Condoms in the USA

What are condoms?

A condom is a barrier method: a thin layer of latex or another material that covers the penis during vaginal, anal or oral sex. It is the only contraceptive method that also reduces the risk of sexually transmitted infections (STIs). It is made to be durable, water-resistant and comfortable to use, and because it works well it is recommended for sex and also when sharing sex toys. Besides the one worn on the penis, there is also the female condom, which is placed inside the vagina.

Types of condoms

There are condoms by thickness, by material, by size and by extras such as taste or texture, from brands like Durex, Control, Pasante, SKYN, Sagami, Sico or EXS. Size is measured by nominal width, which is half the circumference of the condom when it is lying flat. As a guide, standard is 52-54mm; snug fit is 47-49mm; large is 57-60mm; and XXL is 64-69mm.

• Natural condoms: latex, lubricated and without additives. They are the basic option and the most common.
• Delay condoms: contain benzocaine on the inside to help prolong sex.
• Sensitive condoms: with reduced thickness (0.04-0.06mm) so you feel more without losing safety.
• Flavoured condoms: designed for oral sex with a condom, without the taste of latex.
• Latex-free condoms: made of polyurethane or polyisoprene, for anyone with a latex allergy.
• Dotted and ribbed condoms: have a raised surface with ribs, dots or both, to increase your partner's stimulation.
• Larger sizes (XL and XXL): with a nominal width of 57-69mm, for anyone who needs more room.

What the studies say

A Cochrane review of 14 studies of heterosexual couples in which one partner had HIV and the other did not (Weller et al., 2001, Cochrane Database Syst Rev) notes that consistent condom use was associated with a reduction of approximately 80% in new HIV infections. The figure refers to consistent use, not occasional use.

In a randomised trial with 4,884 condom-protected sex acts (Siegler et al., 2019, EClinicalMedicine), breakage or slippage were less frequent when lubricant was used, in both vaginal and anal sex.

In a crossover trial with 300 heterosexual couples (Potter et al., 2024, Reprod Health), ultra-thin polyurethane condoms had more total failures (breakage and slippage) than the latex condom they were compared with, although all had low failure rates.

Safety

Oil is the enemy of latex: in a laboratory test, sixty seconds of contact with mineral oil, present in many hand creams and lubricants, reduced the strength of latex condoms by around 90% (Voeller et al., 1989, Contraception). So if you use massage oils, keep them away from a latex condom. Before opening one, check the expiry date; store condoms away from heat, don't use two at once and use a new one every time you have sex.

How to choose

• Size: the product listing gives the nominal width; compare it with half the circumference of your erect penis.
• Thickness: if the listing gives the thickness in millimetres, the lower the number, the thinner the condom; sensitive condoms are among the thinnest.
• Material: latex or latex-free; if you or your partner has an allergy, look for “latex-free” in the listing.
• Lubrication: some come with extra lubricant or are “ultra lubricated”, which is useful if you notice friction.
• Extras: taste for oral sex, texture with ribs or dots, or a delay effect with benzocaine.
• Quantity: there are small boxes to try and large packs if you already know which one suits you.

Frequently asked questions

How do I find my condom size?

Measure the circumference of your erect penis at its widest part with a flexible tape measure, then divide by 2: that is your nominal width. If you measure 11 cm in circumference, you need a condom with a nominal width of 55mm. A condom in the right size doesn't feel tight, doesn't slip off and is barely noticeable.

Are extra-thin condoms less safe?

No. They pass the same certification tests (breakage, tensile strength and permeability) as standard-thickness ones. The sensation changes: a Sagami Original 002 (0.02mm) feels very different from a standard 0.07mm condom, but the protection is equivalent.

Can I use lubricant with condoms?

Yes, and it is recommended, because it reduces the risk of breakage from friction. With latex condoms, use only water-based lubricant or silicone-based lubricant, never oil-based, which degrades latex. With polyurethane (latex-free) condoms, any type of lubricant is compatible, including oil-based ones; as not all latex-free condoms are polyurethane, if the listing doesn't say it is oil-compatible, use water-based or silicone-based.

Which condoms are the safest?

The ones in your size, within their expiry date and used with lubricant. If there is no allergy, latex ones: in the Potter trial they failed slightly less than ultra-thin polyurethane ones, although all of them failed rarely.

Which condoms should I use the first time?

Natural or sensitive condoms in your size, with lubricant. If it is your first time with a condom, practise putting it on alone beforehand; if you put it on inside out, throw it away and use another.

Can I use a condom for anal sex?

Yes, with plenty of lubricant: the anus doesn't lubricate itself and friction increases the risk of breakage. Anal lubricants are designed for this.

Do I need to put a condom on a shared toy?

Yes. Change it every time the toy passes from one person to another and clean the toy afterwards.

Which condom should I use if I have a latex allergy?

A latex-free one. They come in polyurethane, polyisoprene and other materials, and the female condom is also available in a latex-free version.

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• CONTROL
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