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No matter your age, not being able to get an erection when you want one is frustrating. But, if you’re in your 20s or 30s and find that you’re unable to get or maintain an erection, you may be wondering if what’s going on down there is normal.
Erectile dysfunction (ED) in younger men is much more typical than previously thought. In fact, some estimates show that up to 30% of men under 40 experience erectile dysfunction (Nguyen, 2017). That said, if you’re a previously healthy guy, erectile dysfunction in younger men could be a sign of a more serious health condition. Let’s dive a bit more into some stats surrounding ED in young men and some of the causes of erectile dysfunction in your 20s.
What is erectile dysfunction (ED)?
ED occurs when you can’t get or maintain an erection sufficient for satisfying sex. That might include erections that don’t last as long as you want or aren’t as firm as you’d like. It’s the most common sexual dysfunction. In fact, it’s estimated that 30–50 million American men have experienced it (Sooriyamoorthy, 2020). But, how common is erectile dysfunction for men in their 20s?
How many men in their 20s have ED?
Several studies conducted in the past decade have found a sharp increase in the number of men under 40 reporting ED—a condition once considered exclusive to older men.
For example, an Italian study published in 2013 noted that, out of 439 men who had erectile dysfunction, 114 (26%) were younger than 40 (Capogrosso, 2013). And nearly half of those young men had “severe” ED, according to the International Index of Erectile Function (IIEF), a 15-item questionnaire that assesses erection frequency and quality.
So, is something causing ED to skyrocket among young guys in their 20s? The answers are complicated.
Causes of erectile dysfunction in your 20s
Researchers haven’t definitively determined that the rising numbers of young men reporting ED are caused by something specific that’s going on in that age group, but there are several theories.
A possible cause is that the increase in ED among younger men is due to the development of effective treatments for the condition. After all, Viagra was only introduced in the mid-’90s. That has led to greater awareness of ED, enabling young men to reach out to their healthcare providers, whereas in previous generations, they might have suffered in silence.
Awareness aside, some psychological and physical causes of ED may also be to blame.
Psychological causes of ED in younger men
Some scientists think the rise of internet porn might be affecting young men’s psychological approach to sex and dampening their sex lives. However, a 2019 review of studies found insufficient evidence to support that hypothesis (Dwulit, 2019).
Other potential psychological causes that do have science to back them up include self-esteem issues, performance anxiety, general anxiety, or depression (Rew, 2016).
Physical causes of ED in younger men
If you’re pretty sure your mental health isn’t causing your ED, there are certain physical causes of erectile dysfunction in younger men. Obesity, alcohol or tobacco use, and drug abuse may play a role. Additionally, ED can occur as a side effect of certain medications, including antidepressants (Rew, 2016).
Aside from these lifestyle factors, some medical conditions can also cause ED.
ED can be an early sign of a more significant health condition such as heart disease, low testosterone, high blood pressure, high cholesterol, or diabetes (Sooriyamoorthy, 2021).
Because the blood vessels in the penis are smaller than in other parts of the body, ED symptoms sometimes occur before more serious problems strike, such as a heart attack or stroke (Sooriyamoorthy, 2021). So, when an otherwise healthy man in his 20s experiences ED, it could be cause for concern. This is why it’s essential to talk with a healthcare provider as soon as possible if you’re a younger man with erectile dysfunction.
Treatments for young men with ED
Treating your ED will ultimately depend on its cause. Medications, natural remedies, and lifestyle changes may all be helpful. Let’s dive into each of them now (Sooriyamoorthy, 2021):
Prescription medications for ED are highly effective. Several are available, including sildenafil (brand name Viagra; see Important Safety Information), tadalafil (brand name Cialis; see Important Safety Information), and vardenafil (brand name Levitra).
If low testosterone is responsible for your erectile dysfunction, testosterone replacement therapy (TRT) can boost your testosterone levels via injection, a wearable patch, or gel applied to the skin.
External vacuum devices
For some young men with ED, this non-surgical option—more commonly known as a “penis pump”—may prove to be helpful. Essentially, you place a cylinder over your penis and make sure it’s sealed tightly. Then, you use a vacuum pump that causes an “artificial” erection that can last for up to 30 minutes.
Natural remedies and lifestyle changes
Some men have found natural remedies for ED to be effective. Some studies have shown that certain supplements (such as DHEA, ginseng, L-arginine, L-carnitine, and Yohimbe) may be helpful.
Aside from supplements, your erections will be best when you’re healthy. Making simple lifestyle changes, such as getting regular exercise, eating a healthy diet, quitting smoking, and limiting your alcohol consumption, might be enough to improve your ED.
Penis implant surgery
For severe ED, when all other treatment options have failed, a surgically placed penis implant has been effective in restoring sexual function.
Working with a healthcare provider
For many younger men, talking about erectile dysfunction can be difficult. But rest assured that you are far from alone, and your healthcare provider can help you find a solution that’s right for you—and can potentially catch other health problems that may be causing your ED.
- Capogrosso, P., Colicchia, M., Ventimiglia, E., Castagna, G., Clementi, M. C., Suardi, N., et al. (2013). One patient out of four with newly diagnosed erectile dysfunction is a young man—worrisome picture from the everyday clinical practice. The Journal of Sexual Medicine, 10(7), 1833–1841. doi: 10.1111/jsm.12179. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23651423/
- Dwulit, A. D., & Rzymski, P. (2019). The potential associations of pornography use with sexual dysfunctions: an integrative literature review of observational studies. Journal of Clinical Medicine, 8(7), 914. doi: 10.3390/jcm8070914. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31247949/
- Janjgava, Sh., & Doliashvili, T. (2016). Erectile dysfunction as a predictor of cardiovascular disease. Georgian Medical News, (261), 36–41. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28132040/
- Nguyen, H., Gabrielson, A., & Hellstrom, W. (2017). Erectile dysfunction in young men – a review of the prevalence and risk factors. Sexual Medicine Reviews, 5(4), 508–520. doi: 10.1016/j.sxmr.2017.05.004. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28642047/
- Nunes, K. P., Labazi, H., & Webb, R. C. (2012). New insights into hypertension-associated erectile dysfunction. Current Opinion in Nephrology and Hypertension, 21(2), 163–170. doi: 10.1097/mnh.0b013e32835021bd. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22240443
- Rew, K. T., & Heidelbaugh, J. J. (2016). Erectile dysfunction. American Family Physician, 94(10), 820–827. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27929275/.
- Sooriyamoorthy, T., & Leslie, S. (2021). Erectile Dysfunction. [Updated Aug 12, 2021]. In: StatPearls [Internet]. Retrieved Dec. 8, 2021 from https://pubmed.ncbi.nlm.nih.gov/32965924/
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.