I am a college student who has no difficulty achieving an erection. However, when I put on a condom, I almost instantaneously lose the erection. Does this condition mean that I suffer from a form of impotence, despite my young age and high level of physical fitness? If so, what do you recommend I do about treatment?

Let me preface this response by stating that everyone should have medical problems ruled out by a medical doctor when they are concerned about symptoms and physical health.

That said, it sounds like you probably do not suffer from impotence if your loss of erection is only limited to the moment when you put on a condom. If you have no trouble achieving and maintaining erections at other times (spontaneously, masturbating, oral sex, mutual masturbation, etc), then something else might be going on.

Losing an erection when putting on a condom is something that happens among men, probably more commonly than you think. One explanation for erection loss could simply be the process of having to change one's focus from the emotional excitement of sex to a more cognitive, rational process of safer sex. Let's face it, condoms aren't the most pleasant things and can remind us of infections and illness. Condoms reduce sensation and can be awkward to use.

After you lose your erection the first time, anxiety can mount and further exacerbate the problem, sometimes referred to as "performance anxiety." Simply anticipating putting on a condom can cause someone to lose their erection. Resistance to condom use can arise from previous experiences of erection loss when wearing a condom. To some guys, the shame and embarassment experienced by losing an erection is much worse than having unprotected sex and not losing an erection. Some guys may even think that there is something wrong with them.

There are ways to approach the situation. Try to remember that condom use is not instinctual; it is a learned skill. One suggestion is to attempt to masturbate privately with a condom on. When you are alone and in the mood, try getting an erection and putting the condom on your penis. Take your time, relax, and be patient. Try imagining yourself using the condom with your partner. Eventually you could get to a point where you can maintain an erection or ejaculate inside of the condom while masturbating.

At this point, think about integrating your condom use into the sexual activity with your partner, as opposed to making it a separate act. Maybe your partner could put the condom on for you. You could also try putting the condom on during foreplay and then continue with foreplay for a bit. If you lose your erection, toss the condom, relax, fool around a bit more, and try again if you want. Remember that there are other things you can do besides intercourse/fucking that can be pleasurable and fun. The more pressure you put on yourself to be a rock hard stud, the greater your chances are of having anxiety and losing your erection.

RMK