Condom

Health

A condom is a device, usually made of latex, or more recently polyurethane, that is used during sexual intercourse. It is put on a male's penis and physically blocks ejaculated semen from entering the body of a sexual partner. Condoms are used to prevent pregnancy, transmission of sexually transmitted diseases (STDs - such as gonorrhea, syphilis, and HIV), or both.

Overview

Male condoms are packaged in a rolled-up form, and are designed to be applied to the tip of the penis and then rolled over the erect penis. They are most commonly made from latex, but are also available in other materials. As a method of contraception, condoms have the advantage of being easy to use, having few side-effects, and of offering protection against sexually transmitted diseases. With proper knowledge and application technique - and use at every act of intercourse - condom users experience a 2% per-year pregnancy rate. Condoms may be combined with other forms of contraception (such as spermicide) for greater protection.

Some couples find that putting on a male condom interrupts sex, although others incorporate condom application as part of their foreplay. Some men and women find the physical barrier of a condom dulls sensation. Advantages of dulled sensation can include prolonged erection and delayed ejaculation.

Materials

Latex

Most modern condoms are made of latex. This material has outstanding elastic properties. Tensile strength exceeds 30 MPa. Condoms may be stretched in excess of 800% before breaking. Natural latex condoms have a minimum thickness of 0.046 mm.

Some latex condoms are lubricated at the manufacturer with a small amount of nonoxynyl-9, a spermicidal chemical. According to Consumer Reports, spermicidally lubricated condoms have no additional benefit in preventing pregnancy, have a shorter shelf life, and may cause urinary-tract infections in women. nonoxynyl-9 was once believed to offer additional protection against STDs (including HIV) but recent studies have shown the opposite to be the case. The World Health Organization says that spermicidally lubricated condoms should no longer be promoted. However, they recommend using a nonoxynol-9 lubricated condom over no condom at all. In contrast, application of separately packaged spermicide is believed to increase the contraceptive efficacy of condoms.

Polyurethane

Polyurethane condoms can be thinner than latex condoms, with some polyurethane condoms only 0.02 mm thick. Polyurethane is also the material of many female condoms.

Polyurethane can be considered better than latex in several ways: it conducts heat better than latex, is not as sensitive to temperature and ultraviolet light (and so has less rigid storage requirements and a longer shelf life), can be used with oil-based lubricants, is less allergenic than latex, and does not have an odor.

However, polyurethane condoms are more likely to slip or break than latex, are more expensive, and may not be as effective in protecting against STDs (large clinical trials have not been performed).

Lambskin

Condoms made from one of the oldest condom materials, labeled "lambskin" (made from lamb intestines) are still available. They have a greater ability to transmit body warmth and tactile sensation, when compared to synthetic condoms, and are less allergenic than latex. However, there is a great risk of transmitting STDs because of pores in the material. While the pores are not large enough to allow sperm through, much smaller bacteria and viruses may easily slip in and out between the condom.

Invisible

The Invisible Condom, developed at Université Laval in Québec, Canada, is a gel that hardens upon increased temperature after insertion into the vagina or rectum. In the lab, it has been shown to effectively block HIV and herpes simplex virus. The barrier breaks down and liquefies after several hours. The invisible condom is in the clinical trial phase, and has not yet been approved for use.

Spray-on

As reported on Swiss television news Schweizer Fernsehen on November 29, 2006, the German scientist Jan Vinzenz Krause of the Institut für Kondom-Beratung ("Institute for Condom Consultation") in Germany recently developed a spray-on condom and is test-marketing it. Krause says the advantages to his spray-on condom, which is reported to dry in about 5 seconds, is that it is perfectly formed to each penis.

Form

In recent decades, condom makers have diversified in colors, shapes, and thicknesses. Flavors or designs thought to have stimulating properties are sometimes added. Such stimulating properties include enlarged tips or pouches to fit the glans penis better and textured surfaces such as ribbing or studs (small bumps). Many condoms have spermicidal lubricant added, but it is not an effective substitute for separate spermicide use. Most condoms have a reservoir tip, making it easier to leave space for the man's ejaculate. Condoms also come in different sizes, from magnum to snug.

Testing

In 1990 the International Organization for Standardization (ISO) set standards for production, ISO 4074, Natural latex rubber condoms, and the European Union (EU) followed suit with its CEN standard, Directive 93/42/EEC concerning medical devices.

Condoms are tested for holes with an electrical current. If the condom passes, it is rolled and packaged. Batches of condoms are tested for breakage with air inflation tests.

In preventing STDs

According to a 2006 report by the National Institutes of Health, Recently, a number of Federal agencies sponsored a workshop to answer the following question: "What is the scientific evidence on the effectiveness of latex male condom-use to prevent STD transmission during vaginal intercourse?" This workshop was attended by 180 persons, and the data from numerous peer-reviewed published studies were discussed. Following the workshop, a panel of 28 experts worked to develop this report. [1] Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention correct and consistent use of latex condoms:

• reduces the risk of HIV/AIDS transmission by approximately 85% relative to risk when unprotected. See overall HIV transmission rates.
• reduces the risk of gonorrhea for men by approximately 71% relative to risk when unprotected.

A University of Washington study published in the New England Journal of Medicine in June 2006 reports that proper condom use decreases the risk of transmission for human papilloma virus by approximately 70%. The incidence of genital HPV infection was 37.8 per 100 patient-years at risk among women whose partners used condoms for all instances of intercourse during the eight months before testing, as compared with 89.3 per 100 patient-years at risk in women whose partners used condoms less than 5 percent of the time. Among newly sexually active women, consistent condom use by their partners appears to reduce the risk of cervical and vulvovaginal HPV infection

Other studies have shown that the proper and consistent use of condoms prevented HIV from spreading from an infected partner to a non-infected partner in every case.

While different studies show a wide range of results, every scientific study verifies that engaging in sex with a STD positive partner without a condom increases the chances of transmitting an STD when compared to sex with a condom.

Other sexually transmitted infections may be affected as well, but they could not draw definite conclusions from the research they were working with. In particular, these include STDs associated with ulcerative lesions that may be present on body surfaces where the condom doesn't cover, such as genital herpes simplex (HSV), chancroid, and syphilis. If contact is made with uncovered lesions, transmission of these STIs may still occur despite appropriate condom use. Additionally, the absence of visible lesions or symptoms cannot be used to decide whether caution is needed.

Female condoms

Recently "female condoms" or "femidoms" (not to be confused with femdoms) have become available. They are larger and wider than male condoms but equivalent in length. Female condoms have a flexible ring-shaped opening, and are designed to be inserted into the vagina. The female condom also contains an inner ring which aids insertion and helps keep the condom in place inside the vagina.

The female condom by Wisconsin Pharmacal

The female condom by Wisconsin Pharmacal (WP) is sold under the brand names listed below. It was formerly known as WPC-333 prior to recieving marketing rights. This product seems to be what is meant when referring generically to "female condoms". These are the only condoms that showed up when searching Ebay, Froogle, and Amazon.com (only checked 1st 120 results of 505 at Amazon) for "female condom" Feb 26 2007.

• Brand names: FC Female Condom, Reality, Femidom, Dominique, Femy, Myfemy, Protectiv' and Care
• Manufacturers: Wisconsin Pharmacal (Chartex was the former name of the manufacturer)
• Pre-lubrication / Spermicide: a distributer claims there is no spermicide, NCBI says the WCC-333 was lubricated with nonoxynol-9 "[The female condom has a] dimethicone lubricant, an inert, nonspermicidal silicone-based fluid"
• Material: polyurethane, newer versions may be made from nitrile

Materials

This type of condom was first made from polyurethane, though newer iterations are made of nitrile (this material change was announced in September 2005).

The newer nitrile condoms are less likely to make these potentially distracting noises. It is hoped the nitrile condoms will also allow for significant reductions in female condom pricing.

Female condoms have the advantage of being compatible with oil-based lubricants as they are not made of latex. The external genitals of the wearer and the base of the penis of the inserting partner may be more protected than when the male condom is used, however see studies below. Inserting a female condom does not require male erection.

Uses

Although marketed only for vaginal sex, some researchers promote use of the "female" condoms for anal sex between men.

Effectiveness of WP's female condom

Studies seem to show conflicting results as to whether WP's female condom offers better protection than male condoms:

• "Exposure to semen was significantly less (p = .001 and p = .03) when WPC-333 was used than when the male condom was used." [2].

• This site states it is less effective at preventing pregnancy "The label must compare the pregnancy rate for the female condom, which is approximately 26% per year versus 15% for the latex condom." "Wisconsin Pharmacal Co., studied 200 women who used the device for six months. In the study, the six-month pregnancy rate among U.S. women was approximately 12.5 percent, or an estimated 26 percent per year. This high rate is believed to have been the result of improper use of the device." [3]

• According to Contraceptive Technology: Eighteenth Revised Edition, the typical use failure rate for the first-generation female condoms lies at 21%. This means that of the women who intend to use female condoms as their only form of birth control, 21 out of 100 will become pregnant within one year. Among women who use the condom correctly at every act of intercourse, 5% will become pregnant after one year. The typical use for male condoms was 15%. The perfect use rates were 5% and 2% respectively.

The effectiveness of the female condom at preventing STDs has not been studied to the same extent as male condoms, however it has been put forth that it should have similar effectiveness to preventing pregnancy. They are also dangerous for those who have polyurethane allergies.

Costs, reuse, and lubrication of female condom

Total cost includes 3 factors:

• Per unit price : $4.70 (US) for 1 shipped - $21.75 for 10 shipped Feb 27, 2007 [4]
• How many times it is used
• Costs of compatible lubrication:
  • WP's female condom may come with a lubricant in a container
  • This water/silicone based lube is about $19 (US) shipped for 250 ml Feb 27, 2007
  • oils are possibly compatible with polyurethane female condoms

The per unit price of female condoms is higher than male condoms but there is some evidence to suggest that polyurethane female condoms can be washed, disinfected, and reused.

This site claims that using oil based lubricants may be fine for the penis but can clog pores and lead to infections in the vagina. Since Wisconsin Pharmacal's (WP) female condom is polyurethane and the majority of the lubrication would be on the penis side, oil may be a lubrication option. Both oil and a water based lube could be used, but only the minimal lubrication that is necessary to insert the condom, should be used on the side of the body cavity. The penis is meant to slip through the condom; the condom is not meant to slip through the body cavity or it may slip inside and allow contact. Warning: This author is aware of no studies of the effectiveness of WP's female condom using oil as a lubricant or using "too much" lubricant. Some males report that oil irritates the glans penis as this is a mucous membrane. Too much lubrication of the penis may contact the receptive partner's body. Too little lubrication may cause the outer ring to be pushed inside the cavity or breakage.

The following links are about re-using presumably the WP female condom. Re-using "female condoms" is not recommended, however the WHO says, "Batches of new, unused female condoms were subjected to seven cycles of disinfection, washing, drying and re-lubrication, reflecting the steps and procedures in the draft protocol, but at considerably higher concentrations of bleach and for longer durations. All female condom batches met the manufacturing quality assessment specifications for structural integrity after the test cycles. ... Disinfection, washing, drying, re-lubrication and reuse of the device were not associated with penile discharge, symptomatic vaginal irritation or adverse colposcopic findings in study volunteers." "CONCLUSIONS: From the results it can be concluded that washing, drying and re-lubricating the female condom up to ten time does not significantly alter the structural integrity of the device. Further microbiological and virological tests are required before re-use of the female condom can be recommended."

Female type condoms that may not be available

• The Barrier
  • Coverage / How it is held in place: It fits over the outer vagina and perineum and is held in place with thick elastic straps that encircle the women's upper legs. The tube-shaped pouch is about 1 1/2 times larger and 2 times thicker than a male condom. The penis never directly touches the woman's outer or inner genitalia
  • Material: latex
  • Cost of compatible lubrication: This water/silicone based lube is about $19 (US) shipped for 250 ml Feb 27, 2007

• The Bikini Condom
  • Coverage / How it is held in place: "looks like a G-string panty"
  • Effectiveness: thicker and less slippage than male condoms, a breakage rate of 0.5%, compared to 1-2% for male condoms
  • Advantages: condom pouch can be automatically introduced into the vagina with coitus, reported heightened sensation for women
  • Cost-- reuse: "can be used 5-10 times"

• Women's Choice Female Condomme
  • Coverage / How it is held in place: Has a 2-inch diameter flexible ring that covers the introitus, and a thickened dome of latex resembling a diaphragm at the deep end
  • Pre-lubrication / permicide: silicone lubrication

Anti-condom trends

Studies have shown baby boomers are increasingly contracting sexually transmitted diseases because they choose not to wear condoms. Many have been married, and separated, and now have random sexual partners. Several reasons for this choice are given. Since the women are no longer capable of conceiving children, they do not see the large risk in not protecting themselves, and thus the importance of a condom becomes minimal. Also, since many of them have just come out of a long term relationship, they are starting over and they are too uncomfortable with their new partner to ask them to use a condom.

The practice of barebacking in Western gay culture is another example of a trend away from condoms. Barebacking partners often know that they could reduce their risk of sexually transmitted infection by using a condom, but choose not to.

Laws and policies restricting condoms

Ireland

In Ireland, condoms (and other contraceptives) were originally available only to those with a doctor's prescription (finding a doctor willing to prescribe them was very difficult - almost impossible if one was unmarried) or via the black market (usually smuggled from Northern Ireland). This was later altered to being available only to those over the age of 18 in pharmacies in 1985. Sale outside of pharmacies was only legalised in 1993, although stores such as the Virgin Megastore had in fact been selling them openly since 1988. The age limitations were also removed in 1993.

Philippines

The Philippines is a predominantly Roman Catholic nation, and the Catholic Church is a powerful force in Philippine politics. The Church teaches that only natural family planning methods are moral ways to prevent pregnancy, and opposes promotion of condoms for any purpose.

While condoms are legal in the Philippines, the government will not promote them or pay for their distribution. As of 2004, several local officials - including the mayor of Manila - had banned distribution of condoms in government health facilities, and some locations even ban government health workers from discussing condoms.

Somalia

In 2003, a powerful Somalian Muslim group banned selling or using condoms in Somalia. The punishments for violating this include flogging. Islamic leaders say they have outlawed condoms in Somalia, where the vast majority of the population is Muslim

Environmental impact

While biodegradable, latex condoms damage the environment when disposed of improperly. It is estimated that 61 million to 100 million condoms are improperly disposed of in Britain alone, often ending up in rivers or the ocean. According to the Ocean Conservancy, these condoms cover the coral reefs and smother sea grass and other bottom dwellers. The Environmental Protection Agency (EPA) also has expressed concerns that many animals might mistake the litter for food.

Condoms made of polyurethane, a plastic material, do not break down at all. There have been no studies to determine if lubricated condoms take longer to biodegrade than non-lubricated ones, but it is believed that their landfill mass is negligible.

Etymology

The most likely origin of the word condom is from the Latin word condon, meaning receptacle.

Other explanations abound, however. Folk etymology claims that the word "condom" is derived from a purported "Dr. Condom" or "Quondam", who made the devices for King Charles II of England. There is no verifiable evidence that any such "Dr. Condom" existed. Other stories tell the word "condom" has its root in the 16th century: in particular, when Catherine de Medici married Henry II of France, she brought to France her minister Gondi and the architect Bernardo Buontalenti. Gondi and Buontalenti started producing special waxed protections to be used as condoms. The French soon called them "gondon"; "gondone" is today still used as a synonym of "condom" in Genova, Italy; "goldone", another variation, is still used in Milan, Italy.

It is also hypothesized that a British army officer named Cundum popularized the device between 1680 and 1717.

Zacharias P. Thundy states in "The Etymology of Condom" by (American Speech 60, No. 2, 1985) that condom is derived from condamina or house.

William E. Kruck has written an article "Looking for Dr Condom", Publication of the American Dialect Society, no. 66, 1981, which is a meticulous repudiation of all the "Dr/Colonel/Earl of Condom" myths about the origin of the condom. It disproves many other theories, e.g., that it was named after a town in France, named after the Latin condus named for the Persian kendü).

"French letter"

There are alternative etymologies for the condom:

1. Condom is sometimes considered a clinical expression, it is in fact intimately linked to the history of this fascinating item. In Britain a condom is also known as a French letter, much like the colloquial German word for a condom, "Pariser". English seventeenth century tourists, travelling through France on their pilgrimage to the center of ancient culture that was Rome, came across the town of Condom, Gers in southwestern France. It is said that there they made contact with ingenious French shepherds who were making prophylactics from sheep gut. A trade then ensued, whereby the English gentry would eagerly await their letters from France - French Letters - with a fresh supply of condoms. The French aristocracy then learned of these useful items from their English friends and called them "Capote Anglaise" - English Raincoats. Thus the condom came full circle, being made in France, being used in London, latterly in Paris, and finally being adopted by the Germans as a Pariser.

2. The English phrase "French letter" expresses the old image (or prejudice) that anything coming from France is decadent and has to do with sex. According to British military history, a Britain's Royal Guards Colonel named Condum, in seventeenth century (when Anglo-French enmity was at its mutual height) devised the French letter to protect his troops from the French by using it.

Other terms for condoms

In North America condoms are also commonly known as prophylactics. Many colloquial or slang terms exist, with usage localised across the English speaking world. Examples including "rubbers", "rubber johnny" (or simply "johnny"), "jimmy hats", "rain coats", "Hazmat Suits", "Rubber Straitjackets", and "love gloves". Condoms may also be referred to using the manufacturer's name e.g. "Durex".

In India they are called Nirodh, a government-promoted brand, and are supplied free of cost to the majority of the rural and poor population. They are also called "helmet" or "Topi" (caps in Hindi) or KS (after a condom brandname KamaSutra).

Among the Indian Gay and Transsexual Community it is called "Chocolates" as they are distributed widely for AIDS prevention.

Among Indian Muslims it is popularly known as "Parda" (veil or a curtain in Urdu).

In the Philippines, they are called "CD's" for the intentionally ambiguous effect. (when confused with Compact Discs that are also called CD's) They are also called "kapote" (Filipino term for raincoat).

History

An Egyptian drawing of a condom being worn has been found to be 3,000 years old. It is unknown, however, if the Egyptian pictured wearing the device intended to use it for contraception, or for ritual purposes.

In 16th century Italy, Gabriele Falloppio authored the first-known published description of condom use for disease prevention. He recommended soaking cloth sheaths in a chemical solution and allowing them to dry prior to use.

The oldest condoms found (rather than just pictures or descriptions) are from 1640, discovered in Dudley Castle in England. They were made of animal intestine, and it is believed they were used for STD prevention.

In 19th century Japan, both leather condoms and condoms made of tortoise shells or horns were available.

The rubber vulcanization process was patented by Charles Goodyear in 1844, and the first rubber condom was produced in 1855. These early rubber condoms were 1-2mm thick and had seams down the sides. Although they were reusable, these early rubber condoms were also expensive.

Distribution of condoms in the United States was limited by passage of the Comstock Law in 1873. This law prohibited transport through the postal service of any instructional material or devices intended to prevent pregnancy. Condoms were available by prescription, although legally they were only supposed to be prescribed to prevent disease rather than pregnancy. The Comstock Law remained in force until it was largely overturned by the U.S. Supreme Court in 1936.

In 1912, a German named Julius Fromm developed a new manufacturing technique for condoms: dipping glass molds into the raw rubber solution. This enabled the production of thinner condoms with no seams. Fromm's Act was the first branded line of condoms, and Fromms is still a popular line of condoms in Germany today. By the 1930s, the manufacturing process had improved to produce single-use condoms almost as thin and inexpensive as those currently available.

Condoms were not made available to U.S. soldiers in World War I, and a significant number of returning soldiers carried sexually transmitted infections. During World War II, however, condoms were heavily promoted to soldiers, with one film exhorting "Don't forget — put it on before you put it in." In part because condoms were readily available, soldiers found a number of non-sexual uses for the devices, many of which continue to be utilized to this day.

Other uses

Condoms excel as multipurpose containers because they are waterproof, elastic, durable, and will not arouse suspicion if found. Ongoing military utilization begun during World War II includes:

• Tying a non-lubricated condom around the muzzle of the rifle barrel in order to prevent barrel fouling by keeping out detritus.
• Because long-distance bombers often did not have toilet facilities, condoms could be used to hold urine. It was common practice to throw the filled condoms from the plane whilst at altitude over enemy territory
• The Office of Strategic Services ((OSS - the fore-runner of todays CIA} used condoms for a plethora of applications, from storing corrosive fuel additives and wire garrotes (with the T-handles removed) to holding the acid component of a self-destructing film canister, to finding use in improvised explosives.
• Navy SEALs have used doubled condoms, sealed with neoprene cement, to protect non-electric firing assemblies for underwater demolitions - leading to the term "Dual Waterproof Firing Assemblies."
• Spies during the Cold War used condoms to protect ultra-miniature Minox cameras and film for covert storage and transport.

Other uses of condoms include:

• Condoms have been used to waterproof boxes of matches and kindling, often by hikers and campers.
• Condoms can be used to hold water in emergency survival situations. The British Special Air Service (SAS) carry condoms as a method for carrying water in these emergencies.
• Condoms have also been used in many cases to smuggle cocaine and other drugs across borders and into prisons by filling the condom with drugs, tying it in a knot and then either swallowing it or inserting it into the rectum. These methods are very dangerous for if the condom breaks the drugs inside can cause an overdose.
• In his book entitled Last Chance to See, Douglas Adams reported having used a condom to protect a microphone he used to make an underwater recording. According to one of his travelling companions, this is standard BBC practice when a waterproof microphone is needed but cannot be procured.
• Condoms are used with wireless microphone belt packs to prevent sweat from entering the electronics.
• Condoms are used by engineers to keep soil samples dry during soil tests.
• Foot travelers in Amazon River Basin of South America wear condoms when wading through water to prevent a small catfish known as candirú from swimming into the urethra. The fish is attracted to the scent of blood and urine.
• In movies like The Incredible Shrinking Man, condoms filled with water are a cheap way to simulate giant raindrops.
• In special effects, condoms are often used as containers for fake blood on actors, bursting open upon detonation with a squib to simulate gunshot wounds.
• Condoms are used to cover endovaginal ultrasound probes for sanitary reasons during medical ultrasound examinations.
• Condoms are used as a one way valve by paramedics when performing a chest decompression in the field. The decompression needle is inserted through the condom, and inserted into the chest. The condom folds over the hub allowing air to exit the chest, but preventing it from entering.
• Condoms are used by geological engineers when using displacement rods/probes to measure soil resistance by the cone penetration test method. The condom is unrolled over the pointed metal probe head to protect delicate sensors near the tip during the initial penetration.

References

More information is available at [ Wikipedia:Condom ]

External links

• Information on condoms and condom use — from Planned Parenthood of America
• Fact sheet on condoms and sexually transmitted diseases — from the US Center for Disease Control.

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