Choosing Condoms Pharmacist counseling on the differences among available condoms can help maximize effectiveness in preventing pregnancies and STDs. by Joye Ann Billovv, PhD
The history of the condom goes back to medieval times when sheaths of linen or animal intestine were used. Today the condom is a sheath made of processed lamb cecum or latex that fits over the erect penis. This provides a receptacle that prevents semen from reaching the vagina and cervix. The use of condoms to prevent transmission of sexually transmitted diseases (STDs) and to prevent conception has changed little over the years. Concern about the potential side effects of the oral contraceptives and intrauterine devices stimulated condom use as a barrier method of contraception that is readily available without a prescription. Condom use, as a component of "safer sex" practices, is currently widely encouraged as a means to prevent the transmission and reduce the risk of certain STDs, including human immlllodeficiency virus (lIIV) which causes acquired immune deficiency syndrome (AIDS). This monograph reviews the types of condoms that are available and the advantages and disadvantages of their use.
Types of Condoms for Men
There are a variety of condoms currently available, including those marketed with the trade names Trojan, Fourex, and Ramses. Vol. NS32, No.9 September 1992/739
Two major types of condoms are available for men today: lamb cecum and latex. The lamb cecum condoms are not noted for elasticity; they may slip off the penis during intercourse or withdrawal. Although there are claims that they provide better transmission of body heat and therefore greater sensitivity, the lamb cecum condoms are more
expensive and provide less protection from STDsJ-3 The latex condoms are more elastic and therefore are more likely to remain in place on the penis during intercourse and on withdrawal. Besides the plain latex sheath, condoms are available in a number of variations: reservoir end, lubricated (wet and dry), spermicidally (nonoxynol 9) lubricated, thin latex, extra strength, tapered, contoured, ribbed, studded, textured internal surface, and colored. Most condoms are produced in a standard size; however, Hugger (Ansell) is smaller than the standard size and Trojan Enz Larger (Carter) and Magnum (Carter) are larger than the standard size. A new variation is Mentor (Carter), which provides an adhesive seal to secure it to the penis. 4
Contraceptive Effectiveness In theory, condoms should be completely effective in preventing conception. But according to Facts and Comparisons' review of contraceptive methods, 5 as the sole means of contraception, condoms have a failure rate ranging from three to 36 pregnancies per 100 sexually active women over the course of one year. Failures are attributed to the condom breaking, improper use, or inconsistent use. However, the comparison of contraceptive method reliability found in the USP DI gives a failure rate of 2%-14%. The broad range found within and between studies may result from study deSign, patient characteristics, and socioecoAMERICAN PHARMACY
nomic status. 1 When latex condoms are used with a contraceptive foam, the failure rate may approach that of the oral contraceptives, which ranges from
The history of the condom goes back to medieval times when sheaths of linen or animal intestine were used. Today the condom is a sheath made of processed lamb cecum or latex that fits over the erect penis. This provides a receptacle that prevents semen from reaching the vagina and cervix. The use of condoms to prevent transmission of sexually transmitted diseases (STDs) and to prevent conception has changed little over the years. Concern about the potential side effects of the oral contraceptives and intrauterine devices stimulated condom use as a barrier method of contraception that is readily available without a prescription. Condom use, as a component of "safer sex" practices, is currently widely encouraged as a means to prevent the transmission and reduce the risk of certain STDs, including human immlllodeficiency virus (lIIV) which causes acquired immune deficiency syndrome (AIDS). This monograph reviews the types of condoms that are available and the advantages and disadvantages of their use.
Types of Condoms for Men
There are a variety of condoms currently available, including those marketed with the trade names Trojan, Fourex, and Ramses. Vol. NS32, No.9 September 1992/739
Two major types of condoms are available for men today: lamb cecum and latex. The lamb cecum condoms are not noted for elasticity; they may slip off the penis during intercourse or withdrawal. Although there are claims that they provide better transmission of body heat and therefore greater sensitivity, the lamb cecum condoms are more
expensive and provide less protection from STDsJ-3 The latex condoms are more elastic and therefore are more likely to remain in place on the penis during intercourse and on withdrawal. Besides the plain latex sheath, condoms are available in a number of variations: reservoir end, lubricated (wet and dry), spermicidally (nonoxynol 9) lubricated, thin latex, extra strength, tapered, contoured, ribbed, studded, textured internal surface, and colored. Most condoms are produced in a standard size; however, Hugger (Ansell) is smaller than the standard size and Trojan Enz Larger (Carter) and Magnum (Carter) are larger than the standard size. A new variation is Mentor (Carter), which provides an adhesive seal to secure it to the penis. 4
Contraceptive Effectiveness In theory, condoms should be completely effective in preventing conception. But according to Facts and Comparisons' review of contraceptive methods, 5 as the sole means of contraception, condoms have a failure rate ranging from three to 36 pregnancies per 100 sexually active women over the course of one year. Failures are attributed to the condom breaking, improper use, or inconsistent use. However, the comparison of contraceptive method reliability found in the USP DI gives a failure rate of 2%-14%. The broad range found within and between studies may result from study deSign, patient characteristics, and socioecoAMERICAN PHARMACY
nomic status. 1 When latex condoms are used with a contraceptive foam, the failure rate may approach that of the oral contraceptives, which ranges from
