Sex School: Condoms = Cancer? Uh, No. (Part 3).

Image from the CSPH Sunday Sex School Series

Image from the CSPH Sunday Sex School Series

We’ve spoken out against the condom company, Sustain’s irresponsible marketing ploy which insinuates that many condoms cause cancer. The truth is there is no scientific evidence that any condoms are laden with harmful carcinogens.

Now the greater sex education community is standing up against Sustain condoms.  The Center for Sexual Pleasure and Health (the CSPH) has featured a three part series that exposes Sustain’s confusing and misinformed messages. Here is the final part of that series. You can read the first part here.

In response to Sustain’s fear-mongering attempt to smear other condom products, here’s a refresher on all the wonderful things to know about condoms:

  • Condoms are the only method that protects against both STIs and accidental pregnancy.
  • Correct condom size is essential for the most pleasurable safer sex possible.
  • Adding lube both eases condom application and increases sensitivity.
  • Many condom companies are involved in socially responsible campaigns. When you buy condoms from companies like RFSU, Glyde and Lucky Bloke, you are also helping contribute to aid organizations such as UNICEF, Planned Parenthood and the Global Fund to Prevent AIDS.

This post by Erin Basler-Francis was originally published at the CSPH

BY THE CSPH | theCSPH.org

Over the last two lessons, we have discussed the science of nitrosamines and their suspected link to types of cancer, dispelled myths around nitrosamine levels in condoms and their link to reproductive cancers, and ran down how we got to the point of having this discussion.

So, now let’s look at condoms in a better light: Condoms—what to do with them and what they are doing for you. Note: in this discussion, the terms internal and external condoms are used rather than “male” or “female” condoms.

Condoms: Some Basics

Image from Condom Monologues.com

Image from Condom Monologues.com

There are two main types of condoms, internal and external. Internal condoms are the latex sheath for use over a penis or sex toy that people tend to envision when they use the term. Internal condoms (i.e. the FC2) are inserted into an orifice prior to penetration. Condoms are made from a host of materials, including latex (most common), polyurethane, lambskin, polyisoprene, and nitrile.

Generally, condoms and other barrier methods are recommended as the most effective method to avoid STIs if you are choosing to have genital contact with another person. They prevent the transfer of fluid based STIs (such as HIV and Syphillis) and reduce risk of contracting STIs that spread via surface contact (like Herpes and HPV).

Condoms: What Can You Do With Them

Image from the CSPH

Image from the CSPH

Condoms come in all shapes, sizes, colors, and flavors…and they can be used for many sexual activities beyond penile/vaginal intercourse.

For oral/genital contact, flavored condoms can be an added sexy treat. If going over a penis, adding silicone lube to the inside of the condom can keep the sensation slick, but the act safer. To make safer sex even sexier, one can put the condom on using their mouth. Flavored condoms, on a penis or cut open and spread over a vulva, can add a sweet bonus to going down.

When penetrating an anus, condoms can keep things clean. For people who are squeamish about poop, darker colored condoms will camouflage and fecal residue that might appear. Internal condoms can be used for anal intercourse by removing the insertion device (e.g. the ring in the FC2) and will offer both the security of a built in flange for the condoms and additional stimulation to the nerve endings in the anus and surrounding area. And, like a gift that keeps on giving, the ring removed from the tip of the FC2 can double as a cock ring.

If you are planning on only having sex with yourself, condoms are great for easy cleanup. Slide a condom on the penis or over a sex toy, and you aren’t scrambling for a sock/tissue/towel or a potentially awkward walk to a communal bathroom to wash your dildos in the sink. If premature ejaculation is a concern, condoms can help by changing the sensation of intercourse slightly.

On the size front, the old safer-sex educator trick of fitting a condom over the head, up the arm, or onto a summer squash (or maybe that one is just a fun party trick) gives the message that no one is too big to wear a condom. So why make them in different sizes?

Well, you can buy a suit off the rack and look incredibly dashing, dapper and nail a job interview, or you can decide to go with a bespoke suit and feel like James Bond or Tilda Swinton every time you put it on. Condom sizes are like that—they will function pretty great if you aren’t using the perfect size, but finding a condom with the optimum fit will make it feel even better.

What Are Condom Doing For You?

Many condoms companies—both distributors and retailers, participate in social responsibility campaigns. For example, Sustain, fear campaign aside, launched 10%4Women, in which the company contributes 10 percent of their pretax profits to women who lack access to reproductive health care.

Image from the CSPH

Image from the CSPH

Currently, ONE is running its #LustforLife campaign, in which the company partnered with NYC street artists to bring awareness to and raise money for Lifebeat, a NPO that provides HIV education in urban areas, through social media and an auction of original art pieces.

Glyde, aside from being a vegan, sustainable B-Corp, runs the Red Ribbon Campaign, which distributes condoms to sex workers in Southeast Asia as well as providing HIV prevention education abroad and at home in New Zealand.

Sir Richard’s Condoms employs Buy One, Give One. Global Protection (parent company of ONE Condoms) donates a significant number of condoms to reproductive health clinics and providers around the US. Durex, Trojan, Lifestyles…all of them have run significant awareness campaigns that, combined with the condoms they donate, make sure people are having safer sex.

Aside from reducing your personal risk of STIs and unintended pregnancy, it’s safe to say that when you strap on a condom, you are giving back to the world at large.

Do your part. Wrap up.

condom ad condoms too tight

csphThe CENTER for SEXUAL PLEASURE and HEALTH (The CSPH) is designed to provide adults with a safe, physical space to learn about sexual pleasure, health, and advocacy issues. Led by highly respected founder and director, Megan Andelloux, The CSPH is a sexuality training and education organization that works to reduce sexual shame, fight misinformation, & advance the sexuality field.

Sex School: Condoms = Cancer? Uh, No.

Image from the CSPH Sunday Sex School Series

Image from the CSPH Sunday Sex School Series

In November, a new condom brand called Sustain began promoting a campaign that, at first glance, implies they’d like you to believe some condoms may cause cancer. At the heart of this is a petition demanding the FDA to “Get Carcinogens Out of Condoms.” What isn’t readily apparent is that there is no scientific evidence indicating you could ever get cancer from any condom. Ever.

As we discussed last week, the claim that condoms are laden with harmful carcinogens is unfounded. Sustain’s promotion of these myths is irresponsible and quite dangerous. Insinuating that the majority of mainstream condoms could cause cancer anchors yet another obstacle in the decades-long struggle to improve condom use and know-how.

Now the sex education community is speaking out against Sustain condoms.  The Center for Sexual Pleasure and Health (the CSPH) is kicking off their new Sunday Sex School by featuring a three part series that exposes Sustain’s confusing and misinformed messages. Here is the second part of that series.

This series was written by Erin Basler-Francis of the CSPH. Read the originals here: Part I and Part II.

BY THE CSPH | theCSPH.org

Lesson II.

The previous lesson (scroll to the end of this article) discussed the basics of nitrosamine and its presence in condoms, as well as a short explanation of the report released by The Reproductive Health Technologies Project and the Center for Environmental health. In this lesson we will look a little deeper at the methodology of the report and the response around the Sexuality Education community.

Making a Good Thing Even Better…with facts!

When the RTHP and CEH released their white paper, it included the following chart:

From: http://www.rhtp.org/fertility/vallombrosa/documents/MakingAGoodThingEvenBetter.pdf

From: http://www.rhtp.org/fertility/vallombrosa/documents/MakingAGoodThingEvenBetter.pdf

 

In looking at this list, one has to take into account a few things:

  1. The condoms tested were acquired in December 2013, and with an average shelf life of ~4 years, this means some of the condoms tested could have been manufactured in 2009.
  2. The research was funded by a company that provided prototypes of their condoms for analysis.
  3. Not all of the condoms tested are represented. PPFA’s Proper Attire condoms were kept out of the chart because, “[PPFA] secured a commitment from its manufacturer in May 2014 to phase out nitrosamine levels to below the limits of detection after 12 months…Therefore, we have omitted from the reported findings the results of our testing of what is now an outdated version of PROPER ATTIRE’s Basic condom.” However, Glyde and One are specifically mentioned in the chart footnote as having provided similar documentation, but were not removed.
  4. The condoms tested represent a wide swath of condoms types…including “novelty” condoms.

Comparing Apple-Flavored condoms to Oranges

It is disingenuous to compare novelty condoms—those that are flavored, colored, or include special lubes, to standard condoms. Especially when the funder’s website says this:

From: http://sustaincondoms.com/sustainability-responsibility/free-of-chemicals/

From: http://sustaincondoms.com/sustainability-responsibility/free-of-chemicals/

 

Sure, test all the condoms! If people want to know that they might be putting into their bodies, let them know. But don’t take one off specialty condoms and put them in a chart with plain “vanilla” condoms and combine that with alarmist, unsupported claims that said products are going to give someone penis cancer. When I’m looking for safer sex supplies, my first thought isn’t glow in the dark or blueberry—even if it may make a partners genitals smell like pie. These just aren’t the first choice.

The Condom Market

Speaking of cherry-picking the condom selection in the study, that list has a lot of the major offenders when it comes to using sexist marketing. According to Meika Hollender, co-founder of Sustain,

We didn’t want the packaging to scream neon-flavored sex—we wanted something that would appeal to the consumer. If you look in a drugstore condom aisle today, you will see that none of the products are targeted to women. We understand that women aren’t going to buy our condoms just because we’ve designed a nicer wrapper, but we think it will at least help.

We want women to feel as comfortable carrying a condom in their purse as they do their lipstick, credit card and cell phone (Brandchannel,com, Dec. 02, 2014).

condom-brandsIf one were to look at the condoms packaging and take into account that a number of brands singled out are newer entries to the condom market, one could draw the conclusion that this is a latex turf war. ONE, Sir Richard’s, and Billy Boy are newer distributors that have fun, eye-catching packaging. Sir Richard’s and ONE in particular pay a lot of attention to the exterior design, making the packaging seem at home in a cabinet next to the Method hand soap. Glyde, the oldest, most established of the bunch, holds the distinction of being the vegan condom until Sustain hit shelves in January 2014.

The Condom-Cancer link is a Red Herring

Shortly before the RHTP and CEH released their white paper on 18 SEP 2014, Sustain sent out this tweet:

sustain condoms on Twitter   @LaurenBrim thank you for making this incredible and important video!! https   t.co Bzu1XvfHHH #dowhatsnatural

In the video, titled Are Condoms Killing You, Lauren Brim, a holistic sexuality coach, makes the assertion that “condoms could also be hurting you” by releasing “nitrosamines and these are carcinogens. These are toxic. These cause cancer.” After the intro, complete with dramatic music, Brim goes on to explain the fantastic benefits of Sustain, citing their commitment to fair-trade, ethical manufacturing practices in the same breath as their lack of carcinogens that “can lead to ovarian cancer.” Jeffery Hollender, in a phone interview, stated that Lauren Brim is not affiliated with the company, but had been in contact with Sustain through their regular customer service channels prior to her video.

Although Brim is not linked to Sustain, the prevalence of media outlets stating that condoms cause cancer is. Well over half of the interviews given by the Hollenders regarding Sustain after the report and video contained references to toxic chemicals, carcinogens, and nitrosamine. Many of those articles specifically point out the link to reproductive cancers.

 

From: http://portlandtribune.com/sl/240190-105078-getting-on-top-of-sustainable-sex-

From: http://portlandtribune.com/sl/240190-105078-getting-on-top-of-sustainable-sex-

 

However, the studies—including the white paper funded by Sustain, point out that there is no causal link between reproductive cancers and nitrosamines. And even if there were, a condom contains fewer nitrosamines than a serving of French fries.

From: http://www.dw.de/german-study-says-condoms-contain-cancer-causing-chemical/a-1220847

From: http://www.dw.de/german-study-says-condoms-contain-cancer-causing-chemical/a-1220847

From: http://www.rhtp.org/fertility/vallombrosa/documents/MakingAGoodThingEvenBetter.pdf

From: http://www.rhtp.org/fertility/vallombrosa/documents/MakingAGoodThingEvenBetter.pdf

Banding Together To Challenge Misinformation

Initially, Salon seemed to be the only outlet covering the ludicrousness of the assertion that condoms can kill you. In the article, Former Surgeon General Joycelyn Elders, in a statement from Trojan, said,

Any public statement calling into question the safety of latex condoms, given the mountain of evidence supporting their safe and effective use, simply is not credible. Consumers should continue using condoms to prevent unintended pregnancies, HIV, and other sexually transmitted infections — and they should remain confident that condoms are safe and effective.

Many involved, including Jeffery Hollender, noted the relative quiet after the tweet heard around the industry. Melissa White, sexuality educator and CEO of Lucky Bloke Condoms, along with others in the sexuality education, reproductive health, and condom industry attributed this silence to the hope that, after being admonished by the Patron Saint of Masturbation Advocacy, Sustain would get the hint and lay off the scare tactics. In her piece on RH Reality Check, White says,

With selling condoms comes an undeniable level of responsibility. My work, like many others’, is leading people to a better relationship with condoms, thereby increasing consistent and correct use. Misleading marketing, scare tactics, and irresponsible messaging is doing a disservice to all of us, especially to the millions of people who depend on condoms to protect their health.

(Read the response from RHTP here.)

After the release of the report, ONE Condom’s parent company, Global Protection, released a statement that ended, “We hope that this new RHTP report is not sensationalized in a way that discourages people from using condoms, thereby exposing them to very real, well known risks.

Glyde America responded to the misinformation with the following:

While we applaud Sustain’s enthusiasm for marketing condoms to economically advantaged female millennials, we have repeatedly voiced our concerns about the tactics used which serve to undermine over thirty years of public health efforts promoting condom use within the teen and LGBT communities.

Condoms are highly regulated medical devices. There is no collective conspiracy by the ISO, World Health Organization, FDA, rubber latex suppliers and condom manufacturers to deliver substandard or in any way unsafe condoms to consumers. To the contrary, for decades manufacturers have continually refined materials and processes including reducing if not eliminating nitrosamines. To formulate a non-existent issue, while patently ignoring all scientific data proving condom safety, is not only misleading, it is irresponsible.

For what it is worth, the Sustain Camp seems to have stopped publicly beating the“condoms cause cancer” drum. Wednesday, in a Reddit Ask Me Anything post, Jeffery Hollender did not mention nitrosamines, toxicity, or cancer—although there were questions asked that would have fit that answer and removed a pretty/awful inforgraphicwas pulled from the Sustain website shortly after Melissa White’s article went live.

—————-

Lesson I.

Part of the mission of the Center for Sexual Pleasure and Health is to challenge misinformation. Lately in the sexual and reproductive health field, there has been a growing outcry against the recent use of nitrosamine (a probable carcinogen) levels in condoms as a marketing tactic. Sustain Condoms and The Campaign for Safe Cosmetics are heavily pushing a petition for regulation of nitrosamine by the US Food and Drug Administration (FDA).

Between the petition, a series of interviews by the founders of Sustain, and a study titled “Making a Good Thing Even Better: Removing NITROSAMINES from CONDOMS,” [emphasis theirs] many in the field are concerned that the message being received by the public is, “Condoms cause cancer.”

Where Did This Information Come From?

In September 2014, the Reproductive Health Technologies Project in collaboration with the Center for Environmental Health. In the study, they report the levels of nitrosamine present in 24 different types of condoms, spread across several brands. The report states that selection criteria included units sold, in-store availability, and input from issue and industry experts.

It is important to note at this point that there is one condom that was put into the study in its prototypical form from Sustain Condoms, a new entry to the field of prophylactics founded by Jeffery Hollander (of Seventh Generation products) and his daughter, Meika. As we find out in the acknowledgement section of the study:

www.rhtp_.org-fertility-vallombrosa-documents-MakingAGoodThingEvenBetter.pdfThe report does not disclose which other issue and industry experts it received input from.

What Are Nitrosamines?

Nitrosamines, specifically in latex, are a byproduct of chemical processes used to make latex more elastic. Nitrosamines can also form when nitrates turn to nitrites and meet up with amines during the digestive process.

Nitrosamines are found in a lot of items: rubber products (including condoms, baby pacifiers, and latex gloves), meats, cheese, drinking water, beer, dehydrated dairy products, grains, eggs, tobacco smoke…well, it’s in a lot of things we encounter regularly[1]. Further, the body can take nitrates from things like broccoli (which is naturally high in both nitrates and nitrites) and turn it into nitrosamine.

Nitrosamines, specifically the subcompounds of NDEA (N-nitrosodiethylamine), NDMA (N-nitrosodimethylamine), and NDBA (N-nitrosodibutylamine), are classified by the Environmental Protection Agency (EPA) and the World Health Organization (WHO) as a probable human carcinogen and by the European Union as presumed to have carcinogenic potential for humans; largely based on animal evidence.

What Do Condoms Have To Do With Hamsters?

Syrian Hamster

Image from the CSPH

In the conversation around Nitrosamine levels in condoms, one study is cited the most. The first, a 2001 study where nitrosamine as directly applied to the skin and mucosal tissue (e.g. the walls of the nose and vagina) of Syrian Hamsters. The hamsters developed tumors in the liver and digestive track after the application of 1 gram of nitrosamine. For reference the estimated lifetime absorption of nitrosamine from condoms is .9 micrograms (ug)—also known as .0000009 grams. And people are a lot bigger than hamsters.

As mentioned above, there are nitrosamines everywhere. The average person consumes ~500ug of nitrosamine from food alone every day. More importantly, there is neither a causal or correlative link between reproductive cancers and nitrosamine, a point which is stated clearly in all of the reports, even the one funded by Sustain.

The bottom line: Condoms will not give you cancer.

But they will help protect you from unintended pregnancy and STIs. So wrap up and keep an eye out for Lesson 2.

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786176/table/T2/

csphThe CENTER for SEXUAL PLEASURE and HEALTH (The CSPH) is designed to provide adults with a safe, physical space to learn about sexual pleasure, health, and advocacy issues. Led by highly respected founder and director, Megan Andelloux, The CSPH is a sexuality training and education organization that works to reduce sexual shame, fight misinformation, & advance the sexuality field.