The condom (either external, also known as a “male” condom, or a internal, also referred to as a “female” condom) breaks, and the panic begins. After all, that thin sheath may be the only thing protecting you and your partner from a sexually transmitted infection, a pregnancy, or both.

As scary as it can be, dealing with the situation promptly may make it less likely that you’ll face a serious outcome. At the very least, it’s a good time to take a look at how to choose and use external or internal condoms properly to avoid the problem in the future.

This article explains what to do if an external or internal condom breaks. It also offers some tips on how to prevent external or internal condoms from breaking in the first place.

Immediate Steps

If an external or internal condom breaks during sex, stop right then. You and your partner will need to consider a few questions:

  • Is the external condom still on the penis or is it inside the vagina or rectum?Were you just starting to have sex or were you near ejaculation?Did the breakage happen after ejaculation?

If the condom broke after ejaculation, it’s possible that there was an exchange of semen or other bodily fluids. Try to remove as much semen from the vagina or rectum as possible. You could try squatting and pushing as if you’re trying to have a bowel movement. You can also try sitting on the toilet and bearing down.

Afterward, you can gently wash the genital area with soap and water. Do not douche, scrub, or use a harsh cleanser or disinfectant.

Preventing HIV Infection

If you think fluids might have been exchanged and you’re not sure about your HIV status or your partner’s, the best thing to do is go to the nearest clinic or emergency room (ER) with your partner. This step is even more important if you know that one of you has HIV.

Douching can strip away protective bacteria from the vagina. It can also harm the tissues. Using a disinfectant can also damage cells. Harsh chemicals can cause inflammation that may raise your risk of HIV infection.

Explain to the ER doctor or nurse what has happened. You’ll likely be given a rapid HIV test to see if you or your partner have HIV.

Even if your initial tests are negative, your doctor may start you on a 28-day course of antiretroviral medication. More detailed HIV testing will be sent that may take a few days to return. With or without a negative test, the medication is started to slow the potential spread of the virus in the body. When you take it to prevent HIV infection, it’s called HIV post-exposure prophylaxis therapy (PEP). 

The treatment is usually a combination drug containing Truvada or Descovy (emtricitabine and tenofovir), plus Isentress (raltegravir) or Tivicay (dolutegravir).

Preventing Pregnancy

If an external or internal condom breaks and you’re not using another contraceptive, pregnancy is another possibility. If you’re in this situation, emergency contraception can prevent pregnancy.

Ideally, PEP should be started within 24 hours of possible exposure to HIV. It is often still effective if prescribed within 48 (and maybe 72) hours of exposure.

There are two main options, including two “morning-after” pills and placement of a copper intrauterine device (IUD) within five days of the scare. An IUD is a T-shaped device placed in the uterus or womb to keep sperm from fertilizing an egg.

Plan B One-Step

Available over the counter, the Plan B One-Step (levonorgestrel) pill is in a class of drugs called progestins. It works by preventing your body from releasing an egg or keeping an egg from being fertilized by sperm.

It is a single-dose contraceptive to be taken within 72 hours. There are several generic versions of Plan B One-Step, including Next Choice One Dose, AfterPill, My Way, and Take Action.

Ella

Another one-dose contraceptive is Ella (ulipristal acetate). You’ll need a prescription for this medication. It works by delaying or preventing the release of an egg, or by changing the lining of the uterus. It can be taken within five days, but as soon as possible is better.

ParaGard IUD

This birth control device is wrapped in copper. It slowly releases tiny amounts of the mineral into your body.

A copper IUD prevents pregnancy by making it harder for sperm to reach an egg. An IUD also changes the lining of the uterus. If it is inserted by a doctor within five days of unprotected (or condomless) sex, ParaGard can lower the risk of pregnancy by 99.9%.

How to Keep a Condom from Breaking

Use these tips to reduce the risk of a torn condom:

  • Never use an expired external condom or one that has been stored in either hot or cold temperatures (such as a wallet or the glove compartment of a car).
  • Don’t double up on external or internal condoms. Wearing two at once creates friction that can cause one of them to break.
  • Never use oil-based lubricants, such as Vaseline, and avoid spermicides that contain nonoxynol-9. They can inflame vaginal and rectal tissues. Look for an approved water- or silicone-based lubricant and use lots of it.
  • Use properly sized external condoms. An external condom that’s too big could slip off. One that’s too small is more likely to break.
  • Never reuse an external or internal condom.

Summary

If an external or internal condom breaks while you’re having sex, you can take steps to prevent a pregnancy and protect yourself from HIV. The first step is to try to remove any body fluids without using harsh chemicals or douches.

The next step is to visit a clinic or the ER to get tested for HIV. If you’ve been exposed, your healthcare provider might give you medications to combat the virus.

To prevent pregnancy, you can use a one-dose contraceptive pill. Copper IUDs also prevent pregnancies in emergency situations. The most important thing is to act quickly. Some medications only work if they’re used in the hours or days right after an external or internal condom breaks.

To protect yourself going forward, store your external or internal condoms in climate-controlled places, make sure you use the right size, and avoid doubling up or using products that can damage the external or internal condoms.

Frequently Asked Questions

  • What does a broken external condom look like?
  • It is easy to tell if there is an obvious rip, but smaller tears may be harder to see. If you are concerned about a broken external condom, check to see if there is any semen leaking out.
  • How can you remove a broken external condom from the vagina or rectum?
  • If you can comfortably reach in with clean fingers and pull out the external condom, it is safe to do so. It will be easier if you first relax your muscles. If you can’t reach it, a doctor can use a narrow tool to find and remove it.

It is easy to tell if there is an obvious rip, but smaller tears may be harder to see. If you are concerned about a broken external condom, check to see if there is any semen leaking out.

If you can comfortably reach in with clean fingers and pull out the external condom, it is safe to do so. It will be easier if you first relax your muscles. If you can’t reach it, a doctor can use a narrow tool to find and remove it.

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