Man gripping his groin while wondering at what age erectile dysfunction starts

What Age Does Erectile Dysfunction Start?

Medically reviewed on December 19, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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In specific regions of the brain, aromatase exists, an enzyme that converts the sex hormone testosterone into estrogen. During sexual arousal, this conversion drives male sexual activity. At the same time, the arteries relax, allowing blood to flow to the penis.

Erectile dysfunction (ED), however, is a condition in which this sexual function becomes impaired. In many cases, psychological disturbances cause impotence and sexual dysfunction. Other times, it may arise from physical problems, such as heart disease, high blood pressure, low testosterone levels, or tobacco use.[1]

Studies show that 40 percent of men and people assigned male at birth (AMAB) experience erectile dysfunction, and that number increases to 70 percent at age 70. [2] That said, at what age does erectile dysfunction start? While the risk of erectile dysfunction increases with age, it can occur in younger individuals as well.[2]

Understanding Erectile Dysfunction

An erection is a complex process—a combination of psychological, neurologic, endocrine, vascular, and anatomic systems.[2] Sexual stimuli, such as something one feels, hears, sees, or smells, activate the cortical centers within the brain—areas located in the cerebral cortex that are highly advanced. This activation then triggers the hypothalamus, a key regulator of sexual behavior.[2]

The signals travel through the body, via the nervous system, until they reach the genitals. This stimulates blood flow to the penis, where blood becomes trapped in the erectile tissues to maintain an erection for sexual intercourse.[2]

Can high blood pressure cause erectile dysfunction? Sometimes, but there are multiple plausible causes of erectile dysfunction. These include [1,2]:

  • Cardiovascular disease, such as hypertension, atherosclerosis, and hyperlipidemia
  • Diabetes
  • Depression
  • Alcohol use
  • Smoking
  • Certain medications
  • Certain drugs
  • Pelvic/perineal surgery or trauma
  • Obesity
  • Pelvic radiation
  • Peyronie’s disease
  • Arterial disease
  • Metabolic syndrome
  • Hormone deficiency
  • Neurological diseases or conditions, like vascular accident, multiple sclerosis, Parkinson’s disease, and spinal cord injury

Emotions can also greatly impact sexual arousal in younger men. Feeling insecure, nervous, stressed, anxious, or tired can cause erectile problems.[3]

All that said, healthcare providers classify erectile dysfunction into four categories [3]:

  • Vascular erectile dysfunction– Impacts the blood vessels, inhibiting the flow of blood to the penis
  • Neurogenic erectile dysfunction – Nerve problems prevent signals from traveling from the brain to the penis
  • Hormonal erectile dysfunction< – Testosterone deficiency and/or thyroid issues can inhibit sexual arousal
  • Psychogenic erectile dysfunction – Psychological conditions or emotions impact the ability to have an erection

Erectile problems can range from person to person and include [3]:

  • Only being able to get an erection before sexual intercourse sometimes
  • Being unable to maintain an erection during sexual intercourse
  • A complete inability to get an erection
  • Requiring lots of stimulation to maintain an erection

Who Can Experience Erectile Dysfunction?

Erectile dysfunction most commonly affects people between the ages of 40 and 70.[2,3] That said, ED symptoms and erectile issues can also affect young, seemingly healthy men and people AMAB (below the age of 40)—and reports of such cases are becoming more frequent.[4]

Cases of erectile dysfunction in younger people still pales in comparison to the number of sexual dysfunction cases observed in those over the age of 40. In one study, there was only one young person of the four patients with erectile dysfunction. In other research, only 14.1 percent of more than 3,000 men with erectile dysfunction were aged less than 40.[4]

Erectile dysfunction in younger men can arise for many of the same reasons as listed above—vascular issues, hormonal imbalances, mental health issues, relationship issues, and certain diseases.[4]

In young people, more than older, cardiovascular and metabolic issues are particularly high risk.[4]

Young people facing erectile issues often also face difficulties seeking diagnosis and erectile dysfunction treatment. In many cases, their symptoms are underestimated and attributed to “performance anxiety,” rather than a physical issue.[4]

Treating Erectile Dysfunction

To diagnose erectile dysfunction, a healthcare provider will review the symptoms and medical history of the patient before performing a physical exam. These questions may center around medications, mental health, sexual relationships, and frequency of erectile issues.[3]

To identify the cause, a healthcare provider may also order one of the following tests [3]:

  • Blood tests
  • Complete blood count (CBC)
  • Lipid panel
  • Liver function tests
  • Kidney function tests
  • Thyroid tests
  • Testosterone test
  • Urinalysis (urine test)
  • Penile Doppler ultrasound
  • Tests that measure if the nerves in your penis respond to vibrations (penile biothesiometry)
  • Drugs that temporarily make your penis erect (vasoactive injection)
  • Magnetic resonance angiogram (MRA)

When treating vascular, neurogenic, or hormonal erectile dysfunction, a healthcare provider will target the root cause with ED medication, surgeries, and certain therapies. For people experiencing psychogenic erectile dysfunction, professionals may recommend lifestyle changes, such as speaking to a sex therapist and regularly exercising. [3] Some may also find it helpful to avoid the worst foods for erectile dysfunction.

Prioritize Your Sexual Health With Everlywell

Erectile dysfunction can affect men and people AMAB of all ages; however, it’s most common in people over the age of 40.

If you have questions about your sexual health, the Everlywell Men’s Health Test can give you answers. The at-home test assesses four hormones—cortisol, DHEA, estradiol, and free testosterone—that play a role in your sexual drive, energy levels, and overall health. For more information about your sexual health, you can also book a men’s online health appointment with Everlywell. With this virtual service, you can meet with a licensed provider to discuss your symptoms and seek treatment.

Take the first step to getting erectile dysfunction treatment today.

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  1. Ziegelmann M. Erectile dysfunction. Mayo Clinic. Published May 29, 2022. URL. Accessed December 12, 2023.
  2. Lakin M. Erectile Dysfunction. Cleveland Clinic. Published June 2018. URL. Accessed December 12, 2023.
  3. Erectile Dysfunction. Cleveland Clinic. Published August 28, 2023. URL. Accessed December 12, 2023.
  4. Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol. Published February 2017. URL. Accessed December 12, 2023.

Jillian Foglesong Stabile, MD, FAAFP is a board-certified Family Physician. Since completing her residency training in 2010, she’s been practicing full-scope family medicine in a rural setting. Dr. Foglesong Stabile’s practice includes caring for patients of all ages for preventative care as well as chronic disease management. She also provides prenatal care and delivers babies. Dr. Foglesong Stabile completed a teaching fellowship in 2020 and teaches the family medicine clerkship for one of her local medical schools. Dr. Foglesong Stabile’s favorite thing about family medicine is the variety of patients she sees in her clinical practice.
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