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At What Age Do Men Struggle With Erections?

Erectile Dysfunction

Detailed Answer

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, with studies showing that approximately 40% of men experience some degree of ED by age 40, increasing to over 70% by age 70.¹ The relationship between age and erectile function is progressive, with each decade of life associated with about a 10% increase in prevalence.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 This is particularly significant as ED can precede the onset of cardiovascular symptoms by 3-5 years, offering a critical window for preventive intervention.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. Studies specifically examining sildenafil efficacy by age have shown that it remains effective even in older men, though dosage adjustments may be necessary.⁵ For men who don’t respond to oral medications, the guidelines recommend considering penile implants as a highly effective solution, particularly for those with severe ED regardless of age.⁶ According to the guidelines, penile implants come in two main types: inflatable (twoand three-piece) and semi-rigid devices. The three-piece inflatable implants provide the most natural erection, with high satisfaction rates reported by both patients and their partners following implantation.⁷ The guidelines note no significant difference in efficacy or safety among the various available penile implants, allowing for personalized selection 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 

From the Guidelines

"Erectile dysfunction can improve the sensitivity of screening for asymptomatic CVD in men with or without diabetes. Younger men (especially those < 50 years) with transient and persistent ED have an increased risk of future cardiovascular events." (p. 46)

EAU Guidelines (2025)

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