In a recent analysis of one outpatient clinic, one in four
men seeking medical help for newly-developed erectile dysfunction (ED) was
younger than 40 years, and nearly half of young men with the condition had
While larger population-based studies are needed, the
findings, which were published in The
Journal of Sexual Medicine, suggest that erectile dysfunction in young men
may be more prevalent and more serious than previously thought.
Erectile dysfunction is a common complaint in men over 40
years of age. Prevalence increases with age, but the prevalence and risk
factors of erectile dysfunction among younger men have been scantly analysed.
The research that has been done paints a vague picture, reporting prevalence
rates ranging between 2% and nearly 40%.
To provide more clarity, Paolo Capogrosso, MD, of the
University Vita-Salute San Raffaele, in Milan, Italy, and his colleagues
assessed the sociodemographic and clinical characteristics of 439 men seeking
medical help for newly-developed erectile dysfunction between January 2010 and
June 2012 at a single academic outpatient clinic.
What the study found
Of the 439 patients, 114 (26%) were aged 40 years or
younger. Compared with older patients, younger patients had a lower average
body mass index, a higher average level of testosterone in the blood, and a
lower rate of other medical conditions. (Only 9.6% of younger patients had one
or more concomitant medical conditions compared with 41.7% among older
Younger ED patients smoked cigarettes and used illicit drugs
more frequently than older patients. Premature ejaculation was more common in
younger men, whereas Peyronie's disease (bent erection from scar tissue) was
more prevalent in older patients. Severe erectile dysfunction was found in 48.8%
of younger patients and 40% of older patients while the rates of mild,
mild-to-moderate, and moderate erectile dysfunction were not significantly
different between the two groups.
"These findings, taken together with those of other
studies showing the importance of erectile dysfunction as a potential
"sentinel marker" of major diseases, outline the importance of taking
a comprehensive medical and sexual history and to perform a thorough physical
examination in all men with erectile dysfunction, irrespective of their
age," said Dr. Capogrosso.
"Erectile function, in general, is a marker for overall
cardiovascular function - this is the first research showing evidence of severe
erectile dysfunction in a population of men 40 years of age or younger"
stated Irwin Goldstein, editor-in-chief of The Journal of Sexual Medicine.
"Clinically, when younger patients have presented with erectile
dysfunction, we have in the past had a bias that their ED was primarily
psychologic-based and vascular testing was not needed. We now need to consider
regularly assessing the integrity of arterial inflow in young patients –
identifying arterial pathology in such patients may be very relevant to their
overall long-term health."