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Share your dilemmas and get honest opinions from other Mumsnetters.

Condoms and rate of failure

107 replies

SisterAct123 · 14/02/2023 16:29

Condoms are also 98% effective at preventing pregnancy. This means that 2 out of 100 women using male condoms as contraception will become pregnant in a year. In real world use, about 15 in every 100 women a year who use condoms as contraception become pregnant (85% effective).

This is from the nhs website. How can they be so ineffective?

OP posts:
steppemum · 15/02/2023 17:56

BertieBotts · 15/02/2023 09:26

I think this is a societal myth - younger people are more likely to be on less-reliable forms of contraception and the costs are higher of an unplanned pregnancy so these pregnancies are more "visible" but I'm not sure that the rate of failure is actually higher when these things are taken into account.

I disagree, as I was told it by a medical professional on a talk about supporting teens.
Anyone using them for the first time without some explanation is likely to do things wrong. Eg not put them on properly, not withdraw as soon as ejaculation has happened etc.
That leads to failure rate.
This is of course not that the condom has failed, but rather that they are not being used correctly.

98% always sounds like a nice solid safe number, until you look at a year group on school, eg 200 kids. If they all paired up and all had sex, then there would be a pregnant teen. That is a much scarier, statistic.

QuietlyConfident · 15/02/2023 20:58

Talking about the stats that way round isn't that helpful I've always thought. If you're not very numerate then 95%, 98%, 99%, 99.5%, 99.6% all sound "really effective, you'll be fine". Even the "real world" condom failure rate of 85% effective sounds pretty good. But there's a world of difference between one in twenty and one in two hundred and fifty.

Sexypyjamas · 15/02/2023 21:22

We rely on condoms. I won't let DH inside without a condom on. When it's my fertile time I tend to not want sex because I'm that anxious about things going wrong with the condom. The pill made me feel suicidal so I had to stop it. Couldn't take Microgynon because of headaches. I refuse to have a coil fitted (heard horror stories). DH won't get the snip (he's scared of losing sensitivity or things going wrong). We use Durex and always check the expiry date. We are careful and check it hasn't slipped off mid sex. The condoms do hurt him a little and bigger ones could slip off, so we don't use the latter. I'm now a bit worried after reading this. I love sex with my DH but I'm terrified of getting pregnant at 40. I've never had problems with condoms in the past. I don't want to jinx myself.

xogossipgirlxo · 15/02/2023 21:51

Sexypyjamas · 15/02/2023 21:22

We rely on condoms. I won't let DH inside without a condom on. When it's my fertile time I tend to not want sex because I'm that anxious about things going wrong with the condom. The pill made me feel suicidal so I had to stop it. Couldn't take Microgynon because of headaches. I refuse to have a coil fitted (heard horror stories). DH won't get the snip (he's scared of losing sensitivity or things going wrong). We use Durex and always check the expiry date. We are careful and check it hasn't slipped off mid sex. The condoms do hurt him a little and bigger ones could slip off, so we don't use the latter. I'm now a bit worried after reading this. I love sex with my DH but I'm terrified of getting pregnant at 40. I've never had problems with condoms in the past. I don't want to jinx myself.

durex are very reliable, imo

BertieBotts · 16/02/2023 08:17

Condoms really do not have a 2% failure rate everytime you use them. It’s 2% over a year. So if the average women in the surveyed was having sex once a week then it would be around 50 times less likely to happen in one er, usage. So more like 2/ 100x50 or a 1/2500 chance of falling pregnant from that one off. Of course there are things that we could take into account to make that stat more accurate. Like what point in her cycle she had sex with condom-wearing man. The odds of her getting pregnant from unprotected sex are more like 80-95% over a year (depending on age) and depending on what point in her cycle the sex happened, you could be looking at odds more like 1/3 for a one off occasion.

But this is not quite right either. I know that you said that it matters where she was in her cycle, but it matters much, much, much more than you seem to be suggesting. It is not a 1/2500 chance per occurence of sexual intercourse because that is not how conception chance works. This is a huge misconception that many people have, myself included until I started to look into it due to infertility.

Basically, a woman can only get pregnant if she has sex during her fertile window. It does seem that some women can ovulate more than once so may have multiple fertile windows, though I really don't know how common that is. But in any case, although you would logically think that having sex 10 times during the fertile window would result in 10x higher chance of pregnancy than once, that's not actually the case at all. The reality is if you have sex even once during your fertile window, there is around an 80% chance that at least one sperm will come into contact with that egg. So it doesn't matter if you have sex multiple times or once, because you're already going to have a zygote get created more often than not. You'd have a slightly higher chance if having sex multiple times, but the main benefit (if TTC) or risk (if trying to prevent pregnancy) of having sex multiple times is that most methods we have to determine the fertile window are not particularly accurate and/or only work in retrospect, so if you only have sex once, you might miss the fertile window all together. Some TTC methods even refer to shagging every other day as "carpet bombing" which refers to the attempt to ensure that the fertile window is hit.

Now I'm sure you're going to say but wait, it's not an 80% chance of pregnancy after one fertile cycle, and you're right, because what happens next depends on the quality of the sperm and egg. Even in a young, healthy couple with no genetic issues or sperm issues, around 3/4 of the time, the body rejects this egg/sperm combo as being too low quality and it simply never gets to the stage of implantation and comes out with the woman's period. (Thus reducing the 80% to about 20% conception chance per fertile window) This is not a miscarriage, or even a chemical pregnancy, it's a failure of implantation. It happens before any of those things and it is quite common and normal and not even medically considered to be pregnancy at all. As both men and women age, their egg and sperm quality degrade, so you go from roughly a 20-25% chance of conception per cycle to a lower and lower chance the older that you get, that is the mechanism by how fertility declines with age, as well as of course menopause.

But this is why it doesn't matter how often you have sex and why percentage chances don't vary hugely between different couples even if one couple has sex once a month and another has sex every day. The fertile window is approximately 25% of a woman's cycle, but many people prefer not to have sex on their period, (and if you did, you'd know that you were not fertile) so that wipes out another 25% or so, and biology tends to mean that we are more likely to want to have sex during our fertile phase, so the chances of you having sex at a random time and it just happening to be within the fertile window are quite high, probably about 1/2 or 1/3.

Chance of pregnancy with condom used perfectly during fertile window = about 0.1% / 1 in 1000.
Chance of pregnancy with condom used perfectly during non-fertile part of cycle = essentially null
Chance of pregnancy with condom used perfectly, unknown time in cycle = maybe 1 in 2000-3000?

Hmmm OK so I actually came to the same conclusion as you in the end 😂 I think in a roundabout way, we agree, even though I thought that I was saying something different.

AndTheSurveySays · 16/02/2023 08:46

The condoms do hurt him a little and bigger ones could slip off, so we don't use the latter

If the condoms hurt they are too small and at risk of splitting. Too big and they slip off.
Try other brands. Pasante is well known and sold on the NHS site. Your husband could even get measured and try a more tailored condom from a company like MySize.

RosaBonheur · 16/02/2023 08:52

I used condoms as my sole method of contraception for about three months with my now husband when we were in a long distance relationship. One came off and I found myself crouching on the bathroom floor with my fingers in my vagina, rooting around up by my cervix to retrieve it. The next day I made an appointment to have a coil fitted.

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