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Difficulty achieving or maintaining erections is thought of primarily as a problem of older men.
Rates of erection difficulty generally increase with age, so it’s not something younger men deal with, right? Wrong. Erectile dysfunction (ED) can affect men of any age, and the cause is not always obvious. Men who have not yet reached their 40th birthday can experience erection problems, and if it’s a problem that tends to recur, there’s every reason these men should seek medical care. A new study out of Italy has indicated that erection problems may be far more common than previously thought in men under 40, and in many cases these problems are severe. Fortunately, there are many effective treatment options available.
New Study of ED Prevalence and Age
Researchers at the University Vita-Salute San Raffaele in Milan, Italy recently characterized the demographic and clinical characteristics of 439 men who sought medical help for ED between January 2010 and June 2012 at an outpatient clinic. Prevalence of erection difficulties increases with age, but prevalence and risk factors of erection problems in men under 40 have not been extensively studied.
Of the 439 patients studied by the researchers in Milan, 26% (114 men) were age 40 or younger. These younger patients had lower average body mass index (BMI) than older patients with erection difficulties, higher average testosterone levels, and lower rates of other medical conditions. The younger men were more likely to smoke and use illicit drugs, and were more likely to suffer from premature ejaculation than older men.
Rates of mild to moderate erection problems were not significantly different between the younger and older men, but rates of severe ED were diagnosed in 48.8% of the younger patients, but in only 40% of the older patients. The researchers, who published their findings in the Journal of Sexual Medicine, say that their findings indicate that younger men with erection difficulty should have a comprehensive medical exam, because of the growing view of ED as a “sentinel marker” of major diseases, primarily cardiovascular disease.
Journal of Sexual Medicine: Young Military Men and Erection Problems
Another study recently published in the Journal of Sexual Medicine found that young men in the military suffer from higher rates of erectile dysfunction than civilians of the same age. Researchers at the University of Southern California found that 33% of 367 active duty men under age 40 reported symptoms of ED, and another 8.4% reported issues unrelated to erections like low sex drive and problems with ejaculation.
The military men who reported signs of post-traumatic stress disorder (PTSD) were 30 times more likely to report erection problems and six times more likely to report other sexual problems. Those who reported depression, anxiety, or who were victims of sexual assault were 10 to 13 times more likely to have erection or other sexual difficulties.
Why the discrepancy? It could be due to different study methodologies or selection bias, though the University of Southern California researchers state that the measures they used, the International Index of Erectile Function and the Arizona Sexual Experiences Scale, were highly reliable. They say that broader research on the causes of sexual dysfunction in men in the military is needed to gain a better understanding.
The Old Thinking: Erection Problems in Younger Men “Psychogenic”
The medical profession used to think that in men under age 40, erection problems were psychological in origin, and that there was little need to test these men for the vascular issues that were believed to cause ED in older men. However, as researchers increasingly associate erectile function with cardiovascular function, this line of thinking is changing.
Irwin Goldstein, editor in chief of the Journal of Sexual Medicine, says younger men experiencing erection problems should be evaluated for cardiovascular health: “We now need to consider regularly assessing the integrity of arterial inflow in young patients — identifying arterial pathology in such patients may be very relevant to their overall long-term health.”
Why Younger Men Should Seek Help for Erection Problems
Dr. Stephen Kopecky, professor of medicine and preventive cardiology consultant at the Mayo Clinic says there’s every reason for men under 40 who experience erection problems to consult their physicians. Says Kopecky, “If you are a 70-year-old man with erectile dysfunction, your risk for coronary disease is increased one to 1.4 times, but if you are a 40-year-old man with erectile dysfunction your risk for coronary disease is 40 to 50 times higher.” In other words, erection problems in younger men can be an early indicator of cardiovascular disease.
The good news is, the earlier cardiovascular disease is discovered, the easier it is to treat. Kopecky says that erection difficulties used to be a symptom that doctors might dismiss, but he says doctors should inform patients that treating erection problems in light of its association with heart disease can not only improve a man’s sexual function, but could have a positive impact on his overall health.
Treating Vascular Disease: Effects on Erection Quality
Younger men with erection problems may indeed be treated with drugs like Viagra, Cialis, or Levitra, but if treatment for early heart disease is also necessary, it could help the ED medications work better. Good vascular health not only affects the heart, but the entire body, including the sex organs. When younger men with erection problems are evaluated for early heart disease, not only can they get help with their erection quality, they could get help that improves their cardiac health before it can cause major problems.
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