ORIGINAL RESEARCH–ED PHARMACOTHERAPY: Do Phosphodiesterase Type 5 Inhibitors Protect Against Condom-Associated Erection Loss and Condom Slippage?
Version of Record online: 27 APR 2009
© 2009 International Society for Sexual Medicine
The Journal of Sexual Medicine
Volume 6, Issue 5, pages 1451–1456, May 2009
How to Cite
Sanders, S. A., Milhausen, R. R., Crosby, R. A., Graham, C. A. and Yarber, W. L. (2009), ORIGINAL RESEARCH–ED PHARMACOTHERAPY: Do Phosphodiesterase Type 5 Inhibitors Protect Against Condom-Associated Erection Loss and Condom Slippage?. Journal of Sexual Medicine, 6: 1451–1456. doi: 10.1111/j.1743-6109.2009.01267.x
- Issue online: 27 APR 2009
- Version of Record online: 27 APR 2009
- Phosphodiesterase 5 Inhibitors;
- Sexually Transmitted Infections Risk;
- Erectile Dysfunction
Introduction. Some physicians prescribe phosphodiesterase type 5 inhibitors (PDE5i) for men who experience condom-associated erection difficulties with a view to increasing condom use and reducing risk of sexually transmitted infections.
Aim. To examine whether the prevalence of erection-related condom problems differs between men using and not using PDE5i at the last condom-protected penile–vaginal (PVI) or penile–anal intercourse.
Methods. Seven hundred-five men who had used a male condom during the past 3 months for PVI were selected from a sample recruited through advertisement to an electronic mailing list for a large, internet-based, sexual-enhancement product company. An internet-based questionnaire posted in 2006 assessed condom-use errors and problems.
Main Outcome Measures. Men who did and did not use PDE5i during the last time a condom was used were compared on: (i) erection loss while applying a condom; (ii) erection loss during sex while using a condom; (iii) condom slipped off during sex; (iv) delayed condom application (penetration of the vagina or anus prior to application of the male condom); (v) early condom removal (condom taken off and intercourse continued without it); (vi) “problem with the way the condom fit”; (vii) “problem with the way the condom felt”; and (viii) condom breakage.
Results. Controlling for age, marital status (yes/no), and having children (yes/no), PDE5i users, compared with nonusers, were: (i) three times more likely to report erection loss during sex while using a condom (adjusted odds ratio [AOR] = 3.21, 95% confidence interval [CI] = 1.40–7.39, P = 0.006); (ii) almost five times more likely to report the condom slipped off during sex (AOR = 4.75, 95% CI = 1.68–13.44, P = 0.003); and (iii) more than twice as likely to remove condoms before sex was over (AOR = 2.46, 95% CI = 1.09–5.56, P = 0.03).
Conclusions. Physicians prescribing PDE5i may want to evaluate whether men are experiencing condom-associated erection difficulties and, if they are, consider titrating dosages and/or making referrals for psychosexual therapy and/or condom skills education. Sanders SA, Milhausen RR, Crosby RA, Graham CA, and Yarber WL. Do phosphodiesterase type 5 inhibitors protect against condom-associated erection loss and condom slippage? J Sex Med 2009;6:1451–1456.