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You could assume that erectile dysfunction (ED) is a condition that only affects older men, but you’d be wrong. In actual fact, studies have found it to be more common in younger men than previously thought, and long-term ED will affect 5% of men by the time they turn 40.

Most notably a paper in the Journal of Sexual Medicine reported that one in four patients newly diagnosed with ED were under the age of 40 . And that’s not all – almost half (49%) of this age group were living with a severe case of the condition, while only 40% of men older than 40 were. Despite this, ED isn’t being treated as often as it might be. A study discussed by the European Association of Urology found that only a quarter of men with the condition had ever sought treatment.

Given that problems with erections at 40 or under is a fairly common issue, we’ve taken a look at why it occurs and the various types of treatment that younger men may like to try.

Causes of erectile dysfunction

Men of any age may be unable to get or maintain an erection, also known as impotence, due to a number of physical or psychological factors, or a combination of both. Anxiety, nervousness, and inexperience have long been known as triggers of sexual under-performance in men in their late teens and early 20s. An unhealthy lifestyle and lack of exercise can also contribute to the problem.

But one expert in particular believes there is one increasingly common underlying reason – an addiction to online porn. No official studies have yet taken place to back up her claims about the rise in cases, however, psychosexual therapist Angela Gregory has plenty of anecdotal evidence from her patients.

The link between porn and problems with sexual performance or dissatisfaction with sex isn’t new. Studies have consistently found ED rates of 2 to 5% in men under the age of 40 who regularly watch porn, however, over the past 20 years, that figure has rocketed by almost 1,000%. Gregory puts that down to how much more readily available the material appears to be, thanks to free online streaming sites and the ability for people to watch it on devices such as smartphones and laptops.

She told the BBC: “One of the first assessment questions I’d always ask now is about pornography and masturbatory habit because that can be the cause of their issues about maintaining an erection with a partner.”

Erectile dysfunction can also be linked to depression – one study reported that 82% of men with the sexual condition had symptoms of the illness. Sufferers of depression often have a lowered sex drive – so they’re lacking the urge that originally starts within in the brain and ultimately leads to an erection, often meaning they simply cannot perform well.

Contributing factors of ED can also be of a physical nature and may include injuries from surgery, hormonal problems (such as low testosterone) or even from extended periods of cycling. Narrow blood vessels, although more common in men over the age of 40, are a known cause. High blood pressure, cholesterol, smoking and diabetes can all restrict blood flow to the penis.

There’s also an increased risk of ED in men with relations who suffered from heart disease under the age of 40.

Treatment for erectile dysfunction

When it comes to treating ED, the worst thing you can do is suffer in silence as so many men unfortunately do. Studies have shown that a fifth with the condition are too embarrassed to talk to a doctor, but it’s important you do. That way any underlying causes can be identified, a diagnosis given and treatment started.

A doctor will likely want to discuss your lifestyle, any medicines you may be taking, and other potential reasons for erectile dysfunction. When it comes to treatment options, you might be advised to make lifestyle changes to improve your general health. Quitting smoking, losing weight and eating a healthy diet as well as cutting down on alcohol can all result in better success between the sheets.

However, prescription-only medicines are most commonly used to treat ED in younger men. These include Viagra (sildenafil), Cialis and Levitra, which all work by relaxing the blood vessels around the penis to allow better blood flow. They generally take effect between 15 minutes and an hour of taking them. It’s always a good idea to speak to a doctor about the benefits of these and other ED medicines.

If tablets don’t work, the main message is that those living with ED shouldn’t lose hope, as other treatments are available.

Want to talk?

If you’re under 40 and erectile dysfunction is affecting your confidence or impacting on your love life, don’t be too embarrassed to speak about it. This is a condition that is more common in this age group than you’d think and it responds well to treatment. We offer a no-obligation, confidential consultation through our online doctor service, and our GMC-registered GP is on hand to answer any questions and provide recommendations for treatment. Contrary to what you may think, you don’t need to go through this alone.