Men with condom-associated erection problems (CAEP) may need more time and stimulation to become aroused, American researchers say.
A man with CAEP might lose his erection while putting on a condom or during penile-vaginal intercourse with a condom. While the situation is not uncommon, scientists are not clear on why it happens. However, CAEP may make men less likely to use condoms, which is a public health concern.
In this study, researchers from Indiana University, the University of Chicago, and Michigan State University looked at three aspects of CAEP. First, they wanted to know whether distraction was a factor. Could something in the environment or concerns about performance be contributing to CAEP?
Second, they wondered whether men with CAEP needed more tactile stimulation in order to maintain an erection. And third, the researchers wanted to know if men with CAEP had a higher threshold for sexual arousal.
They recruited 142 heterosexual men with a mean age of 20.8 years to participate in the study. Fifty-three percent of the men had CAEP. Over the previous 90 days, the men had had an average of 16.7 sexual encounters involving penile-vaginal intercourse. They used condoms in an average of 11.5 of these encounters. Just over 60% of the men had had more than one female sex partner in that time period.
In accordance with the study inclusion criteria, none of the men were in a committed relationship. The researchers explained that men who were not in long term relationships were at higher risk for sexually-transmitted diseases and HIV infections. They also pointed out that CAEP in longer-term relationships could be influenced more by the relationship itself rather than the physical aspects of erection.
Each man was shown a series of four sexually-explicit film clips. Each clip lasted three minutes and depicted petting during the first minute, oral sex during the second minute, and penile-vaginal intercourse during the third minute. A 15-minute neutral clip of marine life was shown between each erotic clip.
Three of the erotic clips included some form of stimuli or task. During one clip, the men received vibrotactile stimulation from a ring-shaped vibrator. During another, men were asked to solve a simple arithmetic problem (“neutral distraction”) that was shown in the corner of the screen. A third clip included instructions to get an erection as quickly as possible (“performance demand”). The fourth clip did not have any stimuli or task.
The men’s penile circumference was measured during the first, second, and third minutes of each erotic film clip using a device that the men attached to the penis themselves.
The men with CAEP had significantly smaller penile responses during the first minute of each erotic clip. However, their responses did not differ much from the men without CAEP during the second and third minutes of each film.
The researchers suggested that the men with CAEP were not more sensitive to distraction or performance demand than the men without CAEP. They also noted that men with CAEP “do not necessarily have a stronger need for tactile stimulation.”
However, men with CAEP may need more time, stronger stimulation, or both to become aroused, the authors said.
They acknowledged that the distraction and performance-related factors could be different during an actual sexual encounter. “It is possible that the arithmetic tasks used for the distraction condition do not sufficiently mimic the distraction of condom application,” they wrote.
Still, their results could help healthcare providers develop interventions for men with CAEP. Letting men know that they might need more time and stimulation might encourage men to use condoms more consistently.
The study was first published online in May in the Journal of Sexual Medicine.
The Journal of Sexual Medicine
Janssen, Erick, PhD, et al.
“Patterns of Sexual Arousal in Young, Heterosexual Men Who Experience Condom-Associated Erection Problems (CAEP)”
(Full-text. First published online: May 2, 2014)