Condoms VS Birth Control Pills... What's the Difference?

So What's The Difference?

Have you ever wondered why condoms are called “birth control”, but at the same time, so are birth control pills? Is there any benefit to using condoms if you're taking birth control pills? The bottom line is that condoms provide protection against STI’s (sexually transmitted infections) in addition to preventing pregnancy. Birth control pills only prevent pregnancy. For opposite sex partners who are engaging in non-monogamous sex, or for couples who do not know their STI statuses, doubling up and using both methods may be a benefit. Condoms fall into a group of contraception called “Barrier Methods”, while birth control pills fall under the category of “Hormonal Birth Control”. What else is in these categories? Let’s break it down.

Barrier Methods

The most common way that sexually transmitted infections (STI) are spread is through unprotected sexual contact. Unfortunately, no birth control is able to prevent STI transmission - with the exception of barrier methods. Condoms, when used correctly and persistently, are the most effective method of preventing HIV and other STI transmission. They come in many different shapes, sizes, colors and flavors - here’s how to find the best barrier for you!
 

Why Use a Barrier?

These methods prevent STI transmission by providing a thin physical barrier that prevents direct exposure of skin and fluids between sexual partners. When used properly, they can significantly decrease the risk of transmitting STIs². 

At UCSB, 44.7% of students never use barrier methods when having sexual intercourse⁴. In contrast, 90.8% of students do use some form of birth control when having vaginal intercourse (penis-in-vagina)⁴. These numbers demonstrate that while most students use some form of contraception to prevent pregnancy, there is significantly less use of barrier methods to prevent STI transmission.

For UCSB students that have oral sex, this number is even higher - 92% of students never use a barrier method for oral sex.
 

What Barrier Methods Exist?

External Condoms
Humans have used condoms for over 3,000 years and while they may look slightly different today, they perform the same function. External condoms can be used for vaginal. anal, and oral sex. A new condom should be used for each orifice a penis is inserted into. This is the most common barrier method used by students at UCSB. While typically made out of latex, many brands also carry latex-free condoms for those that have latex allergies. 

Internal Condoms
Internal condoms, formerly called “female condoms,” are larger in size than external condoms and look like a large, loose-fitting nitrile pouch with a flexible ring at each end. Similar to external condoms, internal condoms can be used for vaginal or anal sex. Unlike external condoms, they can be inserted from hours to moments before intercourse. They cover the inside of the vagina or anus and parts of the labia to decrease the chances of contact with semen, pre-cum (cowper's gland secretions/pre-ejaculate) and skin. It can stay in place regardless of whether an erection is maintained or not.

Dental Dams
Primarily used during oral sex, dental dams provide a barrier between the vagina or anus and the mouth. Designed as a rectangular piece of thin latex, the dental dam is laid flat and held over the vagina, anus, and perineum (area between the genitals and anus) during oral sex. These are not effective for preventing STI transmission during penetrative sex. Dental dams can even be made yourself by cutting off the top of the condom, then cutting perpendicular to the bottom opening along the side. It prevents skin-to-skin STI transmission, fluid transmission, and fecal particle transmission (fecal particles can transmit hepatitis).
 

What Should I Check for When Using a Barrier Method?

After finding the barrier method that works best for you, it’s important to ensure that you’re using the barrier properly. 

Things to Check:

• Expiration date. Never use an expired condom or dental dam! These are more likely to break due to the material beginning to break down.
• Lube. Most condoms contain lube in the packaging, but having extra lube can be beneficial. The most common reason that condoms break is insufficient lubrication, so using lube with lubricated condoms will be the most effective. Anuses do not create natural lubrication during sex, so it is particular important to use lube during anal sex and reapply as often as needed.
• Condom size. Condoms are strong, elastic, and can stretch and expand to multiple times of its original size. Condoms that are too large are more likely to slip off, break, and even affect the ability to achieve orgasm⁵. To find the right fit for you, measure the length, width and girth of your penis using tailor's measuring tape (not metal) and compare it to your preferred condom brand’s size chart.
• Tears. There is a possibility that the condom may have torn while opening the package, so make sure to check that the whole condom is intact.

Why Are There Alternative Methods to External Condoms?

Internal condoms were created to provide women with an intravaginal barrier method that gives them greater control over protecting themselves against unwanted pregnancy or STIs. Since internal condoms can be inserted hours before sex, they can be a safe and easy way to prepare for sex ahead of time.

It’s important to note that while using a female condom, using a male condom is unnecessary. Doubling up will not provide extra protection since each is designed to be used on its own. In fact, using both forms of protection at once will increase the risk of tearing and condom failure. 
 

References

¹World Health Organization. (https://www.who.int/health-topics/sexually-transmitted-infections#tab=tab_1)

²World Health Organization. 
(https://www.who.int/reproductivehealth/topics/family_planning/condoms-safety/en/)

³Latka, M. Female-initiated barrier methods for the prevention of STI/HIV: Where are we now? where should we go?. J Urban Health 78, 571–580 (2001). https://doi.org/10.1093/jurban/78.4.571

⁴NCHA 2021 Data

⁵https://www.healthline.com/health/healthy-sex/condom-size-chart#condom-size-chart

https://www.plannedparenthood.org/learn/birth-control/internal-condom