Q What happens if a condom comes off during intercourse? Can it come off during penetration, and if so, will it be "stuck" inside the female? If so, what then?

A Yes, a condom can come off during penetration, it can be stuck inside a female and semen spilled into the vagina can result in an unplanned pregnancy if the female is not on hormonal contraception.

Condom "accidents" are quite common. The most frequent mishap is a condom falling off. This is most likely to happen after the man wearing the condom has ejaculated and is "withdrawing." Once ejaculation has occurred, a man begins to lose his erection almost immediately, making the condom loose and more likely to slip off. Following ejaculation or loss of erection, the man wearing the condom, or his partner, should hold the condom in place at the base of the penis during withdrawal.

It's also not unusual for a condom to break while being put on the penis or during intercourse. One cause for this may be failure to leave a little tip of bagginess or reservoir in the condom at the tip of the penis when applying the condom. Another cause is using old condoms that have been exposed to excessive or extended heat (in the glove compartment of car, a wallet in a back pocket, etc.) causing deterioration in the latex. Of course, there's always the rare guy who, when erect, is just too big for the standard size condom (not as commonly the cause for condom tears, as most guys want to think!). In this case, larger sized condoms are available.

When a condom accident occurs, it's important to look at the condom to see if it is intact. If the entire condom came off during vaginal intercourse and is missing, it is usually an easy matter for a woman to remove the condom herself with a finger. However, if it's torn and the pieces can't be found in the vicinity, then it's likely they are stuck in the vagina. Since it can be difficult for a woman to find the pieces and remove them, it is quite common for women to come to UHS for "condom recovery."

And then there is the possibility of an unplanned pregnancy. If the woman is not on hormonal contraception, it is important to consider Emergency Contraception (Plan B -- two pills). Plan B is readily available by calling UHS at 863-0774.

It significantly reduces the risk for pregnancy following a condom accident and it can be taken up to 5 days post-mishap, but the sooner it's taken the more effective it is in preventing a pregnancy from occurring following a condom accident.

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This column is not intended to replace advice from your personal clinician. If conditions persist, see a clinician.