Authors: Kasper, Candace Sue; Chandler, P.J., Jr.
Citation: JAMA, The Journal of the American Medical Association, March 15,
1995 v273 n11 p846(2)

This risk is due to tale, a dry lubricant present on the surface of
condoms. Talc is a known sclerosing agent, which if introduced into the
female reproductive tract may result in fallopian tube fibrosis with
resultant infertility.[1] Of even greater concern are studies linking talc
to ovarian cancer.[2-4]

Our interest in tale arose fortuitously during a clinico-pathologic study
of fibrotic capsules surrounding silicone gel-filled breast implants. We
found talc, an unwanted contaminant, within 70% of the capsules
evaluated.[5] Microscopic examination of powder on the surface of archived
surgical gloves revealed that gloves manufactured before 1991 probably
represented the source of tale found in implant cavities (unpublished
data, Plastic Surgery Research Forum, April 1994). We also examined other
health- and consumer-related latex devices and determined that condoms and
dental dams were coated with varying amounts of talc, but that pacifiers
and baby bottle nipples were talc free (Table).

The harmful effect of talc on human tissue was first recognized in the
1930s when postoperative granulomatous peritonitis and fibrous adhesions
were causally linked to surgical glove-donning powders. Thirty years
later, Saxen et al[1] reported foreign-body granulomatous peritonitis in a
woman with no previous history of abdominal surgery. Particulate matter
found within her peritoneal granulomas was identical to material found on
the surface of condoms used by her husband. The authors concluded that
material in the condom lubricant traveled upward through the fallopian
tubes and became implanted within the patient's peritoneal cavity; they
also predicted that condom lubricants might contribute to tubal occlusion
and sterility.

A more ominous series of studies linked talc to ovarian carcinoma; talc
was observed in a number of ovarian and uterine tumors as well as in
normal ovarian tissue.[1,3] It was hypothesized that deodorizing tales
placed on the perineum (or on the surface of condoms and diaphragms)
reached the ovaries via ascent through the fallopian tubes.[24] In support
of this hypothesis, retrospective analyses demonstrated that women who
used deodorizing powders on sanitary napkins, but who had blocked tubes
and/or hysterectomies, had a lesser incidence of ovarian carcinoma than
women with patent tubes.[2]

Although tale is no longer used as a surgical glove-donning powder, it is
still used as a surface lubricant on the majority of condoms manufactured
in the United States and abroad. Remarkably, the Food and Drug
Administration never addressed the issue of talc on the surface of
condoms, even though they required surgical glove manufacturers to remove
all tales used in processing.

The last 10 years has seen a dramatic increase in the use of condoms. If
tale contributes to ovarian carcinoma and/or fallopian tube sclerosis, we
predict a significant increase in the incidence of ovarian carcinoma and
infertility due to the deleterious effects of condom talc. We do not
advocate abandoning condom use. To obviate the risk of talc-associated
morbidity in sexually active women, we strongly urge condom distributors
to eliminate all tales used in condom manufacture.

[1.] Saxen L, Kassinen A, Saxen E. Peritoneal foreign-body reaction caused
by condom emulsion. Lancet. 1963;1:1295-1296. [2.] Longo D, Young

R. Cosmetic tale and ovarian cancer. Lancet. 1979;2:349-351. [3.]
Henderson W, Joslin C, Turnbull A, Griffiths K. Tale and carcinoma of the
ovary and cervix. J Obstet Gynecol Br Commonwealth. 1971;78:266-272. [4.]
Harlow B, Weiss N. A case-control study of borderline ovarian tumors: the
influence of perineal exposure to tale. Am J Epidemiol. 1989;130.390-M.
[5.] Kasper C, Chandler P. Talc deposition in skin and tissues surrounding
silicone gel-containing prosthetic devices. Arch Dermatol. 1994-130:48-53.

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