Erectile Dysfunction in Young Adults: A Narrative Review

Erectile dysfunction (ED), traditionally considered a condition of older men, is increasingly reported among men under the age of 40, yet its prevalence in this population remains underestimated. While psychogenic factors have been considered the primary cause, ED is now recognized as a multidimensional condition with both organic and psychological aspects. Hence, this review aims to synthesize current evidence on the epidemiology, psychosocial impact, etiological factors, and management strategies of ED in the young male population. A narrative review was conducted using PubMed's search builder, applying a combination of the following Medical Subject Headings and keywords: "Erectile Dysfunction" and "Young." The search identified 1,981 articles, from which articles were selected based on relevance and methodological quality. The prevalence of ED in young men varies widely, with studies reporting rates as high as 35%. While psychogenic causes such as performance anxiety, depression, and relationship issues are prevalent, a significant proportion of young men also present with organic etiologies, including endothelial dysfunction, hormonal imbalances, metabolic syndrome, and neurogenic disorders. Lifestyle factors such as pornography use, poor sleep quality, dietary habits, lack of physical activity, and recreational drug use have also been independently linked with ED. Management of ED in this population requires a multidisciplinary approach that incorporates both pharmacologic treatments (e.g., phosphodiesterase 5 inhibitors, hormone therapy) and non-pharmacologic interventions, including lifestyle modification and cognitive-behavioral therapy. ED in young men is an increasingly prevalent and clinically complex condition that necessitates comprehensive evaluation and individualized treatment. Further research is essential to improve outcomes in this growing patient population.