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Erectile dysfunction or ED is not exclusive to older men. Rare as it can be, young men can be susceptible. Most cases are temporary, others may require medical intervention as ED can be a symptom of a more serious health condition. Learn more about the risk factors of erectile dysfunction in young men.
Erection occurs when the penis is enlarged and becomes hard due to increased blood flow. This activity is a response to a trigger that stimulates arousal, which involves neural communication between the brain and penile tissue.
During an erectile dysfunction, this physiological process gets disrupted. A young man may fail to get and hold an erection if blood flow is restricted in the penis as a result of a combination of factors ranging from physical to psychological.
In many cases, the causes are more complex rather than singular. Nevertheless, the following physical conditions contribute to the development of ED regardless of age.
A decline can influence erectile dysfunction in testosterone levels. Testosterone is the primary sex hormone for males. Low testosterone(1) can cause decreased libido or sexual drive, impaired blood flow to the penis, and psychological factors that impact erection.
However, it is crucial to understand that low testosterone on its own rarely causes ED. It is possible for young men with normal testosterone levels to have trouble maintaining an erection and for those with decreased testosterone to have healthy ones.
Individuals with heart disease can potentially develop ED. The condition indicates poor vascular health, which impacts penile blood flow.
Atherosclerosis, a well-known heart disease, may narrow the blood vessels and reduce blood flow. In a 2018 study published in Heart Views, over 90% of incidences involving atherosclerosis(2) are among younger individuals. That said, younger men may develop heart disease early, which may lead to erectile dysfunction.
Also Read: 5 Compelling Reasons Why You Should Get Tested for Heart Disease in Your 20s
Hypertension, or high blood pressure, can impair the lining of the blood vessels, restricting blood circulation. Hypertension medications can also cause ED as a side effect. For example, water pills or diuretics can slow down blood flow and cause decreased zinc levels(3), which can potentially contribute to diminished sexual appetite.
Hyperlipidemia or high cholesterol is a gateway for atherosclerosis(4). Bad cholesterol can build up and harden in the lining of the blood vessels. It clogs the bloodstream, which impacts blood flow, including the one directed to the penis.
Also Read: Making Sense of High Cholesterol Warning Signs
At its advanced stage, type 2 diabetes can disrupt vascular functions. In addition, it could cause nerve damage(5) that influences the disconnect between penile stimuli and response. As a result, it may cause delay or total absence of erection. Erectile dysfunction in men with diabetes can also be traced to low testosterone, caused by the condition’s ability to shift hormone levels and psychological factors contributing to ED.
Obesity significantly increases your risk of erectile dysfunction in young men. For one, obesity is typically tied up with other physical factors for ED, like high cholesterol, hypertension, and diabetes. Obesity is also linked to inflammation(6), which further promotes vascular and neural damage.
Peyronie disease is a condition wherein scars accumulate around the connective tissues that stimulate erection. The buildup is referred to as plaques and can cause deformation in the penile form, pain, and erectile dysfunction.
Any damage to your neural function, particularly within proximity to the penis, can potentially lead to ED. This damage can be due to spinal cord or peripheral nerve injuries. The same impact can also be caused by neurological disorders like Parkinson’s disease and multiple sclerosis.
Problems regarding erection can sometimes stem from psychological issues. Some of these go way back to childhood trauma, and others come from day-to-day mental challenges. Depending on the severity of the psychological factor, erectile dysfunction can simply be temporary.
When you’re stressed, your cognitive and neural responses get interrupted. It’s the same during erection. Stress interferes with sexual arousal and focus. As a result, it may be difficult to achieve erection and maintain sexual performance.
In addition, stress forces your body to release cortisol, which stifles the production of testosterone. Stress can also contribute to vascular problems and sleep disturbances, which are factors for ED on their own.
Also Read: How to Deal With Stress If You Are Busy
Much like stress, anxiety also robs you of your focus and the ability to elevate your sex drive. Anxiety also makes it difficult to relax and enjoy sex, contributing to erectile dysfunction. Additionally, certain medications for general anxiety can also have ED as part of their side effect.
Low self-esteem can make you hyperconscious during sex. It can heighten anxiety and encourage negative thought patterns. Plus, poor self-esteem can heavily impact confidence, which influences sexual arousal. This psychological condition can lead focus away from the intercourse itself, causing performance anxiety.
Your emotional state plays a crucial part in erection more than you expect. A young man experiencing guilt can trigger other negative emotions, like shame and anxiety – all of which can interfere with the physiological process of getting an erection.
If you have relationship issues with your partner, it may create an emotional distance, influencing your ability to intimately connect and get or maintain an erection. Plus, you may have communication barriers that create an unhealthy psychological atmosphere for sexual activity.
Erectile dysfunction can be triggered by certain lifestyle choices. While they may not directly cause ED, their influence on your routine can aggravate the condition by stimulating an unpleasant psychological environment during sex. On top of that, they exacerbate the physical factors that cause erectile dysfunction in young men.
Smoking tobacco products(7) can reduce blood flow, destroy the endothelial lining of the blood vessels, and cause hormone problems. It also increases oxidative stress, which further injures the blood vessel tissues.
On top of that, smoking is a notorious factor in the development of many chronic diseases. These include heart disease, hypertension, and diabetes.
There are several pathways in which over drinking alcoholic beverages can be linked to erectile dysfunction in men, even in their 20s. For one, alcohol can cause blood vessel and nerve damage. It can disrupt liver function, which contributes to hormonal imbalance.
Alcohol also influences the psychological factors for ED. These cover anxiety, stress, and even depression – all can be linked to alcohol-induced sexual challenges.
What you eat dictates many aspects of your health, even an erection. An unhealthy diet, especially one high in fats and sugars, can cause vascular blockage to the point of developing atherosclerosis. It’s also a key element in the formation of hypertension and heart disease, as well as the decline in testosterone levels.
Inactivity causes poor blood circulation(8), especially in the pelvic region, causing ED. As blood flow is restricted, it could be challenging to achieve erection. Additionally, a sedentary lifestyle can also lead to metabolic problems that progress to obesity and diabetes, as well as cardiovascular issues, which are also factors for ED.
Also Read: How Harmful Is a Sedentary Lifestyle? (+ Signs of Low Activity)
Specific drugs can interfere with neural hormone functions, causing erectile dysfunction in young men. These drugs include cocaine, amphetamines, and opioids. Specifically, they cause vasoconstriction and can interrupt your mental state during sexual activity, leading to problems with erections.
Research shows that 8% of men ages 20 to 29 have ED(9). In older men, the prevalence of erectile dysfunction is higher, specifically between 61% and 71%(10). The rate goes higher with age.
Based on the above mentioned data, erectile dysfunction among men in their 20s is uncommon. However, occasional problems with erection can be common, especially if psychological triggers are present.
Nonetheless, if you experience erectile dysfunction symptoms as a young man, make sure to take note of other unusual conditions to help your doctor dive into the root cause of the problem.
Resolving ED involves addressing the factors that drive the problem, including diagnosing the medical condition that stands as the culprit. In mild cases, natural treatment can drastically improve erection, especially if the trigger is lifestyle-related. Check out some of the practical ways you can do to help fix erectile dysfunction:
Men in their 20s can have erectile dysfunction. However, it’s not as widespread as with older men. By that standard, the normalcy of experiencing ED is often questioned. In most cases, ED suggests a more serious underlying medical cause that young men must address.
Medical intervention remains the most surefire way to address erectile dysfunction. Keep in mind that ED can be rooted in a complex condition. Hence, it’s possible that curing erectile dysfunction requires multiple approaches, starting with diagnosing the underlying cause.
Depending on the severity of erectile dysfunction, natural remedies can help fix the condition. For example, changing your diet or engaging in alternative therapies like yoga and acupuncture have reportedly helped reduce the psychological factors that drive ED.
It’s best, however, to combine these natural approaches with medical recommendations from your doctor. In addition, be cautious about ED pills promoted online. Make sure they are FDA-approved and greenlit by your physician.
Erectile dysfunction isn’t something young people should be ashamed of. It happens occasionally when you’re stressed or under a lot of pressure. However, if it occurs frequently along with possible symptoms of a medical condition, consult your doctor immediately. ED can be treated, and the earlier you get diagnosed, the faster medicine can resolve the issue.
1 Onyeji IC, Clavijo RI. Testosterone replacement therapy and erectile dysfunction. Int J Impot Res. 2022 Nov;34(7):698-703. doi: 10.1038/s41443-021-00512-w. Epub 2022 Jan 8. PMID: 34997198.
2 Venkatesh K, Deepak DC, Venkatesha VT. Escalation of Coronary Atherosclerosis in Younger People by Comparison of Two Autopsy Studies Conducted a Decade Apart. Heart Views. 2018 Oct-Dec;19(4):128-136. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_49_17. PMID: 31057705; PMCID: PMC6487296.
3 Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med. 1995 Oct;41(10):312-5. PMID: 8556776.
4 Guijarro C, Cosín-Sales J. LDL cholesterol and atherosclerosis: The evidence. Clin Investig Arterioscler. 2021 May;33 Suppl 1:25-32. English, Spanish. doi: 10.1016/j.arteri.2020.12.004. PMID: 33966809.
5 Furukawa S, Sakai T, Niiya T, Miyaoka H, Miyake T, Yamamoto S, Maruyama K, Ueda T, Senba H, Todo Y, Torisu M, Minami H, Onji M, Tanigawa T, Matsuura B, Hiasa Y, Miyake Y. Diabetic peripheral neuropathy and prevalence of erectile dysfunction in Japanese patients aged <65 years with type 2 diabetes mellitus: The Dogo Study. Int J Impot Res. 2017 Jan;29(1):30-34. doi: 10.1038/ijir.2016.40. Epub 2016 Oct 27. PMID: 27784886.
6 Moon KH, Park SY, Kim YW. Obesity and Erectile Dysfunction: From Bench to Clinical Implication. World J Mens Health. 2019 May;37(2):138-147. doi: 10.5534/wjmh.180026. Epub 2018 Jul 25. PMID: 30079640; PMCID: PMC6479091.
7 Jeremy JY, Mikhailidis DP. Cigarette smoking and erectile dysfunction. J R Soc Promot Health. 1998 Jun;118(3):151-5. doi: 10.1177/146642409811800305. PMID: 10076652.
8 Duca Y, Calogero AE, Cannarella R, Giacone F, Mongioi LM, Condorelli RA, La Vignera S. Erectile dysfunction, physical activity and physical exercise: Recommendations for clinical practice. Andrologia. 2019 Jun;51(5):e13264. doi: 10.1111/and.13264. Epub 2019 Mar 15. PMID: 30873650.
9 Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol. 2017 Feb;6(1):79-90. doi: 10.21037/tau.2016.09.06. PMID: 28217453; PMCID: PMC5313296.
10 Shiri R, Koskimäki J, Hakama M, Häkkinen J, Tammela TL, Huhtala H, Auvinen A. Prevalence and severity of erectile dysfunction in 50 to 75-year-old Finnish men. J Urol. 2003 Dec;170(6 Pt 1):2342-4. doi: 10.1097/01.ju.0000090963.88752.84. PMID: 14634411.
