March 2, 2019


A lot of men worry about their ‘romantic’ performance. The wonder how to last longer in bed, focusing on technique, and looking for practical glossaries of steps. In reality, achieving and maintaining erections is a complex process that involves muscle, nerves, blood vessels, hormones, and mind-set. Attraction to your partner matters, but so does the man’s view of himself, physically, emotionally, intellectually, socially, and sexually.

Age comes into it too. A study by the University of Wisconsin suggests 50% of 50-year-old men experience Erectile Dysfunction (ED) at mild levels, while 60% face it in their 60s. The severity varies. Some men can get erect but have trouble retaining those erections. Others can’t achieve erections at all. Fortunately, early ejaculation and  erectile dysfunction treatments are readily available. Younger patients have a hard time seeking them though, because of their sense of inadequacy.

Age is a number that counts

In reality, while Erectile Dysfunction (ED) is less frequent in younger men, it’s not impossible, or even unusual. The Journal of Sex Medicine, in its July 2013 edition, found 26% under the 40s have experienced Erectile Dysfunction (ED), and half those cases were severe. While this isn’t necessarily causation, younger men are more likely to use steroids, engage in illegal drugs, or smoke (cigarettes). Older men generally assume their ED is a natural result of aging, which is why the medical response appeals to them.

As for younger patients, the ED could have physical causes. These men will assume their troubles arise from low testosterone, which threatens their sense of masculinity, making it hard for them to see help or speak openly to a doctor. They feel this issue diminishes their manhood. But it could be a symptom of diabetes or a by-product of clogged arteries and high blood pressure. In the case of diabetes, excess blood glucose damages blood vessels and hinders blood flow.

All three cases prevent blood from filling the erectile tissue in their penis, resulting in premature ejaculation or overall inability to become erect. When the problem is hormonal, the young man may have too much prolactin, or his thyroid hormones may be unhealthily high or low. Obesity is another potential barrier to penile blood flow. Being overweight also puts these men at risk of hypertension and diabetes. Both conditions exacerbate ED.

It starts in the mind

On a psychological level, young men may be faced with ED due to anxiety, depression, alcohol/drug abuse, money problems, job-related stress, or even relationship issues, primarily driven by a loss of trust and poor communication. It’s crucial to identify the source before you can find a solution, which is why it’s important to speak to your doctor openly and honestly. As a young man facing ED, cycle through the basics, beginning with a lifestyle audit.

Eat better, and exercise to keep your heart and weight healthy. Cut down or quit any alcohol and drug habits. Quit smoking. Talk to your partner. If you’re dealing with (performance) anxiety or depression, consider seeing a (sex) therapist. A medical doctor may prescribe enzymes that interrupt nitric oxide inhibitors. (Inhibiting the inhibitors enhances blood flow.)

Vacuum constrictors (cylinder + penile band) can also help you get and keep your erection. Or in extreme cases, patients may opt for penile prosthesis surgery. These implants are pretty drastic though, so talk through your options with your doctor.

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