Erectile dysfunction (ED) and Young Men

Erectile dysfunction (ED) is fairly common in men under age 40, according to a recent study published in the Journal of Sexual Medicine.

Italian researchers have found that 26% of men seeking first-time help for ED were age 40 or younger. Almost half of those men had severe cases of ED.

The risk of ED generally rises as men age. As men get older, they are more likely to develop risk factors for ED, such as diabetes, obesity, cardiovascular disease, and lower urinary tract symptoms.

ED in men younger than 40 had not been widely researched. According to past studies, the prevalence rate for ED in men under 40 may range from 2% to 40%. Causes of ED for men in this age group are thought to stem from psychological or emotional issues, as younger men do not usually have the same degree of comorbidities as older men.

The researchers wanted to learn more about the prevalence of ED among men under 40 and what factors might predict ED in this age group.

The research team collected data from 439 patients who were seeking their first treatment for ED. They used the International Index of Erectile Function (IIEF) to assess erections. To evaluate comorbidities, they used the Charlson Comorbidity Index (CCI). The patients also provided demographic information.

One hundred-fourteen (25.9%) of the men with ED were age 40 or under.

When compared to the men over 40, the younger men had lower rates of comorbid conditions, lower mean body mass indexes (BMIs), and higher total testosterone levels.

Based on IIEF scores, almost half of the men under 40 had severe ED. For the men over 40, this rate was 40%. However, rates of mild, mild-to-moderate, and moderate ED were similar for the two groups.

The younger men had more problems with premature ejaculation. Older men were more likely to have Peyronie’s disease.

Smoking and the use of illicit drugs, such as marijuana and cocaine, were more common among the younger men. It’s possible that these habits could have contributed to their higher rates of ED. Alcohol use was similar among older and younger men.

The results presented a “worrisome picture,” the authors said. They added, “This clearly confirms previous epidemiological data from population-based studies, thus outlining that ED is not only a disorder of the aging male and that erectile function impairment in young men should not be underestimated.”

Because ED is often a marker for other medical conditions like cardiovascular disease, screening younger men for ED can be helpful.

“Moving to the daily clinical practice, current findings prompt us to further outline the importance of taking a comprehensive medical and sexual history and performing a thorough examination of all men with ED, irrespective of their age,” the authors wrote.

Study limitations were acknowledged. For example, rates of depression and anxiety were not assessed with validated psychometric tools. The authors noted that psychological issues like depression and anxiety can have a bidirectional relationship with ED.

Also, the study cohort was small. Further research is needed to confirm the results and explore the role of ED as a marker of other medical conditions for men under 40.


The Journal of Sexual Medicine

Capogrosso, Paolo, MD, et al.
“One Patient Out of Four with Newly Diagnosed Erectile Dysfunction Is a Young Man—Worrisome Picture from the Everyday Clinical Practice”
(Full-text. First published online: May 7, 2013)