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Language matters

In this article, we use “male and female” to refer to someone’s sex as determined by their chromosomes, and “men and women” when referring to their gender (unless quoting from sources using nonspecific language).

Sex is determined by chromosomes, and gender is a social construct that can vary between time periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.

An erection involves the brain, nerves, hormones, muscles, and circulatory system. These systems work together to fill the erectile tissue in the penis with blood.

A male with erectile dysfunction (ED) has trouble getting or maintaining an erection for sexual intercourse. Some males with ED are completely unable to get an erection. Others have trouble maintaining an erection for more than a short time.

ED is more prevalent among older males, according to research, but it also affects younger males in large numbers.

There are many possible causes of ED, and most of them are treatable. Read on to learn more about ED’s causes and how it’s treated.

The University of Wisconsin reports an approximate correlation between the percentage of males affected by mild and moderate ED and their decade in life. In other words, approximately 50 percent of males in their 50s and 60 percent of males in their 60s have mild ED.

A 2013 study published in the Journal of Sexual Medicine suggests that ED is more common among younger males than previously thought.

Researchers found that ED affected 26 percent of adult males under 40 years old. Almost half of these people had severe ED, while only 40 percent of older males with ED had severe ED.

Researchers also noted that younger males with ED were more likely than older males with ED to smoke or use illegal drugs.

You may feel uncomfortable discussing ED with your doctor. However, having an honest conversation is worth it, as facing the problem head-on can lead to proper diagnosis and treatment.

Your doctor will request your complete medical and psychological history. They’ll also perform a physical exam and order certain lab tests, including a testosterone level test.

ED has several potential physical and psychological causes. In some cases, ED can be an early sign of a serious health condition.

Heart problems

Getting and keeping an erection requires healthy circulation. Clogged arteries — a condition known as atherosclerosis — is one possible cause of ED.

High blood pressure can also lead to ED.

Diabetes

ED can be a sign of diabetes. This is because high levels of blood glucose can damage blood vessels, including those responsible for supplying blood to the penis during an erection.

Obesity

Obesity is a risk factor for diabetes and hypertension. For young males who are overweight, taking steps to lose excess weight can be helpful in reducing their risk of ED.

Hormonal disorders

Hormonal disorders, such as low testosterone, may contribute to ED. Another possible hormonal cause of ED is increased production of prolactin, a hormone produced by the pituitary gland.

Additionally, an abnormally high or low thyroid hormone level can result in ED. Young males who use steroids to help build muscle mass are at a higher risk for ED.

The feelings of sexual excitement that lead to an erection start in the brain. Conditions such as depression and anxiety can interfere with that process. One major sign of depression is withdrawal from things that once brought pleasure, including sexual intercourse.

Job-related stress, money, and other life events can contribute to ED, too. Relationship problems such as poor communication with a partner can also cause sexual dysfunction in both males and females.

Substance use disorder is another common cause of ED among young males.

Treating the cause of ED may help resolve the problem. Lifestyle changes and natural remedies can make a positive difference for some males. Others benefit from:

According to recent guidelines published by the American Urological Association, certain groups of males may need specialized testing and evaluation to help shape their treatment plans. These groups include young males and males of any age with a strong family history of heart disease.

Ignoring ED is not advised, particularly because it can be a sign of other health problems.

Healthy lifestyle changes

Eating a nutrient-dense diet, getting more exercise, and losing any excess weight may help minimize the problems caused by ED. Quitting smoking and reducing alcohol use is not only helpful for your overall health, but it may also specifically help with ED.

If you’re considering natural remedies such as herbs, talk with your doctor before trying them.

Communication with your partner is also essential. Performance anxiety can affect and even worsen other causes of ED.

A therapist or other mental health professional may be able to help you. Treating depression, for example, may help resolve ED and bring about additional benefits as well.

Oral medications

Oral phosphodiesterase type 5 (PDE5) inhibitors are prescription drugs that can help treat ED. These medications are recommended before more invasive treatments are considered.

PDE5 is an enzyme that can interfere with the action of nitric oxide (NO). NO helps open the blood vessels in the penis to increase blood flow and produce an erection.

There are four PDE5 inhibitors currently on the market:

Side effects may include:

Only a licensed healthcare professional can prescribe oral medication for ED. You can talk with your doctor, or some companies like Roman and Lemonaid have doctors available online who can prescribe ED medication. These companies also allow you to buy the medication directly from them.

Intracavernosal injections

Alprostadil (Caverject, Edex) is a solution that’s injected into the base of the penis 5 to 20 minutes before sex. It can be used up to three times each week. However, you should wait at least 24 hours between injections.

More commonly, Trimix (alprostadil, phentolamine, and papaverine), is prescribed and may be more effective than alprostadil alone.

Side effects may include pain and burning in the genital area, as well as injection site pain and scarring.

Intraurethral suppositories

Alprostadil is also available as a suppository for erectile dysfunction. It is sold as MUSE (Medicated Urethral System for Erections). It should be used 5 to 10 minutes before sexual activity. Avoid using it more than two times in a 24-hour period.

Side effects may include pain and burning in the genital area.

Testosterone

Males whose ED is the result of low testosterone may undergo testosterone therapy. Testosterone is available in a variety of forms, including:

Side effects may include:

Vacuum constriction devices

Other treatment options may be considered if medications aren’t entirely successful. Vacuum constriction devices are generally safe and effective.

The treatment involves placing a cylinder over the penis. A vacuum is created inside the cylinder. This leads to an erection. A band is placed around the base of the penis to preserve the erection, and the cylinder is removed. The band must be taken off after about 30 minutes.

Surgery

A last resort measure for males with ED is the implantation of a penile prosthesis.

Simple models allow the penis to bend downward for urination and upward for intercourse. More advanced implants allow fluid to fill the implant and form an erection.

There are risks associated with this operation, as there are with any surgery. It should only be considered after other strategies have failed.

Vascular surgery, a rare ED treatment that aims to improve blood flow in the penis, is another surgical option.

It is not uncommon for males to experience trouble achieving or maintaining an erection from time to time. Increased stress, lifestyle changes, and significant alterations to your diet can contribute to erectile issues — even in younger people.

However, if you are experiencing these issues in a majority of your sexual encounters over the period of a few weeks, it may indicate a larger underlying health issue and it is worth contacting your doctor.

Your doctor can run a series of tests to rule out other contributing factors, discuss your concerns, and look at any recent changes in your daily routine that may also be responsible. It is important to keep in mind that while ED may be fairly common, it is not an inevitable stage of aging, particularly for younger males.

Discussing your experiences with your doctor is a good way to not only begin ED treatments, but it could also potentially catch some underlying cardiovascular conditions before they can develop into larger issues.

How common is ED in males under 40?

Some research suggests that around 26 percent of males under 40 years old have erectile dysfunction. It’s important to note that many of these people also smoke or use illegal drugs.

Another study found that in healthy and fit males under 40 years old, only 14 percent of them have complaints of erectile dysfunction.

What natural ED remedies are effective in young males?

There are many natural remedies for erectile dysfunction that your doctor might recommend, and most of them consist of lifestyle changes. These changes may include:

  • making dietary changes
  • improving quality of sleep
  • attending therapy sessions
  • reducing alcohol and drug use
  • reducing stress
  • getting exercise

Can young males reverse erectile dysfunction?

In many cases — yes, erectile dysfunction can be reversed in young people. Whenever a young person experiences difficulty becoming erect or keeping their erection for an entire sexual encounter, the causes might include a sudden lifestyle shift or some other change to their daily routine.

In this circumstance, being mindful of your own stress level, ensuring that you are taking care of your sleep and nutritional needs, and talking to your doctor about ED treatments can lead to your symptoms going away over time.

However, if your erectile dysfunction issue is tied to a larger health or cardiovascular issue, it may not be as easily reversible. These issues may not be as apparent at first and ED could be just one of the early warning signs. This is why it is recommended to talk with your doctor if you experience ED-related symptoms over a period of a few weeks, no matter your age.

Can you become dependent on Viagra if you take it for too long?

Viagra medication is not physically addictive. However, it is possible to become psychologically dependent on these medications if not used in the appropriate setting and under the guidance of a healthcare professional. Like with most prescription medications, exceeding the recommended dosage or taking the medication more frequently than prescribed can cause side effects or health complications that wouldn’t usually occur when used as prescribed.

A 2002 review discussed one fatal instance of a Viagra overdose where autopsy results showed a medication concentration in the blood over four times the recommended level. So, while dependency and overdose aren’t really possible when used as prescribed, there can be very severe consequences from overuse.

ED can be an uncomfortable topic to discuss, especially for younger males. However, it is worth remembering that you’re not alone, and help is available. There are millions of other males dealing with the same issue, and ED is a treatable condition.

It’s important to seek treatment for ED because it may be a sign of other health problems. Addressing the condition directly with your doctor can help lead to faster and more satisfactory results.