Sexual Health Q&A

Is erectile dysfunction (ED) common in men under age 40?

Problems with erections tend to become more frequent as a man gets older. Many people associate erectile dysfunction (ED) with older men, but it’s something younger men should take seriously, too.

In a Journal of Sexual Medicine study published in July 2013, Italian researchers found that about a quarter of the men with ED in their study sample were age 40 or under

Causes of ED

ED in younger men is often caused by psychological or emotional factors, such as depression, anxiety, and stress. Sometimes this relationship is called bidirectional. This means that while depression, anxiety, and stress can lead to ED, the reverse may also be true. ED may worsen depression, anxiety, and stress.

Psychological issues related to ED can have a number of causes. A man may be stressed about his job or financial obligations. He could feel depressed if the relationship with his partner is in trouble.

Performance anxiety is a common culprit, too. A man may be so anxious about pleasing his partner that he cannot perform sexually at all.

The Italian researchers also found that the younger men in their study were more likely to smoke and use illicit drugs like marijuana and cocaine. These substances can contribute to ED.

For example, smoking can lead to atherosclerosis – hardening of the arteries. When this happens, arteries become blocked, making it more difficult for blood to pass through. Blood flow is essential for erections. If penile arteries are blocked, the proper amount of blood can’t get to the penis, causing a weak erection or no erection.

In addition, research has shown that marijuana may impair erectile function much like it impairs brain function. The active ingredient in marijuana interacts with proteins in the brain called cannabinoid receptors. This interaction is what makes people feel “high.” It’s believed that this type of interaction can happen in the penis, too.

Italian researchers did not see any significant differences in alcohol consumption in their older and younger participants. However, alcohol can also interfere with erections by damaging blood vessels in the penis.

Younger men who have ED should not make assumptions about the causes, however. ED can be a marker of other health conditions, such as cardiovascular disease and diabetes. It can also be as severe for young men as it is for older men. So, it’s important to have a thorough checkup with a doctor and get treatment if necessary.

Treating ED

Fortunately, ED is a treatable condition. Sometimes making lifestyle changes, like quitting smoking, take care of it.

Medications and devices are also available. A short course of oral medication can be very helpful. Sometimes, oral therapy is prescribed first to reduce anxiety.

Men with anxiety or depression may benefit from seeing a counselor or sex therapist. Couples may decide to seek counseling together to work on any relationship issues. A sex therapist can also help a man with performance anxiety, teaching him ways to relax and be more confident about sex.