This article was reviewed by Mike Bohl, MD.
“Why can’t I get aroused and I’m 20?” It’s a hard thing to have to type into a search bar while you should be living optimistic and carefree. Unfortunately, for a surprisingly large number of young men, ED isn’t something to treat later in life — it’s happening now. And it’s not uncommon.
In fact, according to the National Institutes of Health, about 30 million American men are affected by ED — that’s roughly one in every five adult men.
First, we want to remind you to take a deep breath. What you’re experiencing is more common than you probably think. And luckily, it’s also very treatable.
While physical causes like injury, obesity and high cholesterol could be at fault, the possible causes might also include mental health concerns — depression, anxiety, low self esteem and more.
Trying to understand what’s affecting you? We get it — and we have answers. But first, some background.
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9 Causes of ED in Your 20s
A quick Google search for “ED in 20s” will lead you to one obvious conclusion: there’s no singular cause of ED. Arousal issues can be caused by a range of factors, from physical ones like cardiovascular health issues to psychological ones like performance anxiety, depression or potentially even overuse of adult content.
Recent census data showed that more than a third of the population is over the age of 45, but in a small 2013 study, researchers noted that one out of every four men seeking treatment for ED is below the age of forty.
More concerning, about half of the men under the age of 40 in the study suffered from severe ED, meaning they were unable to attain or maintain an arousal firm enough for intimacy.
Research also indicates that ED is a growing problem. A 1999 study published in BJU International concluded that ED would likely affect 322 million men worldwide by 2025 — an increase of about 170 million compared to the mid-nineties.
But why?
Getting arousal is a complex, multi-step process that requires your brain, hormones, circulatory system and numerous other parts of your body to work in unison.
ED can signal that something else isn’t right in your body. As we’ll explain below, ED is often caused by issues like cardiovascular disease, high blood pressure, diabetes and other potentially serious health conditions and medical conditions.
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1. High Blood Pressure (Hypertension)
Arousals are all about healthy blood flow. If you have high blood pressure (aka hypertension), you may have an elevated risk of developing ED due to the damage long-term high blood pressure can cause to your blood vessels. It may be more likely for this to be an issue in older men who have had high blood pressure for longer, but it’s possible it could impact men in their 20s.
This damage can affect blood flow throughout your body, making it difficult for blood to flow into the soft tissues of your privates when you’re aroused.
Some research also indicates that high blood pressure reduces your body’s production of intimacy hormones like testosterone — which plays a major role in regulating your drive. Testosterone levels are associated with drive and intimate function.
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2. Having Obesity
As we learn more about what causes ED, science has observed a pretty clear link between obesity and ED.
ED is more common in people with cardiovascular disease or heart disease — a class of diseases that’s significantly more common in people who have overweight or obesity. And yes, it can happen in your twenties.
There’s also evidence that losing weight can boost performance and help get rid of ED. In an Italian study, 31% of men with overweight or obesity who lost an average of 33 pounds in two years reported improved function.
Like high blood pressure, obesity is also associated with a lower level of testosterone — a key hormone for healthy arousal and performance.
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3. Diabetes
Diabetes is one of the main risk factors for ED early or late in life. It can damage blood vessels and affect your blood flow, making it more difficult for your body to supply blood to the soft tissues of your privates. It can also affect the nerves in and around your privates, potentially affecting stimulation.
As we explained in our guide to diabetes and ED, these factors all contribute to an elevated risk of ED if you have diabetes. If you have prediabetes or other symptoms of diabetes, you may want to talk to a healthcare professional about whether it’s connected.
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4. Alcohol
Your drinking habit might be one of the lifestyle changes you need to make as a college student or a recent grad. Not surprisingly, alcohol isn’t great for intimate health, and while a younger man’s hangover may not last as long, the effects of drinking on intimacy can still add up.
While a drink or two is unlikely to hinder your performance permanently, drinking alcohol excessively can affect your arousals in both the short and long term.
In a 2007 study, researchers found that men with alcohol dependence syndrome had a high rate of dysfunction. Of the 100 men who participated in the study, 72 percent had one or several forms of dysfunction, with ED among the most common.
A separate study from Hong Kong found that people who consumed more than three drinks per week were more likely to report ED than those who didn’t drink at all.
So if you’re a heavy or frequent drinker — or even just enjoy a drink socially — there’s a risk your drinking could be a contributing factor to ED.
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5. Drugs
Young men are young enough to remember the anti-drug campaigns that bombarded them in school — but we’re pretty sure that if those campaigns included ED, they’d have more lasting effects on impressionable young minds.
Using illicit drugs could increase your risk of developing ED and other intimacy issues. Although in-depth research in this area is limited, there are clinical reports of ED in people who abuse drugs.
Even recently legalized recreational drugs, such as cannabis, are closely linked to ED and other dysfunctions in some research.
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6. Smoking
Smoking is closely linked to ED — and smokers are at an disadvantage at any age. In a 2015 scientific review, researchers noted that cigarette smokers have an elevated risk of developing ED compared to people who don’t smoke.
Cigarettes and other tobacco products can damage your cardiovascular system. Specifically, the chemicals in cigarettes and other tobacco products can damage your heart and blood vessels, increasing your risk of developing high blood pressure and other cardiovascular conditions often linked to ED.
The nicotine in cigarettes can also cause your arteries to narrow, affecting the flow of blood throughout your body. Since arousals are all about healthy blood flow, this isn’t a good thing for your performance.
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7. Performance Anxiety
Not every problem that affects young men is physical, however. In fact, performance anxiety is a common problem affecting up to 25 percent of men.
With this condition, you might feel nervous or anxious about your appearance or performance before and during intimacy. Performance anxiety can affect men and women of all ages. It can even hit young, otherwise healthy men who don’t see it coming.
As we explained in our guide to performance anxiety and ED, feeling anxious or nervous before and during intimacy is closely associated with intimacy dysfunction.
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8. Difficulty Using a Condom
Call it a problem of inexperience, but if you use condoms incorrectly, struggle to put them on the right way or run into other problems while using this form of contraception, it’s far from uncommon for you to lose your arousal. This is known as a condom-associated arousal problem (CAEP).
CAEP can occur while you’re putting on a condom or just before, like if you feel anxious about making a mistake during condom application. It can also occur during intimacy if your condom isn’t put on properly, feels overly loose or tight or reduces stimulation.
ED caused by condom issues is more common than you may think, especially for men in their twenties. In a 2015 study involving 479 men aged 18 to 24, almost 14 percent had CAEP while putting on a condom.
Another 16 percent had CAEP during intimacy, while roughly 32 percent had CAEP while putting the condom on and while having intimacy.
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9. Adult Content
Though studies are limited, some research has found that watching adult content can change the way your brain responds to stimulation. This may result in a form of ED referred to as adult content-induced ED.
Unlike some causes listed above, adult content-induced ED isn’t caused by a disease or physical factor. Instead, it might be due to changes in the way you respond to intimacy that result from the limitless novelty, quantity and unique potential for escalation of internet-based adult content.
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How to Treat ED in Your 20s
Want to know how to fix ED at 20 or thereabout?
As a younger guy, ED can feel like an embarrassing problem. After all, most guys who feel too young to struggle to get an arousal might deny there’s a problem until it’s too big to ignore.
We suspect one reason for this is fear of the unknown. So, how do you treat ED? It’s pretty simple — some of the most effective options are highlighted below.
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Talk to a Healthcare Provider
Talking to a healthcare provider is essential to root out problems like diabetes, cardiovascular disease or high blood pressure. And it’s a lot more effective than whatever else googling “Sudden ED 21 years old” will lead you to.
A healthcare provider might prescribe medication or recommend another type of treatment that may help to improve your health and intimate function. They can also help you identify medications that might have ED as a side effect.
If you’re not seeing the results you want, always talk with your healthcare provider about the ED medications you use and see if other options are available.
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Consider ED Medications
Prescription medications for ED may sound scary to a 20-year-old, but as ED treatments go, they’re actually among the safest and most reliable options.
Names like sildenafil (generic for Viagra), tadalafil (generic for Cialis), vardenafil (generic for Levitra) and avanafil (sold as Stendra) are FDA-approved medications available to treat ED.
These medications (called PDE5 inhibitors) work by inhibiting a certain enzyme that may prevent your arousal from getting started — but they’ve come a long way since your dad’s little blue pill days.
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Strive for a Healthier Lifestyle
If you’re trying to fix or learn how to prevent ED, your lifestyle may have the biggest clues to offer about what needs attention.
Making changes to your habits and lifestyle to improve your health may help treat ED and boost your performance. If you’re in your 20s and have symptoms of ED, try making the following changes:
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If you have obesity or overweight, try to lose weight.
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Avoid consuming too much alcohol.
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If you smoke, quit.
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Eliminate your drug use — for ED treatment and your general well-being.
One thing you may also want to consider is pelvic floor exercises. There’s some evidence that pelvic floor exercises may help improve intimate function.
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Put Your Mental Health First
You can put your mental health first in several ways, including:
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Taking steps to manage stress and anxiety. Treatment options such as counseling, therapy and performance anxiety therapy may help you get over performance anxiety and other psychological causes of ED.
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Working on low self-esteem. Self-esteem issues may cause some problems in the form of performance anxiety for young people engaging in intimate activity.
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Limiting your adult content consumption. If you think adult content might be affecting your arousal and performance, try watching it less than you normally do — or make an effort to avoid watching it entirely. It may also help to talk to a therapist.
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Talking to your partner. Sometimes, talking to your partner can help reduce anxiety and improve intimacy in the bedroom. Our guide to talking to your partner about ED explains how to make performance-focused conversations easier.
And if you’re already dealing with mental health issues, remember that some antidepressants may cause ED — something you’ll want to discuss with a healthcare provider. But don’t discontinue using them without medical advice.
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Dealing With ED in Your 20s
Although ED is more prevalent in older men, it’s normal and far from uncommon to experience ED at 20.
Dealing with ED can be stressful, especially when it affects budding relationships or an intimate life that’s newer than your car. Here are some fast facts about the issue:
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Yes, ED can affect men in their 20s.
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One common problem for young men is psychological ED, which doesn’t have a physical component.
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Luckily, almost all cases of ED are treatable with a combination of FDA-approved medications and lifestyle changes.
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Solutions like online therapy and online psychiatry can help with the mental conflicts keeping you from getting hard.
If you’re in your 20s and have ED, don’t be afraid of talking to a healthcare provider. You’re not alone in your problem, and they can help you understand your options.
Related: 11 Tips for Better Intimacy
Related: Can PE Condoms Help Men Last Longer?
This article originally appeared on Hims.com and was syndicated by MediaFeed.org
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