A 2013 study published in The Journal of Sexual Medicine evaluated 439 men for erectile dysfunction and compared ED causes and frequency in men 40 or younger to men over 40. They found that 26 percent of the younger men had ED. Although these men were healthier and had higher levels of testosterone than the older men, they were more likely to be smokers or to have used illicit drugs. In almost half of the younger men with ED, the ED was considered severe.

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Performance anxiety: Perhaps the most common cause of erectile problems among younger guys is performance anxiety. Many cultures place pressure on men to be the "experts" when it comes to sex, which can make men feel like they have to be responsible for sex or know how to please their partner every time. This pressure can be stressful and make it more difficult to get or maintain an erection.
Use penile injection therapy. An alternative method that you may be advised on by a doctor is penile injection therapy. For this you will be trained by the doctor how to inject your penis with medicine that relaxes the blood vessels and promotes the blood flow that causes an erection. This treatment has been shown to be effective at treating a range of issues both physical and psychological.
Most men may not openly talk about their erection problems, but erectile dysfunction — when a man cannot achieve or maintain an erection well enough or long enough to have satisfying sex — is very common. According to the National Institutes of Health, 5 percent of 40-year-olds and 15 to 25 percent of 65-years old have ED. But while ED is more likely to occur as a man gets older, it doesn’t come automatically with age.

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UW Health urologists with advanced training offer medical and surgical treatment options for men and their partners affected by erectile dysfunction. There are several different ways that erectile dysfunction can be treated. For some men, making a few healthy lifestyle changes may solve the problem. Your urologist will help determine the most effective course of treatment for your condition.  

"This triggers the release of a neurotransmitter called dopamine, and it sends a chemical message from the brain to the penis, causing an increase of blood flow to the penis. The blood vessels leading to the reproductive system then relax and this allows increased circulation in the genital area. When you aren't aroused, the blood vessels in your penis are only partially open. But when your brain sends messages to your penis that you are ready for sex, the vessels open and allow more blood to enter the area. Because of the increased blood flow, blood gets trapped in the penis, which makes the penis expand and causes an erection."
The reversal of an erection is obviously necessary, but as Dr. Michael Reitano, physician in residence at Roman explains, this can be the impetus for weaker erections. "Usually there is a balance between the chemicals that result in the increased blood flow that results in a firm erection and the chemicals that allow blood to exit the penis and return it to being soft," he says. "That balance is precise and occurs in a sequence that allows an erection to last only as long as needed. However, in someone who experiences a softer erection, the balance of the chemicals that make the penis hard and the chemicals that return it to being soft is off. The scale is tilted."
While physical anatomy and chemical reaction are both important for getting and keeping an erection, the brain is one of the most vital parts of this puzzle. "An erection is controlled by multiple areas of your brain, including the hypothalamus, limbic system and cerebral cortex," notes Axe. "Stimulatory messages are sent to your spinal erection centers and this facilitates an erection. When there's an issue with your brain's ability to send these important messages, it can increase the smooth muscle tone in your penis and prevent the relaxation that is necessary to get an erection."
Research has shown that the same eating patterns that can cause heart attacks due to restricted blood flow in the coronary arteries can also impede blood flow to and within the penis. The blood flow is needed for the penis to become erect. Diets that include very few fruits and vegetables along with lots of fatty, fried, and processed foods can contribute to decreased blood circulation throughout the body.
Improve your nutrition. Certain foods, such as those that are fatty, fried, sugary, and processed, can result in decreased blood flow throughout your body and can contribute to a vascular form of erectile dysfunction. Increase your intake of fruits, vegetables, whole grains, and heart-healthy fats to improve your blood circulation and increase the amount of time you’re able to maintain an erection.
Where it comes from: When talking about erectile dysfunction, it's important to note that while there are many potential causes, they can essentially be divided into two discrete categories: physical and psychological. It's also important to note that there's a huge difference between chronic ED and the occasional (and very normal) inability to maintain an erection during sex.  
Injury to the nerves and arteries near the penis can lead to erectile dysfunction. According to the National Institutes of Diabetes and Digestive and Kidney Diseases, surgeries for prostate and bladder cancer can injure penile nerves and arteries, although it doesn't always happen. Spinal cord injuries can affect the ability to achieve and maintain an erection, as can injuries to the penis, prostate, bladder and pelvis.
Regardless of the reason, men spend a lot more time on their butts than they ever have before, shows data from the CDC. And all that sitting hurts your heart and your waistline, which saps your vigor below your belt, Dr. Köhler explains. You need a good 30 to 45 minutes of vigorous exercise at least 5 days a week to counteract all your chair time, experts say.

Something James, 26, knows for sure about his penis is that it won’t get hard when he’s sleeping with a woman for the first time. No, it has nothing to do with how attracted he is to her. It’s just a classic case of performance anxiety, caused by his personal fears about how awkward and uncomfortable the experience could be—which, of course, turns into a self-fulfilling prophecy.

There are many factors that can lead to ED. “Psychological causes of erectile dysfunction in young men can include performance anxiety, guilt about sex in general, guilt about having sex with a particular partner, feelings of anger or resentment towards a partner, or simply finding a partner undesirable,” said Carole Lieberman, MD, a psychiatrist on the clinical faculty of the UCLA Neuropsychiatric Institute in Los Angeles.

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Depending on the age of the man, the reason why he is experiencing deficiencies in maintaining an erection will be due to a cause or another. Among young men, it is often due to psychological factors, either due to the size of the penis, past experiences, depression, undervaluation or other reasons, but can be summarized as: fear of sexually disappointing the couple.
It’s important not to take a bout of psychological ED personally. Still, when confronting a suddenly soft penis in the moment, “It’s not you” can be hard to believe. For instance, Erin, 22, tried—really tried—to make sex with Drew* happen. The first time his erection died right before they were about to have sex, she improvised and gave him “really long” oral instead. But the lack of a boner was confusing. “That had never happened to me with a sexual partner, so I was like, ‘Okay, he’s just not into me,’” Erin recalls.

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Relationship problems often complicate erectile dysfunction. Improving your relationship may be part of the solution. It may be a good idea to get counseling together from a sex therapist, marriage counselor, or a medical specialist. "I almost always see couples together to discuss erectile dysfunction. It often turns out that both partners have issues regarding the sexual relationship and once they are out in the open, couples can work together on a more satisfying sexual experience," says Feloney.
Achieving an erection is a complex process involving the brain, hormones, nerves, muscles and blood circulation. If something interferes with this process, the result may be erectile dysfunction. In some cases, erectile dysfunction is the first sign of other serious underlying health conditions, such as cardiovascular problems, that need treatment because erectile dysfunction can share the same risk factors for heart attacks and strokes.
Research has shown that the same eating patterns that can cause heart attacks due to restricted blood flow in the coronary arteries can also impede blood flow to and within the penis. The blood flow is needed for the penis to become erect. Diets that include very few fruits and vegetables along with lots of fatty, fried, and processed foods can contribute to decreased blood circulation throughout the body.
1. Staying Busy and Focused. 2. If you want, get help from a specialist. 3. Find a new hobby, or cultivate a skill. 4. Play sports. 5. Eat a healthy diet. Find another outlet for your time and energy. Fill your life with engaging activities. The excitement of doing something different can help replace the urge to masturbate, and you'll have a go-to distraction next time you're tempted.

Stiffy Solution: Luckily, alcohol-induced impotence (also known by the infinitely less classy alias "whiskey d*ck") is a totally temporary condition, one that should clear up as soon as your dude can once again walk a straight line and recite the alphabet backwards. If your dude has consistent erectile problems from consistently drinking too much, however, he should consider cutting down on the sauce, and possibly talking with a doctor. 

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