A guide to erectile dysfunction in young men
Reviewed by Dr Bhavini Shah
Erectile dysfunction (otherwise known as impotence) is the inability to get or maintain an erection which is firm enough for sex. For some men it can mean the penis becomes partly erect, but for others it doesn’t get erect at all.
Erectile dysfunction (ED) is often associated with older men, but it’s a condition that affects men of all ages:
- One in five men in the UK
- Up to 4.3 million men in the UK
- Up to half of men under the age of 50
- Rates of ED have doubled in the last 25 years
So why is ED affecting more young men than previously? In this article we going to focus on erectile dysfunction in young men, the impact of mental health and treatments that are available.
Top causes of erectile dysfunction in young men
The causes of erectile dysfunction in young men are similar to those for older men. They include both physical and psychological causes. Here are some of the most common:
Physiological causes
Health conditions and changes in your body can contribute to erectile dysfunction. These include:
Narrow blood vessels
High blood pressure, cholesterol, smoking and diabetes can all lead to the narrowing of your blood vessels. This restricts blood flow to the penis and reduces the chance of getting a firm erection.
Coronary heart disease affects around 2.3 million people in the UK. If you have a family history of heart disease your risk of having it increases.
Hormonal imbalance
Sometimes hormone imbalances can cause ED. These can abnormally high or low levels of thyroid hormone or prolactin (a hormone produced by the pituitary gland). Using steroids to build up your muscles can put you at higher risk of ED.
Our general health blood test can check your thyroid function and cholesterol levels.
Medicine
Some common drugs can cause erectile dysfunction, such as those prescribed for depression, heart conditions and blood pressure. However, you should talk to your doctor before you stop or change them.
Drinking heavily and using recreational drugs can also contribute towards erectile dysfunction in young men.
Anatomical causes
Certain conditions which change the penis can cause ED, such as:
- Peyronie’s (a bending in the penis when it is erect)
- Phimosis (a tight foreskin)
- Tight frenulum (the piece of skin joining the foreskin the penis shaft)
For more information, see erectile dysfunction causes.
Psychological causes
It’s not just the physical aspects of our bodies that can cause ED but our minds can too.
Anxiety
Anxiety is the most common cause of erectile dysfunction in young men. This can include nervousness about:
- getting your partner pregnant
- losing your erection while putting a condom on
- your sexual performance.
Feeling anxious about these things often creates a negative spiral, because failure to achieve an erection causes yet more anxiety and stress. Find out more about sexual performance anxiety.
Depression, anxiety and stress can also cause ED by reducing libido.
Stress
Stress is also a common cause of ED. If you’re distracted by situations at work or at home, it might impact your ability to get an erection. You also might not feel in the mood to have sex.
Depression
Depression can affect your sex drive, which might affect your ability to have sex and get an erection. Depression can affect people in different ways causing different symptoms. Find out more about what depression is.
Watch our video to find out more about ED
Lifestyle choices that can impact sexual performance
Lifestyles factors can both cause sexual performance issues and help improve them for young men.
Making sure you’re taking the best care of yourself can help you get better erections:
- Alcohol – Binge drinking can lead to ED, drinking the recommended 14 units or less or a week can help.
- Drugs – rather than enhancing sex many recreational drugs can hinder it.
- Smoking and vaping – damages blood vessels and restricts blood flow including to your penis.
- Watching porn – porn can change how we feel when having sex in real life, it may not be as exciting as what someone has seen in porn.
- Unhealthy diet – what we eat can contribute to obesity, diabetes, and cardiovascular issues, which are known risk factors for ED.
- Sedentary lifestyle - being inactive makes it harder to control your weight and can impact heart health.
- Exercise – it’s important to get our bodies moving to support our overall health.
Dr Neel Patel explains that “an increased number of young men are experiencing ED, and may think physical problems such as low testosterone is the cause, however it’s rare that this is the reason. There are a wide range of factors that could be causing it. Relationship issues, anxiety and depression, medication, diet and not getting enough exercise can all play a part."
“It’s important to assess your lifestyle and any psychological issues before presuming there is something physically wrong. Seeking medication for ED and performance issues but not addressing the initial cause will only prolong the issue.”
Can you fix erectile dysfunction naturally?
Lifestyle changes are a good place to start if you’re experiencing erectile dysfunction. Smoking, being overweight and not getting enough exercise can result in narrow blood vessels, which is a cause of ED. Losing weight, quitting smoking and getting fit may therefore help resolve the problem. Men who drink heavily or use illegal drugs may find that giving up these activities helps their ED.
Mental health and erectile dysfunction
Dr Neel Patel explains that “many young men may find it embarrassing or uncomfortable to discuss mental health issues, therefore if ED is being caused by stress, anxiety or depression, they may be unknowingly avoiding the root cause of the problem.”
Even though mental health issues and ED may not be something you’re comfortable talking about, they are increasingly more common. One study found that 1 in every 4 men diagnosed with ED is under 40.
There can be a lot of stigma, fear and shame surrounding these topics. But you’re not alone, sharing your experiences can mean you get the help you need.
Dr Neel Patel shares that “it's important to find healthy ways to manage stress and anxiety, like doing relaxing activities or talking to someone you trust and seeking appropriate mental health support.”
Treatment for ED in young men
ED is treated differently depending on the underlying cause which can be both physical and psychological.
It can be an embarrassing topic, particularly for young men, but the problem affects millions of men around the world. There are many treatment options available regardless of your age:
- Counselling or therapy - These may help you deal with stress, depression or performance anxiety and can be combined with medicines which treat the ED in the short term.
- Vacuum pumps - A cylinder which is placed over the penis. The air is then pumped out of it, gently ‘forcing’ the penis to become erect.
- Constriction rings - Used to maintain an erection. A ring is placed around the base of the penis, trapping blood and keeping it hard for longer.
- Surgery - Usually the last option for men with ED. Implants can be inserted into the penis, allowing it to bend upwards for sex and downwards to urinate. Inflatable implants form an erection by filling with fluid.
“It may not be something you feel comfortable discussing with your friends, but make sure you get medical advice if you’re worried." - Dr Bhavini Shah
Medication
There are many medicines which are used to treat erectile dysfunction in young men, including:
Our clinicians can prescribe these erectile dysfunction medicines through our discreet online service. They all work in roughly the same way, by opening the arteries which supply blood to the penis. This allows blood to fill the erectile tissue in the penis, helping you get and keep an erection.
For more information, see erectile dysfunction treatments.
Conclusion
Erectile dysfunction in young men is becoming more common. It can be caused by a range of factors including physical and psychological. There are treatments available which can help you get better erections. You should also speak to a doctor to check for any underlying causes such as high blood pressure.
References
https://www.kcl.ac.uk/news/the-global-prevalence-of-erectile-dysfunction
https://patient.info/news-and-features/erectile-dysfunction-impotence-in-young-men
https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/bju.14813
https://www.bhf.org.uk/informationsupport/conditions/coronary-heart-disease
https://pubmed.ncbi.nlm.nih.gov/23651423/
