Dear Alice,

Could I have the final, definitive, last word on what type of contraception is best to use with a condom?


Dear Unsure,

In this particular case, the "best" contraception to use paired with condoms is the method that works best for you and your partner. A condom in and of itself is a birth control method with a failure rate of about two percent when used correctly and consistently. It also protects against most sexually transmitted infections (STIs)! However, since condoms are not always used perfectly, there are several contraceptives that can offer even more protection when combined with a condom.

Diaphragms, cervical caps, intrauterine devices (IUDs), birth control pills, and spermicidal foams, creams, or jellies will all contribute to greater pregnancy prevention effectiveness in combination with a condom. For example, when both are used as directed, a condom used in conjunction with a spermicidal foam, cream, or jelly provides close to 100 percent protection against pregnancy. As a side note, while spermicides such as nonoxynol-9 may offer an added layer of protection, they have been shown to actually increase the transmission of HIV and infection due the product's abrasiveness. 

Using contraceptives consistently and correctly will provide the most protection against pregnancy and STIs. Figuring out what you and your partner can realistically do every time while still enjoying your sexuality is key to determining the contraceptives that are best for you. Here are some questions to consider when choosing a secondary method of protection: Is pregnancy your only concern or do you wish to have protection against STIs as well? Are you or your partner comfortable inserting a diaphragm or cervical cap? Are you in a monogamous relationship or do you have multiple partners? Have you or your partner had past pregnancies? Do you plan to have children in the next five years or ever?

Speaking with your health care provider may help you and your partner determine which method is best for you. Also, check out the related questions as well as the Go Ask Alice! Sexual and Reproductive Health archives for more information on different types of contraception.

It's easy to get confused with all the different contraceptives that are available, so kudos to you for seeing out more information on the available options. As for a "final, definitive, last word," on the best contraception to use with a condom — that is for you and your partner to decide!


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