It has been suggested that using additional spermicide with condoms provides added contraceptive effect and protection from infection, and that water-based lubricants may lower condom breakage rates. This questionnaire-based study investigated the use of additional lubrication with condoms amongst 525 female students presenting for post-coital contraception, and the current and past experience of condom and additional lubrication use amongst 481 controls attending the same health centre. Of those requesting post-coital contraception, 83% claimed condom failure as the cause, with 66% of the control group having also experienced condom failure at some time. Use of additional water-based lubrication was significantly associated with lower condom failure rates (odds ratio 8.88, 95% C.I.: 3.79, 20.8). Gender, regularity of use of condoms and using oil-based lubricants were not associated with higher failure rates. Additional lubricant use was not significantly associated with increased condom slippage.
PIP: In England, general practitioners compared data on 525 female students presenting at the Rusholme Health Centre in Manchester for postcoital contraception during 1989-1993 (cases) with data on 481 students attending the same center over a 4-week period in 1993. They aimed to evaluate whether additional lubrication prevents condom failure. 15.1% of the controls who currently used condoms used additional lubrication compared to 2.1% of cases. 8 of the 9 cases who used additional lubrication used water-based lubrication. 13.3% of the controls who used additional contraception used water-based lubrication. 83.4% of the female students requesting postcoital contraception experienced condom failure within the last 72 hours. 65.6% of the controls who had ever used condoms experienced past condom failure. Use of additional water-based lubrication was significantly associated with a lower condom failure rate (odds ratio = 8.88). Condom failure was not associated with gender, regularity of use of condoms, and use of oil-based lubricants. Water-based lubrication did not significantly increase the risk of condom slippage. These findings suggest that use of additional water-based lubrication may provide extra contraceptive and STD (sexually transmitted disease) protective effects.