Learn about the causes of erectile dysfunction in younger men, from lifestyle choices and anxiety to health conditions, and explore effective treatment options so you can get back to living your life.

Published: September 24, 2025

Estimated reading time: 3 minutes

For young men, sexual response is often a reflex. Erectile dysfunction affects older guys, right? Wrong.

Younger men, including guys in their 20s, can experience erection issues. 

Erectile dysfunction is the inability to get an erection, an erection that doesn’t last long enough for sex or getting an erection sometimes but not every time you’re ready for sex. It can be caused by a health condition, such as those affecting your blood vessels, hormones or emotions; medication side effects; and choices like alcohol and smoking.

Erectile dysfunction is common in young men. A 2021 study in the Journal of Urology found nearly 15% of sexually active men under age 31 reported some level of erectile dysfunction.

“Getting erectile dysfunction treatment can feel awkward at first. Health care professionals will put you at ease. None of us are in high school anymore — talking about the condition and solutions as adults is the first step in successful treatment,” said Steven Patton, D.O., a family medicine physician with Norton Community Medical Associates.

Erectile dysfunction causes in young men

The causes of erectile dysfunction in a young man can be wide-ranging and include:

• Limited blood flow to the penis or injured nerves
• Performance anxiety, stress, and depression
• Excessive alcohol consumption, smoking and substance abuse
• Obesity, high blood pressure and a hormonal imbalance such as low testosterone
• Diabetes, metabolic syndrome and cardiovascular disorders
• Some antidepressants and blood pressure medications
• Premature ejaculation, low sexual desire or another sexual dysfunction
• Relationship issues and lack of sexual stimulation

Typically, your primary care provider can treat erectile dysfunction, and some men choose to see a urologist. A health care professional will collect your medical, sexual and mental health history as part of a diagnosis. A physical exam, as well as lab and other tests also will factor into determining the cause.

A physical exam for erectile dysfunction would include an overall physical exam and a brief examination of the genitals for any apparent medical condition.

Erectile dysfunction treatment in younger men

The treatment for erectile dysfunction is going to depend on the cause. For many, medications, such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra), are commonly prescribed for improving sexual function. While commonly known by their brand names, the medications are also available as generics.

All these drugs are phosphodiesterase-5 (PDE5) inhibitors. By blocking the PDE5 enzyme, the smooth muscle cells in the penis relax more easily and allow increased blood flow and an erection.

These drugs come with risks. Misuse, especially in combination with other drugs — prescribed or otherwise — or in those with underlying medical conditions, can lead to dangerous cardiovascular, neurological and psychological conditions.

Treatments also target the erectile dysfunction causes. These include:

• Improving diet, exercising regularly, quitting smoking and reducing alcohol intake
• Addressing psychological issues such as performance anxiety, stress and depression can be effective for psychogenic erectile dysfunction.
• Therapy sessions with a sexual health professional can help address mental health issues and improve sexual performance.
• Testosterone replacement therapy can be a viable option for those with low testosterone levels.
• Counseling combined with Kegel exercises can strengthen pelvic floor muscles and improve erectile function.
• Managing conditions like high blood pressure or metabolic syndrome can improve erectile dysfunction.