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Erectile Dysfunction Is Actually Pretty Common In Younger Guys. Here's Why

The commercials for Viagra may make it seem like erectile dysfunction is an issue reserved for older men (after all, it affects nearly half of men over 40). And while this diagnosis — which is defined as being unable to achieve and maintain an erection — does increase with age, it can affect young men, too. In fact, erectile dysfunction is found in about 26 percent of men under the age of 40, according to a study in the Journal of Sexual Medicine..

“We used to think that psychological disorders were the only cause of ED in this age group, but now we know that’s not the case,” Michael Eisenberg, MD, director of male reproductive medicine and surgery at Stanford Medical Center, tells Yahoo Health. “The same risk factors that apply to older men can also affect younger men,” including obesity, high blood pressure, high cholesterol, and smoking, as well as anatomic factors.

If you’re young and experiencing problems with your erection, there are some common culprits you might want to consider taking a look at:

Stress and anxiety: For men in their teens, 20s, and 30s, most cases of ED are psychological. There’s a lot of anxiety that comes with sex for a man: trying to impress their partner, making the right moves, concerns about size.  This agony can lead to performance anxiety. “Some men with erectile dysfunction point to one specific instance where they lost their erection during sex as the reason for later impotence,” Joseph Harryhill, MD, FACS, an assistant clinical professor of urology at the University of Pennsylvania, tells Yahoo Health. This buildup of anxiety causes an influx of adrenaline, or epinephrine, which can inhibit an erection.

Excessive bicycle riding: Let’s be clear: if you’re an avid biker, that doesn’t mean you’re going to have ED now, or when you’re older. But if you experience numbness as you ride, within the first few miles, or after biking marathons, you may be causing long-term damage. “The nerves that supply the penis are below the prostate and rest on the bicycle’s seat,” Harry Fisch, MD, FACS, a clinical professor of urology and reproductive medicine at Weill Cornell Medical College/New York Presbyterian Hospital, tells Yahoo Health. “If you are riding a bicycle and are numb, you may be damaging these nerves. Either get fitted for a better seat, or get off the bike.”

Related:  Can Bike-Riding Cause Erection Problems?

Taking cold medication, such as Sudafed: Pseudoephedrine acts as epinephrine in your body and will decrease your ability to get it up. Epinephrine increases your body’s natural fight or flight reaction. “It makes your body think you’re scared,” Fisch explains. “If you are being chased by a lion, you can’t get an erection. That’s what too much epinephrine is like.” But don’t worry — the effects aren’t permanent. As the drug wears off, so will your ED.

Drinking and recreational drug use: Sure, alcohol may serve as a form of “liquid courage” if you’re trying to flirt, but it won’t help with much else. “Alcohol acts as a depressant so it relaxes you, but it can cause an inability to have sex,” Fisch says. The illicit drug cocaine, he adds, acts like pseudoephedrine and will lower your testosterone levels and cause ED as well.

Cancer treatments: Chemotherapy and radiation can cause ED. Chemotherapy may lower testosterone levels, which affect blood flow to the penis. Radiation, on the other hand, can directly damage the lining of the blood vessels or cause nerve damage. Doctors who specialize in oncofertility, the preservation of fertility during treatments such as chemotherapy, can recommend treatments options, according to Harryhill.

Diabetes and high blood pressure: Diabetes mellitus is one of the predominant causes of ED because diabetes impacts the body’s production of nitric oxide, Fisch explains. Nitric oxide provides the penis with the blood it needs to raise to attention in the moment. “If you are hypertensive and have high blood pressure, then you are going to have trouble getting it up in your 20s and 30s because your body is acting like you’re in your 60s,” Fisch says.

Obesity or overweight: Anything that’s bad for your heart is bad for your penis. “Blood vessels are tiny in the penis and if they are clogged, the blood won’t flow there,” says Paul Nelson, a clinical sexuality educator for Maze Men’s Sexual and Reproductive Health. A good diet, exercise, and maintaining a healthy weight can make everything work better. “Men don’t realize how complicated erections are,” Nelson said. “We should be amazed when a guy does get an erection. Instead we are amazed when they don’t."