Latex Condom Allergy

Experiencing discomfort after sex? Is it truly an infection or an allergy from the condom used?

In this article, we delve into the medical part of condom allergy, the possible predisposition to other forms of allergies and alternative options to mitigate your concerns.

What is a latex condom allergy?

In latex allergy, a person’s immune system recognises the protein in latex and mistakes them as harmful foreign bodies, releasing exaggerated antibodies to fight the protein. In the cascade of inflammatory response, one manifests clinically with allergic symptoms. 

As most parts of condoms are made up of latex, this can affect a person’s sexual well-being.

Why do I have a latex allergy?

In allergy, a person can develop three mechanisms of response to rubber/latex.

1. IgE-mediated allergic response (type 1 allergic reaction): upon exposure to latex protein via contact, the immune system generates an antibody known as immunoglobulin E (IgE) that causes a cascade of inflammatory response. Clinically, one presents with acute allergic symptoms.
2. Contact Dermatitis (Type 4 allergic reaction/cell-mediated delayed allergic reaction): as the name suggests, upon exposure to the latex protein 24 to 48 hours, the body is sensitised by the latex protein leading to an allergic reaction.
3. Irritant Contact Dermatitis: this can be seen due to repeated close contact with the latex protein, which leads to skin irritation.

Based on the allergic mechanisms discussed above, it becomes evident that condom latex allergy may develop gradually with prolonged use, as the body becomes increasingly sensitised to the latex protein upon repeated exposure.

What are the symptoms of latex condom allergy?

In comparison between men and women, women tend to experience more severe symptoms of latex condom allergy given the thinner mucous membrane of the vaginal tract with a larger surface area of contact and absorption of the allergens from the condom.

Thankfully, most patients with condom latex allergy present with mild allergic symptoms over the contact surface (genital region) of the condom.

Common symptoms of latex allergy include:

• Skin itching
• Redness
• Swelling
• Hives and wheals

In some cases, symptoms may involve systemic symptoms such as wheezing, watery eyes, runny nose, facial swelling or flushing, and rashes over the body.

Rarely can one develop anaphylactic symptoms within seconds to minutes upon exposure to latex.

However, it is still important to be aware of severe allergic symptoms.

Severe symptoms of latex allergy include: 

• Shortness of breath, 
• Swelling and closure of the airway/throat, leading to difficulty in swallowing 
• Facial, lip swelling
• Generalised (whole body) itchy rash
• Dizziness or fainting due to plunging of blood pressure

In such a dire situation, please go to the emergency department immediately as anaphylaxis can be life-threatening, and it is a completely reversible condition if prompt treatment is given.

What is a latex-fruit allergy? 

Interestingly, about 30-50% of people with latex allergies are predisposed to have allergies to certain fruits. This is in view of the cross-reactivity of the allergen from latex and fruits. The body, being sensitised to the protein in the latex, mistakenly recognises the protein in certain fruits, causing a similar allergic reactions in the case of latex allergy. This is known as latex fruit allergy.

One may be more allergic to fruits such as avocado, banana, kiwi, peach, tomato, potato, passion fruit, and bell pepper. 

If you are concerned about latex or fruit allergies, you can reach out to your doctor, who you are comfortable with, for further evaluation. In certain cases, you may be offered an allergy blood test (RAST test) to confirm your latex and fruit allergy.

Is it possible that I am allergic to other chemicals in the condom rather than latex?

Yes, it is possible. One can be allergic to chemicals in the condom such as spermicide (nonoxynol-9), lubricants that have paraben, propylene glycol, glycerin etc. Symptoms associated with sensitivity to other chemicals in condoms are similar to latex condom allergy, such as redness, itch, burning, and swelling over the genital region. 

Often, the symptoms can be challenging to differentiate from a latex allergy or even other differentials such as sexually transmitted diseases (STDs). It is worth speaking to your healthcare providers about your possible concern about allergy to the components of condoms and allow your physician to evaluate further.

If I have an allergy to latex condoms, what are my other options for barrier contraception?

You can consider latex-free condom alternatives such as:

• Lambskin condom: lambskin condoms are more expensive, but they are durable and comfortable. However, as the pore diameter is larger than a latex condom, it does not protect against STIs, including HIV.
• Polyurethane condom: polyurethane condom is a plastic version of a condom. It is cheap and works in preventing pregnancy and STDs. Nonetheless, it is thin, and it is not stretchable in comparison to latex. Hence, it breaks and slips off easily. 
• Polyisoprene condom: polyisoprene condom is a man-made version of a ‘rubber condom’. It is more expensive than a latex condom but cheaper than a lambskin condom. It is comfortable and durable and effective in preventing pregnancy and STDs.

When should I consider seeing a doctor if I am concerned about latex condom allergy?

If you are feeling uncomfortable down below following intercourse, with symptoms such as itching, discharge, pain, redness, swelling, rash, or fever that doesn’t resolve, you should reach out to your doctor for further checkup.

What can my doctor offer me?

Your doctor will obtain your relevant medical and sexual history and then offer a relevant physical medical checkup. In the event of a concern of condom latex allergy, your doctor may offer you an allergy test, such as a RAST blood test, to detect any latex antibodies present in your body. Depending on individual risk of exposure, if there is concern of a concurrent infection, your doctor may discuss with you further STD screening tests.

How is latex condom allergy treated?

In the case of latex condom allergy, avoidance of culprit allergen is key. Your doctor may counsel you on various alternative options of latex-free condoms or other effective modes of contraception.

Antihistamines and topical steroids may be offered for localised latex condom allergic symptoms. In life-threatening allergy reactions, urgent medical attention with an adrenaline injection may be required to reverse the allergy.

Take home message for today:

• While a latex condom is effective in preventing pregnancy, it can be associated with latex allergy in long-term users.
• Allergy symptoms associated with latex condoms can be mild or even severe and life-threatening.
• One may also have simultaneous fruit/food allergy when having a latex allergy.
• Treatment is mainly via avoidance, symptomatic relief in mild cases, or adrenaline injection to reverse life-threatening allergic symptoms.
• You can screen for latex and fruit allergy. The tests are safe and can be done in outpatient settings.

References

1. Mahdy H, Shaeffer AD, McNabb DM. Condoms. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470385/
2. S Wagner et al. The latex-fruit syndrome. Biochem Soc Trans.  2002 Nov;30(Pt 6):935-40.
3. Turjanmaa K. Turjanmaa K. Rubber gloves and condom cause immediate hypersensitivity. Duodecim.1989;105(23-24):1905-8. 
4. Rosenberg MJ, Waugh MS, Solomon HM, Lyszkowski AD. Rosenberg MJ, et al. The male polyurethane condom: a review of current knowledge. Contraception. 1996 Mar;53(3):141-6
5. D A Levy et al. Allergy to latex condoms. Allergy.  1998 Nov;53(11):1107-8.
6. C P Hamann et al. Cutis. Update: immediate and delayed hypersensitivity to natural rubber latex. Cutis. 1993 Nov;52(5):307-11