Dear Dr. Sara Why do condoms break during sex – is it because they’re too small?

A: Condoms usually break because they are not used properly!

Here are some practical tips to keep in mind when using condoms:

– Always check the expiration date on the condoms and use them within the recommended time.
– Pay attention that the package has not been broken because this could lead to the dryness of the condom and eventually shorten its time.
– Always take out the condom immediately before you put it on the sex toy or a penis to prevent the same effect (dryness).
– Don’t tear up condom’s pack with your teeth you might damage the condom.
– Never use a condom twice or between different forms of sex (oral, anal and vaginal). On the same note, if there is more than one partner involved, make sure you change your condom for each partner.
– Don’t wear condoms when fooling around and during foreplay, only put on before you have oral, vaginal or anal sex.
– During long courses of penetrative sex, it is wise to change the condom to lessen the chance of breakage.
– Usually condoms with extra strength are recommended for anal intercourse. They should be used with good amount of lubricant; otherwise the dryness and the fraction between the plastic and the body could rupture the condom.
– Always use condom compatible lubricant when using condoms. Using cream, oil-based lubricants and any other products will weaken the latex texture and will make it easier for the condom to break.
– Usually we recommend that men and women practice how to put a condom on. You can practice it on your partner, a dildo or even a banana so that both of you are confident and competent when the time comes to use your skills. This is a common belief that men should carry condoms and know how to use them but more and more women have realized that this is their responsibility as much as a man’s.
– During oral sex, wearing oil-based lipsticks could lessen the life of the condom.
– Some men don’t like to use condoms because they will lose their erections while reaching out to get a condom. This could be avoided by getting their partners involved, so that one can stimulate the penis and the other person puts the condom on.


A Million Dollor Question:Does Male Circumcision Affect Sexual Function, Sensitivity, or Satisfaction?

This is one of the most common questions I receive.

Circumcision of males is commonly carried out worldwide for reasons of health, medical need, esthetics, tradition, or religion. The debate over whether circumcision impairs or improves male sexual function or pleasure is controversial.

A new study aims to conduct a systematic review of the scientific literature (looking at the most relevant and reliable research on the topic to bring them all to one conclusion). A systematic review of published articles retrieved using keyword searches of the PubMed, EMBASE, and Cochrane databases was performed.

The main outcome measure is the assessment of findings in publications reporting original data relevant to the search terms and rating of quality of each study based on established criteria.

Searches identified 2,675 publications describing the effects of male circumcision on aspects of male sexual function, sensitivity, sensation, or satisfaction. Of these, 36 met our inclusion criteria of containing original data. Those studies reported a total of 40,473 men, including 19,542 uncircumcised and 20,931 circumcised. Rated by the Scottish Intercollegiate Guidelines Network grading system, 2 were 1++ (high quality randomized controlled trials) and 34 were case-control or cohort studies (11 high quality: 2++; 10 well-conducted: 2+; 13 low quality: 2−). The 1++, 2++, and 2+ studies uniformly found that circumcision had no overall adverse effect on penile sensitivity, sexual arousal, sexual sensation, erectile function, premature ejaculation, ejaculatory latency, orgasm difficulties, sexual satisfaction, pleasure, or pain during penetration. Support for these conclusions was provided by a meta-analysis. Impairment in one or more parameters was reported in 10 of the 13 studies rated as 2−. These lower-quality studies contained flaws in study design (11), selection of cases and/or controls (5), statistical analysis (4), and/or data interpretation (6); five had multiple problems.

This systematic assessment of the literature found that higher-quality studies (SIGN level 1++ through 2+) show that male circumcision has no adverse effect on parameters relevant to sexual function, sensation, sensitivity, satisfaction, or pleasure, especially when the circumcision is per- formed in infancy. The parameters that define sexual function include frequency of ED, PE, orgasm difficulties, difficulty with penetration, and dyspareunia. Future research should include more high-quality designs, such as large RCTs in devel- oped countries, physiological testing of men for multiple parameters, that have to date only been applied to individual study cohorts, more well- designed survey studies that limit recruitment bias, and improvements in existing questionnaires. Based on available data to date, it is likely that such high-quality studies will further confirm that cir- cumcision does not reduce any sexual function or sensation parameter, or diminish sexual pleasure.

The highest-quality studies suggest that medical male circumcision has no adverse effect on sexual function, sensitivity, sexual sensation, or satisfaction.


Quality of Online Sex Education Material

A recent study published by the Journal of American College Health, states that little is known about the quality of online sexual health information, how young people access the Internet to answer their sexual health questions, or an individual’s ability to sort through myriad sources for accurate information.

The purpose of this study was to determine how college students search for online sexual health information and whether they retrieve accurate answers to sexual health questions. The Internet has become the leading source for sexual health information. Based on their findings, the authors argue that young people must be educated about how Web search engine results are prioritized/displayed and trained to evaluate Web sites for reliable information.

Most students found accurate answers to the 12 sexual health questions posed. Finding local information and resources online proved more difficult than finding answers to general sexual health questions.

In my years of work with young people, I found this single access issue to be the root-cause of young people delay in getting help when they need it. In my own research (2010) I also found that young people care about the setting that they seek help from (they don’t like getting attitudes just for being sexually active and tend to not seek help if they feel there will be any judgements. They don’t like to be “preached” about how wrong their actions were, but rather, they would like to receive information to solve their immediate problem (mostly in young men) and get the support and counseling they need to overcome their fears and decide over the further actions they need to take (in the case of unintended pregnancy specifically).

Lack of information about the local resources and services is one thing and mixed messages is another. For example, most young people are familiar with Planned Parenthood (at least the name) but the name of this organization is so tightly associated with abortion that many people forget they offer low cost STI screening and treatment as well. I also argue that College students are in a much better place because at least they could access the school nurse but young adults who are not in educational settings or a structured employment setting that has an on-site health care professional are the most vulnerable.


A cost for casual sex

The Journal of Sex Research found there may be a mental cost associated with casual sex, among U.S. college students, and how it manifests itself appears to be somewhat gender-specific. The study was conducted across 30 college campuses nationwide, with more than 3,900 students surveyed. For the purposes of the research, “casual sex” was defined as intercourse between two people acquainted less than a week.

The findings discovered the idea of casual sex was negatively associated with a person’s well-being and positively associated with psychological stress. Women were found to view the practice more negatively than male counterparts, and a double standard of men being accepted more for having multiple partners may be exemplified here.