The Condom FAQ:
CONSUMER REPORTS: HOW RELIABLE ARE CONDOMS?
This report looks at the reliability of condoms, and includes
Ratings, recommendations, and sections on using condoms wisely,
contraception and disease protection, condom failure, and two
nonlatex options.
CONSUMER REPORTS RATINGS
The CR Ratings list the tested PRODUCTs in order of burst INDEX,
the percentage of condoms that inflated to at least 25 liters in
air-burst testing. Products with a higher index should offer
greater assurance against breakage in use. Note: Products tested
were manufactured prior to the U.S. Food and Drug
Administration's (FDA) air-burst test requirements, which should
reduce the defect rate.
LUBR (lubrication) feel indicates which substances feel like oil,
glycerine or surgical jelly. A dash means the condom doesn't have
lubrication. SPERM is the percentage concentration of spermicide
nonoxynol-9 in the lubricant. It may offer some extra safety
against disease and pregnancy if a condom breaks. The extent of
the protection is unknown. A dash means the condom doesn't have
spermicide. SIZE, in millimeters, was measured on unrolled,
flattened condoms and are averages of several samples. Proper fit
affects comfort and may help avoid breakage or slippage. THICK
(thickness), in millimeters, is the average of three measurements
along the length of the condom. The typical condom tested is
about 0.07 millimeters thick. COST is the estimated average,
based on a national survey. A * indicates the price CR paid.
Except where noted, we purchased boxes of 12. The comments
identify textured condoms (raised bumps or rings) and contoured
condoms (flared out near the head).
Consumer Reports Ratings
37 tested
INDEX PRODUCT LUBR SPERM SIZE THICK COST
100 Excita Extra
Ultra-Ribbed,
spermicide Glycerine 8 193x53 0.07 $1.00
100 Ramses Extra Ribbed,
spermicide Glycerine 5 187x52 0.07 .99
100 Sheik Elite Oily -- 187x52 0.07 .53
98 LifeStyles
Vibra-Ribbed Glycerine -- 188x54 0.08 .44
98 Ramses Extra,
spermicide Glycerine 15 200x51 0.07 .75
98 Ramses Sensitol Oily -- 192x52 0.07 .83
98 Sheik Elite Ribbed,
spermicide Oily 8 190x51 0.07 .68
98 Sheik Elite,
spermicide Oily 8 190x51 0.07 .59
98 Trojan-Enz Large Jelly -- 214x56 0.07 .75
98 Trojan-Enz
NonLubricated -- -- 191x53 0.07 .47
97 LifeStyles Glycerine -- 186x54 0.07 .46
97 Touch from Protex,
A BEST BUY Oily -- 193x52 0.07 .31
97 Trojan-Enz,
spermicide Jelly 5 202x51 0.07 .64
96 Saxon Gold
Ultra Lube Jelly -- 191x51 0.08 .43
96 Trojan Magnum Oily -- 205x55 0.07 .69
96 Trojan Very
Sensitive Oily -- 206x50 0.07 .62
93 LifeStyles,
spermicide Glycerine 7 189x54 0.06 .45
92 Trojan Ribbed Oily -- 199x53 0.07 .64
91 Rough Rider
Studded Glycerine -- 186x53 0.10 1.04
88 LifeStyles Extra
Strength,
spermicide Oily 7 191x53 0.09 .65
83 Gold Circle Coin
Nonlubricated -- -- 184x52 0.09 .60
83 Sheik Elite Oily -- 188x51 0.06 .53
83 Trojan Naturalube
Ribbed Jelly -- 205x53 0.07 .66
83 Class Act Ultra
Thin &
Sensitive Oily -- 193x53 0.06 .33
83 Kimono Glycerine -- 193x52 0.07 .39
82 Pleasure Plus Glycerine -- 197x51 0.09 .98
78 Beyond Seven Oily -- 194x50 0.05 .50
78 Gold Circle
Rainbow Coin
Nonlubricated -- -- 180x51 0.08 .67
77 Sheik Super
Thin Glycerine -- 193x51 0.05 .62
64 Ramses Ultra
Thin Glycerine -- 190x51 0.05 .88
The following products, listed alphabetically, were downrated.
They had an overall burst-volume defect rate that exceeded 1.5%.
LifeStyles Ultra
Sensitive Glycerine -- 187x53 0.06 $0.46
Trojan Extra Strength Oily -- 198x53 0.07 .78
Trojan Mentor Glycerine -- 181x52 0.07 1.08*
Trojan Plus Oily -- 196x52 0.07 .66
Trojan Very Thin Oily -- 195x53 0.06 .64
Trojan-Enz Jelly -- 201x54 0.07 .58
Trojans Nonlubricated -- -- 200x53 0.06 .49
Note: Excita Extra Ultra-Ribbed, spermicide has been renamed
Sheik Excita Extra Ribbed. Sheik Elite (renamed Sheik Classic)
made in the U.S. is a higher-rated product. Sheik Elite made in
Japan is lower-rated (box flaps are marked). Ramses Extra,
spermicide now has 5% spermicide. Sheik Elite Ribbed, spermicide
has been renamed Sheik Classic. Sheik Elite, spermicide has been
renamed Sheik Classic. Touch from Protex is purchased in boxes of
13. Rough Rider Studded is purchased in boxes of 3. Gold Circle
Coin Nonlubricated is purchased in boxes of 6. Sheik Elite is now
discontinued. Sheik Elite made in the U.S. was a higher-rated
product. Sheik Elite made in Japan was lower-rated (box flaps are
marked). Class Act Ultra Thin & Sensitive is purchased in boxes
of 13. Gold Circle Rainbow Coin Nonlubricated is purchased in
boxes of 6. Trojan Mentor is purchased in boxes of 6.
Comments
Excita Extra Ultra-Ribbed, spermicide: Textured.
Ramses Extra Ribbed, spermicide: Textured.
LifeStyles Vibra-Ribbed: Wider than most. Textured.
Sheik Elite Ribbed, spermicide: Textured.
Trojan-Enz Large: Wider, longer than most.
LifeStyles: Wider than most.
Trojan-Enz, spermicide: Heavier lubrication than most.
Saxon Gold Ultra Lube: Contoured.
Trojan Magnum: Wider, longer than most. Heavier lubrication than
most.
Trojan Very Sensitive: Longer but narrower than most.
LifeStyles, spermicide: Wider than most. Heavier lubrication than
most.
Trojan Ribbed: Textured.
Rough Rider Studded: Textured. Heavier lubrication Than most.
Gold Circle Coin Nonlubricated: Shorter than most.
Trojan Naturalube Ribbed: Longer than most. Textured.
Class Act Ultra Thin & Sensitive: Wider than most
Kimono: Contoured. Lighter lubrication.
Pleasure Plus: Textured, with floppy pouch.
Beyond Seven: Narrower than most. Lighter lubrication than most.
Gold Circle Rainbow Coin Nonlubricated: Various colors,
contoured.
Trojan Mentor: Contoured. Has applicator and adhesive band.
Trojan Plus: Contoured.
Trojan Very Thin: Lighter lubrication than most.
Trojan-Enz: Wider than most.
Trojan Nonlubricated: No reservoir tip.
CONSUMER REPORTS RECOMMENDATIONS
Latex condoms work well, both to prevent pregnancy and to avoid
sexually transmitted diseases. Unless you know your partner is
uninfected, the Federal Centers for Disease Control and
Prevention (CDC) recommends for disease prevention that you use
condoms, start to finish, for all sex: vaginal, anal and
oral. There are important factors to consider when selecting a
condom. They include strength, sensitivity, size, lubricant,
spermicide and condom age.
Among the 30 products that passed CR's initial screening (in
which no more than 1 1/2% of condoms fell short of government
requirements), those with a higher Burst Index should minimize
the possibility of breakage during sex. But CR's findings don't
match the claims on several packages. Five tested condoms claim
to be strong (or stronger than some other brand), but only Ramses
Extra Ribbed Spermicidally Lubricated earned a top score on our
Burst Index.
When researchers asked a national sample of men in their 20s and
30s about condoms, the biggest gripe concerned sensitivity: Three
out of four complained that condoms reduce sensation. Some brands
claim to enhance sensitivity, but it's not clear how they do.
Some makers say a snug condom helps, but others say it's a looser
fit (Pleasure Plus has a floppy pouch near the head, for
instance). As a group, condoms promising sensitivity aren't
especially thin, by CR's measurements.
Even if a thin condom does heighten sensitivity, thin isn't
necessarily desirable. The following tested products were
thinnest, but they had some of the lowest burst scores:
o Beyond Seven (a Japanese import)
o Sheik Super Thin (an American product)
o Ramses Ultra Thin (an American product)
While these passed CR's minimum standards, they may not always
hold up as well as higher-ranked condoms. When inflated, one-
fourth to one-third of these thinner condoms did not reach the
crucial 25-liter mark before bursting. If you want to try some
"sensitive" products, it's safest to start with the higher-
scoring condoms that make this claim (such as the top-rated
Excita Extra Ultra-Ribbed) before trying thinner ones.
Condom size does matter. If a condom is too tight, it can be
uncomfortable and more likely to break. If it's too loose, it's
more likely to slip off. The width of the tested condoms varied
by 12%, product to product. Length varied by almost 20%. (Trojan-
Enz Large and Trojan Magnum claim to be larger than average. They
were, in fact, longer and wider.)
Using a lubricated condom is largely a matter of preference. If
couples wish to add their own lubricant, they should be certain
not to use petroleum- or mineral-oil-based products, which
rapidly weaken latex. Many condoms' lubricants include a small
amount of nonoxynol-9, a spermicide that promises extra
protection. But it's a promise without much proof. In the test
tube, nonoxynol-9 does kill sperm and inactivate a range of
microbes, including HIV. But no one knows if it works as well in
real use and if there's enough of it to make a difference if the
condom breaks.
As condoms age, the rubber in them may weaken, so it's a good
idea to avoid packages that are more than a few years old. (CR
found no sign of aging among the tested condoms, which were all
less than three years old.) Unfortunately, different brands date
products differently. Bear this in mind when you're checking the
label: Products containing spermicide are given a shelf life of
roughly two or three years (to assure that the spermicide still
works), while other condoms are allowed as many as five years on
the shelf.
USING CONDOMS WISELY
Most of the tested products provide adequate instructions, often
including pictures. But some print the information on the inside
surface of the box, which must be torn apart before the
instructions can be read. That's unfortunate, as good
instructions are key for people unaccustomed to using condoms.
Here are the most important points to remember:
o Open an individual packet only when ready to use the condom.
And open it gently, to avoid tearing the contents. If the rubber
feels brittle or sticky or looks discolored, discard the condom.
It's spoiled.
o Don the condom when the penis is erect but before sexual
contact. Place the tip of the rolled-up condom over the penis.
If there is a reservoir tip, first squeeze out the air. If there is
no tip, leave a half-inch space at the end for semen and squeeze
the air out.
o Unroll the condom down the entire length of the penis
(uncircumcised men should first pull back the foreskin).
o Right after ejaculation, grasp the condom firmly at the ring
and withdraw before losing the erection, to prevent spillage.
o Use a new condom for each act of intercourse. Never reuse
condoms.
o Store condoms in a cool, dry place. Heat, light and air
pollution can all hasten deterioration.
o If you want additional lubrication, use only water-based
lubricants, such as surgical jelly. Petroleum jelly and mineral-oil
products (baby oil, cold cream, many hand lotions) all rapidly
weaken latex. Even some lotions that easily wash off with water
may contain oils. Check the label.
If a condom does fail, both partners should wash their genitals
with soap and water. Urinating may also help to avoid infections.
If the breakage is discovered after ejaculation, having a
separate spermicide handy to apply quickly may help. Or a doctor
can prescribe an intense dose of birth-control pills, which will
block most pregnancies if used within 72 hours of intercourse.
CONTRACEPTION AND DISEASE PREVENTION
As a contraceptive, condoms are cheap and easy to obtain, and
usually cause no side effects. But they're not perfect. The
condom's reliability in preventing pregnancies depends on how
it's measured. Researchers don't count the number of individual
condoms that fail. They define contraceptive failure as the
percentage of women who use a given method but who nonetheless
become pregnant over a year's time.
For condoms, the typical failure rate is about 12%, somewhat
worse than birth-control pills (8%), but better than the
diaphragm (18%), withdrawal (19%) and rhythm (20%). [Source:
"Contraceptive Technology," Irvington Press, and Family Planning
Perspectives journal.]
Researchers know that, as with other
methods, the failure figures include many couples who don't use
contraception every time. If couples used condoms consistently
and correctly, researchers estimate, the condom's failure rate
would plummet to 2% or 3%, or perhaps even less.
As a means of preventing the transfer of disease-causing microbes
between sex partners, condoms have no equal. The condom shields
the penis from cervical, vaginal, oral or rectal secretions. At
the same time, the partner is protected from potentially
infectious semen and any lesions on the penis. The odds of
transmitting disease are cut nearly to zero if condoms are used
consistently and correctly.
The need for protection is apparently greater than many people
realize: Every year, 12 million Americans (one-fourth are teen-
agers) contract sexually transmitted diseases. Chlamydia, the
most common such disease but often unrecognized, can lead to
tubal scarring that experts believe is a key factor in the
quadrupling of ectopic pregnancies in the last 10 years. And AIDS
is still increasing in the U.S., particularly among women. (Gay
men still account for the largest number of AIDS cases. There's
concern that condom use is falling among younger gay men.)
Sexually transmitted diseases are virtually 100% preventable with
proper condom use. So well do latex condoms block germs that,
since 1987, the FDA has allowed condom boxes to list all the
diseases condoms help avert. More recently, the FDA told
companies that the message was so crucial, they should also print
it on the wrappers of individual condoms. Condom boxes warn that the
product is intended for vaginal sex, but health officials say it's crucial
to use condoms in anal and oral sex, too.
Over the decades since the latex condom's introduction,
epidemiologists have amassed considerable evidence that it does
cut disease rates, but not quite to zero. A 1992 review in the
American Journal of Public Health found that condoms on average
cut the risk of infection in half. But the authors said the
studies included many couples who failed to use condoms properly
or consistently. When couples are strongly motivated to use
condoms every single time, the score greatly improves.
Herbert Peterson, chief of the CDC's women's health and fertility
branch, cited two recent "blockbuster" studies on condoms' use
against HIV. Both focused on heterosexual couples, with one
partner carrying HIV at the start of the study, who continued to
have sex regularly for two years or more. In the first study,
Italian researchers followed more than 300 healthy women in
stable, monogamous relationships with HIV-positive men,
questioning the women closely about condom use and testing them
periodically for HIV. In the Italian study, among women whose
partners never or inconsistently used condoms, 12% eventually
were infected with HIV. But fewer than 2% of the women whose
partners always used condoms became infected. The second report,
from the European Study Group, showed even better results for
some 250 uninfected men and women with HIV-positive partners.
Among the half who used condoms inconsistently, 10% of the
previously uninfected partners acquired HIV. When condoms were
used all the time, HIV was never passed on to the healthy
partner, even though the average couple had sex about 120 times
over the course of the study.
CONDOM FAILURE
An estimated 2% to 5% of condoms tear during use. Most of those
failures are thought to stem from misuse, not inherent flaws. And
misuse is common: When the British Consumers' Association asked
some 300 English men to demonstrate putting a condom on a model
penis, nearly one in five got it wrong. They tried to unroll the
condom from the inside out. Bruce Burlington, who heads the FDA's
Center for Devices and Radiological Health, told CR's reporter
that the difference in quality between the best and worst condoms
on the market is "tiny compared with the problems that users
introduce."
When condoms do break despite being used correctly, it's probably
caused by hidden weaknesses in the rubber. Both manufacturers and
the government take steps to catch flawed condoms before they can
leave the factory. Manufacturers test each lot of condoms for
leaks and for strength, according to voluntary guidelines set by
the American Society for Testing and Materials. But those tests,
which destroy the condoms being examined, can be used only to
spot-check a batch of condoms, not to check individual condoms
before packaging and sale.
Companies can test every condom for leaks, with a gentler but
telling electrical procedure. In one variant of the test, each
condom is placed on a charged metal form and swept over by a
soft, conductive brush. Minute holes in the condoms trip
circuitry that shunts many "leakers" aside. Sometimes this test
finds thin spots as well. The FDA, which regulates condoms as
medical devices, sends inspectors to factories unannounced. They
review production records and examine stock at random, checking
for cracked, moldy, dry or sticky rubber. The inspectors also
test the condoms, until recently primarily with a water-leakage
test. In the water-leakage test, manufacturers pour 10 ounces of
water into a condom, then press and roll it along blotter paper.
If leaks turn up in the equivalent of more than 4 per 1,000
condoms in a run, the entire lot must be scrapped.
In 1993, the latest year for which CR could obtain data, the FDA
rejected 2 of the 44 lots of domestic condoms it checked for
leakage. The FDA tests every batch of imported condoms as well,
though imports account for very few condoms used in this country.
Although the smallest hole the water test can find is 100 times
bigger than the HIV virus, officials believe the water test is
sufficient. The laboratory and clinical studies of HIV persuade
them that smaller holes are rare or possibly even nonexistent.
But such minute holes are a problem for "skin" condoms, which are
made from a natural pouch in lambs' intestines.
TWO NONLATEX OPTIONS
If latex condoms irritate your skin, the culprit may be the
lubricant, the spermicide or the materials used in processing.
Try switching brands. If that doesn't work, you may be among the
small percentage of people whose skin is sensitive to latex
itself. You have two other choices in condoms, each with pluses
and minuses.
"Skin" condoms are made from a natural pouch in lambs'
intestines, and cost several times as much as latex ones. The
membrane is especially strong and may enhance sensitivity. The
downside: They have small holes. The microscopic pores in "skin"
condoms can be up to 1.5 microns across. Since sperm cells are
twice as wide as that, skin condoms still make an effective
contraceptive. But viruses and some bacteria are far smaller than
these pores. Lab work has shown that HIV and the herpes and
hepatitis-B viruses can pass through skin condoms. So these
condoms must bear a warning that they're not intended for disease
prevention.
CR examined Fourex and Kling-Tite Naturalamb brands. Fourex
condoms come folded, not rolled, inside plastic capsules (the
condom is pulled on, like a glove). We found the capsules
surprisingly hard to open. Kling-Tite may be easier to don
because it's rolled, like a latex condom. Skin condoms might slip
off some men during intercourse because both Fourex and Kling-
Tite are significantly wider than the latex condoms we tested: 78
and 68 millimeters, respectively (latex condoms average 52
millimeters). Fourex has a rubber band rolled onto the base of
the condom to prevent slippage. The Kling-Tite's elastic band is
sewn on more securely.
Last year, on the basis of limited testing, the FDA gave Schmid
Laboratories approval to sell its new Avanti brand, a clear
condom made of polyurethane. The agency justified approving the
product because it felt a pressing public-health need to offer
latex-sensitive people an alternative that could prevent disease
as well as pregnancy. The Avanti condoms first appeared in
Western states and should be available elsewhere by summer. But
it's unclear just how much protection they offer.
A label on the Avanti's foil packet declares it "effective"
against pregnancy and sexually transmitted diseases, while the
label on the box warns that "the risks of pregnancy and
STDs...are not known for this condom." The FDA says it has noted
the discrepancy. The packet label will be changed to match the
box. The manufacturer says it has demonstrated to the FDA that
Avanti does block viruses and neither slips nor breaks more often
than latex. Studies of its contraceptive value are under way.
CR bought Avanti and Avanti Super Thin, which cost us $1.75 each,
more than the most expensive latex condoms. Both products are in
fact the same condom. The Super Thins come with more lubricant.
In the lab, we found the condoms thinner than any conventional
condoms tested, roughly 0.04 millimeters (mm). They're also among
the shortest of condoms but wider than even larger-size latex
brands (60 mm versus 55 mm or 56 mm). That's probably because
polyurethane doesn't stretch as much as latex.
Despite the company's statements to the contrary, CR suspects
some men might have slippage problems. When we placed the Avanti
on a model of an average-sized penis, the condom could be pulled
off quite easily. Since Avanti isn't latex, the label claims that
any lubricant may be used safely. We cannot comment on the
Avanti's strength. Because synthetic condoms are so new,
researchers don't know how to compare their performance in
standard tests against that of latex condoms.
Copyright Consumers Union of U.S., Inc., May 1995
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