Erectile dysfunction historically has been associated primarily with older men, its symptoms rarely showing up until a man is in his 40s or 50s. But over the past decade, urologic clinics worldwide have been seeing a growing number of young men whose chief complaint is an inability to get and keep an erection firm and long-lasting enough for intercourse. Surprised by this upsurge in ED among men under 40, urologists and other medical professionals have been struggling to find explanations for this growing phenomenon.
Erectile dysfunction is by no means an inevitable consequence of aging. However, the older a man is, the more time he’s had to inflict damage on his body through weight gain, a lack of regular exercise, unhealthy eating habits, smoking, and heavy alcohol consumption. The long-term effect of such unhealthy behaviors is to gradually impede blood flow to the penis, which eventually makes it difficult, if not impossible, to get and keep an erection. And insufficient blood flow to the penis is responsible for the vast majority of ED, far outstripping psychological factors as a cause of male impotence.
Incidence of ED in Young Men Surges
Erection problems are hardly unknown among younger men, but they have not usually been anywhere near as prevalent among the young as they are in men over 40 or 50. While ED of psychological origin is estimated to account for only 10 to 20 percent of all such diagnoses, this form of impotence has historically accounted for the lion’s share of ED in younger men. Psychological factors that can lead to ED include depression, anxiety (particularly performance anxiety), stress, and a lack of self-confidence.
One of the first studies to turn the spotlight on the increasing prevalence of ED among the young was conducted by Italian urologic researchers associated with Milan’s University Vita-Salute San Raffaele and Magna Graecia University in Catanzaro, Italy. Published in the July 2013 issue of “The Journal of Sexual Medicine,” the study found that one patient out of every four newly diagnosed with ED was under the age of 40. Perhaps even more alarming was the finding that roughly half of the younger men diagnosed with ED reported severe symptoms of the type more commonly associated with much older men.
Young Have Fewer Underlying Medical Conditions
The Italian study found that its ED patients under 40 were less likely to have other serious underlying illnesses, some of which are associated with an increased risk of male impotence. However, it did observe that the younger men reported a higher incidence of premature ejaculation and were also more likely to smoke cigarettes and use illegal drugs. Not surprisingly, the younger men had higher blood levels of testosterone and lower body mass index values than was observed in the study’s older men.
The Italian study was confined to a total of only 439 ED patients visiting a urology clinic, of whom 114 were age 40 or younger. To gauge the degree of erectile dysfunction in all these men, they were all subjected to the International Index of Erectile Function, or IIEF, a self-administered test to determine the degree of erection problems. Based on the results of the IIEF tests, 48.8 percent of ED patients under the age of 40 were found to suffer from severe symptoms, compared with only 40 percent of those over 40.
Are Cybersex, Porn to Blame?
Frequently put forward as a possible cause of the upsurge in diagnoses of ED among younger men is the increased access to 21st-century alternatives to sexual intercourse, including cybersex and pornography. Some have theorized that the porn widely available online often depicts sexual acts of an extreme nature carried out by individuals who are idealized models of physical attractiveness and thus may desensitize those who view it. According to this theory, regular porn viewers may have difficulty becoming aroused by real physical sexual activity that pales in comparison to that they have viewed in pornography.
Hand in hand with that theory is the suggestion that frequent masturbation, particularly while watching hard porn, makes it more difficult for some men to get an erection when the opportunity for real sex arises. WebMD.com dismisses such suggestions as myth, noting that “masturbation is normal and won’t cause problems when you have sex with a partner.”
Masturbation Isn’t the Culprit
While most medical professionals agree that masturbation is not a direct cause of ED, some suggest that it can make it harder for men — and women — to achieve orgasm. Interviewed by EverydayHealth.com, Susan Kellogg-Spadt, director of female sexual medicine at the Center for Pelvic Medicine in Bryn Mawr, Pennsylvania, said men and women who masturbate frequently become accustomed “to a certain touch, whether its vibration or your own hand.”
In a more recent overview of the rise in ED among younger men, urologic researchers from Tulane University cite data from multiple studies indicating that the incidence of ED in this age demographic could be as high as 30 percent. Their review of the scientific literature, published in the October 2017 issue of Sexual Medicine Reviews, concludes that erectile dysfunction “in young men is an increasingly common condition.” Because the causes of ED in this age group can vary significantly from one patient to another, the review’s authors urge doctors to conduct “careful diagnostic evaluation” to pinpoint the precise cause of each patient’s ED symptoms.
Multiple Studies Show Rise in ED
Among the more alarming revelations in this recent review, according to an article posted at SexHealthMatters.org, are the following:
- A Swiss study of young men between the ages of 18 and 25 found that roughly 30 percent of them suffered from some degree of erectile dysfunction.
- A broader international study of nearly 28,000 men found that 8 percent of those in their 20s and 11 percent of those in their 30s suffered from ED.
- An Italian study reported a big jump in the incidence of ED in men under the age of 40. Rates rose from 5 percent in 2010 to more than 15 percent in 2015.
ED in Young Men Usually Psychogenic
While insufficient blood flow to the penis is the largest single cause of ED among men of all ages, impotence in younger men is more likely to be psychogenic in origin. However, there are a number of other factors that can cause erection problems. According to the article posted at SexHealthMatters.org, other causes of ED include:
- Hormonal disorders, such as diabetes and both hypothyroidism (underactive thyroid function) and hyperthyroidism (overactive thyroid function) can sabotage normal erectile function.
- Klinefelter syndrome, a relatively rare genetic disorder in which males carry one or more extra X chromosomes. Those suffering from the disorder typically have lower blood levels of testosterone, smaller testicles, and enlarged breasts.
- Nervous system disorders, such as epilepsy, multiple sclerosis, and spinal cord injury, can interfere with normal messaging between the brain and the genitals, thus making it difficult or even impossible to achieve erection.
- The use of certain medications, including some antidepressants, antihistamines, antipsychotics, and even nonsteroidal anti-inflammatory drugs (NSAIDS) can interfere with normal erectile function.
- Smoking and illegal drug use, as reported in the Italian study of 2013, are often seen in patients with varying degrees of ED.
- Overindulgence in alcohol can make it difficult to get and keep an erection, as most men have discovered at some point in their lives.
Psychological Counseling Indicated
Erection problems that are psychogenic in origin usually can be addressed only through psychological counseling designed to identify the root causes of ED. Giving an antidepressant to a man who can’t get an erection because he’s depressed usually is ineffective because so many of those drugs interfere with erectile function.
Erectile dysfunction that is caused by insufficient blood flow to the penis and certain other physiological factors can be treated safely in most men with the oral ED medications known as PDE5 inhibitors. Included in this family of drugs are Viagra, Levitra, Cialis, Staxyn, and Stendra.
Drugs Can Help Some with ED
If you have been diagnosed with ED that’s caused by vascular problems or some related physiological cause, you’ll need a prescription to buy any of the PDE5 inhibitors available in the United States. If you have a prescription, you can get it filled at the pharmacy of your choice or opt instead to order it from a reliable online supplier of ED medications such as AccessRx.com.
If you choose to buy your ED drugs from AccessRx, you can take your doctor’s prescription and fax it or scan and email it to AccessRx along with your order. If you don’t yet have a prescription, AccessRx can arrange a complimentary online consultation with one of its team of licensed U.S. physicians. To learn more about erectile dysfunction and the medications available to treat it, click below to reach AccessRx Erectile Dysfunction page.