Erectile Dysfunction In Your 20s: Everything You Need To Know

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Sexual health is a fairly taboo topic in several cultures, and even many adults often struggle to bring themselves to discuss it with their doctors. Nonetheless, it is vital that men of all ages make it a point to inform themselves and be diligent in their medical consultations if any problems should arise – particularly if they are unexpected or occur at an age when everything seems like it should be working correctly.

This article aims to be an aid in that pursuit by providing you with comprehensive information regarding erectile dysfunction, the physiology underlying it, common causes of the condition, and treatments associated with these causes.

What Actually Is Erectile Dysfunction?

It is common knowledge that erectile dysfunction is a medical condition that prevents a man from getting an erection sufficient for sexual intercourse with a range of potential causes that could each contribute to the condition, including age, medications, injury, and lifestyle. But what is actually going on physiologically when someone suffers from the condition?

Well, the mechanics of an erection rely on a number of physiological processes that work together in order to produce an erection. The first process is the release of chemicals called neurotransmitters from the nerve cells in the penis. These neurotransmitters cause several muscles in the penis (specifically, in the corpus cavernosum, which makes up the core of the penis) to relax and blood to flow in.

This is where the next key process comes in: the flow of blood into the penis. The veins in the penis closest to the surface become engorged with blood and fill the penis with blood that causes the actual erection itself. From there, the release of more hormones within the hypothalamus in the brain influences the smooth muscles in the penis in order to help it maintain the erection.

All of these processes work together to create an erection, and as you should now be able to imagine, there are several potential failure points that could each cause either a soft erection or full-blown erectile dysfunction – so really, ED could be indicative of an entire array of potential health issues.

How Common is Erectile Dysfunction?

Due to the stigma associated with sexual health issues and the physiological dysfunctions they can cause, few people are aware of just how common some of these can really be -- shockingly, erectile dysfunction affects more than half of all men at some point in their lives, and that number only increases with age.

It should not come as a surprise: as we explained above, the penis is a delicate organ that relies on a number of different bodily systems and can be adversely affected by a variety of conditions and problems. In fact, many of the most common causes of erectile dysfunction (including age, diabetes, hypertension, and other health conditions) can also be the culprits behind other types of dysfunction, like poor blood flow and nerve damage.

There is, of course, widespread messaging within a lot of cultures that characterizes erectile dysfunction as an issue that is primarily encountered later in life: from Viagra commercials featuring old men on golf courses to TV shows that poke fun at "old geezers that can't get it up anymore", anyone who hasn't researched the topic could be forgiven for thinking that erectile dysfunction really only becomes a concern after all your hair has gone grey. So -- how does that stack up against the reality of the situation?

Erectile Dysfunction At A Young Age

As you may have guessed by now, Erectile Dysfunction is astonishingly common even among men of a younger age. A recent study coming out of Italy puts the number as high as 26% of men under the age of 40. Consider that for a moment: Over a quarter of all men you've known in their 20s and 30s have likely experienced erectile dysfunction. The degree to which cultural and social messaging around the condition has distorted our preconceptions regarding sexual health and how common it is to encounter issues relating to it is clear.

Dealing With The Stigma

The misconceptions surrounding erectile dysfunctions are not only worrisome because of the stark contrast between reality and messaging, but they are also problematic because they translate into concrete differences in treatment outcomes as the perceived rarity of the condition at younger ages feeds a stigma that leaves men that suffer from the condition hesitant to seek medical advice or otherwise find comfort in the knowledge that this is surprisingly normal.

Studies have shown that early treatment of erectile dysfunction can not only improve the long-term prognosis of patients, but also significantly reduces the risk of developing serious long-term consequences -- remember, erectile function relies on a complex, collaborative effort by a number of bodily systems, and ED can be an early sign that something is wrong in some other part of your body that could eventually result in a more series problem.

In one particular study involving over 1,000 men that reported having difficulty getting and maintaining an erection, over half said that they had never discussed the issue with a doctor. Needless to say, some proportion of those men may well be suffering from ED as a result of an underlying condition that their doctor could well have been able to identify and treat.

If you are a man of any age suffering from erectile dysfunction, please do not let social stigmas fed by common misconceptions lead you to hesitate to reach out for help. There are many reputable sources of information and support available, and the sooner you get started, the better your chances of finding relief.

What Can Cause Erectile Dysfunction?

As discussed above, the male genitalia relies on complex interactions between various bodily systems to facilitate erections. This means that erectile dysfunction can have a whole range of different causes, and they each come with a different prognosis and treatment plan. We explore most of these below.

Low Levels Of Testosterone

Statistically, this is the most common cause of erectile dysfunction in men. Low levels of testosterone can occur for a variety of reasons, including age, illness, medications, and genetics. When testosterone levels are low, it can impact the function of the nerves that lead to the penis, as well as the blood vessels that supply the penis with blood. This can cause difficulty getting and maintaining erections, as well as a decreased libido.

Low levels of testosterone can be treated with certain drugs, but if those prove ineffective, your doctor may also recommend testosterone replacement therapy – this is a more aggressive approach that usually involves injections into the buttocks. If you’re considering testosterone replacement therapy, it’s important to consult with a doctor who is knowledgeable about the therapy and its side effects.

Nervous Dysfunction

Since the nervous system plays such a key role in erectile (and all other) functions, issues relating to nerve or brain function can also cause erectile dysfunction. In these cases, erectile dysfunction is usually accompanied by other symptoms, such as decreased libido or poor orgasmic function -- however, an absence of additional symptoms does not rule a nervous issue out either.

The most common conditions at fault for nervous dysfunction resulting in erectile issues are spinal or brain injuries, but certain neurological disorders like diabetes or multiple sclerosis can also damage the nerves that control erectile function.

Treatment of this particular case varies greatly depending on what underlying condition is to blame, so it is crucial that you consult with your doctor to obtain a diagnosis and devise an effective treatment strategy. This is doubly important because if nervous dysfunction is what underlies your condition, erectile dysfunction may just be an initial symptom.

Blood Flow Complications

Almost every cause of erectile dysfunction ultimately results in some blood flow irregularity at some point or another, but there are times when the flow (or lack thereof) itself is the problem. This can be the case if there's a blockage in one or more of the blood vessels that supply blood to the penis, or if the arteries that help feed blood to the penis have narrowed. Again, this is something that could result in problems well beyond erectile dysfunction, so consulting with a medical professional is essential.

As far as treatment goes -- many of the conditions that cause blood flow complications can be treated with medications or surgery. The specifics of what to do and when will depend on the specifics of each individual case, but common treatments include medications like angiotensin-converting enzyme inhibitors and phosphodiesterase type 5 inhibitors, or surgery like penile angioplasty or penile revascularization.


Erectile dysfunction is a side effect of many medications, and even if it isn't explicitly listed as one, it is possible that you were previously an edge case and that a particular medication finally made the difference. This is especially common with medications that treat blood pressure, heart disease, and other chronic illnesses.

If this is the cause of your erectile dysfunction, the solution could be as simple as adjusting your medication dosage or switching to a different drug. But if the root cause is a medication you're taking for a specific condition, it's likely that your doctor will have more specific advice.

Medical Conditions

There are a number of medical conditions that can lead to erectile dysfunction. These include diabetes and Peyronie's disease -- the former of which causes damage to the blood vessels that supply the penis with blood, and the latter of which is a condition that causes the penis to become curved due to excessive scar tissue following repeated penile injuries. This is another case in which treatment is heavily dependent on the exact condition in question, so consult your doctor.

Lifestyle Factors

Most modern lifestyles are far more unhealthy than people realize, and many of the conditions people experience throughout their lives can ultimately be traced back to unhealthy habits or negligent nutrition. Erectile dysfunction is no exception to this rule. Fortunately, should your erectile dysfunction be the result of specific habits in your daily life, you should be able to fix it by simply making changes and taking care to adopt a healthier lifestyle -- assuming no other conditions that may cause erectile dysfunction themselves have developed, that is.


The most common lifestyle-related issue causing erectile dysfunction is obesity. Obese men are nearly twice as likely to experience erectile dysfunction as men of a healthy weight, and the problem is even more pronounced in older men. The link between obesity and erectile dysfunction is complex, but the weight gain associated with it is thought to contribute to the problem by damaging the blood vessels that supply the penis with oxygen and nutrients.


A poor diet is also a major contributor to erectile dysfunction. Unhealthy diets that can lead to either erectile dysfunction or conditions that cause erectile dysfunction are typically high in fats, processed foods, and sweeteners, which each, in their own ways, lead to inflammation and damage to the blood vessels that help produce erections.

Good rules to follow on this front include avoiding red meat, high-fat dairy products, and processed foods in general. Instead, make sure to include plenty of fruits and vegetables, whole grains, and lean proteins in your diet -- ideally, follow a nutritionally diverse plant-based diet.

Drug Abuse

While responsible recreational drug use does not usually lead to erectile dysfunction, more extensive drug abuse can -- especially when hard drugs are involved. Methamphetamine in particular is a powerful and highly addictive stimulant that can damage blood vessels in the penis, but drugs like cocaine and heroin can also contribute to erectile dysfunction.

This is not limited to illegal drugs either. Legal and more socially normalized drugs like alcohol can cause these issues as well. In fact, alcohol can do so not only because as a central nervous system depressant, it can cause problems with blood flow and circulation -- it can also directly interfere with the production of testosterone, which would result in lower testosterone levels.

If you're struggling with erectile dysfunction and suspect that drug abuse may be a contributing factor, it is incredibly important that you seek help from a medical professional, because again, the damage may be more widespread than erectile dysfunction alone might suggest.


While nicotine is technically also a drug, smoking deserves its own section because it is one of the most well-known and well-established causes of erectile dysfunction. It is also the leading cause of preventable death in men in the United States. This is because cigarettes contain over 4,000 chemicals, many of which are linked to health problems that can cause or exacerbate erectile dysfunction themselves. Smoking also directly causes a decrease in blood flow to the penis and decreases the production of nitric oxide, which is a key chemical in the physiological pathway responsible for maintaining erections.

Quitting smoking is one of the best things you can do not just for your erectile function, but also for your overall health. If you are currently struggling with erectile dysfunction and you smoke, it is important that you try to devise a plan to definitively quit as soon as possible, because as with some other causes, erectile dysfunction may just be the first symptom -- seek out appropriate resources online and consult with your doctor.

Emotional or Psychological Complications

As with anything else in life, mental and emotional health are hugely significant when it comes to sexual function. If you're experiencing a great deal of stress, anxiety, inadequacy, or depression, and especially if any of those feelings are tied to your partner, relationship, or sexual performance, it is entirely possible that your erectile dysfunction is tied to psychological distress rather than a physiological condition. Consulting with your doctor would still be wise as it is difficult to definitively ascertain whether your erectile dysfunction is due to your mental health rather than some physical complication, but in these cases seeking therapy may well be sufficient.

How To Treat Erectile Dysfunction

As discussed above, treatment for erectile dysfunction and its underlying cause can vary greatly. Nonetheless, broader general-purpose solutions do exist -- medications like Viagra and Cialis, for instance, work through the blood vessels of the penis to increase blood flow and cause an erection. Certain vacuum devices or penile prostheses can also prove very effective in treating erectile dysfunction, particularly if the cause turns out to be a chronic physiological issue that cannot be resolved for some reason or another.


If you are experiencing erectile dysfunction, one of the first things that may jump to your mind is the worry that this could be a chronic condition that you will be unable to fix and have to learn to live with. Statistically, however, the majority of men who experience erectile dysfunction will eventually recover.

This is particularly true if you are under the age of 45, as your odds of recovering are even greater. This is because any decrease in the blood flow to the penis resulting from aging is much more difficult to reverse than a decrease resulting from a condition or from some lifestyle issue. If you are over the age of 45, you may still have a relatively hopeful recovery rate -- but it is all the more crucial to ensure that you are evaluated by a doctor if you are experiencing difficulty getting an erection.

ED Treatments That Work

Medications like Sildenafil (Viagra) and Tadalafil (Cialis) are widely accepted worldwide as the best available treatments for erectile dysfunction. These medications can help men with erectile dysfunction experience more satisfying sexual encounters.

Both Sildenafil and Tadalafil work by inhibiting an enzyme called phosphodiesterase-5, or PDE-5. PDE-5 is responsible for breaking down a substance called cyclic guanosine monophosphate, or cGMP. cGMP is a key player in the erectile process, as it relaxes smooth muscle tissue in the penis, allowing blood to flow in and produce an erection.

Inhibiting PDE-5 allows cGMP to stay active in the penis longer, which improves blood flow and allows men to maintain an erection for longer periods of time.

The difference between these two medications lies in their duration of action. Sildenafil remains active in the body for up to 4 hours, while Tadalafil can remain active for up to 36 hours. This means that Tadalafil can be taken once a day, while Sildenafil should be taken around 30 minutes to an hour before sexual activity.

Both Sildenafil and Tadalafil are generally well tolerated, with the most common side effects being headache, flushing, and indigestion. These medications can be taken with or without food, and they are not known to interact with any other medications.

If you are interested in trying one of these medications, you can make an appointment for a free consultation with Phoenix. Phoenix specializes in Canadian men's health, and our chat-based software is discreet, you don't even need to turn on your camera. Make a free appointment today, and Rise Again.

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This blog post is for educational purposes only and does not constitute medical or other professional advice. Your specific circumstances should be discussed with a healthcare provider. All statements of opinion represent the writers' judgement at the time of publication and are subject to change. Phoenix and its affiliates provide no express or implied endorsements of third parties or their advice, opinions, information, products, or services.

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