Breaking the silence: Helping young men with impotence

How can we keep saying that older people are the main candidates of erection dysfunction (ED) in the era where, if I attend to ten young men daily, more than four complain of erection issues?

Years ago, younger men were barely diagnosed with sexual inactivity, unless they were born with underlying conditions, but now with many potential causes triggered by unhealthy lifestyles which often lead to many health issues ranging from high blood pressure to type-2 diabetes, it is very common in middle-aged men and younger.

Many men are embarrassed to see a doctor and are suffering in silence and thus leading to irrational consumptions of pills. This at times host a number of dangerous side effects and sometimes even leading to death.

As doctors, we are starting to become more aware of younger men suffering from erectile dysfunction, and I always receive these complaints from men in their 20s, 30s, or early 40s saying “this shouldn’t be happening to me.”

Psychological instability

Clinically speaking, ED is classed as a constant or recurrent inability to maintain an erection. This means if you have the occasional off night (perhaps under the influence of drugs or alcohol) there’s no cause for concern. However, if that ‘off night’ sparks performance anxiety, leading to a pattern of off nights, it’s wise to look into getting treatment.

There are numerous physical and emotional factors which can cause or contribute to ED.

Anxiety is a major contributor for younger men. You may worry that your partner is negatively judging your sexual performance, or that they won’t reach orgasm. You might fear that a partner will become pregnant. These anxious feelings may result in a stress response, leading to limited blood flow to the penis, and therefore causing loss of erection.

ED in younger men may also be caused by anxiety or stress that is not directly related to sexual activity.

Just a few examples of factors, which can contribute to anxiety and stress are problems in the workplace, financial struggles, ill health (yourself or a relative or friend) or a rocky relationship.

All of this can have an impact on ED.

Our lifestyles

What we eat, what we drink everyday counts, not to mention alcohol abuse and smoking potentially exposes us to developing ED.

If you smoke and suffer with ED, you may want to consider quitting as smoking is a major cause of the condition in many men, younger and older.

The components of cigarette smoke can have a damaging effect on blood vessels, including those in the penis. One such effect is the formation of plaque on the walls of the blood vessels, known as atherosclerosis.

This makes the area through which blood can flow narrower, impairing the surge in blood flow to the penis that is essential for an erection.

Regular alcohol consumption can also be a culprit. In the short term, after a session of heavy drinking, the physiological response to sexual arousal can be sluggish or non-existent, causing an episode of poor erectile function.

Being overweight or obese, particularly if you carry a lot of excess weight around the abdomen, puts you at higher risk of ED.

The author is medical doctor based in Dar es salaam.