Erectile dysfunction in young men may be linked to psychological factors.
Erectile dysfunction in young men can be attributed to a combination of psychological, physical, hormonal, and neurological factors. Although often seen as a problem affecting older men, many younger men also face this condition.
A new literature review on erectile dysfunction in young men, published in 2025 in Cureus and titled “Erectile Dysfunction in Young Adults: A Narrative Review“, found that the prevalence of erectile dysfunction in men under 40 varies widely, reaching up to 35%.
Defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance, erectile dysfunction can have a profound impact on self-esteem and quality of life in young men.
Therefore, understanding its causes, symptoms, and treatments is essential. Learn more below.
Causes of erectile dysfunction in young men
Erection problems in young men should be understood as a multifactorial condition. Causes involve a combination of psychological, behavioral, and organic factors, and it is often difficult to identify a single cause of male impotence in young adults.
Psychological factors
Among young men, erectile dysfunction is frequently associated with emotional states, social contexts, and experiences that influence sexual function.
Everyday stress and anxiety are common causes because they affect concentration, increase body tension, and impair the physiological process of erection.
Performance anxiety can create a vicious cycle: fear of “failing” during sex leads to erection difficulties, reinforcing insecurity and perpetuating anxiety-related erectile dysfunction.
Depression reduces sexual desire and impacts the ability to achieve or maintain an erection. Relationship conflicts—especially lack of communication and intimacy—worsen the situation by increasing emotional pressure and vulnerability.
Behavioral factors
Lifestyle factors influence both immediate erectile function and the risk of future organic complications.
Sedentary lifestyle, poor diet, and sleep deprivation can promote obesity, metabolic syndrome, and hormonal changes. Over many years, these habits can make erection loss more frequent during most encounters—characterizing erectile dysfunction.
Another common habit among young people is substance use and alcohol abuse. This compromises penile blood flow, alters neurological function, and can injure nerves and blood vessels, reducing the ability to maintain an erection.
Erectile dysfunction and pornography can also be related. When consumed excessively, porn may trigger a less satisfying sexual response. By conditioning the brain to unrealistic sexual stimuli, arousal during real-life encounters can decrease, creating frustration and fueling performance anxiety.
Hormonal factors
Hormonal changes can also impair erections. Low testosterone levels, as well as thyroid or adrenal disorders, are associated with erectile dysfunction in young men.
Neurological factors
Neurological conditions—such as spinal cord injury, multiple sclerosis, and Parkinson’s disease—affect the transmission of signals between the brain and the penis, disrupting the process required for an erection.
Symptoms of erectile dysfunction
Symptoms of erectile dysfunction in young men are similar to those seen in older age groups. Watch for the signs:
- Inability to achieve an erection: even with adequate desire and stimulation, the young man cannot obtain the rigidity needed for penetration.
- Difficulty maintaining the erection during sex: if an erection occurs, it cannot be maintained long enough to complete intercourse satisfactorily.
- Reduced sexual interest (low libido): due to difficulties in the moment, combined with hormonal, emotional, or behavioral factors, desire decreases.
Occasional episodes of erectile dysfunction are common. However, when symptoms become frequent or impair most sexual encounters, they are a warning sign to see a urologist.
Diagnosis
Diagnosis of erectile dysfunction in young men involves a comprehensive assessment including discussion of symptoms, medical history, and lifestyle habits.
A physical examination may be performed to evaluate signs that suggest underlying causes.
In addition, laboratory tests are often ordered to check hormone levels and detect medical conditions that may be contributing.
Treatment for erectile dysfunction in young men
Treatment typically combines approaches to address the condition’s multifactorial nature, tailored to each patient.
In many cases, lifestyle changes and psychological support can help, avoiding medication or surgery.
Lifestyle changes
Lifestyle changes—such as regular exercise and a healthy diet—can improve blood flow and cardiovascular health.
Stress reduction through relaxation techniques and leisure activities is also beneficial.
In addition, avoiding substances such as alcohol and tobacco can significantly improve male sexual function.
Psychotherapy for erectile dysfunction
Working with a psychologist or sex therapist helps address issues such as performance anxiety, daily stress, low self-esteem, insecurity, and relationship conflicts.
Cognitive-behavioral therapy (CBT) and specialized sex therapy are commonly recommended psychotherapies for erectile dysfunction. They reduce psychological pressure, strengthen self-confidence, and restore realistic sexual expectations.
Viagra and Cialis for young men
Medications such as phosphodiesterase-5 (PDE5) inhibitors—sildenafil (Viagra), tadalafil (Cialis), and others—are commonly prescribed to treat erectile dysfunction. They work by increasing blood flow to the penis, facilitating erection.
However, use of these drugs by young men should be cautious: while they may work temporarily, they can create psychological dependence when not properly indicated.
The use of Viagra and Cialis among young men has sometimes been indiscriminate, without medical prescription or for non-medical goals. Self-medication carries risks and should only occur with a physician’s supervision.
Surgery for erectile dysfunction in young men
In some cases, a young man may develop Peyronie’s disease—although it is less frequent before age 40. In such cases, penile reconstructive surgery may be indicated by the urologist.
Treatment straightens the penis, optimizes size and girth while respecting nerve limits, and may include placement of a penile implant. This approach can offer sufficient rigidity for intercourse, but results vary by case.
Urologist for erectile dysfunction in young men
Always consult a urologist to investigate the causes of erectile dysfunction and discuss appropriate treatment options for your case.
A confirmed diagnosis should be made by a urologist, who can indicate the most appropriate approach for each situation.
Dr. Paulo Egydio is a urologist with experience in men’s sexual health, including erectile dysfunction across different age groups. Book your appointment here.
Can erectile dysfunction in young men be treated?
Obtaining an accurate diagnosis and appropriate treatment is essential to improving quality of life and sexual health for young men.
If you are experiencing symptoms of erectile dysfunction, seek medical help as soon as possible to restore erectile function.
Learn more:
- Top causes of impotence in men and how to treat
- How to improve your erection: 12 practical tips
- Medication-induced erectile dysfunction: available treatments
- Best supplements for male libido (evidence-based)
- Erectile dysfunction: what it is, main symptoms, and treatments
- Sexologist or urologist: who to see first?
- Vacuum pumps and penile injections
