Premature Ejaculation and Erectile Dysfunction in Young Men

ED PE in young men

Premature ejaculation and erectile dysfunction are usually deemed as sexual disorders which men develop in old age; however, recent surveys have found that younger people are equally susceptible or even more prone to develop such issues.

Let’s find out what are the causative factors that have resulted in such a high preponderance of these sexual disorders in the young population. We shall also discuss some common myths and misconceptions about premature ejaculation and erectile dysfunction, and how these disorders can be treated.

What are Premature Ejaculation and Erectile Dysfunction?

Premature ejaculation is a condition when you get the orgasm and ejaculate semen sooner than you want during sex. International guidelines document it as ejaculation within 1 minute after penetration; however, it is up to you and your partner to decide at what time you want to have the climax. Ejaculating before that is regarded as premature ejaculation.

Erectile dysfunction, on the other hand, is a sexual disorder in which you are unable to get or maintain an erection hard enough to have sexual intercourse. It leaves both partners unsatisfied after sex.

How Many Young Men Suffer from these Problems?

Premature ejaculation is the most common sexual problem faced by men. According to the statistics given by American Urological Association, one in every five men with age between 18 to 59 years, suffers from premature ejaculation.

The prevalence is even higher in young men as 30% to 70% of men in the U.S. below 40 years of age develop some degree of premature ejaculation problems at some point in their lives.

Similarly, large multinational studies have found that the incidence of erectile dysfunction is reaching up to 30% in young men.[1]

Role of Mental Stress in Premature Ejaculation and Erectile Dysfunction – What Does Research Say?

Where there are various causes of premature ejaculation and erectile dysfunction, psychological stress and mental health play a major role in the development of such problems.

Although the experts are not fully sure about the precise cause of premature ejaculation, research suggests that the condition is primarily psychological in nature. Mental stresses, like anxiety, depression lack of confidence, etc, can lead to sexual disorders and premature ejaculation is one of them.[2]

A study conducted in 2014, in India, found that 70% of the patients with premature ejaculation had sexual performance anxiety while the incidence was 80% in married men who had anxiety issues due to marital disharmony or conflicts.[3]

Similarly, depression is closely linked to sexual disorders.  A meta-analysis of 8 studies comprising more than 18,000 patients proved that depression is a significant risk factor for developing premature ejaculation.[4] Likewise, the TAMUS study (Tampere Aging Male Urological Study) conducted in Finland, also proved the bidirectional relationship between depression and erectile dysfunction. It concluded that depressive mood and anti-depressant medications can lead to erectile dysfunction, and vice versa.[5]

Some prior bad sexual experiences, including sexual abuse or childhood trauma, can also cause depression and sexual dysfunctions in adulthood.

Apart from that lack of confidence, fear, and guilt of not satisfying the partner during sex, or even stress related to the job, finance, and other daily chores have been deemed as the psychological culprits of causing sexual problems like early ejaculation and erectile dysfunction.

For instance, a study conducted among male nurses in 2018, observed that there was a relatively high prevalence of erectile dysfunction in men who do not have clear job roles and their jobs demand more work and effort.[6] Similarly, stressful life events that cause loss of socioeconomic resources, like loss of job, etc, have also been regarded as a risk factor for causing these sexual problems.[7]

In short, mental and psychological stressors play a major role in the development of premature ejaculation and erectile dysfunction in young men.

What Other Factors can lead to Premature Ejaculation and Erectile Dysfunction in Young Men?

Early ejaculation and erection problems do not just have psychological explanations rather such issues can also arise with certain types of lifestyles and organic factors. Some of the major ones are described below;

Smoking

As you may know, an erection occurs when the blood vessels of the penis dilate and blood collects in the penis.

While smoking damages various organs of the body, it also affects the lining of the blood vessels in the penis disrupting its blood supply. This can lead to complaints of erectile dysfunction.

A study published in the American Journal of Epidemiology in 2005, has shown that smokers are more likely to develop problems of erectile dysfunction as compared to those who never smoke.[8] However, the condition is reversible and can go away if you quit smoking.

 On the other hand, smoking also decreases the production of nitric oxide. A study has found that decreased levels of nitric oxide are associated with premature ejaculation.[9]

Alcohol Intake

Alcohol also interferes with your sexual life. It interferes with chemical messengers in the brain that signal the collection of blood in the penis. Besides, it also decreases the testosterone levels in your body which is the male hormone driving the sexual functions in men.

According to an estimate, 72% of the men who are addicted to alcohol have one or more sexual disorders, early ejaculation being the most prevalent followed by low sexual desires (libido), and erectile dysfunction.[10]

Watching Porn

These days, it is a common perception that watching porn can also cause sexual problems. There is some reality to that.

Watching porn releases high amounts of dopamine in your body which creates a sense of pleasure and satisfaction. When you get repeatedly stimulated, the body gets used to this response over time. This ultimately results in quicker and less-satisfying orgasms.

Besides, porn can also produce unrealistic expectations of sexual pleasure or performance, and when these expectations are not met, it can cause anxiety and depression which is itself a risk factor for sexual dysfunctions.

However, a few studies conducted on men between 18 to 44 years of age found no significant association between watching internet porn with erectile dysfunction, early ejaculation, and lack of sexual satisfaction.[11] More research is required in this regard.

Lack of Physical Activity

A sedentary lifestyle is also considered a risk factor for ejaculation and erection problems. People who indulge themselves in regular physical activity are less likely to have premature ejaculation.

Similarly, lack of physical activity creates an interrelated web of cardiovascular risk factors, obesity, hypertension, etc, all of which can make it harder for you to get or maintain an erection hard enough to have sexual intercourse.

Sensitive Skin

As you may know, sensations from the penis skin send signals to the brain, and the brain, in turn, induces the process of an erection and semen ejaculation.

Therefore, penile hypersensitivity can also lead to early ejaculation. A study published in 2017 established the association between penile sensitivity and premature ejaculation. It found that people with such a disorder were less tolerant towards vibrations generated from a biothesiometer showing more sensitive penile skin.[12]

Others

There is several other factors that can cause early ejaculation and erectile dysfunction in young men. These include obesity, diabetes, hypertension, inadequate sleep, injuries, neurological and cardiovascular disorders, etc. Some medications can also lead to these sexual disorders, particularly erectile dysfunction. These drugs include some antidepressants, anti-hypertensives, antihistamines, muscle relaxants, etc.

Why do Such Issues Go Undiagnosed and Untreated?

Sexual disorders like premature ejaculation and erectile dysfunction are highly underdiagnosed and under-treated in the younger population. Young men feel uncomfortable and shameful while talking about such issues.

The major reason is the prevalent stigma in society. Sexual sturdiness is regarded as a sign of manliness. These sorts of hyper-sexual stereotypical notions keep men from discussing such problems even with doctors and healthcare professionals. 

You will be surprised to know that according to an estimate; more than 70% of men with erectile dysfunctions do not seek treatment and remain undiagnosed just because they feel reluctant to talk about these problems.[13]  That’s a huge number!

Well, there is no need to get embarrassed or stigmatize your problems as these conditions are just like other medical disorders, and can be treated.

Common Myths and Wrong Notions about Premature Ejaculation and Erectile Dysfunction

Like premature ejaculation and erectile dysfunction are underdiagnosed, people also know less about these sexual disorders and have some misconceptions about them.

Myth # 1│ Early ejaculation and Difficulty with Erection are the Disorders of Old Age

Age does have a role in causing problems with ejaculation and erection. Like with increasing age, your muscles and nerves become weak and changes occur in blood vessels that can disrupt the normal flow of blood to the penis. Besides, the sensitivity of the penile skin also decreases as you become older.

However, this does not mean that premature ejaculation and erectile dysfunctions are the disorders of old age. Young people are equally vulnerable to developing such conditions as described earlier every 1 in 3 men with age between 18 to 40 years, are suffering from such problems.

Myth # 2│Sexual Disorders are Untreatable

Some people think that once you develop complaints of premature ejaculation and erectile dysfunction, you have to live with them throughout your life as these conditions are irreversible and have no treatment.

That’s not true. Like any other medical condition, these sexual disorders have modifiable risk factors and causes that can be treated. If you know what factors lead to such problems, you can simply avoid them and enjoy a happy and healthy sexual life.

Myth # 3│It’s All in your Mind

Previously, it was thought that early ejaculation and erectile dysfunction happen due to mental and psychological reasons. However, as we have discussed earlier, many organic causes and lifestyle factors can lead to such issues in the young population.

Treatment of Premature Ejaculation and Erectile Dysfunction

Premature ejaculation can be treated in the following ways;

  • Psychotherapy – also known as talk therapy, helps you get over your negative emotions and perceptions when you talk to a mental health provider. It can also offer help in resolving the discords between you and your partner that are hindering your sexual life.
  • Pelvic floor exercises – There are some exercises (Kegel exercises) that strengthen your pelvic floor muscles, and help you delay or control ejaculation.
  • Condoms – using condoms will decrease the sensitivity of the penis and can help in delaying semen ejaculation.
  • Medications – applying topical numbing creams, gels, etc can also reduce penile sensations and can help you with early ejaculation; however, it can also decrease the sexual pleasure in both partners. On the other hand, oral medications used to treat anxiety and depressive mood disorders i.e. antidepressants can also help you in this regard.

The treatment options for erectile dysfunction are described below;

Psychological and Behavioral Counseling

  • Oral Medications – some drugs, like Sildenafil (Viagra, commonly known as the blue pill), can increase the blood flow to the penis by releasing nitric oxide that relaxes the smooth muscles and dilates blood vessels.
  • Testosterone Replacement – some people suffer from erectile dysfunction due to low levels of testosterone in their bodies. Replacing testosterone can help such men with these problems.
  • Penis Vacuum Pump – the suction applied to the penis by using hollow vacuum pumps allows the blood to collect in the penis and causes an erection. A tension ring is then applied at the base of the penis which keeps the blood in the penis. The vacuum tube is then removed. It helps you maintain an erection during sexual intercourse. However, use such devices after consultation with a doctor.
  • Penile Implants – inflatable and malleable implants are also available that can be surgically placed in the penis. However, they are usually not recommended until other treatment methods have failed. 

How to Avoid Developing Premature Ejaculation and Erectile Dysfunction at Young Age?

The answer is simple. Stop doing things that cause such problems. Here are some tips;

  • Quit smoking
  • Decrease alcohol intake
  • Eat a healthy diet, low in carbs and fats
  • Do exercise regularly
  • Sleep adequately
  • Maintain healthy weight
  • Keep your blood pressure and diabetes under control
  • Avoid stress
  • Don’t take medications without your doctor’s prescription
  • Avoid watching internet porn – etc

Bottom Line

Premature ejaculation and erectile dysfunction are common sexual disorders that are highly prevalent among young men. Psychological and mental stressors have a huge role in causing such problems. However, your lifestyle, physical health, medications can also lead to these disorders. Good thing is that these issues are not permanent, and can be easily treated and avoided.

References

  1. Nguyen HM, Gabrielson AT, Hellstrom WJ. Erectile dysfunction in young men—a review of the prevalence and risk factors. Sexual medicine reviews. 2017 Oct;5(4):508-20.
  2. Crowdis M, Nazir S. Premature ejaculation.
  3. Rajkumar RP, Kumaran AK. The association of anxiety with the subtypes of premature ejaculation: a chart review. The primary care companion for CNS disorders. 2014 Aug 15;16(4):26666.
  4. Xia Y, Li J, Shan G, Qian H, Wang T, Wu W, Chen J, Liu L. Relationship between premature ejaculation and depression: A PRISMA-compliant systematic review and meta-analysis. Medicine. 2016 Aug;95(35).
  5. Shiri R, Koskimäki J, Tammela TL, Häkkinen J, Auvinen A, Hakama M. Bidirectional relationship between depression and erectile dysfunction. The Journal of urology. 2007 Feb 1;177(2):669-73.
  6. Mokarami H, Toderi S, Rahimi Pordanjani T, Taban E. Role of psychosocial job stressors on sexual function of male nurses: The mediator role of work ability. American journal of men’s health. 2018 Nov;12(6):1908-15.
  7. Dadomo H, Ponzi D, Nicolini Y, Volpi R, Palanza P, Pelosi A, Bartolomucci A, Parmigiani S. Loss of socio-economic condition and psychogenic erectile dysfunction: the role of temperament and depression. Adaptive Human Behavior and Physiology. 2020 Mar;6:57-74.
  8. Gades NM, Nehra A, Jacobson DJ, McGree ME, Girman CJ, Rhodes T, Roberts RO, Lieber MM, Jacobsen SJ. Association between smoking and erectile dysfunction: a population-based study. American journal of epidemiology. 2005 Feb 15;161(4):346-51.
  9. Otunctemur A, Ozbek E, Kirecci SL, Ozcan L, Dursun M, Cekmen MU, Ozdogan HK. Relevance of serum nitric oxide levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation: decreased nitric oxide is associated with premature ejaculation. Andrologia. 2014 Nov;46(9):951-5.
  10. Arackal BS, Benegal V. Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian Journal of Psychiatry. 2007 Apr;49(2):109.
  11. Whelan G, Brown J. Pornography addiction: an exploration of the association between use, perceived addiction, erectile dysfunction, premature (early) ejaculation, and sexual satisfaction in males aged 18-44 years. The Journal of Sexual Medicine. 2021 Sep;18(9):1582-91.
  12. Guo L, Liu Y, Wang X, Yuan M, Yu Y, Zhang X, Zhao S. Significance of penile hypersensitivity in premature ejaculation. Scientific reports. 2017 Sep 5;7(1):10441.
  13. Al-Shaiji TF. Breaking the Ice of Erectile Dysfunction Taboo: A Focus on Clinician–Patient Communication. Journal of Patient Experience. 2022 Jan;9:23743735221077512.

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