Size Matters, Say Condom Experts

Almost half of men who use condoms find they are ill-fitting, according to new research, which can impair both sexual pleasure and the condom's protective abilities.

For the study, R. A. Crosby, of the College of Public Health at the University of Kentucky, and colleagues enrolled 436 men ages 18-67 who had used a condom for vaginal intercourse in the previous three months.

Of the men, 44.7 percent reported experiencing ill-fitting condoms. This alone more than doubled the risk of breakage, slippage, loss of erection, and difficulty of either partner reaching orgasm. Poorly fitting condoms were also five times more likely to irritate the penis. Problems related to fit made many users remove the condom during intercourse, with the consequent loss of its protection against STDs and pregnancy.

The authors suggested the study's findings show the need for public health messages to encourage men to buy the proper size of condoms. Since the study is based on self-reports, its data are somewhat limited, they acknowledged.

Another difficulty that needs addressing involves the terms that should be used to indicate condom size, the authors said. "The old saying is, 'Women don't have penis envy, men do,'" said co-author W.L. Yarber. Condom makers would be well-advised to label the smaller sizes "large," moving on to "extra-large" for medium and so on, Yarber suggested.

The full report, "Does It Fit Okay? Problems with Condom Use as a Function of Self-Reported Poor Fit," was published in Sexually Transmitted Infections (2010;86:36-38).

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