Dr. Rick, Are condom manufactures making stronger and more durable condoms, that are less likely to tear and break during sexual intercourse? Are "plastic" condoms less likely to rip and tear than latex condoms. Thanks a million.
Mr. Sowadsky's Response:Hi. Thank you for your question. In the United States, condoms must meet strict FDA (Food & Drug Administration) guidelines, before they can be sold here. I do not know condom guidelines for other countries. Before a condom can be sold in the USA, it must be proven to be safe and effective. If a brand of condom is found to break too often, it is not allowed to be sold. Most of the time condoms break is because they are not being used correctly. If condoms are used correctly, the chances of them breaking are actually very small. However, there is some variability in condom breakage rates between brands. Consumer Reports magazine did a brand-by-brand comparison of latex condoms in their May 1995 issue, with an update in the January 1996 issue. This is perhaps the best review I have seen of failure rates for latex condoms. Because Consumer Reports does not accept any advertising, they were able to be totally objective at rating one brand of latex condom versus another. Consumer Reports is available at most libraries, and is also available through several online services, including America Online, CompuServe, and Prodigy.
In regard to polyurethane condoms (plastic condoms), in the USA, these are sold under the brand name "Avanti." Presently they can only be sold for persons who are allergic to latex. When using polyurethane condoms, any type of lubricant can be used; this differs from latex condoms in which only water-based lubricants can be used. Like latex, polyurethane does not have any holes in it, and therefore provides an effective barrier against pregnancy, HIV, and other Sexually Transmitted Diseases (STD's).
As to the effectiveness of these condoms, final results are not yet available as to how well these condoms compare to latex condoms. The original version of the polyurethane condoms was very thin, and was found to have broken more often than latex condoms. These very thin polyurethane condoms were taken off the market, and were replaced by thicker versions of these condoms. Since these new versions of the condoms are thicker, they would be expected to break less often.
I have only seen one preliminary study comparing breakage rates of polyurethane condoms and latex condoms (see below). Because this is a preliminary report, we cannot say for sure if polyurethane condoms will protect as much as latex condoms. But like latex condoms, as long as polyurethane condoms are used correctly, and they do not break, they should protect against both pregnancy, and HIV/STD's.
There is also a female version of the polyurethane condom. For more information about the female condom, see the post, "Female condom and HIV"
If you have any further questions, please call the Centers for Disease Control at 1-800-342-2437 (Nationwide).
The male polyurethane condom: a review of current knowledge.
Condoms are one of the oldest form of contraceptive and the best recognized form of protection against sexually transmitted diseases. Their use, however, is limited by both behavioral factors and device-related factors, including complaints about decreased sensitivity and sexual enjoyment. To address these limitations, a male condom made of polyurethane was developed. Polyurethane is a strong impermeable material with good heat transfer characteristics that is less susceptible to deterioration during storage than latex. Because little information is available comparing polyurethane and latex condoms in terms of consumer preferences as well as breakage and slippage, we reviewed four pre-marketing studies of polyurethane condoms, one of which included comparison to latex. No significant differences in slippage and breakage rates between latex and polyurethane condoms were reported in the study that included a latex comparator, and other studies of polyurethane condoms alone resulted in rates in the same range as published for latex condoms. Subjectively, consumers expressed significantly greater preference for the polyurethane condom over latex in regard to appearance, lack of smell, likelihood of slippage, comfort, sensitivity, natural look, natural feel, and overall. While additional testing is needed, these preliminary results suggest that the male polyurethane condom reviewed performed at least as well as latex condoms and is preferred by consumers. If preference translates to greater use, the male polyurethane condom may address important barriers that have been linked with inadequate condom use in the past. These results, however, may not be generalizable to other brands of polyurethane condom currently under development.
Following an investigation of the Avanti condom, the Food and Drug Administration (FDA) allowed the manufacturer to replace the original thin polyurethane condom with a thicker version. London International Group made the switch in May 1996 but has not changed the packaging except to add a sticker on recent boxes that alerts customers that the condom is only approved for latex-sensitive users. Avanti was introduced in 1994 as a thinner, stronger, and more sensitive alternative to latex condoms. However, expectations that the product would revolutionize the condom market were not met, in part because of safety concerns. Although Avanti was approved by the FDA in 1991, the National Institutes of Health (NIH) ordered the company to develop a thicker condom, after further studies showed that its breakage rate was four times higher than that of latex condoms. The FDA allowed the thin version to be sold, however, because it was the only latex-free, HIV-impermeable condom available. Labeling on the condom noted that it was recommended only for latex-sensitive customers. Avanti grew in popularity until customers began complaining of frequent breakage. The thinner condom was then discontinued and replaced with the thicker version. FDA official Lillian Yin said a recall of the thinner condom was not necessary.
Senior Communicable Disease Specialist
NV AIDS Hotline Coordinator