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Erectile dysfunction and age: This is when ED typically presents

Cases of erectile dysfunction tend to increase with age.

Written by
Leeza Schwarzkopf
Medically reviewed by
Last updated
May 15, 2024
min read
Erectile dysfunction and age: This is when ED typically presents
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Sexual pleasure and expression are an important part of your well-being. And, it doesn't matter your age — sexuality can be just as important for someone in their 70s as it is for someone in their 20s.

This is why it's important that we work against the stigma that is often attached to erectile dysfunction (ED). And, if you do happen to have personal experience with ED, know that there is no shame in seeking support for something so important.

While it might seem like an issue associated with ageing men, it can also affect men in their youth and middle age — unfortunately, erectile dysfunction doesn't discriminate based on age.

With this in mind, we're exploring why ED can develop at different stages of life, the risk factors and the ED treatment options that you can access from the comfort of your own home.

What are the symptoms of erectile dysfunction?

Typically, erections occur during sexual stimulation. Your brain sends a message down the spine, to the nerves in the penis. This message tells the arteries in your penis to fill with blood, while also restricting blood flow away from the penis by closing the veins [1].

The extra blood is what makes the penis hard during sexual arousal. When there are disruptions to these blood vessels, nerves or tissues, that's when you may experience challenges with erectile function and develop ED.

The main characteristics of male sexual dysfunction include an inability to consistently have an erection, only being able to maintain an erection for a short amount of time, or a total inability to have an erection at all.

The patterns of erectile dysfunction can vary quite widely from person to person. Some may lose their erection during sex, while others may lose theirs before sexual penetration. In other cases, some men are able to experience erections during masturbation or when they wake up, but not with their sexual partner [2].

While most men may experience one-off challenges with erectile function at some point in their lives due to tiredness or stress, the actual condition of erectile dysfunction is defined as a consistent inability to have and maintain an erection.

Erectile dysfunction is sometimes also called impotence, however, that term is becoming less used.

Can erectile dysfunction be caused by age?

Although cases of erectile dysfunction certainly increase with age, it is not directly caused by age, nor is it an inevitable part of ageing [1]. It's also important to highlight that sexual desire and activity don't automatically reduce with age.

In fact, some people may find more satisfaction in their sex lives as they age as they tend to have fewer stressful distractions in their life [3]. In fact, one study from 2003 found that 13% of women reported an increased interest in sexual activity as they aged [4].

But, it's important to note that ED in ageing men is extremely common, with approximately 26% of men in their 50s experiencing erectile dysfunction. That increases to 40% of men in their 60s and 77% of men over the age of 75 [2].

What are the causes of erectile dysfunction in your 20s?

Although erectile dysfunction is more commonly experienced at an older age, it is still possible to experience it in your 20s. It's estimated that around 2-7% of men under the age of 30 experience erectile dysfunction [5].

Psychological issues seem to be the most common causes of erectile dysfunction during one's 20s, with health professionals reporting that they consistently see patients with depression, stress and anxiety-related erectile dysfunction [5][6][7].

Other negative feelings, such as guilt, low self-esteem and trouble managing anger can also play a role in erectile dysfunction [2].

In addition to mental health challenges, physical factors such as obesity, diabetes, heart problems and hypogonadism (meaning low testosterone production in men) can contribute to erection problems in men in their 20s.

Researchers have also found that younger men are often more likely to smoke or use recreational drugs compared to those older and this is another risk factor that can impair erectile function.

What are other causes of erectile dysfunction?

There's quite a wide range of reasons why a person might experience erectile dysfunction, but broadly speaking, physical causes account for more than 60% of cases [1].

When looking at all age groups, diabetes mellitus is the most common cause of erectile dysfunction. This is because poor blood sugar control over the long term can damage nerves and blood vessels [2]. Around 50% of men with diabetes experience erectile dysfunction.

Having diabetes also puts you at risk of an arterial disease called arteriosclerosis. This is when your arteries become narrow and can restrict blood flow to your penis. This health condition is the main cause of erectile dysfunction in men over the age of 60 [1].

ED is also commonly associated with other health conditions affecting the vascular system, such as increased blood pressure and heart disease.

Spinal cord trauma and neurological diseases, such as Alzheimer's or multiple sclerosis, can also cause ED because of the way they affect the brain and spine.

Any physical injury or disease that directly affects the tissues or blood flow of the penis can also prevent or cause trouble maintaining erections. One example is Peyronie's disease, which causes penile curvature.

Certain types of medications can also play a role in ED, including high blood pressure medications, certain antidepressants, sedatives and tranquillisers.

At what age do men typically experience erectile problems?

Erectile problems can be experienced by men of any age — as long as they have gone through puberty. However, it is most common among men over the age of 50 [1].

This is because you're more likely to experience other health conditions as you get older, such as high blood pressure, high cholesterol and cardiovascular disease. These conditions have a flow-on effect that can impair sexual function.

At what age can erectile dysfunction begin?

There's no exact starting age for erectile dysfunction. Even though it's more common among older men, it can technically be experienced by any sexually mature male.

As previously mentioned, there is a small percentage of ED patients in their 20s and the rate of erectile dysfunction increases with age.

How can erectile dysfunction be treated?

There are a few ways to treat ED, no matter whether you're trying to figure out how to fix erectile dysfunction at a young age or want to remain sexually active as you get older.

A holistic approach to treating ED may start with lifestyle changes that address the associated risk factors. These might include increasing physical activity, quitting smoking (and vaping!), reducing alcohol consumption and getting support for drug abuse [2].

One study found that 30% of obese men with erectile dysfunction experienced better erections following weight loss.

Plus, there are effective treatment options available for ED and Pilot is here to help. Pilot's erectile dysfunction treatment includes two types of medication.

One is a daily tablet that allows you to develop an erection at any time you experience sexual desire, while the other is an on-demand tablet that you take 1 hour before you want to have sex and it assists with sexual arousal for 4-6 hours.

Neither of these medications causes automatic or spontaneous erections — they work by amplifying your body's signals, so you still need to feel sexual arousal to form an erection firm enough for sex.

Known as PDE5 inhibitors, these ED medications work by targeting the enzyme responsible for the contraction of blood vessels in the penis. This helps improve blood flow and helps men maintain firm erections throughout sex.

With treatment, 78% of men will achieve lasting erections and Pilot practitioners have helped improve the sex lives of 94% of patients [8][9].

Pilot also provides judgement-free online consultations with ongoing care, discreet home delivery and automatic refills every two months. Simply take an online consult with an Aussie practitioner and your treatment will be delivered straight to your door.

Medical treatments can also be combined with counselling or therapy, especially for those experiencing erectile dysfunction related to mental health challenges. Psychosexual counselling or couples therapy can also be beneficial in helping you talk to your partner about your experience with ED [2].

No matter what age you are, it's important to seek support from a doctor if you're experiencing erectile dysfunction. Not only because it's important to sexual well-being, but because it may be the first sign of a more serious health problem.

Photo credit: Getty Images

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