Urologists Report Rising Erectile Dysfunction Cases Among Younger Men

Medical professionals have noted a growing number of erectile dysfunction cases among younger men in the United States. Dr. Joel Hillelsohn, a board-certified urologist at NYU Langone Ambulatory Care Chelsea, stated that he is seeing more young patients who no longer respond to common medications.

Rocky Tishma, a licensed marriage and family therapist and co-founder of Manhattan Sex Therapy, explained that erectile dysfunction was traditionally associated with men over 50 due to factors like atherosclerosis, cardiovascular disease, hypertension, diabetes, medication side effects, and low testosterone.

studies indicate that more than a quarter of men under 40 experience difficulty getting or maintaining an erection sufficient for satisfying sex. Tishma said that many younger men seeking help have no underlying physical issues, with problems often stemming from stress, anxiety, and other psychological factors.

Hillelsohn described a pattern where initial erectile dysfunction episodes, possibly after drinking or nervousness, lead individuals to seek medications like Viagra or Cialis through online sources.

These drugs increase blood flow to the penis during arousal, but Hillelsohn stated that their use can reinforce feelings of inadequacy, leading to depression and reduced libido. He explained the sexual tipping point concept, where minor physical issues combined with mental factors like self-doubt and nervousness disrupt erections.

Anxiety activates the fight-or-flight response, releasing adrenaline that can cause a venous leak, where blood enters the penis but does not remain, resulting in loss of erection.

predicted that in five to seven years, there may be more cases where medications fail due to escalating anxiety outweighing their benefits. In such instances, patients may turn to injectable drugs like Trimix, which can lead to scarring and conditions like Peyronie's disease if used frequently or improperly.

Hillelsohn reported having performed penile implant surgeries on young patients, including one at age 32, after other treatments failed.

patients with primarily psychological issues, Hillelsohn recommends tests to confirm physical capability, followed by a low daily dose of Cialis taken like a vitamin to avoid pre-sex anticipation. He combines this with referrals to sex therapy to address anxiety and confidence issues, aiming to taper off medication gradually after successful experiences.

Hillelsohn noted that patients who have already used erectile dysfunction drugs, often obtained via telehealth, are more challenging to treat due to entrenched patterns.