Latex was first used for condoms ar...

Latex was first used for condoms around 1850 and remains the in the greatest degree common material despite significant disadvantages. An estimated 7 percent of the general population (and up to 25 percent of health care workers) are allergic to latex. Other disadvantages include short shelf life, vulnerability to failure if used with oil-based lubricants, moot points with correct usage, inhibition of sensation, and relatively subdued conduction of heat compared with other materials. Loose-fitting polyurethane condoms were unfolded as an alternative for latex-sensitive living bodys and may be easier to use and provide greater sensitivity than latex. Steiner and colleagues studied the effectiveness and acceptability of polyurethane condoms compared with latex condoms in a randomized controll trial.

They recruited 900 healthy couplings from 10 U.S. sites. application of mind participants had to be in a stable, mutually monogamous relationship, have at least six episodes of sexual intercourse through month, and be willing to use single the type of condom provided during each act of vaginal intercourse. Women were required to have a history of regular mense when not using hormonal contraception and could not have had any novel abnormal Papanicolaou smear findings other than inflammation, infection, or atypical squamous lonely dwellings of undetermined significance. Women could not have evidence of infertility, genital tract disease, or sexually transmitted disease, including human immunodeficiency virus infection. If women had used an injectable contraceptive, the last injection must have been six month before the meditation and they must have had at least pair normal menses since the last injection; if they had used an oral contraceptive pill, they must have had at least single in kind normal menses since discontinuing the pill.

The ties were randomly assigned to receive latex or polyurethane condoms. All participants received comprehensive instructions in succession condom use, and women were touchstoneed for pregnancy at the beginning of the investigation and at weeks 4, 10 16 and 22 Women were interviewed by means of telephone at week 26, and as well-as; not only-but also; not only-but; not alone-but partners were interviewed at the clinic at week 30 In addition, all participants complet questionnaires at week 4 and were asked to report all adverse weights or suspected pregnancies.

The sum of two units groups were similar in all important characteristics. The rates of discontinuation and reasons for doing with equal reason were similar. The probability of pregnancy occurring in six month of typical use was 90 percent for polyurethane condoms (95 percent confidence interval [CI], 59 to 122) and 54 percent for latex condoms (95 percent CI, 29 to 78) Polyurethane condoms were more likely to break (38 compared with 12 percent) or slip (49 compared with 20 percent) Polyurethane condoms were associated with les local irritation, and men and women rated them significantly higher than latex condoms for comfort and sensitivity. Although users of polyurethane condoms reported lower confidence in this performance at the beginning of the thought they were more likely than users of the latex condom to commit the product to a friend. However, this difference had disappeared according to the final week of the thought The groups rated both shadows of condom equal in ease of use.

The authors gather that polyurethane condoms were not as effective as latex in preventing pregnancy, on the other hand that both offered pregnancy protection in the range of other barrier regularitys of contraception. Persons who find latex condoms unacceptable may fancy polyurethane condoms because of increased sensitivity and a lower rate of local irritation. For ones with latex sensitivity, polyurethane condoms provide a well adapted alternative.

ANNE D WALLING, MD

Steiner MJ et al. Contraceptive effectiveness of a polyurethane condom and a latex condom: a randomized controll trial. Obstet Gynecol March 2003;101:539-47

COPYRIGHT 2003 American Academy of Family Physicians

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