Sex, condoms and lubricants: an interview with Dr Debby Herbenick

Interview conducted by April Cashin-Garbutt, MA (Editor)Jan 23 2013

Why is it important to study the use of condoms and lubricants?

Condoms and lubricants are widely used by both women and men and so they are part of many people’s sexual experiences. They are used for both pleasure-related reasons as well as, in the case of lubricants, comfort and making sex easier for people. The use of condoms of course reduces the risk of pregnancy or infection.

Condoms and lubricants are an important part of many people’s sex lives and we need to know how they play out in terms of the quality of people’s sexual experience.

How frequently are condoms and lubricants used?

It does depend on a lot of factors including:

• the person they are having sex with
• how old they are
• the type of relationship they are in

Overall, in this particular study, we had a nationally representative study of Americans aged 18 – 59, roughly around one fifth to a quarter of women and men used a condom during their most recent sexual act. Similar numbers of people used lubricants - a little bit less if they were using a lubricated condom.

That was just based on their most recent sexual act. Overall, most people in the US have used condoms. Most people in the US have used lubricants more than a few times in their lives. We need to know what people are doing with these products that they are adding to their sexual lives.

What are the main misconceptions about using a condom?

I think there are a lot of misconceptions about how condom use may or may not change sex. Health educators often recommend condoms, but sometimes people worry that they make sex feel less natural or less pleasurable. We haven’t found this to be the case when you actually look at people’s experiences of condom use.

What did your recent study involve?

This was a nationally representative study of Americans which actually came from a larger study – The 2009 National Survey of Sexual Health and Behaviour. We surveyed close to 6,000 Americans between the ages of 14 – 94 about their sexual lives. The survey included questions about sex over the course of their lives but it also included a large number of questions just based on their most recent sexual experience.

That latter part is what these data are from. We analysed the most recent sexual experience for 18 to 59 year olds. We looked into all kinds of factors that went into:

• what sex was like for them
• what they did
• who they did it with
• whether they used a condom
• whether they used lubricant
• their ratings of the experience

Then we were able to statistically analyse these and see whether using a condom or lubricant was linked in any specific way to their experience.

What did your research find?

We found that sex was largely rated very pleasurable and satisfying by women and men during their most recent act, whether or not they used a condom or lubricant. Those that used condoms found sex to still be highly pleasurable and highly arousing. There were still high rates of orgasm reported by both women and men.

What impact do you think your research will have?

Our research adds to an already existing and growing body of literature that shows that condom use in contemporary times is generally linked to sex that is pleasurable and arousing – just like sex without a condom.

We don’t have very good historical data to know if that was always the case. But certainly today’s condoms - which benefit from innovative design - give the opportunity for people to find a condom that works for their bodies, for their partner and for the experience that they are having.

In recent years too we have seen more types of lubricant. There used to be only a couple of different types of lubricants in stores, now we see there are so many different types of lubricant and that gives the consumer many more choices again to find something that works for them.

I hope what people will take from this is that if they want or need to use a condom or lubricant during sex that they don’t have to worry about it dampening sex in any way for them. Using a condom or lubricant can be part of a pleasurable sex life. So can not using one, but this really gives women and men more opportunities to create safer and pleasurable sexual experiences for themselves and their partners.

Your research found that women were less likely to know what material condoms were made of. What do you think were the reasons for this?

I think for the most part, at least in the US, we are still in a situation where men are more likely to be the people who are buying condoms and therefore making choices about condoms. Men are the ones looking on the shelf to see which ones that they want. Of course, if they are the ones bringing condoms to the sexual encounter they know what type of condoms they are.

In male-female couple situations if a woman is just using whatever her male partner provides, it is unlikely that in the moment she is going to ask to take a look at the box to see what type of condoms they are!

So, unless women are more actively involved in condom decisions it seems that they are just not aware of the type of condoms they are using as well as whether or not it is lubricated.

Do you think it is important for women to become more familiar with condoms and are there any plans in place to achieve this?

I do think it is important for women to learn more about condoms and about the kinds that fit with their bodies. I have been a sex researcher and a sex educator for more than a decade and over and over again I have encountered women who are knowledgeable about their bodies and condoms and who will say that certain condoms work better for them; are more comfortable for them and more pleasurable.

For women who know that they can make choices about buying the condoms they want or insisting to their partner that they get a certain brand or a certain style - that is important. It is important for pleasurable sex, for comfortable sex, and for preventing situations where people might unintentionally use a product that they are sensitive or allergic to (which is rare, but can happen).

I don’t see a lot of programs in place for enhancing women’s education of condom use. School-based sexual health education has long been at the heart of political struggles about whether or not information on condoms is included. Many people are increasingly advocating for including information about condoms as a safer sex device in school-based sexual education. Some communities are doing that well and some aren’t.

As somebody who teaches college human sexuality classes I still find that many of my students arrive at college without knowing very basic information about these important devices that could reduce their risk of pregnancy and reduce their risk of sexually transmitted infections including HIV.

How effective are condoms at protecting against sexually transmitted infections, HIV, and unintended pregnancies?

Condoms are extremely effective; in fact they are the only device that we have that protects against STIs and HIV. I think people often forget that. It is not like we have lots of different options to reduce the risk of STIs and HIV – we have condoms. We need to be teaching people how to use them correctly, how to choose condoms that fit with what they and their partner want out of a sexual experience, and how to use them in ways that don’t interfere with pleasure so that they do want to use them and use them in ways that protect them and their partner.

As for preventing pregnancy, we certainly have many options for birth control methods, including hormonal and non-hormonal types of birth control, and condoms are one of many highly effective methods available to couples.

How are you most likely to break or damage a condom?

Fortunately most people don’t break. Condoms are made well, they tend to be used well and they are packaged well. The materials that are chosen for condoms are materials that are very safe to use – after all, condoms are FDA approved devices They don’t break very often. When condoms are used correctly by people, they offer extremely high protection against both pregnancy and infection.

Should you use more than one condom at once?

No – only one condom should be used at at a time. Two condoms can rub against each other and cause more friction and that could lead to breakage. So it is not recommended that people ever use two condoms at once.

Can you be allergic to condoms?

People can be allergic to some materials used to make condoms such as latex. Fortunately there are many different condoms made from other materials. Polyurethane condoms are one example but there are some newer materials too. So if you do have a latex allergy or sensitivity to latex there are other options for you.

What are the main reasons why people are uncomfortable with using condoms?

I think a lot of it is just that they don’t have a lot of information or education about condoms and that needs to change. I certainly know that my college students have often heard about condoms, maybe they’ve seen them in their health classes if they were lucky, maybe their partner has even used one, but they are still sometimes shy about buying them at the store which doesn’t have to be the case.

Sometimes people are worried about using condoms correctly. Men can practise putting a condom on their penis during masturbation to make sure they know what they are doing. Women can always practise putting a condom on a banana or a cucumber or a dildo if they want to get better at putting one on. Luckily condoms are really not hard to put on – they are actually easy to use. Condoms come with package instructions, these instructions are also on the internet so people can find out how to do it and practise and then feel more confident doing it.

Where can readers find more information?

Our paper was published in The Journal of Sexual Medicine.

About Dr Debby Herbenick

Dr. Debby Herbenick is an Associate Research Scientist and Co-Director of the Center for Sexual Health Promotion at Indiana University’s School of Public Health-Bloomington.

She is also a sexual health educator at The Kinsey Institute for Research in Sex, Gender, and Reproduction and is the author of five books about sex and love.

Follow her on Twitter @DebbyHerbenick