While erectile dysfunction (ED) is widely thought to be an issue of older men, ED can also affect younger men, with some even developing the condition while in college. In a study published in the Journal of Sexual Medicine, 25% of men presenting for first-time treatment of erectile dysfunction were younger than the age of 40. Even more interesting was the fact that almost half (48.8%) of these young men with ED had severe cases of the condition. This study suggests that ED in young men is more commonplace than previously thought. In this current “hookup culture,” younger women report that erectile dysfunction among their male partners happens more often than you think or more than those young men would like to readily admit. As a result, the stigma associated with erectile dysfunction may explain why ED in young men is not being treated very often.
ED in Young Men Is More Common Than You Think
Overall, only 33% of all men experiencing ED, regardless of age, are seeking treatment. Another confounding factor is the attitude of health care professionals toward young men with erectile dysfunction. Many physicians erroneously assume that ED in young men is either temporary or psychological in nature, which may inevitably lead to bias and prevents young males from obtaining the care they need and are entitled to for their very real problem.
What Causes ED in Young Males?
ED in young men is typically not a life-threatening condition, although some men feel it’s the end of the world. In general, the causes of ED in young men, like older men, fall into one of two broad categories—psychological or physical. In rare instances, erectile dysfunction may be a combination of the two. One of the first considerations for young men is whether the ED is occasional or chronic. Occasional ED is somewhat normal and can usually be attributed to psychological factors. In fact, anxiety is the most common cause of erectile dysfunction in young men. When erectile dysfunction is chronic, there is a very high probability that its origins are biological, in other words physical.
Psychological Causes of ED
Psychological factors may be responsible for ED in young men. These factors may include:
- Fear of sexual failure, also known as performance anxiety
- Depression
- Stress/ anxiety
- Guilt
- Low self-esteem
- Posttraumatic stress disorder (PTSD).
It is also worth noting that many medications used for the treatment of high blood pressure or depression and other psychological disorders may themselves cause erectile dysfunction. For example, many of the selective serotonin reuptake inhibitors (SSRIs), which are the primary treatments for depression and anxiety, can not only cause ED but also ejaculatory dysfunction in males. Examples of commonly used SSRIs include fluoxetine (Prozac®), paroxetine (Paxil®), sertraline (Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®).
Physical Causes of ED
Drugs
The experiences of younger men are very different compared to those of older men, and ED is no different. Young men are more likely to abuse alcohol and illicit drugs than older men, making these substances more likely to be contributing factors for erectile dysfunction. For example, daily marijuana smokers are three times more likely to develop ED compared to those who don’t use it at all. Also, young men with ED are more likely to be smokers. In fact, your risk of developing erectile dysfunction is increased by 60% if you smoke more than one pack daily. Electronic, or E-, cigarettes are becoming wildly popular, especially among young males, but they contain nicotine and other harmful chemicals and may have the same ED-causing effect as regular cigarettes. Furthermore, ED in young men is much more likely to be the result of physical trauma rather than a medical diagnosis. For example, a sports injury or a sexual injury.
Chronic Diseases
Occasionally, ED in young men can be a symptom of something more sinister. For many older men, and some younger men, chronic diseases such as diabetes, high blood pressure, heart disease, and kidney disease are often contributing factors to erectile dysfunction. For instance, 35% to 75% of men with diabetes will experience some degree of ED, and a great majority of men with high blood pressure (68%) are plagued by erectile dysfunction. Some young men can attribute their ED to hormone imbalance, specifically underproduction of the male hormone testosterone (hypogonadism). Additionally, many of the medications used to treat the aforementioned chronic diseases may themselves cause ED. Upwards of 200 prescription medications list erectile dysfunction as a potential side effect, including antidepressant or antianxiety medications, blood pressure medications, and non-steroidal anti-inflammatory drugs (NSAIDs).
Treatment for ED in Young Males
Although your chances of experiencing erectile dysfunction increase with age, it does not have to be a certainty of aging, especially in men experiencing it at a young age. Treatment for ED in young males can help restore self-confidence and even sometimes repair intimate relationships. For the majority of young men with ED, lifestyle changes may be enough to eliminate ED and bring back sexual confidence. Measures such as eating a heart-healthy diet, regular exercise, quitting smoking, moderate to no alcohol intake, eliminating stress, and abstinence from illicit drugs are recommended.
Prescription Medication
If lifestyle changes are not sufficient to improve or eliminate ED, health care professionals may recommend prescription medications. The historical anchors for the treatment of ED are oral medications, including sildenafil (Viagra®), vardenafil (Levitra®), tadalafil (Cialis®), and avanafil (Stendra®). These medications, like all treatments for ED, stimulate blood flow to the penis, helping a man achieve and maintain an erection. Oral erectile dysfunction medications can be effective, as 66% of men who have taken Viagra reported successful sexual intercourse. As with any prescription medication, there are potential for side effects. Almost half (48%) of men who have taken Viagra for erectile dysfunction reported one or more side effects (e.g., stuffy nose, headache, or visual changes). Nonetheless, treatment with oral ED medications is not always successful, and 69% of men reported that their ED persisted despite oral medications.
External Aids
If oral medications don’t successfully treat ED in young men, there are other treatment options, including penile injections or suppositories. It goes without saying that these treatments would be reserved for young men with severe erectile dysfunction. A great majority of men with ED (80%), regardless of their age or the cause of ED, report achieving adequate erections with penile injections. Only the medication alprostadil is approved by the Food and Drug Administration (FDA) for self-injection for ED therapy. Alprostadil is also approved in suppository form but is less effective than self-injection, as only 30% to 40% of men with ED report achieving adequate erections with this form. It should be noted that if your erection lasts longer than 4 hours on these or other ED treatments (i.e., oral medications), you should seek emergency medical evaluation. You may be experiencing priapism, which is a very painful prolonged erection and can lead to irreparable penile damage and untreatable erectile dysfunction.
Other treatments for severe ED in young men are vacuum erectile devices and surgery for the placement of penile implants. They have a fair to excellent response rate, as 50% to 80% of men reported being pleased with the results of vacuum erectile devices. Additionally, 90% to 95% of penile implants produce erections adequate for sexual intercourse. Admittedly, these treatments may be extreme, cumbersome, and even embarrassing for men, especially young men.
A New ED Treatment Option: Low-Intensity Shockwave Therapy (PulseWave)
As a result, there has been growing interest in non-invasive and non-surgical treatments for ED in young men. An emerging innovative treatment for ED that fits this bill is low-intensity shockwave therapy (LISWT). This technology utilizes gentle low-frequency sound waves to increase blood flow to the penis by repairing aged blood vessels and stimulating the formation of new blood vessels. As a result, LISWT addresses the root cause of erectile dysfunction, resulting in firmer, more maintainable erections. Data show that this ED treatment is effective. After only 6 in-office treatment sessions with LISWT, 70%- 80% of men with ED reported a positive effect. Additionally, 92% of men who responded positively maintained that response for at least 1 year.
Erectile dysfunction can take a physical as well as a psychological toll, which is why it’s so important to treat it as soon as possible. If you are seeking erectile dysfunction treatment, do not hesitate to contact Comprehensive Urology today for an initial consultation. The board-certified physicians at Comprehensive Urology are specialists in the treatment of ED and will provide personalized treatment with the utmost discretion.