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J Sex Med. 2015 Sep;12(9):1897-904. doi: 10.1111/jsm.12964. Epub 2015 Aug 17.

General Erectile Functioning among Young, Heterosexual Men Who Do and Do Not Report Condom-Associated Erection Problems (CAEP).

Sanders SA1,2,3, Hill BJ1,4, Janssen E1,5, Graham CA1,2,6, Crosby RA1,2,7, Milhausen RR1,2,8, Yarber WL1,2,3,9.

Author information

  • 1The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.
  • 2Department of Gender Studies, Indiana University, Bloomington, IN, USA.
  • 3Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA.
  • 4Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, USA.
  • 5Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium.
  • 6Department of Psychology, University of Southampton, Southampton, UK.
  • 7Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, KY, USA.
  • 8Department of Family Relations and Applied Nutrition, University of Guelph, Ontario, Canada.
  • 9Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA.



Condom-associated erection problems (CAEP) are an underestimated factor related to inconsistent or incomplete male condom use. The underlying mechanisms of CAEP are not understood, and whether men who report these difficulties are also likely to experience erectile problems in situations when condoms are not used has not been studied.


The aim of the study was to investigate, in a sample of condom-using young, heterosexual men (aged 18-24 years), whether men who report CAEP are more likely to (i) have erection problems when not using condoms and (ii) meet criteria for erectile dysfunction.


A total of 479 men recruited online completed the International Index of Erectile Function (IIEF-5) and answered questions about erection problems experienced when using and not using condoms during the last 90 days. Demographic, sexual experience, and health status variables were investigated as correlates.


Self-reported frequency of erection loss during condom application or during penile-vaginal intercourse (PVI) in the past 90 days and IIEF-5 scores.


Of the men, 38.4% were classified in the no CAEP group, 13.8% as having CAEP during condom application, 15.7% as having CAEP during PVI, and 32.2% as having CAEP during both condom application and PVI. Men reporting any form of CAEP were significantly more likely than men reporting no CAEP to also report erection difficulties during sexual activity when not using condoms. Men who reported CAEP during PVI only or during both application and PVI scored significantly lower on the IIEF-5 than men without CAEP.


The findings suggest that men who report CAEP are also more likely to experience more generalized erection difficulties. Clinicians should assess whether men using condoms experience CAEP and where appropriate, refer for psychosexual therapy or provide condom skills education.


Condom-Associated Erection Problems; Condoms; Condoms for Penile-Vaginal Intercourse; Sexual Arousal

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