Why do so many young men suddenly have erectile dysfunction?

Harlan Randell was a latecomer to the bedroom.

The 24-year-old Brit didn’t lose his virginity until he was 21 – and when he finally took the plunge, he ran into an unexpected obstacle that would haunt him for years: erectile dysfunction.

“I was absolutely mortified,” Randell, a sports distribution customer service and logistics specialist, told the Post.

He is hardly alone.

Not long ago, erectile dysfunction was primarily seen as a problem affecting older men, typically affecting patients over 50 with underlying health conditions. But this stereotype is fading.

Younger men are increasingly facing problems in bed, with studies suggesting that more than a quarter of men under 40 cannot get or maintain an erection firm enough for satisfactory sex.

The Post spoke with six urologists and two sex therapists who said they’ve seen a steady stream of men in their 20s and 30s seeking help for erectile dysfunction — with even younger patients joining the mix.

“We’re definitely seeing an increase in concern among older adolescents about their erectile dysfunction,” said Dr. Lane Palmer, chief of pediatric urology at Northwell Cohen Children’s Medical Center in New Hyde Park. “We receive one or two calls a week to request a consultation. »

So what’s behind the rise of young men in their sexual prime struggling to perform? Here’s what the experts say.

Hardware problem

For years, erectile dysfunction was thought to be primarily a psychological problem. But for men who fit the classic patient profile, doctors now know that physical problems often play a major role, particularly anything that interferes with blood flow to the penis.

“When we see an older patient come into the office and they have erectile dysfunction, they often have a combination of obesity, diabetes, high blood pressure and medications to treat these conditions, which can contribute to erectile dysfunction, as well as some underlying cardiovascular diseases,” said Dr. Jason B. Carter, board-certified urologist and medical advisor to Aeroflow Urology.

Low testosterone levels, common in men 45 and older, can also affect sexual function, particularly libido. Lifestyle factors like smoking, substance use, and poor diet can make the condition worse.

“In general, older men are more likely to have erectile inconsistencies due to biological factors,” said Rocky Tishma, co-founder of Manhattan Sex Therapy Group.

“But recently, many younger men are coming in after seeing a primary care provider or urologist and finding that there is nothing physiologically wrong,” he added.

In fact, all the experts interviewed by The Post agreed: The erectile dysfunction that affects many young men cannot be attributed to anything that can be detected in a blood test or physical exam.

“In my clinical practice, we see a clear and steady increase in the number of younger men experiencing symptoms of erectile dysfunction,” said Dr. Bilal Chughtai, chief of urology at Northwell Plainview Hospital in New York. “What is particularly remarkable is that these patients are often healthy.”

Mind before mojo

“A very large portion of erectile dysfunction in younger men is what’s called psychosomatic, primarily induced by stress and anxiety,” said Dr. Leon Telis, a board-certified urologist and director of the Men’s Health Program at Mount Sinai Hospital.

Much of this stress comes from the constant messages about sex that young men receive from their friends, social media and pornography.

In the United States, 57% of young adults aged 18 to 25 watch porn at least once a month. A survey found that two-thirds of Gen Z started watching before the age of 16, subtly shaping their ideas about sex.

Tishma often sees a pattern: Young men have no problem getting erections in the morning or while masturbating, but as soon as they try to be intimate with another person, their penis doesn’t rise to the occasion.

“This ends up leading to a lot of stress, anxiety and psychological issues that prevent them from manifesting in their body the way they want to when interacting with another person,” he said.

While watching porn isn’t automatically a bad thing, Telis explained that it can desensitize young men to real-world intimacy. “Their level of excitement about what they imagine will be much higher than what’s happening in reality,” he said.

It can also create unrealistic expectations for performance in bed.

“Pornography is often an exaggeration of sexuality,” Palmer said. “Now with AI, who knows what kinds of images and messages are going to be created, and it’s only going to cause even more anxiety and worry.”

Randell knows this struggle firsthand. He went to his doctor with concerns about erectile dysfunction, and all the tests came back normal – but the problem persisted.

“I would definitely say it was due to my anxiety and exposure to pornography from a young age,” Randell said. Researchers have linked higher rates of erectile dysfunction to men who started watching pornography early in life.

“Social media and body dysmorphia definitely played a role as well,” Randell admitted. “I’ve always hated my body, which adds an extra layer of anxiety.”

Part of the problem is that anxiety doesn’t just live in the mind: it affects the body too. Erections rely on the parasympathetic nervous system, which releases nitric oxide to fill the penis with blood, explained Dr. Joel Hillelsohn, a board-certified urologist at NYU Langone Ambulatory Care Chelsea.

Even fleeting worry about performance triggers the brain to release adrenaline, the body’s fight-or-flight hormone, which constricts blood vessels and softens the penis.

“If you are nervous about maintaining an erection, you will secrete adrenaline and make your erection worse,” Hillelsohn said.

A single experience like this can set the stage for performance anxiety that affects future erections, a phenomenon called a “sexual tipping point.”

“It becomes a pattern — and a pattern is very hard to break,” Hillelsohn said. “What are we left with? We’re left with a bunch of young men in their 20s and 30s who are convinced they have broken lives. [penis].”

Growing Awareness, Shrinking Penis

Although experts agree that erectile dysfunction has increased among young men, they note that the broader debate around the problem has also allowed more patients to seek help for a problem that was once — and sometimes still is — relatively taboo.

“I think it’s become more socially acceptable to have erectile dysfunction,” Hillelsohn said. “It still persisted and the patients just suffered in silence. »

Much of this change is coming from the Internet, Palmer said. “It’s not uncommon now for Dr. Google to type in the symptom and then go into a doctor’s office and say, ‘I have this problem.’

Experts hypothesize that the increase in direct-to-consumer websites selling treatments like Viagra, Cialis, and testosterone replacement therapy has also fueled this trend.

“Everywhere you look you see an ad for companies like Ro or Hims who have made erectile dysfunction medications so readily available now that I think people are much more willing to talk about it,” Telis said.

But whether all these young men actually need drugs is another matter.

“Many younger men are quick to turn to medications like sildenafil (Viagra) or tadalafil (Cialis), often through direct-to-consumer platforms, without full evaluation,” Chughtai said. “While these medications can be effective, they do not address the underlying cause, especially when the problem is psychological or lifestyle-related.”

Determined to get to the bottom of his erectile dysfunction, Randell limited his masturbation and porn consumption and obtained a prescription for Viagra. It helped, but he said the real change was having a relationship with someone who made him feel safe in the bedroom.

“She understands that it’s not an insult or anything that she did,” Randell said. “The biggest change was that she was able to put my nerves at ease.”

These days, he rarely takes Viagra, finding that his sex-related anxiety — and the erectile dysfunction that accompanies it — has largely faded.

“It wasn’t my body that was broken,” Randell said. “It’s just that my mind doesn’t connect to it.”