Among the many reasons reported by men for not using condoms consistently is that they can’t “keep it up” when they’re wearing a rubber. In other words, some guys stay away from condoms because they believe that using them causes erectile difficulties. While this may be the truth for some guys, a study just published in The Journal of Sexual Medicine finds that, for a lot of men, condoms aren’t necessarily to blame because they appear to have broader erectile problems.

In this study, researchers looked at data from 479 heterosexual, sexually active college men aged 18-24 who were not currently in long-term relationships. Participants completed a scale to assess their general level of erectile functioning (the International Index of Erectile Function or IIEF) and were asked questions about erection problems they had experienced in the past 90 days during times they had sexual intercourse with and without a condom.

Reports of condom-associated erection problems were common, with 61.6% of participants reporting such problems at least occasionally during application of a condom, sexual penetration with a condom, or both.

Among those who reported no condom-associated erection problems, reports of erectile difficulties when not using a condom were relatively rare (9.9%). In contrast, among those who said that condoms caused performance problems, the prevalence of erectile difficulties during condomless sex was much higher (24.6%-43.0%).

Results from the IIEF (the general scale of erectile function) were consistent with these findings, such that for men who reported no condom-associated erection problems, their IIEF scores were the highest, indicating better erectile functioning. Those who reported that condoms interfered with their erections had lower IIEF scores (especially those who claimed erection problems during condom application and subsequent penetration). For both groups, however, mean IIEF scores were in the normal range and the vast majority of men did not meet clinical criteria for erectile dysfunction.

To sum it up, reports of condom-associated erection problems were linked to having more general (albeit mostly mild) erectile difficulties. This pattern of results suggests that, for a lot of guys who say that condoms cause erection problems, condoms aren't really the issue.

That said, the very specific inclusion criteria used to select participants for this study necessarily limits the potential generalizability of these findings. In addition, the researchers only asked about experiences with erection problems, not whether guys felt distressed or bothered by those problems.

It is also worth noting that, while generalized erection difficulties may contribute to condom-associated erection problems, such problems may also result from lack of knowledge or confidence in using condoms, or possibly inadequate sexual stimulation. Indeed, more than one-third of participants in the study described here reported never having been taught proper condom use. Thus, improved sex education could potentially play a key role in reducing condom-associated erection problems.

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To learn more about this research, see: Sanders, S. A., Hill, B. J., Janssen, E., Graham, C. A., Crosby, R. A., Milhausen, R. R., & Yarber, W. L. (2015). General Erectile Functioning among Young, Heterosexual Men Who Do and Do Not Report Condom‐Associated Erection Problems (CAEP). The Journal of Sexual Medicine.

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