Last month, a new condom brand called Sustain began promoting a petition through email and social media calling on the FDA to “Get Carcinogens Out of Condoms.” Obviously, the possibility of carcinogens in condoms is a frightening thought. But the reality is that there is no scientific evidence linking condoms to cancer—and to claim otherwise has the potential to unravel decades of committed work focused on saving lives through encouraging condom use and education. Those of us who support and advocate for sexual wellness and reproductive health need to take notice and work to combat misinformation like this.
As the petition notes, most of us are exposed daily to nitrosamines, chemicals which are indeed classified as carcinogens. They are found in our drinking water, in the food we eat, and the air we breathe—at doses 1,000– to 10,000-fold higher than can ever be expected from condom use.
Condom manufacturers have worked diligently to keep these levels as low as possible. Nitrosamine residues are largely removed during manufacturing by a thorough washing or leaching process. Even so, based on the findings of the leading toxicological study evaluating nitrosamines in condoms, in order for condoms to cause cancer, they would have to contain a million times more nitrosamines than they actually do. Furthermore, a person would have to use more than 1,500 of such hypothetical condoms spanning decades.
According to that study, nitrosamine occurrence in condoms is, in fact, so low that they are measured in ppb—parts per billion. Yes, billion.
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Simply put, condoms have been proven exceedingly safe.
The petition being promoted by Sustain bases its claims on a study: Making a Good Thing Even Better: Removing NITROSAMINES from CONDOMS produced by the Reproductive Health Technologies Project (RHTP) and the Center for Environmental Health. But this research, which was funded in part by Sustain co-founder Jeffrey Hollender, is plagued by questionable methodology.
Based on the white paper released by RHTP, researchers in the study compared the nitrosamine levels of condoms of varying expiration dates procured from various unsecure locations, such as retail stores or online. Of the 24 condoms tested, ten were manufactured by Trojan, three by LifeStyles, and two by Durex; the other nine were an eclectic blend of brands and styles that included a female (internal) condom, flavored and colored condoms, arousal condoms, and textured condoms. This does not accurately represent the consumer market, because the authors of the study did not test the most popular styles and brands available, or test the same style among a variety of different brands. Furthermore, the methodology section of the study reported that all 24 condoms were latex. In reality, two—Lifestyles SKYN and the FC2—are actually non-latex.
The study was also not published in a medical or scientific journal, suggesting that it was not peer-reviewed by the academic community. In September, it was simply promoted via a press release and Twitter.
Additionally, documentation from the world’s leading independent testing lab proved that contrary to RHTP’s results, the styles it tested from three brands—ONE, Sir Richard’s, and GLYDE—have effectively non-detectable amounts of nitrosamines.
The authors of the study acknowledged that nitrosamines do exist throughout our environment. But their conclusion that “it is possible to manufacture quality condoms on a large scale with little to no nitrosamines” still effectively positions condoms that don’t contain nitrosamines—like Sustain—as superior. In turn, the public could easily interpret their results—that two-thirds of the condoms they tested contained nitrosamines—as an implication that the condom industry in general is negligent. Faulty methodology aside, this is incredibly misleading, and possibly dangerous.
And former Surgeon General Joycelyn Elders seems to agree. In September, Salon quoted Elders as saying:
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.
The RHTP study itself warns that any condom use is better than none. Its authors also “recognize that some people with […] a sensationalist bent may seek to distort the results of this study and erroneously claim that condoms cause cancer. Anyone who does so—be it the media, politicians, or advocates—is acting irresponsibly and not in the best interests of public health.”
Even so, Sustain’s leaders have continued to lean on nitrosamines as a danger. Jeffrey Hollender recently told the Portland Tribune that “Nitrosamines are known to cause cervical cancer.” Meika, his daughter and co-founder of Sustain, added, “And penile cancer.”
Again, there has been no research showing that condom-based nitrosamines cause cervical or penile cancer.
Neither Hollender nor Jessica Arons, the head of RHTP, would comment for this article on the study’s methodology, the evidence that several brands targeted in their study had undetectable nitrosamines, or on the implications of publicizing or promoting the “condoms contain carcinogens” argument.
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.
According to the Kaiser Family Foundation, one-third of U.S. teens believe condoms are “not too” or “not at all” effective at preventing pregnancy. In fact, if consistently and correctly used, condoms are 98 percent effective. The longevity of these falsehoods demonstrates how difficult it’s been to promote consistent condom use. Hence, it is essential that the information used to promote condoms is accurate and easy to understand.
Fear campaigns, by their nature, are compelling. Tweets and top-level messages are often the only takeaways needed to shift opinion. People who don’t have the time, inclination, or interest to research the claims behind petitions may simply opt out of using condoms altogether. And that is definitely far more dangerous than the negligible levels of nitrosamine in condoms.
As health educators, teachers, parents, and communities, we must act. This kind of misinformation cannot—and must not—unravel the dedicated work we have accomplished across the globe, for decades, to educate consistent and correct condom use, shift attitudes around condoms, and stop the stigma, shame, and myths that often prevent consistent condom use.