ED in Young Men: Causes & Treatment Options

Erectile dysfunction in teenagers is not a common occurrence when compared with middle-aged men, but for some young men, it can nevertheless be a reality — and a scary one. 

Erectile dysfunction (ED) isn’t supposed to be a problem for young guys, with their normal testosterone levels that don’t require replacement therapy, their general absence of age-related sexual dysfunction, and their youthful blood vessels.

Compared to middle-aged guys, young men have a lower overall risk for erectile dysfunction (ED). Why? They’re less prone to the possible causes that are more common later in life — think high cholesterol, hypertension, and low testosterone levels. But ED in young men and teenagers can happen.

We’ll explore why, how, and when young men may experience sexual dysfunction, along with how they can treat it when it happens.

Erectile dysfunction isn’t as common in younger men as the middle-aged and older set. On the other hand, it’s not an uncommon experience for guys of any age. Unfortunately, there’s not a ton of information on the topic of ED in young men, as it hasn’t been very well studied.

For example, one study estimates that up to 30 percent of men under 40 experience ED. And while substantial research has been done on sexual function and erectile difficulties in men over 40, there’s significantly less data on young men under 20.

ED in Young Men vs. Other Age Groups

ED is an aging man’s problem in most cases, typically affecting those over age 40. 

Young men are more likely to have normal testosterone levels, healthy blood vessels, and a lower risk of age-related sexual dysfunction. Still, the risk of ED among men in their 20s (and even teens) isn’t as low as you might assume — it’s just usually due to different causes.

Younger men can experience ED as a result of obesity and other medical issues. However, the prevalence of psychogenic ED — ED caused by relationship problems, low self-esteem, or performance anxiety during sexual intercourse — can be just as high (or higher) than among older generations.

Research on ED in Young Men and Teenagers

Take this study from 2021, for instance. Researchers looked at data from more than 2,500 young men and found that 11.3 percent of sexually active men reported mild erectile dysfunction, and nearly three percent had moderate to severe issues.

However, the study qualified “young adult men” as those aged 18 to 31 — including men out of their twenties.

As for teenagers, a multi-year study looking at ED databases found 40 males between the ages of 14 and 19 with some form of ED. A majority had a surgical cause or a form of trauma to the penis or genitals connected to their erectile difficulties.

For the most part, healthcare providers tend to default to psychological causes when confronted with a young patient with ED. But again, not all young, healthy ED patients are necessarily struggling with psychological ED triggers.

In fact, ED can be caused by a range of factors in your life.

Why can’t I stay hard at 18? Let’s just say you’re not the first 18-year-old to Google this.

There are a number of ways a young adult might get ED. Stress at school, undiagnosed mental health issues, or even carrying extra body weight can raise the risk. Injuries, spinal trauma, neurological conditions, and certain medications might also be causing problems.

If you’re a young guy experiencing sexual dysfunction, the following potential causes may explain what’s going on.

Psychological and Emotional Problems That Cause ED in Young Men

ED symptoms are a combination of things. But it’s fair to say that, for some guys having issues with sexual well-being, the problem might actually be psychological.

Guys with low self-esteem, teenagers who feel guilty about their sexual activities or attractions, and those experiencing lots of stress or similar mental health problems could face erectile function issues.

Conditions like anxiety, depression, and the trio of performance anxiety, fear of failure, and fear of rejection can all swirl out of control. This could mess with your sex drive and ability to get and maintain erections.

Antidepressants and Other Meds That Cause ED in Young Men

Antidepressants like selective serotonin reuptake inhibitors (SSRIs), prescription sedatives like benzodiazepines, antiandrogens, and blood pressure medications can have erectile dysfunction as a possible side effect.

That 2021 study on young men found that even after you adjust for a history of depression, antidepressant users were three times more likely to have moderate to severe ED.

If you’re taking any of these prescription drugs, ask your provider about whether it might be causing your erectile function problems.

That said, it’s important not to stop antidepressants like Zoloft® (sertraline) or other drugs treating mental health problems without talking to your healthcare provider. There are ways to still have healthy erections while taking antidepressants (more on that below).

Diseases and Health Conditions That May Cause ED

Some medical conditions can be risk factors, too, increasing your individual chances of developing ED.

These include:

• Type 2 diabetes

• Heart disease

• High blood pressure (hypertension)

• Atherosclerosis (plaque buildup in the arteries)

• Chronic kidney disease

• Multiple sclerosis

• Peyronie’s disease (penile deformities due to scarring)

• Prostate, spinal cord, or penile injuries

So if you’re a young man or teen and have any of these conditions, your risk might be elevated.

How Living the Single Life Affects Erectile Function

In some cases, sexual dysfunction could also be linked to something that’s going on in a young man’s personal life.

That 2021 study of 2,500 men between age 18 and 31 also found that those with long-term partners saw their odds of ED reduced by 65 percent compared to single men. So it might be the case that a more stable or healthy intimate relationship could reduce the risk of sexual function issues.

But that doesn’t mean being single increases the risk of erectile dysfunction. Many single men have no issues with erections. Plus, rushing into a relationship with the “wrong” partner won’t solve any sexual health problems and may even make them worse.

Lifestyle Choices and Habits That May Cause ED in Young Men

Most men understand that physical activity improves the way they look (naked or otherwise). But it’s sometimes less obvious that regular exercise and an all-around healthy lifestyle can also make you perform better in the bedroom.

Excessive drinking, smoking cigarettes, and using recreational drugs aren’t just a parent’s list of no-nos — they might also be adversaries of your sex life. Along with being overweight or sedentary, those vices can impact your ability to perform. 

​​A study of 100 men with alcohol dependence found that 72 percent experienced sexual dysfunction, including premature ejaculation (PE), erectile dysfunction, or low libido (sex drive).

The CDC (Centers for Disease Control and Prevention) advises men to limit alcohol intake to no more than two drinks a day — classified as “moderate drinking.”

Erectile dysfunction can be temporary or long-term, lasting anywhere from a few months to a lifetime, depending on the underlying cause. If an underlying health issue causes erectile dysfunction and is left untreated, ED can become a lifelong problem.

Having said that, ED treatment is typically effective for most men who don’t have major injuries, traumas, or other permanent damage to their reproductive organs.

That 2021 study we mentioned had another interesting statistic: Less than two percent of the 2,500 men reported using erectile dysfunction medication or supplements. And a third of those who said they were using these drugs were misusing them (taking too much or improper timing, for example).

Education and proper treatment are key to addressing ED. While medication isn’t the only solution, more young men would likely use erectile dysfunction drugs correctly if they sought treatment from a healthcare provider. This could also reduce the rate of self-reported misuse.

If you’re a young adult or teen and think you might have ED, one of the best strategies to reduce the chances of having it forever is to seek professional help from someone who specializes in sexual medicine.

A physical exam with a urology professional or another healthcare provider can help pinpoint or rule out potential causes of ED, like hypogonadism (when the gonads underproduce testosterone) or thyroid issues.

Once they figure out what’s going on, your provider will help get the right treatments in your hands, whether for physiological or psychological causes.

As for ED treatments, they’ll fall into one of several categories.

ED Medication

Medications for ED typically come from a popular category known as PDE5 inhibitors (phosphodiesterase-5 inhibitors). These include:

• Sildenafil (generic for Viagra®)

• Vardenafil (Levitra®)

• Tadalafil (Cialis®)

These treatments help increase blood flow to your penis in a way that can help you better achieve and support erections.

Therapy for ED

When emotional issues like lack of self-confidence and performance anxiety start affecting you in bed, therapy can help you work through those negative thoughts.

Cognitive behavioral therapy (CBT), in particular, can be an excellent tool for learning to reject negative thoughts and thinking patterns that might lead you to imagine worst-case scenarios.

Lifestyle Changes for ED

Wondering how to fix erectile dysfunction at a young age naturally? There are some tweaks you can make to your daily life.

You know how we mentioned lifestyle issues as one of the potential causes of ED? Well, they can affect you at any age and worsen as you get older.

It’s best to cut back on (or outright abandon) habits like smoking or drug use while you’re still young. The same goes for things like exercise and eating healthy foods, which can prevent the types of heart disease and cardiovascular diseases associated with ED later in life.

If you’re a teenager or twenty-something with ED, try not to fret. You still have your whole sexual life ahead of you.

Consider a few things before sweeping these issues under the rug:

• Erectile dysfunction is more common among older men, but it can affect guys at any age.

• Letting fear or anxiety about what might be wrong keep you from seeking help is the surest way to make the problem worse.

• ED is rarely a permanent condition, but if left untreated, it can worsen in severity while your relationships and self-confidence suffer.

• The sooner you get help for ED, the sooner you can get it under control.

Your teens and twenties will come and go before you know it, but ED might not leave without action. If you’re not sure where to look for help, we can connect you with someone who’ll listen and provide answers.

Our online sexual health resources include prescription medication and other treatments for erectile dysfunction. Get help today.