Condoms offer fantastic protection against STDs and reduce pregnancy risk. Most are made from latex, to which some people are allergic.

Latex condoms are a well-rounded form of birth control: Not only are they great for preventing pregnancy, but they reduce the risk of passing on or receiving a sexually transmitted disease (STD). When used consistently and correctly, they offer fantastic protection. Although condoms have been around for centuries, their modern construction from latex is a vast improvement over the silk and viscera of yore. A product of the industrial age, they are manufactured by dipping a porcelain mold into natural rubber latex, a material that originates from a tree.

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Latex is tops, but other options include polyisoprene and polyurethane. Beware: Lambskin isn’t effective STD protection.

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Because of latex’s many advantages, the majority of condoms are manufactured from this material. However, up to 6 percent of the population is allergic to latex. There is a range of symptoms associated with latex allergies. Most people with latex allergies experience only a localized reaction on the vulva or penis (contact dermatitis); systemic reactions (like asthma or anaphylaxis) are rare. Allergy tests can be performed on people who suspect they might be sensitive to latex.

Luckily, even if you have a latex allergy you can still find condoms to facilitate your safer-sex experiences, including condoms made out of polyurethane and polyisoprene. Not all condoms protect against pregnancy or STDs, so read the label carefully. In the United States, if the packaging doesn’t explicitly state that the condoms are made to prevent disease, they haven’t been approved by the FDA for that purpose.

We have the most safety information on condoms made from latex, which has been shown to be a very reliable material. The FDA recommends latex condoms above all others, though it has approved polyurethane condoms as well. Polyurethane and polyisoprene condoms are relatively new to the market — introduced in 1994 and 2008 respectively — and there have not been as many studies of their relative safety and performance. The FDA’s information about condoms is, for the most part, not up to date. Having said that, polyurethane and polyisoprene seem to be good materials, though they haven’t withstood the test of time as can be boasted by the latex condom.

Polyurethane

Although latex condoms are a relatively new advancement in contraceptive technology, they’ve been around since the 1920s, before most of you were born! It wasn’t until 1994 that the polyurethane condom, the first good alternative to latex, was produced. They are more expensive than latex, but are also thinner and better able to conduct heat. Whereas oil-based lubricants will destroy latex, they are fine to use in combination with polyurethane condoms. While polyurethane has its advantages, it is, unfortunately, not as effective a material as latex.

A 2003 study found that polyurethane condoms were more likely to break during sexual intercourse than their latex counterparts. However, despite being less effective than latex condoms, polyurethane condoms were still found to be in the same range of effectiveness as other barrier methods of birth control. A 2000 study also found that polyurethane broke and slipped more than latex, but these results were not found to be statistically significant. This study also found that both male and female participants found latex condoms easier to use than polyurethane condoms. A Guttmacher Institute study reached similar conclusions, also finding that polyurethane condoms lost their shape or bunched up more than latex condoms.

When used in combination with other contraceptive methods, such as the Pill or the IUD, polyurethane condoms should provide excellent protection against pregnancy.

Polyisoprene

Polyisoprene is a heavily refined, synthetic form of latex from which the allergenic latex proteins have been removed. Condoms made from polyisoprene are suitable for most people with latex allergies, though it’s possible that people who are highly sensitive to latex could experience delayed allergic contact dermatitis.

There are several brands of polyisoprene condoms on the market, though they may be more difficult to find than their latex and polyurethane counterparts. Like polyurethane condoms, they are said to do a better job of transmitting body heat. Unlike polyurethane condoms, they cannot be used with an oil-based lubricant — as they are a hypoallergenic but ultimately latex-derived material, oil-based lubricants will damage polyisoprene just as they damage latex condoms.

They are shown to protect against both pregnancy and the transmission of viruses, bacteria, and other pathogens.

One study suggested that polyisoprene condoms take longer to break than latex condoms. However, the researchers were not investigating condom durability but rather a new kind of machine that testers can use to determine condom durability.

Lambskin condoms are made from the intestines of sheep.

What about lambskin condoms?

When it comes to protecting against STDs, there really aren’t a lot of benefits to using a lambskin condom (also called a sheepskin condom). Some people use them because they think they are more “natural,” which may offer an appealing aesthetic.

It’s true that lambskin is natural — “skin” is a euphemism for intestines. Yup, this condom is made from the digestive tract of a sheep. The intestines are the site of the majority of digestion — it is here that foods are blasted with enzymes and broken down into small pieces. When the pieces are small enough, they are absorbed through tiny holes in the intestine’s porous membrane. Intestines, by their very nature, must be permeable — otherwise, malnutrition and starvation would result. So, yes, lambskin condoms are “natural” — and so are the holes through which viruses (also “natural”!) can pass.

According to the FDA, lambskin condoms have not been shown to protect against the passage of viruses, such as HIV, herpes, or human papillomavirus (HPV). In the early 1990s, Trojan-brand lambskin condoms were recalled en masse by the FDA because they didn’t contain adequate labeling. There were reports from customers who had used these condoms and, despite believing they were practicing safer sex, contracted HIV.

The size of a virus compared to a sperm. Viruses are small enough to pass through the pores in lambskin condoms. Illustration: FDA

The pores in lambskin condoms, while big enough to allow viruses to pass through, should be small enough to keep sperm out. They might be a suitable barrier method for a monogamous heterosexual couple, who have both been previously screened for STDs, wishing to decrease risk of pregnancy. (Though it bears pointing out that there aren’t good tests for HPV, so one partner could unknowingly be infected with HPV and pass that virus to the other through the pores in the lambskin condom.)

Condoms are available at all Planned Parenthood health centers. In addition, you can make an appointment with a clinician to discuss the pros and cons of various birth-control and barrier methods and find which one is appropriate for you.