The male condom is a thin sheath made of latex, natural animal membrane or synthetic material that fits over the erect penis and prevents semen from entering the vagina and cervix during ejaculation. Most of the currently available male condoms in the US are made of natural rubber latex. Latex condoms provide dual protection against unintended pregnancy and many sexually transmitted infections. Latex condoms are not compatible with oil-based lubricants or medications and cannot be used by persons with latex sensitivity or allergy. A small proportion of male condoms are manufactured from the intestinal cecum of lambs (“natural skin,” “natural membrane” or “lambskin” condoms). Any type of lubricant can be used with natural membrane condoms, but they are not recommended for prevention of sexually transmitted infections because they contain small pores that may allow the passage of viruses, including hepatitis B virus, herpes simplex virus, and HIV. Nonlatex condoms made of polyurethane film or synthetic elastomers are generally nonallergenic, compatible with both oil-based and water-based lubricants, and have a longer shelf-life. Synthetic condoms are associated with higher rates of clinical breakage and slippage than latex condoms, which may affect their efficacy against sexually transmitted infections and pregnancy. Condoms prelubricated with the spermicide nonoxynol-9 are no more effective than other lubricated condoms, have a higher cost and shorter shelf-life.

With correct and consistent use, male condoms have an annual 2% failure rate. The typical-use annual failure rate is about 15%. Most failures with this method of contraception occur in the first year of use because the condoms are used incorrectly or not at all. A new condom should be used at every coital exposure. The condom should be applied before any genital contact. The rolled-up condom is placed on the tip of the erect penis. The small pouch at the tip of the condom accommodates ejaculated semen and is grasped while the condom is unrolled over the entire length of the penis. Immediately after ejaculation, the condom should be grasped at the base of the penis and the penis withdrawn from the vagina while still erect to avoid leakage of semen. If the condom breaks or falls off during intercourse but before ejaculation, it should be replaced with a new condom. New condoms should also be used for prolonged intercourse and for different types of intercourse within a single session. The condom should be observed for visible damage after it is removed. There is a risk of pregnancy and infection if the condom breaks, falls off, leaks, is damaged or is not used at all.

The advantages of male condoms include easy accessibility without a prescription, medical examination or special fitting; easily reversible when pregnancy is desired and have no systemic effects; protect against sexual transmitted infections; are inexpensive, easy to use, and easily and discretely carried by men and women. Disadvantages include lower efficacy with typical use than some other nonbarrier methods; disruption of foreplay to put the condom on; reduced sensitivity during intercourse and difficulty for some males to maintain an erection while wearing the condom; partner co-operation is required, and some individuals are sensitive or allergic to latex.

In 1994 the female condom was approved for marketing in the US. The female condom is a soft, loose-fitting polyurethane sheath with two flexible polyurethane rings designed for vaginal use only. One ring lies within the closed end of the sheath and is used to insert and retain the sheath in the vaginal vault. The second ring forms the external open edge of the device and remains outside the vagina, covering the external female genitalia after insertion. The female condom is nonallergenic. There is a silicone-based lubricant on the inside of the condom but additional water- or oil-based lubricants may be used.

The female condom prevents pre-ejaculatory fluid and semen from entering the vagina and is used for a single act of coitus. It can be placed in the vagina up to 8 hours before initiating sexual activity and can remain in the vagina for several hours following ejaculation. Theoretically the female condom offers a greater degree of protection from sexually transmitted diseases, especially those transmitted via skin lesions or shedding, than the male condom, due to the external ring forming a physical barrier over the labia. Laboratory data suggest that the female condom provides an impermeable barrier to HIV, cytomegalovirus and other sexually transmitted infections. No clinical studies have specifically evaluated the ability of the female condom to prevent HIV transmission.

Failure rates for the female condom are extrapolated from results of a 6-month trial with the assumption that the probability of pregnancy in the second 6 months of use would be the same. The annual failure rate of the female condom with correct and consistent use is 5%. The annual typical-use failure rate of this method is 21%. The female condom should not be used with a male condom as friction between the two condoms may cause breakage.