Erectile issues aren't just a problem for older men—they're becoming increasingly common among young men too. But what's ...

avoid-the-erection-killing-mistakes-most-young-men-make

Avoid the Erection-Killing MIstakes Most Young Men Make

why are younger men having problems with erections hi I'm Dr Reena Malik urologist and pelvic surgeon and today we're going to talk about why young men develop issues with erections and how it's not as uncommon as you might think recent Studies have shown that the prevalence of erectile dysfunction in young men under the age of 40 is on the rise large multinational Studies have estimated it to be as high as 30% that means that one in three men under 40 might experience some degree of erectile dysfunction and the percentage of young men actually looking for treatment for Ed has significantly increased now I think that is great because it is really really hard to go to the doctor but if you are making this a priority and actually taking time to see your doctor that is the first step to getting better now this is not just my experience one study actually reported that the percentage of men under the age of 40 coming in for Ed in a specific Clinic had in increased from 5% in 2010 to 15% in 2015 now why are these young men actually having Ed so there's two main categories right of causes of Ed psychogenic and organic Ed psychogenic Ed is often due to issues with stress or anxiety around erectile dysfunction and the way you can expect it to appear is that you sort of have a sudden onset of symptoms you may have decreased libido or sexual desire but you'll still have good spontaneous or self-stimulated erections now as I mentioned before this is typically linked to psychological factors like depression anxiety and relationship issues and I tell my patients that basically everyone who has Ed whether they have an organic cause meaning it's from their body somewhere has some component of psychogenic erectile dysfunction because the first time you have difficulty with an erection it's on your mind you're thinking about it you're stressed about it you're wondering if you're going to be able to get an erection that you can sustain during intercourse and so you're not thinking about actually enjoying the experience you're stressed and so every single person has a little bit of psychogenic Ed now on the other hand organic Ed or something that comes from your physiology often presents with a gradual onset of symptoms usually you'll still have a normal desire but not always because when you have issues with the rectile dysfunction sometimes you'll avoid sex because you're embarrassed and so you'll it'll sometimes present as having lower sexual desire but It's really because you're avoiding it because you don't want to have issues with your erections when you're with your partner now what are the different causes so it can be divided into a multitude of different categories first is vasculogenic or issues with blood flow next is hormonal Rel to any sort of hormonal imbalance third is neurogenic which is nerve related then it's structural so any physical abnormalities like sometimes Pon disease or plaques on the penis can cause ED or iatrogenic meaning from medication you're taking that may cause the side effect of erectile dysfunction now most often a lot of doctors will see a young man complaining of issues with erections and immediately think it's all in their head or they're watching too much pornography or masturbating too much however recent Studies have found that up to 87% of young men with Ed also have an organic component to their condition so no it's not in your head and it's definitely not something that you're doing to yourself but why are young men actually having these issues so certainly we know that in today's society there are increasing rates of obesity high blood pressure high cholesterol and diabetes and so these conditions have been linked to an increased risk of Ed in young men and seemingly in men who generally appear very young and healthy you can find or uncover these issues and sometimes they're even what we call subclinical let me explain in a study of 26 young men men who had Ed but were otherwise low risk for heart disease or other chronic conditions meaning they appeared pretty healthy they were evaluated from markers that we call subclinical endothelial dysfunction or lowgrade inflammation compared to young men without Ed and so subclinical means that you're not seeing any of the effects of the changes and when you get blood work they're still within the normal range but they're just on the high end of normal and they found that when these young men took a number of different tests they were at High high risk mean they had increased systolic blood pressure C-reactive protein total cholesterol and triglyceride levels cored intima media thickness which measures the thickness of the inner two layers of this cored artery which can indicate the presence of AOS sceris or plaques and Vascular dysfunction they also had higher what we call Framingham risk scores which estimate a person's 10year risk of developing cardiovascular disease and a lower what we call flu low mediate brachial Vaso dilation which measures the ability of the brachial artery to dilate in response to increased blood flow and this is essentially a measure of how healthy your blood vessels are so all these things were again within normal but they were subclinical meaning they were high but on the high end of normal now the theory is that these subtle physiological changes might be early warning signs of underlying vascular or inflammatory problems now another cause as I mentioned is ponis disease so ponis disease is a condition where you have plaque formation on the penis that causes curvature and 88.2% of patients who have this condition are younger than 40 and 21% of those 8.2 have Ed due to that next up is endocrinological issues specific to young men we are seeing higher rates of low testosterone diabetes and even thyroid disorders all of which can affect sexual function only 4% of men younger than 50 with Ed were found to have low testosterone so that's not a huge percentage and it's not surprising to me because when you look at the data on Ed in the entire population we see that hormonal issues only contribute to about 3 to 6% of erectile dysfunction alone meaning that it could be part of it but it's certainly not the whole thing there's a whole host of other things that we're going to talk about like the vascular dysfunction like the ponis like neurologic condition or medications that are also contributing to erectile dysfunction so unfortunately it's not as simple as just taking testosterone and improving your erectile function now next up as I mentioned neurological issues can cause it so things like multiple sclerosis and epilepsy so in a large populationbased study of men who had multiple sclerosis looking at a National Database 28% of them were younger than 40 and those men were 2.2 times more likely to have Ed also men in their 30s with Ed were three times more likely to have been diagnosed with something like epilepsy so these conditions are very interl now lastly I mentioned iatrogenic or medications now certain medications can cause erectile dysfunction the most common that I hear about or see about in my patients are anti-depressants particularly in younger men now anti-depressants I've talked about before make sure you check out the full video to learn more about how these cause erectile dis D function but the important thing to know is that this is dose dependent so you can either scale down your dose or switch to a different anti-depressant if you are struggling with erectile dysfunction now one really interesting thing that I found when I was reviewing was that regular nid use meaning using Motrin ibuprofen neoen Al was also correlated with potential erectile dysfunction more than what's expected when they adjust for age and other health conditions if you were to take nset regularly and you adjusted for age and comorbidities in a study they found that men who took those medications more regularly were 38% more likely to develop Ed than men who weren't so I actually don't ask about this typically in my practice but now that I've reviewed this data I'm definitely going to ask and so there is potentially some benefit for not taking these for long periods of time regularly so the theory as to why these cause issues is because the vast def which is a structure that carries sperm from the testicle into towards the ejaculatory duct this structure releases prostaglandins and so nids work by inhibiting prostaglandins and the thought is that maybe these prostaglandins are important for penal erection now again this is something that I've not heard of so it's not widely talked about but maybe there is something there now lastly the most important thing I want you to take away from this is that Ed has been identified as an early warning sign of heart disease in young men a study looked at 18 to 40y old men who had what we call a weak masturbatory erection which is a sign that you know this is not in your brain and these men had a higher risk of heart disease than men who had normal erections so it is really an important moment for you if you are a young man to go get tested go get EV valued by your primary care doctor to check for these risk factors that may be causing underlying blood flow issues that will then affect your heart now when we treat young men with Ed we obviously have have to deal with these underlying risk factors or you won't be able to reverse the issue but psychogenic causes are still very common so it's great to do sort of a multimodal approach to attack this from all sides in the past I've reviewed psychogenic erectile dysfunction as well as the multitude of treatment options available to help you with that so make sure you check out that video but ultimately it's important to realize that it doesn't mean that you're broken and this is not fixable there's so much that we can do to help you and of course as I mentioned it can really strain relationships and when you're young and maybe single or dating multiple partners this can be even more challenging so bottom line what I want you to take away from this is that Edan young men is not all in their head it deserves an appropriate evaluation and treatment so if you're struggling or you know someone who is support them please go get evaluated and get treated because you might not only improve your quality of life but you might save your life from a future heart attack or cardiovascular issue down the line before you go ah I have to let you know that I have a newsletter and in my newsletter every week I send out information about a study that I've never covered before as well as something about what I'm doing that week and highlights from the podcast as well as the channel and most importantly I answer a random question from a newsletter subscriber every single week so if you are interested in being a part of our group please join our newsletter it's called youry by Dr mik and sign up in the link Below in the description and as always I'm going to take care of yourself because you're worth it

Dr.

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