lyrl Talk C 23:49, 23 February 2007 (UTC)

Yes, it makes sense and that generally what I was saying when I was pointing out that since breakage and slippage is included in both the perfect/method use and in typical use. Perhaps if we introduced some terms in the beginning of the section we could create an even better section that includes both "perfect use" and "method failure"... perhaps using both in an opening sentance explaining what perfect use and method failure are and expanding from there. DanielZimmerman 15:54, 26 February 2007 (UTC)
Including both terms would be a good solution for me. I'd like to repeat again, though, that I feel the connotations associated with the word perfect give an incorrect impression of how difficult condoms are to use. From a condom study published in the International Journal of STDs and AIDS (PMID 15949062), perfect use of a condom consists of four items:
  • Starting the tear where the package is notched (The article does not say why, but I'm guessing this is to keep sharp things like fingernails and teeth to the side of the package rather than near the condom where damage is likely)
  • Putting the condom on right side out
  • Pinching the tip to avoid air entering
  • Rolling the condom all the way down the penis
Regarding the third point, this article says that, while widely speculated as a cause of breakage, studies have shown that pinching the air out (or not) actually has no effect on breakage. So that brings us down to three items. To me, that does not deserve the difficulty connoted by perfect. Lyrl Talk C 22:48, 26 February 2007 (UTC)
I dont think perfect use says that it is difficult to do, I just think it states that there is a correct way to do it and if you dont follow the instructions you reduce the effectiveness. Im sure tearing at the notch is good because it keeps the fingernails away, but one should never use their teeth to open the package. Heck, we could even include "perfect use consists of...." to show people how easy it is. DanielZimmerman 23:43, 26 February 2007 (UTC)

[edit] Quotes around description of pregnancy rate

I'm not sure the phrases perfect use and typical use should be treated as quotes from the reference, with quotation marks. I had not considered two-word phrases quotes, and had thought quotes around such short phrases were usually scare quotes. While I do not think there is a danger of readers interpreting "perfect use" as a scare quote because of the context, I still feel it looks unencyclopedic. I do see a benefit in marking the phrases as special the first time they are used - they are technical language being defined. However, I would prefer to use italics rather than quotation marks. Thoughts? Lyrl Talk C 23:49, 23 February 2007 (UTC)

If using italics is a proper way to quote the source then I would have no problem changing it to that, to avoid the potential of having people think it might be "scare quotes". DanielZimmerman 15:55, 26 February 2007 (UTC)

[edit] Putting a range on method or perfect-use failure

I am not sure listing the method or perfect-use pregnancy rate as being 2-5% is accurate. The reference it seems to be using for the 5% number is actually describing female condoms. This article is currently set up to mostly talk about male condoms, with information on female condoms being isolated to the "Female condoms" section. I believe all sources for male condoms give either a 2% or 3% annual pregnancy rate. This issue was discussed some time ago (see Talk:Condom/Archive 2#Perfect use failure rates - 2% or 3%?), and the consensus at that time was to use 2% for this article. Is there a new argument for including the 3% number? Lyrl Talk C 23:49, 23 February 2007 (UTC)

You are correct, the 5% is relating to the female condom. I misread the source. The other articles do list 3% as the failure rate though.... so I would say use 3% unless there are other sources that list 2... then list 2-3%. DanielZimmerman 15:59, 26 February 2007 (UTC)
It looks like the 16th edition of Contraceptive Technology - the publication that practically every medical establishment uses as the authority for contraceptive failure rates - listed a perfect use failure rate of 3% per year for condoms. And lots of webpages used that source.
The latest (18th) edition of Contraceptive Technology lists a perfect use pregnancy rate of 2% for condoms, and that is starting to appear in more recently created/updated websites. I assume the authors had good reasons for changing the rate and support changing the rates listed in this article to match.
I do not own (and have not asked my library for) a copy of the latest edition of Contraceptive Technology, so I do not know the exact reason they changed the failure rate from 3% to 2%. However, I have done a PubMed search for studies of pregnancy rates with condoms and found the following:
  • Walsh T, Frezieres R, Peacock K, Nelson A, Clark V, Bernstein L, Wraxall B (2004). "Effectiveness of the male latex condom: combined results for three popular condom brands used as controls in randomized clinical trials.". Contraception 70 (5): 407-13. PMID 15504381.  - 1% failure rate in six months.
  • (1997) "Avanti: similar efficacy to latex, more breaks.". Contracept Technol Update 18 (10): 123-5. PMID 12321211.  - 3.1% failure for Avanti (polyurethane), 1.2% for latex in six months.
  • Steiner M, Taylor D, Feldblum P, Wheeless A (2000). "How well do male latex condoms work? Pregnancy outcome during one menstrual cycle of use.". Contraception 62 (6): 315-9. PMID 11239619.  - 0% failure rate amoung 234 women followed for one cycle. (Because this was a very short and small study, however, the confidence interval includes up to 10% per-year failure rate.)
  • Faúndes A, Elias C, Coggins C (1994). "Spermicides and barrier contraception.". Curr Opin Obstet Gynecol 6 (6): 552-8. PMID 7893963.  - says different studies find failure rates of 2%-13% (presumably the 2% is the perfect-use rate, and 13% is typical-use, as I've never seen perfect-use condom rate as high as 13%!)
  • Dicker D, Wachsman Y, Feldberg D, Ashkenazi J, Yeshaya A, Goldman J (1989). "The vaginal contraceptive diaphragm and the condom--a reevaluation and comparison of two barrier methods with the rhythm method.". Contraception 40 (4): 497-504. PMID 2582773.  - 3.2% pregnancy rate after 2 years (note this is actual failure, not perfect-use, although the study does note "All [participants] were highly motivated.")
I did not find any studies on PubMed with higher perfect-use failure rates for condoms. The rates found in the above studies (1% over six months, 0% over one month, and 3% over 2 years) all support the 2% over one year assertion. Lyrl Talk C 22:58, 26 February 2007 (UTC)
Some sources say 2, other sources say 3. I say, lets word it like I have and say "depending on the source, the failure rate for perfect use can range between 2 and 3 percent". If your math is correct.... if it is 2% a year, wouldnt it be 4% over 2 years? The answer is no, and that is because you cannot just add probabilities of independent trials and get a correct result. DanielZimmerman 23:39, 26 February 2007 (UTC)
One source - the 16th edition of Contraceptive Technology - says 3%. All the web pages that say 3% got their information from that one source. One other source - the 18th edition of Contraceptive Technology - says 2%. All the web pages that say 2% got their information from that one source. If a second, independent source is found for the 3% number, my opinion would change. But I see no reason a Wikipedia article should provide information from an outdated medical publication. So I currently support including the 2% number only. Lyrl Talk C 02:11, 27 February 2007 (UTC)
Maybe I am missing it, but where on this site does it say what source it used to get the 3% figure? DanielZimmerman 15:07, 28 February 2007 (UTC)
A webpage that posts claims with no evidence to back it up is not a reliable source. My belief that their source was the old edition of Contraceptive Technology comes from the fact that engengerhealth's numbers match up with the numbers from that source - I may be wrong, that may be a coincidence. But lacking the original source, the 3% number given from that engenderhealth is not reliable by Wikipedia's standards. Lyrl Talk C 00:03, 1 March 2007 (UTC)

Re-indenting---- Did the Contraceptive Technology 18th edition give reasons why they changed the rates? Was there a difference in the methodology used? I find it odd that the 16th and 17th would list 3% yet the 18th would list 2%. (I have found an example of a source using 16 and saying 3 and another using 18 and saying 2, I just want to know what caused the difference). Is that 1% within a margin of error. (Is there a margin of error?) Those kinds of questions need to be answered before I will firmly support the 2% because 3% had been THE number for a while. DanielZimmerman 04:17, 1 March 2007 (UTC)

I've emailed someone I think has a copy to see if she will look for that information and type it up for me. My local public library doesn't have a copy, and the medical libraries in my area appear to have 17th edition or older. I've not quite worked myself up to pay $40 plus shipping (the cheapest used copy on Amazon) to get my own copy, either.
If I don't hear back from my contact in about a week, I'll see if I can request a copy through interlibrary loan. If any editors have a copy or can access one easily, that would be very helpful. Lyrl Talk C 00:03, 2 March 2007 (UTC)
OK, got a response already! The following I have typed from a jpeg image of the text that was emailed to me. From the 18th edition, Perfect Use of the Male Condom:
Our estimate of the proportion becoming pregnant during a year of perfect use of the male condom is based on results from the only three studies of the male condom meeting modern standards of design, execution, and analysis.(22,41,42) In each study couples were randomly assigned to use either a latex condom or a polyurethane condom. All three studies reported efficacy during consistent use but only one reported efficacy during perfect use;(41) in that study the 6-cycle probability of pregnancy during perfect use (0.7%) was 70% of that (1%) during typical use. We assumed that in the other two studies the 6-cycle probability of pregnancy during perfect use would also be 70% of the 6-cycle probability during typical use, assumed that the pregnancy rate per cycle during perfect use would be constant, extrapolated a one-year probability from the 6-cycle probability reported for the latex condom in each trial, and took as our estimate the median (2%, also the mean) of those 3 estimates. This estimate is consistent with an estimate based on studies of condom breakage and slippage.(23) Under the assumption that 1.5% of condoms break or slip off the penis and that women have intercourse twice a week, then about 1.5% of women would experience condom breaks during the half-week that they are at risk of pregnancy during each cycle. The per-cycle probability of conception would be reduced by 98.5%, from 0.1358 to only 0.0020, if a condom failure results in no protection whatsoever against pregnancy, so that about 2.6% of women would become pregnant each year.(24) Unfortunately, breakage and slippage rates did not accurately predict pregnancy rates during consistent use in one clinical trial of the latex and polyurethane male condom,(22) and estimates of condom breakage and slippage during intercourse or withdrawal vary substantially across studies in developed countries,(23) from a low of 0.6% among commercial sex workers in Nevada's legal brothels(23) to a high of 7.2% among monogamous couples in North Carolina.(25)
And from the 17th edition, Male Condom (Perfect Use):
Our estimate of the proportion becoming pregnant during a year of perfect use of the male condom is based on results from the only study of the male condom meeting modern standards of design, execution, and analysis.(40) Couples were randomly assigned to use either a latex condom or a polyurethane condom for 7 months. Adjusted for the use of emergency contraceptive pills, the six-cycle probability of pregnancy during consistent use of the latex condom was 1.2%. Assuming a constant per-cycle probability of pregnancy, the 13-cycle probability of pregnancy during consistent use would be 2.6%. This estimate is consistent with an estimate based on studies of condom breakage and slippage.(1) Under the assumption that 1.5% of condoms break or slip off the penis and that women have intercourse twice a week, then about 1.5% of women would experience condom breaks during the half-week that they are at risk of pregnancy during each cycle. The per-cycle probability of conception would be reduced by 98.5%, from 0.1358 to only 0.0020, if a condom failure results in no protection whatsoever against pregnancy, so that about 2.6% of women would become pregnant each year.(15) Unfortunately, breakage and slippage rates did not accurately predict pregnancy rates during consistent use in the clinical trial of the latex and polyurethane male condom,(40) and estimates of condom breakage and slippage during intercourse and withdrawal vary substantially across studies in developed countries,(1) from a low of 0.5% among commercial sex workers in Nevada's legal brothels(1) to a high of 7.2% among monogamous couples in North Carolina.(30)
It looks like the 17th edition got a rate of 2.6% from just one study, while the 18th edition included two newer studies and averaged the results from the three studies, arriving at 2.0%. Lyrl Talk C 02:12, 2 March 2007 (UTC)
Ok, so this one journal has an average rate of 2.0%. And my original wording was that the rate depended on the survey given. How about we mention the contraceptive technology book specifically, stating that the average rate among many studies is 2% and that figure was obtained by 3 different studies. This way, people know that 2% isnt the absolute rate and that it depends on the specific survey. DanielZimmerman 02:27, 2 March 2007 (UTC)
I guess I'm puzzled here. Why would there be a range on the method or perfect use rate? I understand for typical, because it includes user behavior, different groups of users are going to behave differently. But all condoms are manufactured to the same standards. Why would the failure rate of the condom itself have any variation?
As a side note, while Contraceptive Technology is the name of a journal, the publication we're talking about here is actually a book, unrelated to the journal. Lyrl Talk C 00:47, 3 March 2007 (UTC)
The rate listed is an average rate based on several surveys. This is why there would be a range, depending on the survey taken on usage. Someone can use a condom perfectly but still have different experiences with breakage and slippage that would impact the results. While breakage and slippage rates where not found to accurately predict pregnancy rates, they still have an effect on them. DanielZimmerman 17:08, 3 March 2007 (UTC)
I understand that the three research studies found slightly different perfect-use failure rates. (As adjusted by Hatcher, if both the mean and median was 2.0%, and one study reported a rate of 2.6%, I'm going to speculate the other studies reported rates of 2.0% and 1.4%.) That doesn't help me understand why a perfect use failure rate would vary. I'm currently looking at it like this: a coin toss has an exactly 50% chance of heads. One study of 100 tosses might result in 46 heads. Another study of 100 tosses might result in 54 heads. This does not mean the probability of heads varies from 46-54%; just that the studies were not large enough to give an accurate result. Similarly (to me) the variation in study results of perfect-use rates does not mean the actual rate has a variation, just that the studies were not large enough to always give an exactly accurate result. Averaging them into effectively one larger study should give a more accurate result. Does that make sense? Lyrl Talk C 03:03, 4 March 2007 (UTC)

[edit] Failure rate vs. Pregnancy rate

Every study I've read for the 2% per year number was describing the pregnancy rate. The chance that condoms will "fail" (meaning break or slip off) is at least 1% per use. (This study found for experienced users (had used a condom more than 15 times), male condoms broke or slipped off 2.3% of the time. For new users (up to 15 uses of a condom), the rate was 9%. This study found that male condoms broke or slipped off 8.8% of the time, though it seems like there were a lot of new users in the study group, and it references other studies that have found breakage/slippage rates anywhere from 1% to 12%. This study reports that for experienced users slippage/breakage rates are between 1.0 and 3.6%.) Daniel, not to single you out, but your confusion in thinking the 2% per year number was the chance of breakage/slippage is an example of exactly why I support the change to "pregnancy rate" from "failure rate". Lyrl Talk C 23:49, 23 February 2007 (UTC)

I am not confused and the sources you cite actually seem to back me up and here is why. In those surveys, experienced condom users had a smaller failure/breakage rate than inexperienced ones. The ones who have more experience using a condom are more likely to use it "perfectly" so their numbers would tend to match the "perfect use failure rate" while those who are inexperience are more likely to make an error in the application of the condom, therefore tending to be closer to the "typical use failure rate". The reason why it is 9% and not closer to the 15% because those studies dont include non-use. When following the method perfectly, the only reason that one would become pregnant is condom failure. When following the method imperfectly, one of the reasons that one would become pregnant is condom failure. Since it is either a failure on the part of the user or failure on the part of the condom that causes the pregnancy, I think using "failure rate" is the best choice. (Especially since the section is already titled "effectiveness in preventing pregnancy"). The one thing I would suggest is perhaps adding terms like "user failure" and "condom failure" and rename the 3rd subsection of the effectivness section "causes of condom failure" while earlier informing the reader about these two possibilities of failures and how they come into play in the failure rates of a condom in preventing pregnancy. DanielZimmerman 16:11, 26 February 2007 (UTC)
A pregnancy can result from a tear or puncture too small to be noticed. So use of a condom with no failure can result in pregnancy.
Pregnancy is highly unlikely to result if a condom breaks or slips off in the middle of intercourse, is noticed, and replaced with a second condom that does not break or slip off (see the coitus interruptus article for documentation of no viable sperm in pre-e fluid). So use of a condom that did fail can be highly unlikely to result in pregnancy.
Furthermore, the lowest reported breakage/slippage rate for the most experienced users is 1.0% per use. So if a couple used a condom 100 times in a year, that could correspond to a 100% chance per year of condom breakage or slippage. Taking the same 100 uses a year, a 2% annual pregnancy rate would come out to a 0.02% per use risk of pregnancy.
To me, the numbers do not make sense if one is trying to say the breakage/slippage rate is directly related to the pregnancy rate. Lyrl Talk C 23:09, 26 February 2007 (UTC)
Lyl, if the tear or puncture is too small to be noticed is still a failure. I will have to check out the article on the "no viable sperm in pre-e fluid" because that is something that I have never heard before. I have always heard that a woman can be impregnated by the pre-e in every sex ed class I have ever had. Your math is incorrect as well. If I have a coin I have a 50% chance of getting heads "per flip", that does not mean that in 2 flips I have a 100% chance of getting tails. Each use is an independent trial as well. If I use a condom 100 times in a year, that does not mean that I will have one of those condoms slip or break... i may, but it is not definite. DanielZimmerman 23:35, 26 February 2007 (UTC)
A tear or puncture too small to notice is not breakage or slippage. The failure numbers for condoms from breakage/slippage studies refer only to breakage and slippage. Claims that the per-use study results from breakage/slippage studies directly correlate to annual pregnancy rates (i.e. what do you think the 2-5% under the "perfect use" category is? It is the chance that those condoms will fail... it is "breakage and slippage" that can occur. and ..."typical use failure rate". The reason why it is 9% and not closer to the 15% because those studies don't include non-use.) are untrue.
Studies have been done testing vaginal fluids for PSA (a protein found only in human semen) shortly after intercourse. An example would be PMID 15504381 - researchers tested 243 women after they had intercourse using a condom that did not slip or break: 1.2% tested positive for PSA. PMID 10717781 found that, of 47 women who had used a condom that did not slip or break, 2% tested positive for PSA.
If 100 experienced couples used a condom an average of 100 times a year, they would, collectively, most probably experience 100 breakages and/or slippages. And 2 pregnancies. I understand that one breakage/slippage per couple would be extremely unlikely (and the Family Health International article describes how the distribution is far from random) - but I'm trying to illustrate the point that breakage and slippage numbers (100 in this thought experiment) do not directly correlate to pregnancy numbers (2 in this thought experiment). They are certainly a major factor, but I have never read any article claiming that all pregnancies among consistent condom users result from breakage or slippage.
Even by including all the possible ways semen can get into the vagina while using a condom - slippage, breakage, and "inapparent failure" as the Contraception article called it - there are different levels of failure. Having a condom slip or break early in intercourse, and replacing it, carries practically no risk of pregnancy. Having a condom break results in more than twice the semen exposure of a condom slipping off (PMID 12586324). Using a condom that broke results in less than half the semen exposure of unprotected intercourse (same study). Presumably a lower level of semen exposure translates into a lower risk of pregnancy, though I doubt the relationship is linear. Lyrl Talk C 02:56, 27 February 2007 (UTC)
A tear too small to notice is absolutely a condom failure and it is "breakage". What source are you reading that states that a tear is not a failure or is not breakage? The 2-3% rate under perfect use is ABSOLUTELY related to condom failure, breakage, or slippage. You may not have read an article claiming that pregnancies under "perfect use" are not from breakage or slippage. But answer me this... how else would someone following the condom guidelines perfectly become pregnant other than the failures of breakage (all forms of tears) and slippage? DanielZimmerman 15:19, 28 February 2007 (UTC)
To me, there is a big difference between a failure that was noticed at the time of use, and a failure that went unnoticed, both in the severity of semen leakage (probably much smaller if it went unnoticed) and in the implications for the users (having or not having the information they need to think about using ec, for example). Making the distinction more important in my eyes, the studies on breakage and slippage (that I have read) rely completely on user reporting. Failures that were not noticed by the couples are not included in the breakage/slippage numbers from those studies. So trying make a direct connection between the study numbers (failures observed by the users) and the pregnancy rate is missing an important part of the picture: "inapparent failure", as one of the PSA studies (PMID 10717781) called it. Lyrl Talk C 00:22, 1 March 2007 (UTC)

Reindenting: I would agree that a tear just a few pin holes wide and a huge gaping hole would havea difference. But they are still failures. I think the most important thing to note in all this is that when perfectly using the contraceptive method as described, condom failure (breakage, slippage, etc) plays a roll in the reason why someone who uses the method perfectly will still have a risk of pregnancy. DanielZimmerman 04:22, 1 March 2007 (UTC)

[edit] Failures during application issue.

Lyrl: you stated "Failures that occur during application generally pose no risk to the user". I have an issue with this statement. To me, this reads that if someone fails to apply the condom properly that there is no risk to the user and this is absolutely untrue. What exactly was the source trying to say and how can we word it differently? DanielZimmerman 15:04, 28 February 2007 (UTC)

I think what they meant was if the condom is obviously broken, the users notice, and replace it with a good condom. Feel free to reword it. Lyrl Talk C 00:25, 1 March 2007 (UTC)
That is very risky wording though, because if a failure in application (like using ones teeth to open the condom and causing a small tear that one might not see (given that many people do not have "good lighting" when applying a condom) happens, then the statement is clearly false and there is much to fear from that user. DanielZimmerman 04:18, 1 March 2007 (UTC)

[edit] Ghana

I removed the piece about Ghana because it was ignorant and quite racist. Without explaining on which aspects of Ghanian culture clashed with condom use, the previous author declared that Ghanians were unable to understand the consequences of not using condoms. If there are citations to the contrary, please disregard this. 212.219.239.213 15:59, 16 March 2007 (UTC)

I agree with your deletion of the content. I didn't notice it in previous revisions I made. JohnCub 16:06, 16 March 2007 (UTC)


[edit] Condom confort and sensations

Somwhere there should be something that explains that condom does indeed reduce the sensations of lovemaking, and can be quite unconfortable for men. I think it's just important to explain it.—The preceding unsigned comment was added by 136.206.1.17 (talk • contribs) 19:20, 20 March 2007 (UTC)

[edit] Sex education

Our article has a section on sex education, which is fine. What isn't fine is that the part devoted to discussion of opposition to teaching about condoms in sex education in one single country occupies about 80% of that section. This section is in severe need of balancing. This encycopedia isn't about one single country and religious opposition is--at best--peripheral to the use of condoms in sex education. --Tony Sidaway 15:47, 24 March 2007 (UTC)

I don't have information from other countries, so can't help with the balancing, but I pruned the U.S. section to try to cut down on peripheral discussion. Lyrl Talk C 15:51, 24 March 2007 (UTC)

[edit] Good article status

I think this article is close to being a good article. Is anyone else interested in helping polish and shine it, before submitting it for GA review? The issues I think which need addressing (see Wikipedia:What is a good article?) are

  • Length. Currently the article is 58kb, which is a bit longer than article size guidelines suggest is good. I already did a bit of trimming, but some additional places which could be cleaned up
  • Etymology/French letter/Other terms could be shortened
  • Prevalence and Laws sections can be combined. I don't think it would be a good idea to try and list the laws regarding condom access in every country. Perhaps if the specific countries listed could be worked into (shorter) examples of governmental restriction on access.
  • Other uses could probably be culled to only the notable examples of alternative condom uses.
  • Cite needed tags. There are many requests for citations. Some work is ahead at filling the bulk of the requests. In some cases, the claims may be incorrect or extremely rare, and thus we should just remove the claim.
  • I feel like History should be more prominent in the article (and perhaps etymology made a subset of it?)
  • General refocusing of the article on key topics and cutting back on the coverage of minor topics. (this one is a bit vague...)

What do folks think? Any takers on a concerted drive to improve the article and/or additional suggestions? --TeaDrinker 03:15, 7 April 2007 (UTC)

I'd like to help. Lyrl Talk C 18:04, 7 April 2007 (UTC)
I noticed TeaDrinker removed the citations for the sabotage paragraph in the "Causes of failure" section. That paragraph was discussed extensively about two years ago at Talk:Condom/Archive 2#Sabotage and the consensus at that time was to leave it in. I agree with the arguments Kasreyn made for keeping the paragraph. What are the thoughts of other editors? Lyrl Talk C 18:04, 7 April 2007 (UTC)
Thanks for the interest, the pointer to the old discussion, and as always, the superb work. My concern was the same as mentioned in the old discussion: the source fell short of being reliable in my view, and additionally may have moved on the interwebs. I have no problem with the inclusion of information about condom sabotage, but did not have any reliable citations. Some google searching, this source is marginally better, and may be sufficient, but there must be a proper study on it somewhere. This pdf also indicates male sabotage is supported. Would it be better worked into a larger section on barriers to effective use of the condom? --TeaDrinker 18:54, 7 April 2007 (UTC)
Thanks for the source suggestions; I'll take a longer look at that section tomorrow.
On article size, WP:SIZE says "Readers may tire of reading a page much longer than about 6,000 to 10,000 words, which roughly corresponds to 30 to 50 KB of readable prose." I copied the text into notepad and saved it on my computer; it was 37KB in size. So I think length-wise this article is in good shape. Lyrl Talk C 01:01, 8 April 2007 (UTC)

[edit] Something is missing in this sentence

"It is estimated that 61 million to 100 million condoms are improperly disposed of in Britain alone, often ending up in rivers or the ocean." It should have a time period, shouldn't it? 61 million in a day? a month? a year? —The preceding unsigned comment was added by 200.114.151.76 (talk) 22:37, 7 April 2007 (UTC).

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