If you’re a man in your 20s struggling with erectile dysfunction (ED), or impotence, you may be wondering: “How could this be happening to me?” or “ED doesn’t happen to young men.”
It’s important to know that erectile dysfunction can happen to anyone - regardless of your age. In fact, research shows that up to 25% of men actively seeking treatment for ED are under 40 years old. Even though this condition is normal, it doesn’t mean you want to spend your 20s worried it will get in the way of your sex life. Here’s what you need to know about what might be causing your erectile dysfunction, and how to treat it.
The average age of erectile dysfunction
You may be wondering the average age when erectile dysfunction starts. It’s largely believed that the majority of men will have experienced an episode of ED by the time they reach 50. In one 2018 study, age was shown to be the variable most strongly associated with ED, demonstrating that about 40% of men are affected at age 40, and 70% of men are affected at age 70.
Analysis of one survey showed that the highest percentage of men who reported having ED were between the ages of 46 and 65. Among these subjects, health conditions that exacerbate ED, such as hypertension, depression, and diabetes, were high across all age groups. This suggests that no matter your age, it’s likely your erectile dysfunction came from somewhere. Once you identify the cause, you’re more likely to be able to address it and put ED behind you.
Erectile dysfunction in young men is relatively common
While the risk of erectile dysfunction does increase with age, if you’re wrestling with ED in your 20s, know that this is normal, and you’re not alone in your experience.
Research over the last decade has proven that impotence in young men is not uncommon. (Hint: This means it’s also normal to struggle with erectile dysfunction in your 30s too!) One look into a US-based group of 2,660 sexually active men between 18 and 31 showed that erectile dysfunction was common and linked to a few common causes, such as relationship status and mental health. Another study of “fit and healthy subjects” demonstrated that ED in young men is likely due to a combination of psychological and relational factors and can be managed without medical intervention.
In short: You’re normal, and you’re not without resources to fix this ordinary problem.
8 causes of erectile dysfunction in your 20s
Even in your 20s, there are several major causes that can lead to erectile dysfunction. Here are few to consider, from the physical to the psychological.
1. Stress, anxiety, or depression
Mental health issues typically emerge when you’re in your late teens and early twenties, including stress, anxiety, and depression. Research has indicated that depression has a typical onset in your mid-20s. Anxiety has also been increasing in young Americans year-over-year throughout the last decade. If you’re battling mental health-related obstacles, getting aroused and staying aroused can become more difficult.
2. Trauma or guilt associated with sex
Trauma can occur at any age and easily get in the way of a healthy sex life. One study of 1,079 patients who displayed PTSD showed significantly higher risk of ED than a group of subjects without PTSD. If you’ve experienced trauma or abuse surrounding intimacy or sexual acts, you may feel triggered when it comes time to get physical, or you may feel guilt around enjoying sex at all. Naturally, this can lead to difficulties getting hard and staying hard.
3. Low sexual confidence
Concerns about your self-worth, attractiveness, or ability to perform can contribute to getting and maintaining an erection. If you’re regularly plagued by thoughts and feelings of insecurity, you’re not alone. Research shows that the overall emotional experience, including self-esteem and conviction, increases with age. Being in your 20s means you’re likely still figuring yourself out.
This can be a beautiful thing, but it can also contribute to erectile dysfunction. Getting and maintaining an erection is harder with stress and anxiety in the mix. Low confidence can create a cycle of doubt: if you are fixated on performance, you can get into your head about your sexual abilities, and work yourself into an anxious state known as performance anxiety. While sex isn’t a performance, thinking of it as such can perpetuate ED. Reimagining sex as an experience as opposed to a performance might be helpful in mitigating your stress.
4. Lack of sexual education
If you don’t have a proper understanding of how the body operates and how erections work, erectile dysfunction could be a result. Dr. Natalie Goldberg, LMFT, is no stranger to this in her line of work.
“Many young men might expect that they should be able to just think about sex and begin to get hard,” she tells MysteryVibe. “The reality is that some might need some actual physical stimulation or touching to begin to get erect. If they are thinking about sex and not getting hard, they might begin to panic and assume something is ‘wrong’ with them, which will ultimately perpetuate their ED.”
Everyone’s body is different, and it’s important to understand how you respond to stimuli or experience desire. For example, a lack of education around your arousal and desire response might lead someone with erectile dysfunction in their 20s to believe their erection is “gone” if it goes flaccid during the act. Erections can ebb and flow and return, but if a person doesn't know that about their body and panics, they might have difficulties getting hard again. It all boils down to knowing yourself and what you like and staying educated around how your body reacts to pleasure.
5. Relationship issues
According to Dr. Goldberg, certain relationship dynamics can lead to difficulties with arousal when you're with a significant other.
“Anger or resentment towards your partner, [pressure in your relationship] if you’re trying to conceive, feeling emasculated, feeling objectified, a lack of attraction. I believe these things further exacerbate erectile dysfunction,” Goldberg tells MysteryVibe.
Maybe your relationship is undergoing strain while you’re trying for a baby, or maybe you’re on the rocks due to a recurring conflict. Perhaps communication issues have left you feeling distant or misunderstood. It can be hard to feel sexy when there’s conflict in the relationship, and thus, you may have a harder time becoming erect.
6. Physical conditions
Any number of physical factors can trigger ED. While some of the most common ones are more frequent in older people, there are plenty of medical conditions related to erectile dysfunction that are normal for young men in their 20s. If you have high blood pressure, diabetes, low testosterone, or are obese, you can suffer from ED at any age.
Traumatic injuries, such as pelvic fractures or spinal cord injuries, have been known to cause impotence. You may be a few years out from that high school or college sports injury, but that doesn’t mean it hasn’t left you with a harder time keeping an erection.
8. Lifestyle factors
While your 20s can be an exciting time of taking risks, experimenting, and indulging, there are several common lifestyle circumstances that may be related to your erectile dysfunction. If you’re smoking, drinking excessively, or eating a poor diet high in saturated fats, you could be impacting hormone levels or blood flow in your body. Healthy and balanced hormones and blood flow are essential for maintaining erections.
Treatment for ED in your 20s
In pinpointing the cause for your erectile dysfunction, it’s important to explore and unpack each of the possible causes to discover what exactly might be contributing to the issue. Then, you can address that hurdle specifically. Consider the following fixes:
• Consult an expert
Sometimes erectile dysfunction is heavily rooted in a medical condition, like high blood pressure. Other times, it can be psychological. In either case, it’s always wise to consult an expert instead of self-diagnosing. Make an appointment with a urologist, a psychologist, or even your primary care physician to determine what’s affecting your erectile health. Remember: In most cases, erectile dysfunction can be treated with limited medical intervention. And, there’s no shame in seeking help when you need it.
• Take a good hard look at your state of mind (and how you’d like to improve it)
If you suspect your problem might lie in poor mental health, low self-esteem, or thoughts of doubt around your sexual abilities, it’s time to step out of your own head. Pay attention to the way you talk to yourself about sex. If your self-talk is riddled with thoughts of “I’m not enough” or “I won’t meet expectations,” challenge those thoughts and reframe them.
Enhancing your state of mind looks different to everyone. Maybe you’re looking to boost your mood and decrease your anxiety. Maybe you’re working on self-love. Any number of these things can play a role in a more fulfilling sex life. If you’re struggling to set goals that help you overcome mental hurdles that lead to your ED, consider making an appointment with a psychologist or therapist.
• Reevaluate your lifestyle
Not only will making a few health-forward lifestyle tweaks help with your erectile functioning, it’ll make you feel better overall. Smoking damages blood vessels and reduces blood flow to the penis, binge drinking can interfere with the body’s natural ability to produce an erection, and lack of exercise can reduce healthy blood flow. Consider taking a break from the fast life and hitting the trail; see how that elevates your sexual function over time.
• Mend bridges with your partner
If there’s friction in your relationship in the form of regular arguments, weak communication, or lack of romance, emotional factors like stress and anxiety can magnify and contribute to ED. When you feel less connected to your significant other, you can experience decreased sexual desire.
If this resonates with you, it might be time to sit down with your partner and talk through the origin of your issues. Letting your partner in and speaking candidly about how you’re feeling and how it’s interrupting your sex drive can go a long way in improving emotional connection. Don’t be ashamed to enlist the help of a couples’ counselor if you need help finding the right words.
The bottom line
“I think the difference between people in their 20's with ED compared to people who experience it later in life is that it's more normalized in older men. Ads for Viagra and Cialis always feature older men; jokes about ‘losing it’ when you're older are rampant,” Dr. Goldberg says. “Very few young men joke about it, let alone talk about it, so there's more psychological stigma.”
The key to treatment might be in admitting it’s normal to experience ED even in your 20s, and open the lines of communication around it with a healthcare professional or with your partner. With the right approach to treatment, it’s perfectly possible to have a fulfilling and healthy sex life even with the occasional bout of erectile dysfunction. Take steps to maintain a healthy lifestyle, manage your stress, and seek support where you need it (either from a urologist or your favorite sex toy), and you can improve your overall sexual wellbeing and go on to have your best sex life yet.