Common causes of erectile dysfunction in young men

A look at the leading reasons for impotence in younger men


Erectile dysfunction is defined as the inability to achieve or maintain an erection long enough to perform sexual intercourse.

It is easy to assume that erectile dysfunction is a problem suffered by older men whereas, in fact, 25% of cases are seen in men under the age of forty. We need to bear in mind that this figure is an estimate based on the number of younger men who present with the problem in the health professionals consulting room;  many young men will be too embarrassed to seek help. 

In order to achieve a healthy erection, it is vital that the brain, nervous system, endocrine system (hormones) and vascular system are in good working order, working together to fill the erectile tissue (corpora cavernosa) in the penis with blood and so produce an erection.  As a general rule, health problems in these areas are more likely to be seen the older we get and so erectile dysfunction is more likely to occur as we get older.  So what is causing the problem in younger men?

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Physical causes

There are a number of conditions that can be seen in young men that will contribute to or cause erectile dysfunction. Whilst they are likely to be less common than in older men, these conditions can be seen in younger men

  • A microvascular disease where it is caused by severe diabetes will inhibit the blood supply to the penis and so result in the inability to achieve an erection
  • Heart disease.  Although this is unusual in younger men, it is not unheard of and should be eliminated as a cause
  • Nerve injury to the genital area
  • Spinal cord injury
  • Hypogonadism.  This is a disease whereby the body does not produce enough sex hormone
  • Multiple sclerosis
  • Penile abnormalities such as curvature of the penis (Peyronies disease) or foreskin problems
  • Some medication, for instance, antidepressants

There are other conditions which may contribute to erectile dysfunction in young men that are preventable and reversible:

  • Relationship stress
  • Obesity
  • Smoking
  • Lack of exercise
  • Excessive alcohol
  • Poor diet
  • Recreational drugs

Even if you believe that you know the reason for your erectile dysfunction it is important that you consult a doctor in order that they can eliminate the possibility of it being caused by a serious disease


Psychological causes

It is unlikely that all or even the majority of ED cases in younger men can be attributed to physical causes, mainly because of their age. However, it is extremely likely that the cause has a psychological origin. The same psychological issues that older men have can be experienced by younger men

  • Stress - to some extent, stress is part of everybody's daily life and is brought about by money worries, work concerns, busy schedules, children and family issues for example. Stress, however, brings its own health issues and erectile dysfunction can be one of them. Physiologically speaking, stress can produce the fight or flight hormone, adrenaline which will divert blood from the penis making it difficult to achieve an erection
  • Performance anxiety - anxiety is a psychological issue which can also exhibit physical symptoms such as elevated blood pressure, increased heart rate and fatigue which in themselves can affect sexual performance.

However, there is also the historical aspect of performance anxiety when historic events affect the way a person views their ability to perform sexually.  For instance, being walked in on by his girlfriend's mother whilst having sex.   From then on, every time he has sex he is anxious about being interrupted which prevents him from achieving an erection. As a result, next time he attempts sex he does so nervously and this may have the effect of his not being able to perform again - the vicious circle has begun!

  • Depression/anxiety - these conditions can affect a person physically and emotionally and have a great influence on their ability to perform sexually. The symptom list is vast but some signs are:

    1. Sadness, emptiness and hopelessness
    2. Irritability or frustration which can lead to angry outbursts
    3. Loss of interest in normal activities
    4. Lethargy and lack of energy
    5. Anxiety, restlessness and agitation
    6. Feeling worthless
    7. Feeling of guilt
    8. Difficulty concentrating
    9. Feeling nervous, restless and tense
    10. A sense of impending doom, panic or danger
    11. Constant worry


Any of these symptoms can affect sexual desire and the body’s ability to perform in normal activities, including sexual activities. In addition, many of the drugs prescribed for depression and anxiety can add to the problems of low libido and erectile dysfunction

  • Low self-esteem - It seems fairly obvious that if someone is unable to perform an otherwise normal human function such as sexual intercourse it is going to have a marked effect of the person’s self-esteem. Whilst the ED may, at first, have been as a result of a medical condition, the lack of confidence that was started is perpetuated by the negative self-belief that resulted.

  • Guilt - if a person is feeling guilty about something, having an affair, for instance, it may affect their ability to achieve an erection

  • Indifference - if you feel indifferent towards your partner it is very likely that you will not wish to be intimate with them and this can interfere with the ability to achieve an erection

  • Relationship problems - if you have problems in your relationship it is not likely that you will be seeking intimacy with your partner and if you do it is unlikely that the desire for intimacy will be present making it more difficult to perform

  • Pornography - pornography may help some people spice up their sex life but at the same time it can produce unrealistic expectations around sexual performance

  • Substance abuse - historic emotional issues can often be attributed to current tendencies in a person to self destruct through substance abuse




There are some medications that can be considered for erectile dysfunction such as sildenafil (Viagra) and tadalafil (Cialis) are the two most prescribed medications for erectile dysfunction


Lifestyle changes

Making your lifestyle healthier including losing weight, more exercise, a better diet and giving up smoking and reducing alcohol intake will help you cope with stress as well as reduce the likelihood of experiencing erectile dysfunction 



Talk to your GP about the best ways to address psychological issues surrounding erectile dysfunction.  They will be able to point you in the direction of a suitable counsellor



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