Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 11/04/2020
Dealing with erectile dysfunction can be a stressful experience, especially if you’re a young, fit and healthy person.
Erections are, to put it simply, complicated. Getting hard involves more than just being aroused — it’s a complex, multi-step process that requires your brain, hormones, circulatory system and numerous other parts of your body to work in unison.
Despite its reputation as something that mostly affects older men, erectile dysfunction (ED) can and often does affect younger men. If you’re in your 20s and sometimes find it difficult to get an erection, you aren’t alone — in fact, there are many other men out there in the same situation.
Below, we’ve explained how and why erectile dysfunction can occur in your 20s, as well as what you can do about it. We’ve also looked at public statistics to see how prevalent ED is for men in their 20s, as well as the factors that may increase your risk of dealing with ED.
Although it’s not something people talk about often, erectile dysfunction is a very common issue for men. According to the National Institutes of Health, about 30 million in the United States are affected by erectile dysfunction — about one in every five men.
At first glance, it’s easy to brush off this statistic as irrelevant for younger men. After all, census data shows that more than a third of the population is over the age of forty-five. Since ED is usually a condition that affects older men, surely they make up most of this demographic? Right?
Well, not quite. Although ED is more common in men in their 40s, 50s and 60s than in younger men, it’s still very possible and even somewhat common to develop erectile dysfunction in your 20s.
In a 2013 study, researchers noted that one out of every four men seeking treatment for erectile dysfunction is below the age of forty.
More concerning, about half of the men under the age of 40 in the study suffered from severe erectile dysfunction, meaning they were unable to attain or maintain an erection firm enough for penetrative sex.
Research also indicates that erectile dysfunction 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-90s.
If you’re in your 20s and find it hard to get an erection, or find that you lose your erection easily, it’s best to talk to a healthcare provider to find out what’s causing it and what you can do to treat it.
ED can often be a signal that something else isn’t right in your body. As we’ve explained below, erectile dysfunction is often caused by issues like cardiovascular disease, high blood pressure, diabetes and other potentially serious health conditions.
By talking to a healthcare provider about your ED, you’ll be able to identify what’s causing it and take action before the underlying issue becomes more serious.
There’s no singular cause for erectile dysfunction. Instead, erection issues can be caused by a range of different factors, from physical ones like cardiovascular health issues, to psychological ones like performance anxiety, depression or potentially even overuse of pornography.
If you have erectile dysfunction or sudden erectile dysfunction in your 20s, working out the cause can help you more effectively treat your ED and improve your sexual performance. We’ve listed some of the common causes of ED below, with information on how each one can affect your erectile health.
Erections are all about healthy blood flow. If you have high blood pressure (hypertension), you may have an elevated risk of developing erectile dysfunction due to the damage that long-term high blood pressure can have on your blood vessels.
This damage can affect blood flow throughout your body, making it difficult for blood to flow into the soft tissue of your penis when you’re aroused.
Some research also indicates that high blood pressure reduces your body’s production of sex hormones such as testosterone.
Testosterone plays a major role in regulating your sex drive. Studies have found that high levels of total and bioavailable testosterone may be associated with a stronger sex drive and better erectile function.
As we’re learning more about what causes erectile dysfunction, science has observed a pretty clear link between obesity and ED.
For example, ED is more common in people cardiovascular disease — a class of disease that is significantly more common in people who are overweight or obese.
There’s also evidence that losing weight can boost sexual performance and help to get rid of erectile dysfunction. In an Italian study, overweight and obese men who lost an average of 33 lbs over the course of two years reported improved erectile function.
Like high blood pressure, obesity is also associated with a lower level of testosterone — a key hormone for healthy erections and sexual performance. We’ve explained this relationship in more detail in our guide to weight and erection quality.
Diabetes can damage blood vessels and affect your blood flow, making it more difficult for your body to supply blood to the soft tissue of your penis. It can also affect the nerves in and around your penis, potentially affecting sexual stimulation.
As we’ve explained in our guide to diabetes and ED, these factors all contribute to an elevated risk of erectile dysfunction if you have diabetes.
Not surprisingly, alcohol isn’t great for erectile health. While a drink or two is unlikely to damage your sexual performance, drinking alcohol excessively can affect your erections in both the short term and the long term.
In a 2007 study, researchers found that men with alcohol dependence syndrome had a high rate of sexual dysfunction. Of the 100 men that participated in the study, 72 percent had either one or several forms of sexual dysfunction, with erectile dysfunction one of 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 erectile dysfunction than those who didn’t drink at all.
Simply put, if you’re a heavy or frequent drinker, or even just enjoy a drink socially, there’s a risk that your drinking could be a contributing factor to erectile dysfunction.
Likewise, using illicit drugs could increase your risk of developing erectile dysfunction and other sexual issues.
Although in-depth research in this area is limited, there are clinical reports of erectile dysfunction in people who abuse drugs such as cocaine. Even recently legal drugs, such as cannabis, are closely linked to erectile dysfunction and other sexual dysfunctions in some research.
Smoking is closely linked to erectile dysfunction.
In a 2015 scientific review, researchers noted that cigarette smokers have an elevated risk of developing erectile dysfunction when compared to people who don’t smoke.
Cigarettes and other tobacco products can harm your erectile health and sexual performance in several different ways.
First, smoking can damage your cardiovascular system. 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 that are often linked to ED.
Second, the nicotine in cigarettes can cause your arteries to narrow, affecting the flow of blood throughout your body. Since erections are all about healthy blood flow, this isn’t a good thing for your sexual performance.
Our full guide to smoking and ED goes into more detail on the effects of cigarettes on erections and sexual health.
Sexual performance anxiety is a common problem in which you might feel nervous or anxious about your appearance or sexual performance before and during sex.
Performance anxiety can affect men and women of all ages. As we’ve explained in our guide to sexual performance anxiety and ED, feeling anxious or nervous before and during sex is closely associated with sexual dysfunction.
Putting on a condom is simple in theory, but in the heat of the moment, it’s often a much harder process than you’d think.
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 erection. This is known as a condom-associated erection problem (CAEP).
CAEP can occur while you’re putting on a condom or before, such as if you feel anxious about making a mistake during condom application. It can also occur during sex if your condom isn’t put on properly, feels overly loose or tight or reduces sexual stimulation.
Erectile dysfunction caused by condom issues is more common than you may think, especially for men in their 20s. In a 2015 study involving 479 men aged 18 to 24, 13.8 percent had CAEP while putting a condom on.
Another 15.7 percent had CAEP during penis-in-vagina sexual intercourse, while 32.2 percent had CAEP while putting the condom on and while having sex.
Although studies are limited, some research has found that watching porn can change the way your brain responds to sexual stimulation. This may result in a form of ED that’s referred to as porn-induced erectile dysfunction.
Unlike some of the causes listed above, porn-induced ED isn’t caused by a disease or physical factor. Instead, it may be a result of changes in the way you respond to sex that result from the limitless novelty, quantity and unique potential for escalation of internet-based porn.
Several different FDA-approved medications are available to treat erectile dysfunction. All work effectively to treat ED, although there are a few key differences that may make one medication a better choice for you than others:
Sildenafil. Best known as Viagra® or generic Viagra, sildenafil is also available as a generic medication. It works to treat erectile dysfunction by increasing the flow of blood to the erectile tissue of your penis. This makes it easier for you to get and maintain an erection.
Sildenafil is a fast-acting medication. After you take it, you’ll notice effects within 30 to 60 minutes. A normal dose of sildenafil lasts for three to five hours, making it a good choice if you need to treat ED for a single night.
Tadalafil. Sold as Cialis®, tadalafil is also available as a generic medication. It works in the same way as sildenafil and other ED drugs, by increasing the flow of blood to your penis when you’re sexually aroused.
Tadalafil is a much longer-lasting medication than sildenafil. A single dose usually starts to work within 60 minutes and can last for 36 hours, making this a good choice if you’re looking for an ED treatment that will continue working throughout the day.
Stendra®. Stendra, which contains the active ingredient avanafil, is a new medication approved by the FDA for treating ED. Its effects are more focused than those of older ED medications, meaning it has a low rate of side effects.
Compared to other ED treatments, Stendra is very fast-acting. It can work in as little as 15 minutes, making it a good choice if you want an erectile dysfunction medication that you can take shortly before you have sex.
Vardenafil. Sold as Levitra®, vardenafil has similar effects to sildenafil but lasts slightly longer in the body. It’s effective within 30 to 60 minutes and lasts for five to eight hours, making it a good choice if you need to treat ED for a single evening.
All of these medications require a prescription, meaning you’ll need to talk to a healthcare provider before you can purchase and use them. Our telehealth platform allows you to talk to an independent healthcare professional and, if appropriate, receive a prescription for ED medication online.
Therapy. As we mentioned in our guide to erectile dysfunction treatments, therapy can be a helpful option for treating ED that’s related to a psychological factor such as stress or sexual performance anxiety.
Pelvic floor exercises. There’s some evidence that pelvic floor exercises may help to improve erectile function. We’ve dug into the science behind these exercises and put together a list of basic movements you can do at home in our guide to ED exercises.
Making changes to your habits and lifestyle that improve your health may help to treat erectile dysfunction and improve your sexual performance. If you’re in your 20s and have symptoms of ED, try making the following changes:
If you have diabetes, cardiovascular disease or high blood pressure, talk to your healthcare provider. They may be able to prescribe medication or recommend another type of treatment that may help to improve your health and sexual function.
If you use medications, talk to your healthcare provider about side effects such as ED. Certain medications can cause sexual side effects, including erectile dysfunction. Talk with your healthcare provider about the ed medications you use and see if other options are available.
If you’re obese or overweight, try to lose weight. Although the BMI system has some limitations, if you’re overweight, aiming for a target weight in the “normal weight” range is a good idea that may help to improve your erectile health and sexual performance.
Consider limiting your porn consumption. If you think that porn might be affecting your erections and sexual performance, try watching it less than you normally do, or make an effort to avoid watching porn entirely. It may also help to talk to a therapist.
Take steps to manage stress and anxiety. Treatment options such as counseling, sex therapy and sexual performance anxiety therapy may help you to get over performance anxiety and other psychological causes of ED.
Avoid consuming too much alcohol. If you drink often, try reducing your consumption of alcohol, especially on nights when you plan to have sex. When you do drink, take care not to drink excessively and limit yourself to just a few servings of alcohol per night.
If you smoke, quit. Quitting smoking has countless health benefits, including a reduced risk of erectile dysfunction. A study from 2004 found that many ex-smokers experience a measurable reduction in erectile dysfunction symptoms after quitting.
Talk to your partner. Sometimes, talking to your partner can help to reduce anxiety and improve intimacy in the bedroom. Our guide to talking to your partner about ED explains what you can do to make any sexual performance-focused conversations easier.
Although erectile dysfunction is more prevalent in older men, it’s normal and far from uncommon to experience difficulty getting or maintaining an erection in your 20s.
Dealing with ED can be stressful, especially when it affects your relationships. Luckily, almost all cases of ED are treatable using a combination of FDA-approved medications and changes to your habits and lifestyle.
If you’re in your 20s and have ED, don’t be afraid to take action. Talking to a healthcare provider is a great way to learn more about what you can do to get over erection problems, improve your sexual performance and enjoy a higher quality of life.
Concerned about erectile dysfunction? Don’t be. Our guide to the most common treatments for erectile dysfunction goes into greater detail about the options that are available for treating ED and improving your sexual performance.