"Some physical problems that can lead to weak erections are the inability of your brain to send signals to your penis, which can be caused by neurological conditions like MS, Parkinson's disease and Alzheimer's," adds Axe. "Studies suggest that stress, anxiety and depression can produce major chemical changes in your brain, leading to the inability of smooth muscles to relax and allow for an erection. On top of this, researchers have also indicated that the failure to achieve an erection can aggravate a man's anxiety levels, leading to a vicious cycle."
What young men should not do is take an ED drug like Viagra without a prescription, or mix them with other drugs. “This is a huge problem and not a safe practice,” says Penny Kaye Jensen, PhD, president of the American Academy of Nurse Practitioners. “Some young men are mixing ED drugs with mind-altering drugs, such as ecstasy or crystal methamphetamine. This is on the rise and is a potentially deadly combination.”
Some men experience erectile dysfunction as a result of physiological factors, including medications that can interfere with sexual response, chronic illness (e.g., heart disease, high blood pressure, diabetes), physical disability, alcoholism, drug use, or injury that impedes blood flow to the erectile tissue. High cholesterol, which can limit blood flow through the atreries that supply the genital area, can also be associated with erectile dysfunction. For others, psychological concerns, including stress, anxiety, self-esteem, or fatigue are the source. Researchers believe that for many men erectile dysfunction is caused by a combination of physical, psychological, and cultural factors.
Getting hard is also an overwhelmingly mental task. "Yes, men are saddled with the scheduled 'morning boner' and may experience an occasional random erection but by and large an erection needs to be achieved through mental stimulation," says Backe. "If you aren't turned on, your body isn't going to send more blood to the penis — bottom line. So, ultimately, you need a clean and clear mind for healthy and clear erections. Keeping the mind healthy will allow proper mental stimulation to occur at the right time." 

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.

As recently as two decades ago, doctors tended to blame erectile dysfunction on psychological problems or, with older men, on the normal aging process. Today, the pendulum of medical opinion has swung away from both notions. While arousal takes longer as a man ages, chronic erectile dysfunction warrants medical attention. Moreover, the difficulty is often not psychological in origin. Today, urologists believe that physical factors underlie the majority of cases of persistent erectile dysfunction in men over age 50.
Remember that he is in his 40's, and that's a huge factor too. Around the age of 30, testosterone, androgen, and other hormone levels gradually begin to drop at about a rate of 1 percent. and as a direct result, by the time a man reaches 40, hormone drops cause loss of muscle mass and increased body fat. As a man reaches 45 these gradual hormone drops cause brain capacity and function to slowly regress. This, mixed with risks of genetic diseases like diabetes and high blood pressure, all take a toll on the body, especially the sex organs. Those who are physically active are at a huge advantage, as working out inhibits hormone levels, the neuromuscular system, and protein synthesis to maintain.

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.
It can be difficult and frustrating for men and their partners to cope with erectile dysfunction, especially when the cause is unclear. At this point, it is important to be supportive and understanding of the situation and of one another. Erectile difficulties can cause feelings of inadequacy in both men and their partners. Each may internalize the situation, fearing that s/he is the one to blame. Therefore, open and honest communication with one another is an essential ingredient in strengthening your relationship as you work through this situation together.

Natural treatments: Although natural remedies are increasingly available for sale over the counter, there is little scientific evidence to support their claims of improving ED. These remedies may produce adverse side effects or react negatively with other medications a man is taking. Before trying any over-the-counter treatments, it is essential to consult a doctor.

What causes erectile dysfunction in 20s?


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.

What foods make you more sexually active?


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.
“With the success of Viagra-type drugs, there has been a tendency to start all patients with ED on one of these drugs and not look much further for a medical cause. But we now know that ED may be an early warning for heart and blood vessel disease, so it is important to look for common risk factors. These include high blood pressure, diabetes, medications, smoking, drinking, and drugs,” said Dr. Wang.

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.
Exercise on a regular basis. There is evidence that suggests that a sedentary lifestyle can be a factor in erectile dysfunction. Aerobic exercises, such as running and swimming, can help prevent ED. The exercise can help improve blood flow and circulation, naturally help lower high blood pressure and cholesterol, and can even help improve hormonal balance and drive weight loss – all of which are factors that can help you improve ED and maintain an erection.
Lifestyle changes: One of the first things a young man can do to potentially improve or eliminate ED is make positive choices that will also have an impact on the rest of his life. Some changes a man can consider include increasing exercise, eating a heart-healthy diet, quitting smoking, and drinking alcohol only in moderation. Where a man has relationship problems, seeking counseling may also be helpful.

It may be that after trialling all the above, including the little blue pills, you are still having challenges. There are always other options. The only issue is that they tend to move further away from science, proven efficacy and fact and more towards anecdotal evidence and illegitimate science, all while preying on a natural desperation to find a solution. I would say, if you are at this stage, go and see your doctor to discuss a referral to see a urology specialist. It may spare you dabbling, unsuccessfully, with the various less-proven methods, including:


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The strength and frequency of your erection are an important indicator of your overall health. The blood vessels in the penis are smaller than arteries and veins in other parts of your body, so any problems like blockages, blood vessel dilation issues, or hormone imbalances will often show up as erectile dysfunction (or less firm erections) before something more serious like a heart attack or stroke.

Despite some very recent legislative changes, opioids—ultra-strong narcotic painkillers—have never been more popular. According to the newest stats from the Centers for Disease Control and Prevention (CDC), enough opioid prescriptions are written each year to stock the medicine cabinets of every single adult in America (with plenty left over for teens, too). “These types of narcotics suppress testosterone levels,” says Dr. Köhler. That means they also mess with your hard-on. So does smoking, drinking a lot of booze, and any other bad habits that hurt your heart and/or vascular function.

Regular exercise and a diet rich in antioxidants is also the foundation of permanent weight control and diabetes prevention. Studies at the Duke University Diet and Fitness Center show that weight loss is strongly associated with better sexual function. Other studies show that diabetes is a major risk factor for ED, and that a healthy lifestyle prevents the disease and can restore erection function.

Is there a natural alternative to Viagra?


For many older men, issues like diabetes, hypertension and heart attacks are often contributing factors to erectile dysfunction. But Goldstein said that in younger men, ED is far more likely to stem from physical trauma. This could be the result of a sports injury, such as a misplaced karate kick, a surfboard hitting the wrong area or long-distance bike riding. It could also be a result of a sexual injury. (This is most common during heterosexual intercourse, especially in the woman-on-top position, the sex position dubbed "most dangerous" by a 2015 study.)
But recently, slick, millennial-chic ads started popping up on social media from new men’s brands like Roman and Hims. Even though the (young) founders of these companies say they aren’t trying to market ED meds to your Tinder dates or male partners, clearly they are looping 20- and 30something guys into the deflated-D narrative for the first time ever.
Additionally, financial struggles, issues at work, and issues at home with children or external family can impact the quality of sex you’re having. Remember that sex is a two person game. Both people need to be invested in it for it to be good. And good sex leads to longer, stronger, more powerful erections. It’s in both of your best interest to have better sex.
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.
“Although having sex at 70 is not the same as having sex at 20, erectile dysfunction is not a normal part of aging,” according to Michael Feloney, MD, urologic surgeon and expert on sexual dysfunction issues at the Nebraska Medical Center in Omaha. “You should still be able to have a satisfying sex life as you age." If you are experiencing erectile dysfunction, these 10 dos and don'ts may help.
Natural treatments: Although natural remedies are increasingly available for sale over the counter, there is little scientific evidence to support their claims of improving ED. These remedies may produce adverse side effects or react negatively with other medications a man is taking. Before trying any over-the-counter treatments, it is essential to consult a doctor.
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.

How often do 70 year olds make love?


The most common diagnostic test for erectile dysfunction is called penile ultrasound. This test uses sound waves to look for abnormal penile blood supply. Another test that may be done is nocturnal penile tumescence testing, in which a type of computer is attached to the penis to see if nighttime erections are occurring. If a young man is having nighttime erections but can’t get an erection during sex, a psychological cause becomes more likely.
...the root of the ground cover, Panax ginseng, which is the Asian species, and Panax quinquefolius, the American plant (grown mostly in Wisconsin). Ginseng is an "adaptogen," a medicinal herb that helps build and maintain body vitality, allowing users to better adapt to the stresses they face in life. Ginseng is available where herbal medicines are sold.

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.

Does aspirin work like Viagra?


Now, it may be that all you need to do is tackle some of the issues outlined in these key tools. However, yes, that advice may also come in the form of a small magic blue pill. Sildenafil (Viagra) is a phosphodiesterase type 5 inhibitor, designed to promote blood flow to your penis and achieve a sustainable erection. It can sometimes be a short-term option to help you "get back on the horse" or a longer-term method (if there is an irreversible dysfunction) to help you enjoy a healthy intimate relationship.
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.
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.
Alcohol is a depressant, not an aphrodisiac or a libido enhancer. Excessive consumption can interfere with the ability to achieve an erection at any age, and even occasional drinking can make erectile dysfunction worse in older men. Feloney advises using alcohol in moderation: "In small amounts, alcohol can relieve anxiety and may help with erectile dysfunction, but if you drink too much, it can cause erectile dysfunction or make the problem worse."
Cigarette smoking is a risk factor for ED, according to the 2014 Report of the U.S. Surgeon General. Excess weight can also contribute to erectile dysfunction. A 2004 Italian study found that one-third of their 110 obese study subjects were able to eliminate their erectile dysfunction problems by losing fifteen percent of their weight through diet and exercise.
The American Medical Association (AMA) estimates that more than 30 million men in the US experience ED. And they expect that number to double by 2025, largely due to the fact that erectile dysfunction is affecting more and more guys in their 20’s and 30’s. ED in your 20’s is becoming more common, and that can signal some serious health risks to a growing number of young men.
When it happened a second time, she brought it up to some friends, who reassured her they’ve been there too. And according to our survey, more than 75 percent of women have had a male partner struggle with ED at least once—which is shockingly high. The most common word these women used to describe how ED makes them feel is “embarrassed.” “It’s like, ‘Oh, I’m obviously doing something wrong if I can’t even keep him aroused long enough for us to have sex,’” says Leigh*, 24, whose casual hookup Chris* started losing his erections a few months into their situationship.

Stiffy Solution: Frustratingly enough, the only solution to exhaustion-based impotence is to get some rest, which is obviously difficult (or your dude wouldn't be having this problem in the first place). But if your guy has been resistant to getting help for his insomnia or asking for different hours at work, the inability to get his nine iron out on the putting green might be the thing that finally motivates him to make a life change. So, at least there's that.
Both James and Michael fit the profile of millennial ED: healthy men with functional penises who experience occasional deflation for psychological reasons rather than mechanical issues (the latter of which typically plagues older men). Researchers and the medical community are aware of this specific problem facing younger men, says Landon Trost, MD, a urologist at the Mayo Clinic.
A dating death sentence: How men perceive their ED issues also changes with age. With older men, "they've had a life of good erections to look back on," Rose Hartzell, Ph.D., EdS, an AASECT-certified sex therapist with San Diego Sexual Medicine, told Mic. But with some younger men who haven't had much opportunity to be sexually active, "they might feel cheated" out of having a good sex life.
As it turns out, there are actually tons of things that can keep guys from getting an erection that have nothing to do with you (also, all that stuff you learned in middle school about how all guys are hump-crazed sex lunatics might have been slightly off). Between 20 and 30 million American men experience recurring erection difficulties, and almost all men have, at one time or another, had their top ramen refuse to boil. And while erectile issues are often seen as an older man's problem, in reality, one quarter of men seeking medical treatment for erectile difficulties are under 40.

Is toothpaste good for erectile dysfunction?

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