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  • Title: Choosing condoms.
    Author: Billow JA.
    Journal: Am Pharm; 1992 Sep; NS32(9):55-8. PubMed ID: 1442556.
    Abstract:
    Condoms for men are currently the most effective of the nonprescription contraceptive methods. They are readily available, simple to use, and relatively inexpensive, and they are not associated with major adverse effects. If used both properly and consistently, condoms can significantly reduce the risk of transmission of HIV and other STDs. The protection offered by the latex condom may be increased by the concurrent use of a vaginal foam or cream containing nonoxynol 9. The practicing pharmacist should know about the variety of condoms available, be able to explain their correct use to maximize effectiveness, and compare condom use with other types of contraceptives. The practitioner should be available to answer patrons' questions and provide counseling on contraceptives and "safe sex" practices. In the US. condoms for males are made of either lamb cecum or latex. Lamb cecum condoms are less elastic than latex condoms. Thus, they can come off the penis making them less effective form of protection from sexually transmitted diseases (STDs). They are also more expensive. Condoms come in several varieties (reservoir end and lubricated with a spermicide, nonoxynol 9) and in several sizes (standard and large). Their contraceptive effectiveness ranges from 64% to 97%. Study design, patient characteristics, and socioeconomic status may explain this broad range. Breaking, improper use, and inconsistent use account for contraceptive failures. Use with vaginal foam reduces the failure rate to 1 to 3%. Some advantages identified by consumers and health workers were peace of mind, ease of use, convenience, preventing, STDs, arousing to put on, easily obtained, safe and effective, no side effects or toxicity, inexpensive, medical supervision not required, and can be used as a backup contraceptive. Some disadvantages include reduced sensation, breakage or slippage and improper use. Men and women sometimes suffer allergic reactions from the lubricants, spermicides, or chemicals used in manufacturing. Pharmacists could advise consumers to switch to another condom brand. If this does not stop the irritation, the consumer should see a physician because an STD may be causing the irritation. In vitro studies indicate that nonoxynol 9 kills or inactivates many STD pathogens including herpes simplex virus and HIV. A female condom should be available by the end of 1992. Trials show it to protect effectively against pregnancy and STDs. Even though neither the female condom nor diaphragm cause vaginal trauma, the condom does not change the vaginal flora significantly. Pharmacists should familiarize themselves with the different types of male and female condoms and be able to adequately counsel customers about their correct use and safe sex practices.
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