
We Should Have a Better Condom by Now - danso
http://www.slate.com/articles/health_and_science/science/2015/04/latex_condoms_are_the_worst_why_after_all_these_years_don_t_we_have_a_better.html
======
graeme
Orthogonal to the article: condoms are not one size fit all.

A lot of people think they are, and this causes problems. Too small, and
condoms break. Too large, and they slip off. Either way feels far less
comfortable than with a properly fitting condom. This ultimately leads to less
usage.

Condom boxes have something called "nominal width" on the side. To fit
properly, you or your partner need to take a precise measure of the penis
circumference, then match that to the appropriate width:

[http://www.condom-sizes.org/condom-sizes/suggested-condom-
wi...](http://www.condom-sizes.org/condom-sizes/suggested-condom-width-in-
relation-to-penis-circumference)

Note that you have to double check the comdoms. For instance, magnums list
58mm, but actually are 54mm at the base, which is the most important place.

Fitted properly, latex condoms will feel significantly better and work better.

~~~
rpenm
Not orthogonal: the article discusses the role of size in breakage and
comfort. It also discusses how the FDA forced TheyFit to discontinue their
custom-fit condoms due to unreasonable ASTM testing requirements.

~~~
ta_994855
_In spite of their niche popularity [...] the FDA challenged the acceptability
of TheyFit condoms [...] having noticed [...] that some of the sizes did not
meet ASTM dimensional requirements. The smaller sizes, in particular, didn’t
hold the requisite volume of air and water in the air-burst test and the
water-leak test, because they were, well, smaller. Glickman [...] was given 30
days to remove his condom from the market, and, after consulting with an
attorney, complied._

Wow. So they were forced to take these off the market because they didn't
conform to a completely irrelevant FDA standard....

~~~
tadfisher
In an alternate universe, adolescent children are being taught to abstain from
ingesting more than three liters of water and air.

------
bostik
This thread practically demands a NSFW link for classic 4-panel comic strip.
If you are at work, think at least twice before clicking the following link:

[NSFW]
[http://thinhline.tumblr.com/post/5370750268/thl-7-nothing-i-...](http://thinhline.tumblr.com/post/5370750268/thl-7-nothing-
i-can-condom-click-on-the)

The article touches the issue of sensitivity and the need to develop a condom
that makes sex _more_ enjoyable. So does the comic at the link above, if in a
slightly different way.

In case of markets and products, one can rely on cynicism and economics. In
case of sex, we should be able to rely on hedonism.

(Are there any other SL fans?)

~~~
MichaelGG
Anti sensitivity condoms seem to be fairly popular, to improve "male
performance". Any simple condom or device like in that comic would be a
massive success. I don't know the stats but I'd be shocked to find many guys
don't rate their partner's pleasure over their own.

And yes, SexyLosers is the funniest "adult" comic I've ever read.

------
throwaway76453
I was kind of shocked that the entire article doesn't mention that Japan has
basically solved this problem. They have had 0.03 mm (that's .03 MM, not 3 mm)
and more recently 0.02mm polyurethane condoms for quite some time. The only
negative to them is that they have to be sold in different size ranges
(Normal, Large, probably there's an XL) since they are not very stretchable.
Also, being so insanely thin, it takes a fair bit of skill to apply one. They
are expensive, but not as expensive as a disease.

They feel so close to nothing that someone unwilling to wear one with an
unknown partner is shocking to me, yet even in Japan, condom use is extremely
low.

On a side note, I'm surprised that so many people take their life in their
hands to slightly improve the sensory feel of sex, and yet circumcision, which
removes a huge percentage of the nerve endings in the area, remains popular in
the US.

~~~
devonkim
As a user of said Japanese condoms, I still have to admit that I can tell that
there's something there. There's nothing that will actually solve the problem
that you will want something that feels good.

If you ask me, we can get more people to use condoms if we develop a condom
that feels even better than not wearing one. If we can combine a sex toy and
contraceptive together that works during sex basically, it might be hard to
get people to NOT use condoms. Some people swear that fleshlights feel better
than actual sex in itself, so who knows if we could develop advanced haptics
for condoms or something down the road?

------
wdewind
Yeesh what an overwritten article. I plowed through it because this is
relevant to my interests but man this could've been 3 paragraphs. I'll try and
sum it up:

-People don't use condoms mostly because they are uncomfortable

-Current condoms are highly suboptimal for anal sex in particular

-Materials other than latex are generally difficult to get to pass FDA tests, and it looks like there is some disagreeing science about why. All condoms seem to be good at blocking pregnancy, some, like polyurethane and lambskin condoms, have disagreeing science about how well they stop the transmission of STDs (including HIV).

-New condoms sometimes get blocked because of somewhat antiquated tests (specifically sizing tests)

Overall there was not a lot of information here. It follows someone named
Resnic, loosely, who claims to be making a new revolutionary condom, but who
ultimately decides to change his condom back to latex because it's so much
easier to manufacture in the US. It's not clear what his key innovations are
that will make his condom more useful/comfortable to more people.

Overall the point that a better condom would get more people to use it makes
sense, but the article doesn't make the case that one is on the way, or
explain what one even would be. Yes, a better material might transmit heat
better, but there are obvious downsides, especially with regards to Africa,
where STD transmission is the primary concern, not pregnancy.

If there is one conclusion I take from this article it's that if you are in a
committed relationship where you are not worried about STD transmission and
are primarily concerned about pregnancy prevention, and do not like latex
condoms, give lamb skin or polyurethane condoms a shot. Otherwise you're
probably best sticking to latex.

~~~
mbroshi
Or, to sum up even more succinctly:

\- Government regulations have stifled innovation, thereby making existing
products less safe, less comfortable, and less used than they would be
otherwise.

In other words, nothing new.

~~~
jfuhrman
That doesn't explain why the innovation didn't happen in, say Somalia, where
there are no government regulations to speak of.

~~~
baddox
The situation in Somalia can be readily explained by low incomes and decades
of violence.

~~~
foldr
Which in turn can readily be explained by the lack of a strong government.

~~~
baddox
I presume you know very little about Somalia's recent history. It had a strong
government from 1969 to 1991. It was a military dictatorship with a centrally
planned economy ("scientific socialism"). After the regime's collapse in 1991,
Somalia was essentially stateless, and there was dispersed fighting between
various groups for control of various areas of Somalia. Yet, perhaps
surprisingly to many people, it's not clear that things were worse under
"anarchy" than under Barre's regime. For instance, life expectancy improved
dramatically, as did access to health care and technology.

~~~
foldr
You appear to be confusing strength with brutality. The military dictatorship
was not strong. That’s why it collapsed. In general, dictatorships tend to be
weak and unstable in comparison to more democratic forms of government.

~~~
baddox
I'm not confusing the two. The government was brutal, and it was also strong.
It censored the media. It nationalized all major industries. It carried out
large scale terror campaigns against political dissidents and Somali clans. It
suppressed civil liberties on a very wide scale.

------
larrys
Highly recommended:

"Female Condoms"

[http://www.plannedparenthood.org/learn/birth-
control/female-...](http://www.plannedparenthood.org/learn/birth-
control/female-condom)

Don't want to get into a bunch of inappropriate talk but suffice to say much
better for both parties.

~~~
hackuser
> Don't want to get into a bunch of inappropriate talk but suffice to say much
> better for both parties.

I'd encourage you to talk. The more people know about it, the more they will
use effective contraception and the fewer HIV (and other STD) infections there
will be. And people who read it from you will tell others. We're all adults
here; I don't think it's inappropriate.

~~~
larrys
From my experience there is no comparison to the feeling and sensitivity
experienced when using this. Almost feels like nothing is there (or close to
it).

Women don't seem to mind using it either (and it is actually marketed or was
marketed at one point as women taking control).

All in all to me no comparison to a traditional condom for men. Edit: And
after using it it's hard for me to understand why it's not more widely known.
[2]

The only drawback is the cost, about $2 each at retail. [1] In theory it can
be re-used as well since it's not stretchy but simply a large sheath like
protection.

[1] Planned parenthood gives them and and sells them. If you are nice to them
they will give you a bunch at no cost for a small donation. (Call it $5).

[2] My guess is that it lacks the marketing budget to take off. The local
pharmacy used to carry them but then stopped for lack of demand which
mystifies me given my personal experience. Not a new product by the way has
been around for quite some time but as I said primarily distributed by PP and
to women, not men.

------
jaldoretta
Contraceptive innovation is WAY behind other industries. Condoms are
completely outdated, the pill really hasn't changed since the 1960s, the IUD
since the '70s, the "new" implants are really just a minor evolution of the
pill, etc. You'd think such a basic human need would be more of a priority.

My startup is helping to tackle this problem by trying to inform people that
menstrual cycle data, on its own, can help prevent pregnancy with the same
efficacy as hormonal contraception (and this isn't the rhythm method, despite
the common misconception). While it doesn't prevent the spread of STIs like
condoms, tech that replaces "modern" methods for women could change the
industry.

We actually just released a marketing campaign for that exact purpose:

[https://youtube.com/watch?v=3PzfJ4caalY](https://youtube.com/watch?v=3PzfJ4caalY)

I'm really looking forward to the much-needed innovation in this industry.

~~~
jacquesm
> My startup is helping to tackle this problem by trying to inform people that
> menstrual cycle data, on its own, can help prevent pregnancy with the same
> efficacy as hormonal contraception (and this isn't the rhythm method,
> despite the common misconception).

I think you should be _very_ careful with making unqualified statements like
that. If it _isn 't_ the rhythm method then you should explain exactly what it
is because the 'common misconception' requiring you to distance yourself from
the rhythm method before someone even brings it up is alive and kicking and it
is up to you to provide the evidence that it isn't so by explaining how it
does work.

Your marketing video certainly does nothing to clarify, and the app
description on your website screams 'rhythm method in an app' from every page.

~~~
bsmith
Noted.

If you read our "App" page, you would have seen 'sympto-thermal method of
fertility awareness' mentioned at least once. Check out "Learn" for a literal
book's worth of information (complete with references) about how this works.
We've taken an approach of trying to ease people into this, but maybe that
hasn't come across in this instance.

How would you suggest we introduce the topic without scaring people off with
such scientifically dense-sounding terms as "sympto-thermal method"? Is
anything we can say going to be believable to our target customer off the bat?

~~~
jacquesm
> sympto-thermal method of fertility awareness

You're going to run smack into the wall of terminology here.

The 'rhythm method' or 'calender method' was a Rome sanctioned family planning
method whose _only_ ingredient was a calendar. The fact that it had a
spectacular failure rate as an anti-conceptive method must not have been lost
on the promotors.

But since a calendar is part of pretty much any fertility/anti-conception
scheme you'd do well to highlight the _differences_ rather than the
similarities with the rhythm method.

Using clever marketing words isn't going to work here, just stick to the cold
hard facts and assume that the women and men you're trying to address here
don't need to be talked down to but are perfectly capable of understanding
what you're trying to say if you are un-ambiguous and direct about it.

You're talking about people that are having intercourse, the least you could
do is treat them as the adults they think they are.

Historically plenty of couples that used the rhythm method added a thermometer
or other symptoms to increase reliability complicating your quest for proper
terminology even further.

~~~
JoeAltmaier
Arguably, people since Roman times have been bred for calendar-incompetence.
Those that have a hard time operating a calendar, had more children.

------
mkr-hn
I'd probably worry less about this if PrEP were cheap enough to get without
insurance (or wealth). The odds of finding a monogomous (or at least
polyfidelitous) partner around here is slim, and I'm not too keen on taking my
chances with Grindr. A better condom would alleviate a lot of worries.

~~~
foobarqux
Doesn't PrEP have serious side-effects?

~~~
peter303
About $15,000 a year for someone to pay. Insurance companies resist expensive
drugs not used to treat an existing disease.

Seems to be readily available under medicaid. But you have to keep you income
under $15K or ($10K in non-Obamacare states) to qualify.

~~~
gboss
That's actually not true. Insurance companies, such as Kaiser Permanente, see
a few years of PrEP during a patients active sexual years favorable to
treating HIV for life. I have a few friends that are on Prep and have private
insurance and have not had any difficulty acquiring the prescription.

------
up_and_up
I recommend this company: [https://thisisl.com/](https://thisisl.com/)

You buy one, they give one away model. They also use less toxic ingredients in
general.

~~~
jseliger
Thanks for this link. These look great, and I've never heard of them.

------
jbhatab
I could only imagine the positive impact a noticeable increase in condom usage
would bring to the world. I feel like it would be a silent yet very beneficial
change if condom usage went up about 10% globally.

~~~
alexashka
Let's start with making them free. Are the medical/abortion costs really lower
than providing everyone with unlimited plastic with a little lotion on it?

~~~
jpgauthier
I'm from Québec (Canada) and you can easily find free condoms at your Local
Community Services Centre or any anti-aids/healthcare organization. But, I'm
not exactly sure that it helped to reduce AIDS transmission or the number of
abortions (if we look at the numbers they have increased in past years), but
there's a lot more to take into account than condoms usage alone. Still, I
completely agree with you that it should be free. I'm curious, are we alone in
this world to give free condoms or it's a common practice?

~~~
retardedelk
You can get free condoms just about everywhere (including the United States).
The problem is that you get them free from your local family-planning clinic,
or community centre, etc.

People who are at risk for having unprotected sex probably need the condoms to
be easily available (i.e free in high-schools, free in bars/nightclubs, etc.).
If they have enough forethought in order to make a trip to one of the places
where they are free, they probably have enough forethought to buy them
themselves without problems.

------
j_lev
Japan has had polyurethane condoms as standard for at least 15 years (indeed
there is the stereotype of foreigners stocking up on latex ones whenever they
go home).

Polyurethane is definitely superior in many regards, but they are less
stretchy than latex and if you're not used to them they can be a little
frustrating.

------
morenoh149
What I'd really like to see is research on a a male version of The Pill. The
Pill was introduced in the 1960s. What efforts, research, has been done to
bring a similar product for males?

Though it wouldn't help on the disease transmission front.

~~~
jacob_naked
Here it is. Very cool:

[http://www.newmalecontraception.org/vasalgel/](http://www.newmalecontraception.org/vasalgel/)

------
peterwwillis
I've always wondered why you can't dip a penis into liquid latex or a similar
compound. Perfect fit, won't slip off (presumably?), probably harder to break.
Getting it off without lots of screaming might be tricky...

~~~
lotsofmangos
I wondered if a temporary glue could fix a thin flexible tube in the urethra,
containing a carefully folded sealed bag. Full sensitivity, no cum.

------
ars
An article on ebola said that the condom provides 95% protection per use. i.e.
a 5% chance of infection anyway each time they are used.

That's basically worthless because after 13 uses there is a 50/50 chance of
infecting someone.

They are more effective with HIV only because HIV is not as infective, not
because the condom is more effective.

So the problem with the condom is not the design, but that they are not as
effective as people think. Couples using them consistently every time still
have a good lifetime chance of transmitting HIV if their partner is infected.

~~~
sz4kerto
"That's basically worthless because after 13 uses there is a 50/50 chance of
infecting someone."

Well, there's 50/50 chance of not infecting anybody vs infecting at least one
person from 13. That's a much better chance than say 50% chance of infecting
at least 10 person from 13. When you are thinking about spreading a disease,
this matters a lot. Sure, for couples, the chances of infection after N use is
high, but that's not the only use case. (E.g. one night stands.)

~~~
ars
You are forgetting that people change behavior based on risk.

Telling someone there is a tool to reduce risk, that doesn't actually reduce
risk (enough), actually makes things much much worse.

~~~
sz4kerto
Yes, they do change, you're right. However, if it comes to sex, people do not
care that much about risks.

Condom usage decreases the prevalence and spread of STDs. That is a very hard
fact. Therefore I guess that in this specific case increased risk taking does
not offset the advantages of decreased risk. (Same seems to be true for things
like airbags or seat belts in cars. You could not possibly argue that we
should remove these from cars because we end up with more fatalities with them
as it is simply not the case.)

~~~
nickff
Many have argued that airbags actually increase auto-related fatalities
through the so-called 'Peltzman effect' (also known as 'risk compensation'),
and that removing airbags from vehicles would cause automobile fatalities to
decrease or remain constant.[1][2][3]

I am no aware of the state of the debate of this effect on condoms or
STIs/STDs.

[1]
[http://en.wikipedia.org/wiki/Risk_compensation](http://en.wikipedia.org/wiki/Risk_compensation)

[2]
[http://www.econtalk.org/archives/2006/11/peltzman_on_reg.htm...](http://www.econtalk.org/archives/2006/11/peltzman_on_reg.html)

[3]
[https://news.uns.purdue.edu/html4ever/2006/060927ManneringOf...](https://news.uns.purdue.edu/html4ever/2006/060927ManneringOffset.html)

------
wwijs
Many reasons that hinder condom usage can never be fixed, even with free,
plentiful, good feeling condoms:

The ability to go from foreplay to sex without stopping

The ability to switch between oral and penetrative sex

------
mattpavelle
A while back (2013?), the Bill & Melinda Gates Foundation offered financing
for a "next generation" condom.

I can't find the link on the Gates Foundation site now (dead links on Google)
but this is some press around it and mentions the 11 finalists:

[http://theweek.com/articles/455793/meet-11-condoms-future-
se...](http://theweek.com/articles/455793/meet-11-condoms-future-selected-by-
bill-gates)

So I guess better condoms are in the works already?

~~~
zethraeus
the article follows one of the funded parties

------
spiralpolitik
I would also add that the reason that nobody has developed a better condom is
that there is no profit in doing so.

At a minimum you are looking at a couple of million in research, more if you
want to go crazy with material science. Then you have the cost of testing,
approval etc. After that you have marketing. It's a great project that will
save many lives but the cost/risk analysis alone would put off any for profit
organization.

The fact that the Gates Foundation is having to get involved is a sign that
the market simply isn't going to solve this one.

(Government research probably won't deliver it either, at least in the US, due
to the politics around contraception)

~~~
sebular
What a ridiculous and false assertion-- all you've demonstrated is that there
are costs of entering the market.

That says nothing about the potentially enormous profits to be made if your
redesigned condom beats the competition and becomes a new consumer favorite.
Condoms are purchased by people in a wide age range, income bracket,
geographic location, etc. Even a small percentage of the total market would be
an enormous amount of money.

You might as well have said that Tesla Motors was a terrible idea, arguing
that there's no money to be made in automobiles because of all the upfront
costs of designing cars, building factories, and obtaining regulatory
permission.

In fact, the entire point of starting any business is to overcome upfront
costs by seeking long-term profits.

------
randywatkins
This article seems to ignore cost. I think a pretty fundamental benefit of a
simple latex condom is how cheap it is.

------
joeclark77
We do. It's called abstinence. Works every time.

~~~
greggyb
[http://quotesjunk.com/wp-
content/uploads/2014/07/abstinence-...](http://quotesjunk.com/wp-
content/uploads/2014/07/abstinence-virgin-mary.jpg)

------
jacob_naked
Here is a folow-up article that trashes Danny Resnic, the CEO of Origami
Condoms.

If you want to try out a similar condom that is the best one out there in my
opinion, check out nakedcondoms.com

------
yzh
Just love the pictures.

