Erectile Dysfunction (and Function!) in Young Men

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Too busy to read the whole article? [1600 words, a 7-minute read] Here are the key takeaways:

  • Young men think of erectile dysfunction (ED) as an old man’s problem, but the problem is increasing in the young population.
  • Erectile dysfunction, particularly in young men, isn’t just about sex. It’s more likely an indicator of more serious health problems.
  • Worst thing you can do to “fix” your erectile dysfunction: pop pills without a prescription.
  • Best things you can do to fix erectile dysfunction: (1) Start with lifestyle changes (2) Have the guts to talk to your doctor

ED is increasingly becoming a young man’s problem

If my spam folder is any indication, there is an international epidemic of erectile dysfunction the likes of which the world has never seen before.

Not quite, but there is some cause for concern. We’ve known for some time now that long-term ED affects 5% of men at age 40. That figure goes to 15 to 25% of men by age 65.But, what about young men? Young men are suffering from ED at rates higher than previously considered normal. A recent study observed that 1 in 4 patients newly-diagnosed with ED was a young man and almost half of these young men suffered from severe* erectile dysfunction.2

*Severe ED: A patient is incapable of getting and maintaining  an erection to have satisfying sexual intercourse. The less severe cases can still occasionally get it up.

How do I know if I have ED or if it’s just a temporary issue?

I’m sure you’re aware that the main symptom of erectile dysfunction is the inability to achieve and maintain an erection for satisfying sexual intercourse.

There are three main reasons why you might develop ED: (1) physical problems, (2) psychological problems, and (3) problems caused by medication.3

Your doctor should advise you if any medication you’re taking could cause erection issues. So if it’s not medication, then your symptoms are either physical or psychological. Here’s a quick test: if you can get an erection when masturbating or still wake up at full salute, then your troubles are probably psychological.* Temporary contributors to erectile dysfunction include fatigue, stress, and relationship issues, among other causes.

For the purposes of this article, we’ll focus on physical causes of ED, since these may be indicative of more serious and permanent issues.

*The underlying problem may then be stress-related or caused by an over-indulgence with alcohol. Chronic alcoholism can negatively affect hormone metabolism or trigger the onset of a mental condition. One’s mental status can affect erectile function; e.g. anxiety, repeated life stressors (work, relationships), depression or psychosis. That’s as much as we’ll get into that here; leave us a comment a if you’d like to know more about psychological causes of ED.

Why penis health is a good indicator of overall health

There are three main health conditions* that, when affected, can lead to erectile dysfunction: (1) hormonal, (2) vasculogenic, and (3) anatomical.

Simply put, poor penis function can be an indicator of all kinds of other health problems.

Hormone disorders such as hypogandism can cause the body to produce incredibly low levels of testosterone, which in turn could decrease erectile function. But it’s not just sufferers of bona-fide disorders who should be worried about testosterone. There’s a strange endemic in modern society: the testosterone levels in young men are decreasing.4

Testosterone governs your interest in sex, the number of times you’ll want to have sex and the frequency of getting an erection. Suffice it to say, testosterone is a pretty big deal. And testosterone isn’t just about feeling more like a man or growing giant biceps. Testosterone affects a wide range of bodily functions from muscle growth to cardiovascular function.

Vasculogenic problems affect blood flow to the penis. The human penis is populated with a collection of arteries, all of which (except for 1) branch throughout the length of the penis.3 Under normal conditions when it’s time to perform, a man’s brain alerts the nerves in the penis, the arteries dilate (expand), more blood is supplied to the erectile tissue, and the penis becomes engorged with blood.

Think of the ability to get an erection as synonymous with proper blood flow throughout the body. Erection difficulties may therefore be indicators for larger issues with blood flow in general. A fully functional heart and a fully functional penis are a package deal (no pun intended).

Since cardiovascular disease can cause erectile dysfunction, think of ED as a warning sign for possible heart attack—not to be taken lightly.

Coronary artery disease (CAD) is caused by the blockage of the arteries that transport oxygen-rich blood to the heart. A build-up of plaque narrows the passage of the arteries leading to heart problems ranging from chest pain to a full-blown heart attack. CAD is the foremost cause of death for both men and women in the United States. Since cardiovascular disease can cause erectile dysfunction, think of ED as a warning sign for possible heart attack—not to be taken lightly.5,6,7,8

Anatomical disorders of the penis can lead to ED. For example, pudendal nerve entrapment is characterized by reduced or complete loss of penile sensation and experiencing pain when sitting.3 This nerve can be blocked or damaged due to accidents or excessive riding on hard and narrow bicycle seats.

*Neurogenic conditions can also affect penis function. These include spinal cord injuries, stroke, and other ailments affecting brain function. The brain sends signals to the penis when it’s time to perform; if those messages can’t get to the penis, it stays flaccid even if everything else is working. You’ll probably know if you have one of these conditions due to other, more serious symptoms, which is why we’re leaving it out of our discussion of ED.

Erectile function: How to prevent ED and improve penis function

Lets assume you’ve ruled out neurogenic and anatomical disorders as causes for ED. That leaves testosterone levels and vasculogenic (cardiovascular) health.

As it turns out, you can boost testosterone levels while also improving cardiovascular health with the exact same lifestyle changes. The basic prescription? Exercise (with weights!) and watch what you eat. Don’t pop pills.

Don’t fall for the “erectile enhancement” ads. The drug companies would love for us all to believe that our greatest fears and challenges can be solved with a single pill. The truth, however, is that any medication designed to treat ED will have consequences throughout the body, for all the reasons we discussed above. That’s why many men with pre-existing conditions can’t take oral medication. These conditions include heart problems, recent history of stroke, eye problems and kidney disease. On top of that, some medications to treat other conditions interfere with the actions of ED meds.9 Basically, what we’re saying is: consult a doctor before trying any sort of medication or supplement for ED.

Exercise with weights. The exact explanations for why exercise does so much good throughout the body is still a little foggy, but specific research has proven that men who are physically active overall have better erectile function.10 Here’s one particular study of interest: obese men with ED were put on a calorie-restricted diet for two years and were advised to be more physically active. Not only did these men lose quite a lot of weight but the severity of their ED was also decreased.11

Another study showed that exercise alone can help preserve erectile function even if you don’t adhere to a healthy diet.12 The only caveat: if you do eat junk food, you need a higher level of physical activity to maintain erectile function and cardioprotection. Why do we specifically think weight training helps? Because weight lifting can significantly increase testosterone levels while improving cardiovascular health.13

Watch what you eat. As you can probably imagine, obesity has been associated with all sorts of negative effects in the body. Rather than generalizing about obesity, let’s look at specific factors that contribute to ED. People who eat a Western Diet generally consume an excess amount of refined carbohydrates (sugars) and a harmful mix of fats. Chronic high levels of blood glucose (too much sugar in the blood) causes the blood to get thick, which means it becomes much harder for the heart to circulate blood to the extremities. As you might imagine, poor circulation to the penis can mean chronic ED.

There are two main arguments for which fats are worst in the Western Diet. Some research has shown that excess consumption of saturated fats are linked to high cholesterol and high blood pressure, two factors that then lead to heart disease. Others argue that the ratio between Omega-6 polyunsaturated fatty acids (PUFAs) and Omega-3 polyunsaturated fatty acids is more important. Continued, excessive omega-6 PUFA intake has been linked to the development of breast and prostate cancer, inflammation and arthritis.14

Penis, penis penis. Please don’t be afraid to talk about your PENIS.

Listen, guys: if there’s anything you should take from this article it’s that you need to watch out for erectile dysfunction and address it with your doctor if you think it’s an issue.

A line from above bears repeating: proper penis function and proper heart function are a package deal. More than likely, your prescription will simply be some intervals and weights. But, you’ll also be making sure your penis problems aren’t hiding more serious health issues.

Your next action: ask about your erectile health

  • If you’ve been having long-term trouble with erectile function, schedule a visit to a doctor immediately and make sure to get a full physical. ED in young men could be an indicator of more serious cardiovascular or hormonal problems
  • If you’re happy with your ability to get and maintain an erection, still consider a weight-training exercise regimen and watching what you eat to prevent the onset of ED as you get older.

Alright gents, let’s keep it clean in the comments, but I encourage you to talk as much as you want (for once) about your penises.

References

  1. Erectile Dysfunction Basics, WebMD
  2. Capogrosso, P et al. One Patient Out of Four with Newly Diagnosed Erectile Dysfunction Is a Young Man—Worrisome Picture from the Everyday Clinical Practice. Journal of Sexual Medicine, 10: 1833–1841, 2013.
  3. Erectile Dysfunction, Mayo Clinic [last accessed: 23-09-13]
  4. Travison, T.G. et alThe Relative Contributions of Aging, Health, and Lifestyle Factors to Serum Testosterone Decline in Men. JCEM 92:1, 2007.
  5. BMJ-British Medical Journal (2008, October 22). Erectile Dysfunction Gives Early Warning Of A Heart Attack, Warns ExpertScienceDaily.
  6. What is Coronary Artery Disease?, NIH/NHLBI [last accessed: 23-09-13]
  7. Mayo Clinic (2009, February 8). Younger Men With Erectile Dysfunction At Double Risk Of Heart Disease. ScienceDaily. Retrieved August 29, 2013.
  8. Vlachopoulos, CV et al. Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systemic review and meta-analysis of cohort studies. Circ Cardiovasc Qual Outcomes 6: 99-109, 2013.
  9. Erectile dysfunction: Viagra and other oral medications. Mayo Clinic.
  10. Joyner, MJ and Green, DJ. Exercise protects the cardiovascular system: effects beyond traditional risk factors. J Physiol 587: 5551-5558, 2009.
  11. Esposito, K et al. Effect of lifestyle changes on erectile dysfunction in obese men. JAMA 291: 2978-2984, 2004.
  12. Hsiao, W et al. Exercise is associated with better erectile function in men under 40 as evaluated by the international index of erectile function. J Sex Med 9: 524-530, 2012.
  13. Fry, A.C. and Lohnes, C.A. Acute testosterone and cortisol responses to high power resistance exercise. Human Physiology, 36:4  pp 457-461, 2010
  14. Omega-6 Fatty Acids. University of Maryland Medical Center [last accessed: 23-09-13]

More reading

  1. Banks, E. et al. Erectile Dysfunction Severity as a Risk Marker for Cardiovascular Disease Hospitalisation and All-Cause Mortality: A Prospective Cohort Study. PLOS medicine, 2013.
  2. La Favor, JD et al. Exercise prevents Western-diet associated erectile dysfunction and coronary artery endothelial dysfunction: response to acute apocynin and sepiapterin treatment. American Journal of Physiological Regul Integr Comp Physiol, 2013.
  3. La Favor, JD et al. Erectile dysfunction precedes coronary artery endothelial dysfunction in rats fed a high-fat, high-sucrose, Western pattern diet. J Sex Med 10: 694-703, 2013.