Sexual Health Birth Control Condoms The Pros and Cons of Spermicidal Lubricant External Condoms By Elizabeth Boskey, PhD Elizabeth Boskey, PhD Facebook LinkedIn Twitter Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. Learn about our editorial process Updated on December 05, 2022 Medically reviewed by Brian Levine, MD Medically reviewed by Brian Levine, MD LinkedIn Brian Levine, MD, MS, FACOG, is board-certified in obstetrics and gynecology, as well as in reproductive endocrinology and infertility. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents What Is Nonoxynol-9? Dangers of N-9 N-9 and Safer Sex Uses A spermicide is any compound that can be used to kill sperm. They are used in many contraceptives and come in several forms, including spermicidal lubricant. Rattanakun Thongbun / EyeEm / Getty Images External condoms with spermicidal lube used to be a pretty common option for safer sex. However, that began to change once people started to become aware of the potential dangers of nonoxynol-9 (N-9) use. Many spermicides currently available in the United States contain N-9. Other spermicides and spermicidal microbicides are currently under development. Many are being designed to avoid the problems currently being seen with N-9 use. This article looks at the pros and cons of using external condoms with spermicidal lubricant. What Is Nonoxynol-9? N-9 is basically a type of detergent. It disrupts the plasma membranes (outer barrier) of sperm and other cells. Most spermicide products in the U.S. contain the chemical N-9. Scientists once believed N-9 to be effective at destroying sexually transmitted infection (STI) pathogens, including HIV, herpes, chlamydia, and gonorrhea, but current research no longer supports this theory. Other commercial spermicides that contain N-9 are also detergents. These products have similar properties to N-9. Hidden Dangers of N-9 Many people think that if a little bit of spermicide is good, then a lot of spermicide is bound to be better. However, that theory is actually incorrect. It turns out that many spermicides, when used in excess, can make sex more hazardous. They can actually increase your risk of acquiring or transmitting an STI. When used frequently or in high amounts, N-9 causes inflammation of the vagina and cervix. It can also actually kill off layers of cells in the vaginal epithelium, the layers of skin cells that line the vagina. That damage increases susceptibility to infection by STIs and the likelihood of transmitting them. Regular use of N-9 may increase your risk of HIV, herpes, and other STIs. Some people may experience problems with even infrequent use. It's also possible to have a sensitivity or allergy to spermicides containing N-9. High Risk of STIs? If you're using a diaphragm, cervical cap, or the Today Sponge for contraception and you're at high risk of sexually transmitted infections, talk to your healthcare provider about possible alternative forms of contraception. N-9 and Safer Sex Not everyone needs to worry about N-9. However, it's good to have other options for practicing safer sex. That's particularly true if you have frequent sex. It's also true for people who are at high risk of STIs. If you have frequent sex, consider using non-lubricated external or internal condoms with your own N-9-free lubricant, or non-spermicidal external or internal condoms. This is particularly important if you have sexual intercourse more than once or twice a day. Lubricant is an important component of safer sex. It's important to use the right kind, though, and one containing N-9 may not be right for you. If you're in a mutually monogamous relationship and you've all been tested, then the potentially increased STI risk may be less of a concern since STIs are passed from one partner to another. If you choose to use condoms with spermicide on them, keep in mind that spermicide products are for vaginal use only and should not be used for anal sex. How to Prevent STIs Uses of Spermicidal Lube Condoms If you're at high risk of pregnancy and low risk of STIs, spermicidal-lubricated external condoms may still be a reasonable choice. To help you decide, information about external condoms with spermicidal lubricant is provided below: Price: Spermicidal-lubricated external condoms don't cost more than other external condoms. Ease of acquisition: External condoms with spermicidal lube are available over the counter at most drug stores and online. They can also be found at some family planning clinics. Use during penile-vaginal intercourse: External condoms with spermicidal lubricant may have an advantage for people in monogamous heterosexual relationships who are more concerned with pregnancy than STIs. Otherwise, they have no advantage over other external condoms. Use during oral sex: External condoms with a spermicidal lubricant are particularly bad for oral sex. N-9 not only can make your tongue numb, but it also tastes horrible. Use during anal sex: N-9 may cause damage to the rectal lining that could increase the likelihood of transmitting HIV or another infection. External condoms without N-9 are probably a better idea for anal sex. What Is the Risk of HIV From Anal Sex? A Word From Verywell Spermicidal-lubricated external condoms are, most often, latex condoms lubricated with N-9. Although spermicide should increase the contraceptive efficacy of the external condom, that may be offset by the disadvantages of a spermicidal personal lubricant. There's evidence that use—and particularly frequent use—of a spermicidal lubricant containing N-9 may actually increase your susceptibility to STIs. Because of this, few sex educators recommend using spermicidal-lubricated external condoms. Their only really appropriate use is for preventing pregnancy in low-risk relationships. What to Do If You Suspect an STI 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. World Health Organization. Nonoxynol-9 ineffective in preventing HIV infection. Zalenskaya IA, Cerocchi OG, Joseph T, Donaghay MA, Schriver SD, Doncel GF. Increased COX-2 expression in human vaginal epithelial cells exposed to nonoxynol-9, a vaginal contraceptive microbicide that failed to protect women from HIV-1 infection. Am J Reprod Immunol. 2011;65(6):569-577. doi:10.1111/j.1600-0897.2010.00964.x Planned Parenthood. What are the disadvantages of using spermicide? Memorial Sloan Kettering Cancer Center. Nonoxynol 9. By Elizabeth Boskey, PhD Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit