Preventing Erection Problems Linked to Condom Use: Causes & Solutions

Depending on the study, 18 to 36 percent of condom users—roughly one-quarter—report condom-associated erection loss, usually difficulties maintaining firmness once condoms have been rolled over erections. Those at greatest risk include teens and young adult men, who are otherwise unlikely to report erection problems.

Oddly, public health officials have largely ignored condom-related erection loss. Presumably, they fear that addressing the issue might deter condom use and increase unplanned pregnancies and sexually transmitted infections (STIs). But ignoring this problem perpetuates it.

Fortunately, with a few minor adjustments, men of all ages can use condoms and maintain firm erections.

Two Eras

Throughout much of the world, condom use can be divided into two eras—before AIDS and after. Prior to AIDS, that is, before the early 1980s, a small proportion of men used condoms, but few liked them.

Condoms, then called rubbers or prophylactics (preventives), were not sold openly at U.S. pharmacies. Customers had to request them. Many men, especially teens and young adults, found that difficult to impossible.

And many, if not most men had objections to condoms: Donning them interrupted sex. During vigorous intercourse, they sometimes ripped or slipped off. And the biggest complaint—condoms reduced the penis’ erotic sensitivity and destroyed men’s sexual pleasure. The operant phrase was "showering in a raincoat."

Then in 1981, AIDS arrived. It has killed more than 700,000 Americans, more than twice the current toll of coronavirus. AIDS turned safe sex into a worldwide crusade and condoms into a public health priority. When used properly, condoms reliably prevent transmission of the AIDS virus (HIV). Health officials exhorted everyone who was non-monogamous to use them every time. Pharmacies switched to selling them openly and sales soared. Sure, men still raised objections, but in a world seriously threatened by AIDS, what was a little dulled sensitivity when the alternative might well be death?

Today, condoms rank as the nation's fourth most widely used contraceptive. Female sterilization is number one (19 percent of reproductive-age couples), followed by the Pill (13 percent), long-acting reversible contraceptives (IUDs, implants, 10 percent), and condoms (9 percent). Condoms are not rare, but considering they’re the only method that prevents both pregnancies and STIs, they’re under-utilized—and a significant reason is condom-related erection trouble.

Why Condoms Boost Risk of Erection Difficulties

Researchers at McGill University in Montreal analyzed nine rigorous studies of condom-related erection problems, and identified these risk factors:

• Alcohol. As pre-sex drinking increased, so did the risk of condom-related erection trouble. With or without condoms, alcohol is the world’s leading cause of drug-induced erection loss. Sex while drunk also compromises lovers’ motivation to use condoms and their ability to use them properly.
• Sexual anxieties. Compared with men who used condoms frequently and comfortably, those who rarely used them or felt anxious about them reported up to three times more erection problems, and significantly more ripping and slip-offs. In addition, independent of concerns about condoms, men who felt unsure of their lovemaking skills experienced significantly more condom-linked erection problems. Finally, compared with monogamous men, those with three or more lovers during the previous year had twice the risk of condom-related erection difficulties. Men tend to be more anxious with new partners.
• Timing. Rolling condoms on before full erection increased the risk of erection difficulties. Ditto for applying them moments before attempting intercourse. And as time spent fiddling with condoms increased, so did the risk of erection difficulties.
• Distraction. If condoms interfered with men’s erotic focus, erection difficulties became more likely.
• Who applied them. When men rolled them on, erection problems were more likely than when women did.
• Fit and feel. If men thought condoms didn’t fit properly or feel right, their likelihood of erection problems increased.
• Previous erection problems. Men who reported any history of erection impairment with or without condoms often reported condom-related problems as well.
• Depression and anxiety disorders. These mental health challenges interfere with the focus required to use condoms correctly.

How to Maintain Firm Erections While Using Condoms

Once men and their partners understand the risk factors for condom-linked erection problems, it’s not difficult to use condoms happily:

• Limit alcohol before sex. One drink is usually fine, two maybe, but any more, and men face a substantial risk of erection impairment, especially if they feel unfamiliar with condoms or uncomfortable using them.
• First practice solo. Before attempting condom-covered intercourse, men should practice rolling them on by themselves during self-sexing. Practice reduces condom anxieties, increases comfort, and reduces the risk of erection loss. Men should play with solo sex until they feel confident they can maintain erections while using condoms.
• Women should apply them. While rolling condoms onto themselves, men may become distracted, and sex may feel interrupted. But when women do it, condom application can be easily incorporated into hand jobs and fellatio, which eliminates distractions and interruption, and reduces the risk of erection loss. Women should wait to unroll condoms until men have firm erections.
• After the woman places the condom, the couple should make sure the woman is well lubricated before attempting intercourse. Many women of all ages don’t produce much self-lubrication. Vaginal dryness increases the risk of discomfort and condom breakage. Men should provide generous cunnilingus before intercourse (assuming women enjoy it — most do). In addition, couples should consider commercial lubricants.
• If men have mental health issues, they should seek professional treatment.

Showering in a Raincoat?

Gentlemen, imagine you and your girlfriend are watching a movie. She leans over, unzips your pants, and starts giving you a handjob. You’re probably getting excited just reading this little fantasy. Now consider this. Your pants and underwear are 500 times thicker than any condom. In this visualization, no one has even touched you and you may well feel some arousal. Really, how much sensation can condoms block?

As I discuss in my new book, Sizzling Sex for Life, unless lovers specify otherwise, sizzling sex is based on touching each other all over—gently and playfully for a good 20 minutes before anyone reaches between anyone else's legs. If you massage everything, covering one little part with something as thin as a condom hardly matters. Condoms aren’t like showering in a raincoat. They’re more like showering with a ring on one finger.

Men who accuse condoms of reducing sensitivity are usually young and sexually inexperienced. Indiana University researchers gave a dozen condoms to 1,875 men aged 18 or older and asked them to keep daily sex diaries for a month. The men expressing the most discomfort were the youngest. As age and sexual experience increased, so did comfort with condoms and enjoyment of condom-covered lovemaking.

To enhance sensitivity, place some saliva or a drop of lubricant on the head of the penis before unrolling the condom. But be careful. This increases the risk of slip-offs. One of you might hold the condom onto the base of the penis.

Condom manufacturers all claim their brands “deliver” the most sensitivity. Actually, all condoms are pretty much the same. Personal preferences are possible, but condoms don’t deliver pleasure—lovers create it with kissing, hugging, whispered endearments, and after 20 minutes or so of mutual whole-body massage, genital play.

Some condoms have ribbed sides that supposedly excite women. But the ribs are virtually imperceptible and don’t touch women’s orgasm trigger, the clitoris, which sits outside the vagina above it beneath the top junction of the vaginal lips. For all practical purposes, the ribs are useless.

Men who know what they’re doing don’t develop condom-related erection problems. Men who hope to become more sexually skilled—and more comfortable with condoms—might read my previous post, “Advanced Sexual Techniques for World-Class Lovers” or my book.