The Amazing History of the Condom – and Why it is Important Today

Drawings from ancient Egypt show men with sheaths over the penis; the purpose of this – whether ritual or sexual – is not known. The material used was probably linen. Evidence dating back to the 14^thcentury suggests that upper classes in Asia used ‘glans condoms’ that covered the tip of the penis, and could be dislodged during use.  The Chinese made theirs from oiled silk paper or lamb intestine, and the Japanese made theirs from harder materials such as tortoise shell (!). 

In the late 15^thcentury, a well-documented outbreak of syphilis occurred among French troops; the disease spread across Europe, and then into Asia.  Syphilis was more serious than it is today, covering the body with pustules and leading to death in a few months.  To the rescue came an Italian anatomist , Gabriele Fallopio, who invented a device made of linen sheaths soaked in a chemical solution and then dried.  The cloths were held on with a ribbon. Fallopio as an anatomist is famous for his description of the woman’s fallopian tubes.  He performed an experiment, recruiting 1100 men to use his device.  Epidemiologists today say that 1000 subjects are necessary to get a representative sample.  This happened in the 1490’s and is amazing.  We do not know the length of his experiment.  He reported that none of his subjects became infected with syphilis.

The first documented use of the word ‘condom’ is thought to have occurred in 1666 when the English Birth Rate Commission reported a drop in birth rates and attributed it to condoms.  Condom usage was rising in this era.  They were made of animal bladder or intestine, or of linen soaked in chemicals.  Condoms were available to buy in pubs, markets, barber shops and from chemists, but due to expense their use was usually confined to the middle and upper classes.  In the 1700s Casanova is thought to have been a frequent user of condoms for protection against syphilis.  His memoirs make reference to this, as does a picture of him with several attractive young women as he blows a condom like a balloon. 

In the 19^thcentury birth control advocates began to promote condom use to less affluent people – advocates in England included Jeremy Bentham and in the U.S. Robert Dale Owen.  Assertive and popular women and men traveled and lectured around the country teaching about physiology and sexual matters.  They often sold condoms after their lectures.  Moralists and some medical professionals condemned this practice as spreading abortion and prostitution.  However, in 1861 a condom advertisement appeared in the New York Times, 10 years after the paper was founded.   

The rubber vulcanization process was invented by Charles Goodyearand patented in 1844.^[7] The first rubber condom was produced in 1855,^[8] and in a few years several major rubber companies were mass-producing rubber condoms. A main advantage of these condoms was their reusability, making them a more economical choice in the long term.  However, skin condoms were initially cheaper and offered better sensitivity.  By the end of the 19th century "rubber" had become a euphemism for condoms in countries around the world.

 In 1919, due to high rates of sexually transmitted disease (STDs) in World War 1, the search was on for better protection.  Frederick Killian in Ohio invented a latex condom which was thinner and easier to use than rubber.  The latex used in condoms is a natural compound  from rubber that is not vulcanized.  Condom making increased, leading to mass production. In the 1920’s quality control of condoms was pursued.  In the 1950’s a reservoir tip and lubricant was added to collect semen and reduce leakage.  A lubricant was added to reduce friction.  In the 1980s the AIDS epidemic increased condom use worldwide.  In 1994 polyurethane condoms were introduced to reduce allergies to latex.  And so the refinement and improvement of condoms goes on.  The female condom is available in the U.S. and many other countries – its effectiveness against STDs has not been thoroughly studied. Its use is somewhat awkward and cannot be hidden from a partner.

What is the take-home message of this long and rather amazing history of the condom? Be aware that rates of syphilis, gonorrhea and chlamydia have climbed rapidly for the 4^thconsecutive year in the U.S. according to the Centers for Disease Control.  Antibiotics are in danger of becoming resistant.  If not treated early, STD’s can lead to serious illness.  Hepatitis B and HIV can also be a danger to people of any age who have sex with new partners. Talk honestly with your health care provider and protect yourself.  Human ingenuity is impressive.  Use yours!!

Sadja Greenwood MD,MPH