At What Age Do Men Struggle With Erections?

Erectile dysfunction (ED) can affect men of all ages, though its prevalence and severity tend to increase significantly as men get older. According to the 2025 EAU Guidelines, while ED is more common in older men, younger men are not immune: the Massachusetts Male Aging Study reported ED in 52% of men aged 40-70 years, and the Cologne study found a steep age-related increase in prevalence, from 2.3% to 53.4%, in men aged 30-80 years.¹ The relationship between age and erectile function is progressive.² For younger men (especially those under 50 years) experiencing erectile difficulties, the guidelines emphasize that this should not be dismissed as merely psychological. The EAU Guidelines specifically note that younger men with transient and persistent ED have an increased risk of future cardiovascular events, making ED an important early warning sign.³ The guidelines state that ED should be considered a precursor of cardiovascular disease, and that more severe and longer-standing ED yields greater risk.⁴ The 2025 EAU Guidelines outline several treatment options for men struggling with erections, including oral medications (PDE5 inhibitors), which have demonstrated efficacy across all age groups. PDE5 inhibitors such as sildenafil have proven effective in almost every subgroup of men with ED, and the dose can be adjusted according to response and side effects.⁵ For men who don’t respond to other treatments, or who prefer a definitive therapy, the guidelines recommend penile implants, which have high efficacy and satisfaction rates.⁶ According to the guidelines, penile implants come in two main types: inflatable (two- and three-piece) and semi-rigid devices. Patients may prefer three-piece inflatable implants because they provide more natural erections, and implants overall have high satisfaction rates reported by both patients and their partners.⁷ The guidelines note no difference in efficacy or safety among the various available penile implants, so the choice can be based on individual patient factors and preferences.⁸ For men concerned about erectile function, the EAU Guidelines emphasize the importance of addressing modifiable risk factors at any age. These include maintaining a healthy weight, regular physical activity, avoiding tobacco use, limiting alcohol consumption, and managing conditions like diabetes, hypertension, and high cholesterol.⁹ The guidelines also highlight that psychological factors can contribute to ED at any age, and that combination approaches addressing both physical and psychological aspects often yield the best results.¹⁰ It’s worth noting that the 2025 EAU Guidelines recommend a comprehensive evaluation for all men with ED, regardless of age, including assessment of cardiovascular risk factors. This is particularly important for younger men with ED, as early intervention may not only improve erectile function but potentially prevent more serious cardiovascular events in the future.¹¹