Erectile Dysfunction in Younger Men?

Sometimes an unwelcome byproduct of male aging is erectile dysfunction, or trouble performing sexually. But you don’t have to be an older guy to experience it.

If you’re a younger man and you’re consistently having trouble keeping and maintaining an erection, you’re far from alone. The first thing to do is see your doctor.

There may be physical reasons for the issue, an underlying illness ranging from diabetes to high blood pressure to kidney disease. Your doctor will do a thorough history on you to find out if this is the cause. And of course the use of drugs and alcohol can affect performance.

If these factors don’t apply to you, the cause is likely psychological: performance anxiety. Drogo Montague, MD, of the Glickman Urological and Kidney Institute says P.A. is a serious problem. “But sometimes if we tell patients it’s psychological, it’s viewed as dismissive.”

Nothing could be further from the truth. This is real anxiety that goes to the core of who we are sexually.

The obvious answer may be oral medications like Viagra or Cialis, but Dr. Montague says they don’t work well because the problem isn’t physical. Your blood may flow normally to your penis, but performance anxiety keeps you and your partner from sustaining and enjoying sex.

There may be a wide range of causes for P.A.: simple lack of experience or confidence; failure in earlier sexual encounters that affect each subsequent effort; a religious background that teaches that sexuality is sinful or evil. For many men, performance anxiety transforms sex from something pleasurable to a source of pressure and pain.

Performance anxiety is treated with behavior modification therapy. Sexual therapists help you (or you and your partner, in couples therapy) find ways to encourage physical stimulation that sustains pleasure rather than focusing on the end result of ejaculation. The aim is to help you enjoy sex — not “perform.”

“You’ll get a better erection if it’s associated with pleasure rather than the act itself,” says Dr. Montague.

There’s no reason to live with this kind of anxiety. Sex therapy might not sound like something you’d do, but think of it simply as treatment for a health problem — because that’s what it is.

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