Say it with rubber

Condoms are trusty, well known, and well used by many of us for protection against sexually transmitted infections. We know the hassles, let alone the embarrassment, that using them can bring. But looking back over history we've never had it so comfortable, says Clare Hughes, and we shouldn't stop being safe because of some minor irritations

There was a time when buying condoms was excruciatingly embarrassing and resulted in the purchase of a year's supply of toothpaste. Now things have changed, and we can celebrate our more liberal attitudes in National Condom Week.

PORNCHAI KITTIWONGSAKUL/AFP
"We shouldn't stop being safe because of some minor irritations" A waiter from the Cabbages & Condoms restaurant

This special week is dedicated to the most popular contraceptive in the UK.¹ You may wish to follow the example of No Smoking Day and give condoms up, but celebrating with abstinence would not be most people's preference. Use the opportunity to "say it with rubber."

Dolphins and humans are the only animals to have sex purely for pleasure, but dolphins don't seem to contract sexually transmitted infections.² In humans, however, sexually transmitted infections are on the increase³ and, despite numerous health campaigns promoting safe sex, nearly a quarter of students never use condoms.⁴ This may be one reason why most new diagnoses were in people aged between 16 and 24³; perhaps student transmitted infections is a better description.

Older students who live off the campus are less likely to use condoms, reasoning that they are in more stable relationships than their younger counterparts in halls.⁴ But is it really safe to assume, before making a serious commitment, that partners are faithful; up to a third of people have extramarital sex?⁵

Condoms have a long and interesting history: the origin of the word condom is debatable. It could come from the Latin "condon" which means "receptacle." Alternatively, there are suggestions that it was named after Dr Condom, who supplied King Charles II with animal tissue sheaths to stop him from catching diseases from prostitutes.⁶

One hundred and sixty million condoms are sold in the United Kingdom each year; men buy over half of them.⁷ Self consciousness when buying these desirable unmentionables has a significant role in the high level of student condom evasion.

About three quarters of condom buyers are embarrassed when making their purchases, and as a result they purchase smaller packets less frequently.⁸ Vending machines in public toilets and purchase over the internet enable coy copulators to practise their hobby more safely.

Some men use the excuse that condoms cut off their circulation. The average erect penis is 16 cm long with a circumference of 13 cm.⁷ As condoms can stretch to longer than 90 cm and 45 cm wide before bursting,⁷ the risk of serious ischaemic damage seems unlikely.

A large assortment of condoms is available, capable of catering for every taste--literally. The textured varieties are designed to enhance the pleasure of sex; and before complaining that condoms reduce sensual pleasure, spare a thought for the unfortunate Japanese people who used to use tortoise shells or horns.⁹

Condoms have not always been as widely available as they are in today's consumer driven society. Imagine having to gut a fish before using its bladder for protection, like King Minos of Crete did in 3000 bc.¹⁰ Talk about spoiling the mood.

Cave paintings from ad 100 indicate that the French brought the condom to Europe. The first documentation of a penis sheath was in 1564 by the Italian anatomist Gabriel Fallopius. He had fallopian tubes named after him, but don't panic, he used linen for his sheath.¹¹

The Romans used sheep intestines to protect themselves but the outcome was a rise in infections.⁹ This is hardly surprising--after all, who wants to wrap sheep guts around their privates? In the 1700s such condoms were described as "an armour against pleasure and a cobweb against infection."¹¹

Reusable sheep intestine condoms were still available in the 1950s. After intercourse they were washed, slathered in petroleum jelly, and kept in a little wooden box on the bedside table. It is a sobering thought that our grandparents could have used this very method of contraception.

These trivia should not allow us to lose sight of one of the main objectives of the condom. Sexually transmitted infections, against which they guard, are not just about temporary discomfort but leave a legacy of ill health, infertility, and cervical cancer.¹² National condom week should serve to remind us of just how fragile we really are. The ultimate irony is that the act of creating life can also lead to loss of life.

National condom week begins on 7 May 2002.

Clare Hughes, intercalating medical student, Guy's, King's, and St Thomas's School of Medicine, London


studentBMJ 2002;10:131-170 May ISSN 0966-6494

1. Addenbrooke's NHS Trust. Be aware, be safe: get it on [press release]. Cambridge: Addenbrooke's NHS Trust, 2001 May 8. www.addenbrookes.org.uk/
   news/news2001/may/condomweek_080501.html (accessed 26 Mar 2002).
2. Diamond J. Why is sex fun? The evolution of human sexuality. New York: Basic Books, 1997.
3. Public Health Laboratory Service. Sexually transmitted infections in the UK: data tables. London: PHLS, 2001. www.phls.co.uk/facts/STI/files/sti_report2001_tables.pdf (accessed 25 Mar 2002).
4. Eisenberg M. Differences in sexual risk behaviours between college students with same-sex and opposite-sex experience: results from a national survey. Arch Sex Behav 2001;42:15.
5. Face reality statistical studies. Percentage of adults who have had extramarital sex. www.facereality.com/survey/statistics.html (accessed 26 Mar 2002).
6. Knowles, J. Notes on the history of the condom. www.plannedparenthood.org/articles/condomhistory.html (accessed 25 Mar 2002).
7. Durex. www.durex.com (accessed 28 Feb 2002).
8. Forgacs S. Few students carry condoms, study says. University of British Columbia Reports 1996 September 19:42. www.publicaffairs.ubc.ca/reports/se19/condom
   .html (accessed 25 Mar 2002).
9. Louk J. Condom history 101. http://kstatecollegian.
   com/ISSUES/v101/ (accessed 26 Mar 2002).
10. Brief history of condoms. www.postalcondoms.
    co.uk/history.htm (accessed 25 Mar 2002).
11. History of condoms. www.avert.org/condoms.htm (accessed 25 Mar 2002).
12. Public Health Laboratory Service. National condom week. London: PHLS, 2001. www.phls.co.uk/news/bulletins/2000/000512id.htm#2 (accessed 25 Mar 2002).