The Independent Pharmacy

Erectile Dysfunction In Your 20s | Help To Identify And Treat

Andy Boysan
Andy BoysanBPharmDirector & Superintendent Pharmacist

Reviewed on 5 Feb 2024

It's a common misconception that only older men experience issues with erections. In reality, many men in their 20s face this challenge as well. It's important to know that if you're going through this, you're not alone.

There's a range of causes of erectile dysfunction in 20s that can get in the way of younger guys. Factors like being overweight, having high blood pressure, diabetes, smoking, or even drinking excessively can contribute to these difficulties. It’s understandable and quite common for these lifestyle factors to have an impact. It’s completely normal to feel nervous about sexual performance, and these feelings can sometimes lead to difficulties. Remember, it's okay to feel this way, and there are ways to help manage these feelings. And problems from using drugs or even condoms incorrectly can contribute too.

The reality is that 8% of men in their 20s deal with erection problems. So, if you're having issues getting hard or staying hard for sex, you’re not alone. The good news is there are solutions, but first, it helps to understand what's causing the trouble in the first place.

Key Takeaways:

  • Erectile dysfunction can impact men as young as their 20s due to health conditions, emotional issues, and lifestyle factors
  • Seeking a doctor's input for persistent ED helps diagnose potential causes through exams and testing
  • Erectile dysfunction treatments may include medications that improve the flow of blood, customised diet/exercise plans, or counselling
  • Taking action to address ED leads to restored sexual function and regained intimacy and confidence
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Medical Reasons for Erection Issues in Your 20s

Hormone Changes

Feeling turned on and getting hard relies on hormones in your system, signalling properly from your brain down to your penis. One big player is testosterone. This hormone helps start sexual thoughts and the physical process of getting an erection. If you've got low testosterone levels or other hormone problems, it can mess with your ability to get aroused and keep a stiff erection for sexual activity.

Hormone issues can happen if your testicles aren't working well or if a certain small gland in your brain is too active, thyroid issues, tumours messing with growth and sex chemicals, or diabetes, which disrupts many hormone pathways. When sickness throws your hormones out of balance, it puts up roadblocks to getting and keeping a hard erection when you want one.

Physical Health Problems

Problems with the heart, such as high blood pressure or blocked blood vessels, can also cause issues that make it hard for blood to flow well into your penis to fill it up for an erection. Being overweight or obese also harms blood vessel function. Other health problems, like diabetes, multiple sclerosis, or Parkinson's disease, can damage the nerves needed for starting an erection. Basically, any physical issue limiting blood circulation or nerve signals can make it tough to get and maintain a hard erection suitable for sex.

Condom Discomfort

Putting on a condom can cause some guys to lose their erection or have trouble getting hard in the first place. This is called a condom-associated erection problem (CAEP). Things like the tightness of the fit, thickness of the material, lack of sensation, or taking too long to put on can contribute to these issues. Finding the right style and size condom for comfort and sensitivity can help prevent these problems.

Lifestyle Factors Contributing to Erection Difficulties

Diet and Exercise

Eating a whole bunch of fried, sweet snack foods instead of healthier stuff like lean meats, high-fibre bread and cereals, and fresh fruits and vegetables can be hard on your heart and clog up blood vessels. Also, carrying around too much body weight adds more strain. All this limits the healthy blood flow needed to properly fill up the spongy tissue in the penis when you get turned on.

When blood flows into the soft parts of the penis, it becomes stiff and erect. Without good blood circulation, it’s tougher to get that firm swelling when you want to get busy. By changing to a balanced, healthy diet and adding in regular exercise like brisk walks, light jogging, sports or strength training a few times a week, you promote improved blood flow. This makes it easier to achieve and maintain harder, longer-lasting erections.

Smoking, Drinking and Drugs

The use of substances like tobacco products, excessive consumption of alcohol, and illicit or recreational drugs has a range of detrimental effects, making it harder to get and sustain firm erections. Nicotine and alcohol both damage blood vessel walls while also influencing hormone regulation needed for sexual desire and performance. Illicit drugs have more direct impacts on hormonal pathways and vascular function. Cutting back or quitting smoking and avoiding drug abuse limits these disruptions to biological sexual response, supporting improved erectile capacity.

Emotional and Psychological Factors Influencing Erectile Function

Stress and Anxiety

Carrying around major worry, tension or feeling overwhelmed – whether about big life stresses or specific fears about sexual ability – activates chemicals and biological processes that interfere with becoming turned on and achieving an erection. Too much stress causes release of cortisol, adrenaline and other hormones that inhibit arousal signals to the brain and tense up muscles, preventing healthy blood flow to the penis. Practising relaxation through deep breathing, yoga poses, meditation or making time for hobbies helps calm worries and unwind tension tied to poor erection quality. If doubt or sexual performance anxiety feels constant and outsized, meeting with a professional counsellor or therapist helps enormously in constructively processing these roadblocks to realising your bedroom potential.

Relationship Problems

Ongoing relationship tension with a sexual partner, having heated arguments often, feeling emotionally disconnected, or poor openness in communicating needs and intimacy preferences – these dynamics commonly undermine erection readiness as well. By carving out quality time together, working through disagreements in a thoughtful manner, nurturing emotional bonds through shared activities, and creating space for vulnerable check-ins, individuals can dissolve interpersonal strains sabotaging sexual connection. Seeking guidance from a couples’ counsellor or relationship therapist further assists in getting to root issues harming sexual chemistry and readiness for erotic connection, empowering constructive steps forward united.

Overusing Pornography

Watching a lot of pornography can overwork the part of your brain that gets excited about sex. Over time, this can make it harder for your brain to respond to normal sexual feelings. Backing away from excessive consumption allows the brain to recalibrate these sensitive arousal bands to more moderate levels, supporting healthier intimacy and erection response with a real-life partner. Occasional and mindful masturbation habits also help align mental expectations of sex with common physiological experiences, keeping erotic baseline attunement realistic.

When to Consult a Healthcare Professional

If you've been working hard on improving your diet, exercise, and managing stress but still find yourself struggling, please remember that it's a sign of strength, not weakness, to seek medical help. Doctors are there to support you, not judge you.

Being upfront with your primary doctor about difficulties getting it up or keeping it up allows them to explore potential underlying health factors connected to the issue. Expect them to inquire about current medications and family medical history, plus gather precise details about your situation - when erectile problems happen, the extent of softness, if it's consistent or intermittent, etc.

From there, your physician will likely conduct a physical exam checking vitals, weight, and hormones and run blood work to detect possible biological causes. Arming your doctor with all this information allows them to put together a tailored treatment plan matched to your particular symptoms and circumstances.

Treatment and Management Options


There are special medicines called PDE5 inhibitors that help increase blood flow to the penis, which helps with erections. Common PDE5 drugs include:

Your doctor will advise on proper dosage, administration instructions, and side effect considerations tailored to your profile.

Additional delivery methods can also be effective for absorption, such as:

  • Injectable formulations
  • Topical gels or creams like Vitaros

Lifestyle Changes and Alternative Therapies

In concert with medications in applicable cases, physicians also strongly recommend lifestyle changes to address underlying cardiovascular and metabolic risk factors shown to clearly contribute to erectile disorders. This includes an effective treatment plan to encourage:

  • Heart-healthy eating patterns lower in processed foods and rich in fruits/vegetables
  • Regular aerobic exercises 4-5 times weekly, including brisk walking, light jogging or swimming
  • Stress reduction techniques such as yoga, meditation or mantra repetition
  • Smoking cessation and avoidance of excessive alcohol/substance abuse

For some patients, alternative therapies like penile vacuum restriction devices, penile injections, or testosterone replacement regimens may also be incorporated into customised treatment plans after weighing potential risks/benefits. Your prescribing doctor will guide you through the details of any proposed therapy route.

Take the Next Step With The Independent Pharmacy

As difficult as it may feel, overcoming any hesitation or embarrassment keeping you from addressing erectile dysfunction is an important first step towards restoration. Delaying action typically enables worsening symptoms of erectile dysfunction over time.

Luckily, the team of professionals at The Independent Pharmacy offers personalised assistance in assessing your situation and devising workable solutions tailored to your needs.

Our easy online questionnaire explores lifestyle factors, medical history and symptom onset to arm clinicians with a detailed health profile for analysis. This information forms the foundation, enabling customised treatment suggestions.

Based on assessment findings, our experts put together targeted recommendations for a treatment for erectile dysfunction matched to contributing issues identified through sensitive review and analysis.

Are you ready to start your journey towards better sexual health? Get in touch with our team today.


Can stress make it hard to get an erection?

Absolutely. Carrying intense mental stress or worry disables the relaxation response needed to achieve an erection. When you're really stressed, your brain makes it hard for the penis to get enough blood to become erect. Managing stress through regular exercise, therapy, or mindfulness allows proper arousal mechanics to occur.

Why might erections be more difficult nowadays?

Age, weight gain, developing medical conditions like heart disease or diabetes, alcohol consumption patterns, and general lifestyle factors can shift hormonal balances and vascular integrity that enable reliable erections in youth. Consulting a physician helps diagnose contributing issues.

Can a guy still seem aroused without getting an actual erection?

Yes, a degree of physical or psychological arousal may occur without culminating in an actual erection. If you often feel aroused but have difficulty achieving an erection, it might be a sign to seek some help. There's no shame in this – taking care of your sexual health is an important part of your overall well-being.


Erectile dysfunction in fit and healthy young men: psychological or pathological? - PMC (

Erectile dysfunction: A sign of heart disease? - Mayo Clinic

Condom-Related Erection Problems Can Easily Be Prevented | Psychology Today United Kingdom

Lifestyle modifications and erectile dysfunction: what can be expected? - PMC (

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