Types of condoms

Dear Reader and Condom Confusion,

Kudos to you both for wanting to putting so much thought into your future condom purchases. With so many different varieties of condoms available on the market, making a decision about which one(s) to purchase may be overwhelming. Before getting into the details of condom selection, it’s good to know that in the United States, condom manufacturers must follow the Food and Drug Administration (FDA) standards, meaning that every condom is checked for defects using electronic testing before it’s packaged. But, no matter which brand or type of condom you settle on, you may rest easy that the condoms have low error rates if used correctly and consistently.

When making your prophylactic picks, it’s wise to consider the type, material, lubrication, size, texture, and novelty (flavors, etc.) that may be preferable for you and your partner(s). Here's a rundown on all your choices:

Type

• External (or male) condoms are barriers that are rolled on to the penis prior to sexual contact. They're available in various materials, lubrication preferences, and textures.
• Internal (or female) condoms are inserted into the vagina to create a barrier between partners. They're made of nitrile and come already lubricated (more on this in a bit). You could also insert this condom up to eight hours before having sex. 

External condoms are generally 98 percent effective in preventing pregnancy while internal condoms, though still effective, are closer to 95 percent when used consistently and correctly. Not using them in this way can reduce their effectiveness. This is worth considering when you're thinking about picking what type of condom is right for you and your partner. You may also take this into consideration if you're already using a second method of birth control such as the pill or an intrauterine device (IUD). 

Material

• Latex: The majority of external condoms manufactured and used in the US are made of latex (a substance derived from rubber trees). Condoms made from this material boast the widest selection of brands and types, are the least expensive, and are the most researched and regulated type of condom. Latex condoms are only intended to be used with water- or silicone-based lubricants (no oil, petroleum jelly, or lotion, please!). Some people are allergic to latex and may want to consider using non-latex condoms instead.
• Polyurethane: Made from a synthetic material similar to plastic, polyurethane external condoms are recommended for people who are allergic or sensitive to latex. They're clear in color, not as elastic or stretchy as latex, and are wider than the average-sized condom. They’re intended to be used with water- or silicone-based lubricants. Additionally, the material conducts heat well, which may create more sensation during sex. Polyurethane condoms are thinner than latex barriers and they tend to be pricier. Research shows that polyurethane condoms are effective in pregnancy and sexually transmitted infection (STI) prevention — nearly as effective as latex condoms.
• Polyisoprene: A newer type of non-latex external condom is also available. These synthetic rubber sheaths have a feel, durability, and elasticity more similar to latex than polyurethane. Polyisoprene condoms are held to the same industry standards and have passed the same physical test requirements that are required of latex condoms. Water- or silicone-based lubricants may be used with these condoms.  
• Lambskin: External condoms made of lambskin (the intestine of a lamb) are the oldest type of condoms. These condoms, or "skins," are effective in reducing the risk of pregnancy, but the same might not be said for reducing the risk of STIs or HIV transmission. Lambskin condoms have pores (much like your own skin) that may allow small particles, such as viruses and bacteria, to pass through. Lambskin condoms may offer a more natural feel and could be used with both water- and oil-based lube (unlike latex), but they tend to be the most expensive type of condom.
• Nitrile: Internal condoms are made with another synthetic rubber material called nitrile. Similar to the polyurethane material (of which internal condoms were previously made), the material warms up easily to body temperature. The switch to the new, less expensive nitrile material has made internal condoms more affordable. They’re typically found wherever external condoms are sold. Nitrile condoms are compatible with water-, silicone-, or oil-based lubricants.

Lubrication

• Non-lubricated: These external condoms are most useful for oral sex and for people with allergies or sensitivities to lubricants.
• Lubricated: Condoms with a water-based or silicone-based lubricant coating could ease penetration and minimize friction and the risk of breakage. To add your own water- or silicone-based lubricant to an external condom, apply a couple of drops to the inside of the condom before it’s rolled onto the penis, and then add more to the outside of the condom. Internal condoms come lubricated, but you may add additional lubricant if necessary.
• Spermicidally lubricated: Originally, spermicides (including nonoxynol-9 or N-9) was thought to reduce sperm mobility and thus reduce pregnancy risk. Studies have found though that N-9 may irritate or damage skin cells in the vagina or rectum, and therefore may actually facilitate the transmission of HIV and other STIs. Spermicidal condoms also cost more than non-spermicidal barriers, and they have a shorter shelf life.

Size

Most condoms (external and internal) are manufactured as one-size-fits-all. However, when it comes to external condoms, the standard sizes and the tightness of the elastic rings vary by manufacturer. They generally fit folks whose erect penis is average-sized — anywhere from four to seven inches when erect. Some external condoms are a snugger fit, while others are larger sized. It may be helpful to pick up a variety to figure out what’s appealing and fits for you and your partner. A snug, yet comfortable fit decreases the chances that a condom will slip off during penetrative sex.

Texture

When reading external condom packaging, brands list descriptive terms, such as ultra thin, sensitive, high sensation, or extra strength. Some people prefer thinner condoms that allow for more sensation. Others prefer thicker condoms to feel more secure (although studies have shown that ultra thin condoms are just as effective as regular condoms). Other choices include ribbed or studded condoms, which are designed to give one or both partners' increased pleasure. The use of these different types of textures is a matter of personal preference; there haven’t really been studies that rate the relative effectiveness. All condoms that are intended for sex, however, are FDA-approved and meet the agency's standards of effectiveness.

Novelty

Flavored external condoms (coated with lubes that contain sugar, corn syrup, or other fructose) are recommended for oral sex only. Why? Well, if inserted into the vagina, they could alter the vagina's natural balance of bacteria, setting the stage for an infection. Other novelty external condoms, including most glow-in-the-dark, may make great gag gifts but aren’t intended for use during any kind of sex. Unless they’re labeled as FDA-approved (which some are, so read carefully), these condoms don’t meet the FDA standards for protection against pregnancy and STIs.

Now that you know what to look for when purchasing condoms, it's time to make your selection. Before purchasing, you may want to talk with your partner(s) about condom options, or even share the experience of selecting condoms together. Purchases could be made in stores or online — but, there are places you might pick up quality prophylactics at no cost, such as a local reproductive health clinic or a university student health center (if you’re a student). What’s more, some people are brand loyal, while others sample different brands to find their favorite. Test-driving different brands with your partner could be fun! No matter the variety, though, if you open a condom that looks, smells, or fits funny, it’s good to throw it out and move on to the next. As another consideration, it’s wise to take note of those expiration dates once you've made your choice(s) and before you stock up.

Best of luck and have fun making your selections!