Dear Alice,

My boyfriend and I have recently decided that we will use condoms and spermicide for contraceptive purposes. We have begun experimenting with various brands/types of condoms, which has caused concern. Can you explain the various types of condoms, and/or the advantages/disadvantages of each, i.e., effectiveness, etc. Lambskin vs. latex vs. polyurethane??? We are monogamous and primarily concerned with pregnancy prevention.

Thanks for the help!

— Condom Confusion

Dear Condom Confusion,

As you've noted, condoms are made from a variety of materials — lambskin, latex, polyurethane, polyisoprene, and nitrile. Some already come coated with spermicide (more specifically, nonoxynol-9 or N-9), but what you might not know is that they may not provide any additional protection against pregnancy and sexually transmitted infections (STIs) — in fact, they may increase the risk for STI transmission, most notably for HIV. As such, it’s highly recommended to avoid using spermicide-lubricated condoms or spermicide as an additional lubricant when seeking to avoid pregnancies or STIs. A fun aspect of condoms is that either you or your partner can wear them since they come in both internal and external forms, commonly referred to as “female” and “male” condoms respectively. What’s more — all condom types provide similar protections against unintended pregnancies when used correctly and consistently! Read on to learn more about the condom options that are available and how to select the choice that is best for you and your partner.

To get into the nuts and bolts of condom choices, check out Time to go condom shopping! Brands, sizes, textures — What to buy? in the Go Ask Alice! Sexual and Reproductive Health archives, but here’s a quick overview: external condoms are made from latex, polyisoprene, polyurethane, and lambskin. Latex condoms are the most popular external condom; they are the most widely available and the least expensive on the market. If you’re looking for alternatives to latex, polyisoprene and polyurethane condoms could be an option. Similar to latex, polyisoprene condoms are a newer alternative made of synthetic material. They have a soft, natural feel that conforms to the skin. Some people claim that polyisoprene condoms are more comfortable than latex, but you’ll want to experiment as a couple to find which material suits your groove the best. Polyurethane condoms are stronger and thinner than latex condoms, and they transfer heat more efficiently, which may enhance sensation and feel as if there’s less of a barrier between you and your partner. Latex, polyisoprene, and polyurethane condoms are all effective at preventing pregnancy and protecting against the spread of STIs. Last but certainly not least, lambskin condoms are made from the oldest material on the market. The pores of the lambskin are small enough to prevent sperm from passing through but aren’t small enough to prevent viruses from passing through, making them effective for pregnancy prevention, but less effective for protection against STIs.

If you aren’t feeling the external condoms, you can also try using an internal condom. However, it’s imperative that only one of you wear a condom at a time, as two condoms of any kind together can create friction, causing one or both to break. The internal condom is a nitrile (synthetic rubber) sheath that's inserted into a vagina up to eight hours before sex. For more information on how the internal condom works, head over to What is a female condom? to learn more.

If you choose to use additional lubricant (some come already lubricated), you’ll want to consider the type of condom you’ve chosen; water- or silicone-based varieties are compatible with latex and polyisoprene condoms, as oil-based lubricants can break those materials down and reduce their effectiveness. However, oil-based lubricants are safe to use with polyurethane condoms. Adding extra water-based lube to an internal condom helps increase comfort and helps with inserting it. Check out What is lube? for even more information on the slippery stuff.

This may seem like a lot of information, so here's the primary takeaway: Each of these types of condoms offers approximately the same statistical effectiveness against pregnancy, which is your primary concern. When used consistently and correctly, it’s estimated that only two percent of couples who use external condoms will experience failure in the first year of usage. The same measure is about five percent for internal condoms; though the rate of pregnancy is higher, they’re still an effective method of pregnancy prevention. You may also decide to use a combination of birth control methods to avoid an unexpected pregnancy; using a hormonal birth control or the copper IUD with a backup method, such as an external or internal condom, may offer more protection than one method alone. If you choose to only use condoms, How to use a condom properly — avoid breakage and slippage can help ensure you are using them properly.

Though you expressed that you’re primarily concerned with pregnancy prevention, you and your partner may wish to consider choosing a condom that offers optimal protection against pregnancy and STIs. Other factors affecting your choice might include your budget, their availability, how they feel, your willingness to experiment, and your respective preferences. But now that you have all of this information, you and your partner get to have fun trying them out!

With all this condom talk, it’s time to wrap this up. Happy exploring!

Alice!

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