Erectile dysfunction in your 20s and 30s: what causes it?
It’s common, and treatment can usually help. Stress, tiredness or too much alcohol cause most one-off failures. If it keeps happening, one clue helps point to the cause: do you still get erections on waking?
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Is erectile dysfunction at 30 normal?
It’s common. The NHS says most men sometimes fail to get or keep an erection. Erectile dysfunction (ED) is when you can’t get one, or can’t keep it long enough for sex.
Young men get it too. At one Italian clinic, 1 in 4 men seeking help for new ED were 40 or under. Their average age was 32.
| How often | What can cause it | What to do |
|---|---|---|
| Now and then | Usually stress, tiredness or too much alcohol. | Usually nothing to worry about. |
| Often | It may be high blood pressure or cholesterol, diabetes, depression or anxiety, hormone problems, or a medicine. | See a GP or a sexual health clinic. |
Source: NHS
One bad night after a few pints is the first row. A pattern over weeks is the second.
The good news: the NHS says treatment can usually help. So if it keeps happening, get it looked at rather than wait.
Is my ED in my head or physical?
That clue is your morning erections. The NHS says that, depending on the cause, you may still get erections at other times, such as when you wake up.
| What you notice | Tends to point to |
|---|---|
| It started suddenly | Stress, anxiety, low mood or relationship worries. |
| Erections still work on waking or alone | Stress, anxiety, low mood or relationship worries. |
| It came on slowly over time | A body cause, such as blood flow, hormones, nerves or a medicine. |
A review of ED in young men found that worry-led ED tends to start suddenly, with good erections alone or on waking. Body causes usually come on slowly.
Think of a car that won’t start in a busy car park but starts fine at home. That suggests the engine works. It’s a clue, though, not proof, so get checked if it keeps happening.
Mental health stands out at this age. In a Swiss survey of young men, poor mental health was the one thing linked with both ED and coming too quickly. See anxiety and hormones for how the two can look alike.
Note when it started and whether you get morning erections. Tell your GP both.
What causes ED in young men?
Some causes are things you can change. Younger men at the Italian clinic were more likely to smoke and use illegal drugs than older men.
| Cause | What the NHS says |
|---|---|
| Stress, anxiety or low mood | Depression and anxiety are listed causes. Try to reduce stress and anxiety. |
| Alcohol | Do not drink more than 14 units a week. |
| Smoking | Stop smoking. |
| Anabolic steroids | Erectile dysfunction is listed among their effects in men. |
| Antidepressants (SSRIs) | Can make erections hard to get or keep. For some, this may carry on after stopping. |
| Cycling over 3 hours a week | Do not cycle for a while. |
Sources: NHS: ED; NHS: steroids; NHS: SSRIs
On an antidepressant? Never stop or change a prescribed medicine without your prescriber. The NHS says your doctor may switch you to a different one.
What about porn? In three US groups of men, using porn was not clearly linked to ED. Men who felt their use was a problem did report more ED, but the study found no proof porn caused it.
Hormones can play a part too. See low testosterone in young men and alcohol and testosterone.
What happens if I see a GP about ED?
It’s a normal visit for them. You can go to your GP or a sexual health clinic. Many clinics offer a walk-in service, with no appointment.
What a GP or clinic may do
- 1
Talk
Questions about your lifestyle, relationships and any problems.
- 2
Checks
Basic health checks, such as your blood pressure.
- 3
Exam
A look at your genitals for any obvious physical cause.
- 4
Treatment
Medicine, a switch of medicine, or talking therapy.
Source: NHS
Why check your heart at 30? The BHF says penis arteries are so narrow that erection problems can be one of the first warning signs of narrowing arteries.
In one US study, men in their 40s with ED had far more heart disease later than those without. It didn’t include younger men. Your GP may refer you for tests; see blood tests for ED.
Sildenafil (Viagra) is sold in pharmacies after you speak with a pharmacist.
Buying online? The NHS warns that many websites sell fake medicines. It’s best to see a doctor before buying online.
What can I do about ED in my 20s and 30s?
Healthy changes can sometimes help, the NHS says. Start here.
Your erection checklist
- Drink no more than 14 units of alcohol a week.
- Stop smoking.
- Eat a healthy diet and exercise daily.
- Lose weight if you’re overweight.
- Try to reduce stress and anxiety.
- Write down how it started, and if you still get erections on waking or alone. Show your GP.
Sources: NHS: erectile dysfunction; Nguyen and others
Cycle more than 3 hours a week? The NHS says stop for a while.
If worry is behind it, counselling and therapy can help. NHS waits can be long. Relate offers sex therapy for a fee.
Smoke or vape? See what helps people stop.
When to speak to a GP
See a GP or go to a sexual health clinic if:
- Erection problems keep happening. The NHS says it might be a sign of a health condition that can be treated.
- They started after a new medicine, such as an antidepressant. Your doctor may switch you to a different medicine.
- They come with low mood or anxiety. Counselling and therapy can help.
- You use anabolic steroids and want to stop. A GP may refer you to a trained drugs counsellor.
- You bought sildenafil without a prescription. The NHS advises a check-up within 6 months of starting it.
On sildenafil, call 999 if you think you’re having a severe allergic reaction, a heart attack or a seizure (fit). Call 111 for a painful erection lasting longer than 4 hours. Call 111 for any other serious side effects.