Erectile dysfunction (ED) often tends to be associated with the elderly male population. However, recent findings show an increasing number of men under the age of 40 are experiencing the condition. While in the past, primarily attributed to psychological factors, it is being increasingly realised that younger men are affected by an intricate combination of emotional, lifestyle, medical, and hormonal factors. Everything from performance anxiety and overconsumption of pornography to unhealthy lifestyle decisions of smoking, drinking, and poor nutrition is culpable. Hormonal disturbances and certain medicines can also aggravate the condition. It is imperative to understand these pathological issues so that identification and intervention, like prescribing the best ED medication, can be done early.
What is Erectile Dysfunction?
Erectile Dysfunction is the inability to get or maintain an erection long enough to have sexual intercourse. It is very common, particularly in men over 40. ED can have different causes. In the past, it was thought that ED was mainly due to psychological reasons. However, it is now realised that psychological and physiological factors contribute to ED.
What Causes Erectile Dysfunction in Men Under 40?
Erectile Dysfunction usually affects older men, but more and more younger men under 40 are also having problems with erections. The younger generation does not expect to have this issue. However, according to a research study published in ‘The Journal of Sexual Medicine’, 26% of men under the age of 40 suffer from erectile dysfunction problems. It is crucial to fully understand what causes ED for prevention and treatment, especially as ED at a younger age can cause both physiological and psychological effects that reduce
self-esteem and damage relationships and well-being.
- Psychological Factors
In younger men, psychological problems are among the most common causes of erectile dysfunction (ED). Performance anxiety, for instance, provokes a stress reaction that hinders the body’s natural ability to achieve an erection. Likewise, depression may dull eroticism and hinder arousal, along with fatigue and low motivation. General work stress, finances, or personal issues are also messing up the balance of hormones and interfere with sexual functioning. Problems in the relationship, emotional disconnection, the lack of communication, or unresolved conflicts further reduce sexual confidence and desire. Further, excessive pornography use has been related to porn-induced erectile dysfunction, whereby desensitisation and unrealistic anticipations impair arousal during real-life sexual encounters.
- Lifestyle and Behavioral Causes
Younger men are more prone to be affected by lifestyle changes and poor behavioural patterns that can lead to erectile dysfunction (ED). Smoking is one of the biggest causes, as tobacco usage damages blood vessels and inhibits the circulation that is necessary for erection. Alcohol consumed in excess, especially over time, can inflict sexual function by being a CNS depressant. The same applies to recreational drugs, including cocaine, marijuana, and opioids, and their effects can impair nerve signalling and hormone balance for sexual function. An unhealthy diet high in fat and deficient in essential nutrients would eventually lead to obesity and cardiovascular diseases that reduce the blood flow crucial for getting an erection. A sedentary lifestyle would contribute to increased weight, leading to diabetes and reduced testosterone levels, hence increasing the chances of ED among men under 40 years old.
- Medical and Physiological Causes
Although it is less common compared with older men, medical as well as physiological conditions contribute to erectile dysfunction in men under the age of 40. Chronic diseases, such as diabetes, particularly type 1 diabetes, can damage blood vessels and nerves required for getting or keeping a good erection. Blood pressure can result in poor perfusion injury to the arteries supplying the penis. Hypogonadism, or reduced testosterone levels,
although often seen in older men, may affect younger men as well due to some kind of hormonal imbalance or endocrine disorders, causing low eroticism and sexual dysfunction.
Neurological diseases affect the communication between the nervous system and the mechanism of erection. Another high-risk factor is the signal disruption by such disorders, which causes damage to the lower motor neurons and/or brain stem through conditions like multiple sclerosis or spinal cord injuries. Moreover, the formation in the penis of fibrous scar tissue can also lead to painful erections, as well as an inability to hold an erection. Thus, these conditions underscore the need for a thorough medical evaluation when younger adults complain of continuous ED symptoms.
- Medications and Medical Treatments
Some medications can cause or worsen ED as a side effect:
- Antidepressants (SSRIs, SNRIs)
- Anti-anxiety medications
- Blood pressure drugs (especially beta-blockers)
- Hormonal medications or treatments affecting the endocrine system
Always consult a healthcare provider before stopping or adjusting any medication.
- Hormonal and Endocrine Issues
Low testosterone or thyroid disorders are examples of hormonal imbalances that can significantly affect eroticism and sexual function. Stress, obesity, and inherent problems can cause endocrine malfunction among younger men, with all factors harming signalling hormonal imbalance.
When to Seek Help?
Erectile dysfunction is not something to be shy about or to ignore in men under 40. Often, it may be an indication of a more serious health issue. Getting to the physician earlier will
result in better outcomes later. If it becomes an occasional problem or this pattern keeps reoccurring, the individual should see their urologist, endocrinologist, and/or a mental health professional. For confidential telehealth service, FullhousePill offers generic medications for erectile dysfunction, making professional medical help more accessible.
What are the best ED medications?
There are several effective medications for treating erectile dysfunction (ED), most of which belong to a class called PDE5 inhibitors. Of these medications, the best known and most often prescribed are Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), and Avanafil (Stendra). All these medications operate by increasing blood flow into the penis, thus facilitating an erection during sexual stimulation. Of the two, Sildenafil and Vardenafil are fast-acting: an hour before sexual intercourse, with effects lasting typically up to 4-6 hours.
Tadalafil lasts up to 36 hours and may also be taken at a lower daily dose for more spontaneous acts. Avanafil is the newest option and has the benefit of quick onset with fewer side effects for some individuals. Generally safe to take, these medications do require a prescription and may not be appropriate for men with certain medical conditions, notably the ones who are taking nitrates or heart medications. These matters should be discussed with a healthcare provider to determine the best treatment option, considering personal preferences and medical history.
