What is driving younger men to seek treatment for ED?

November 1, 2016

“I think we’re seeing more younger men coming in with erectile dysfunction, because there’s just a lot more publicity about the issue," one urologist said.

Urology Times reached out to three urologists (selected randomly) and asked them each the following question: What is driving younger men to seek treatment for ED?

Dr. Shaw

“I think we’re seeing more younger men coming in with erectile dysfunction, because there’s just a lot more publicity about the issue. The low-T centers are driving this through awareness; low-T centers are advertising a lot. People want to be younger, want to act younger, so you see a lot of patients with increased ED because low T seems to kind of dovetail with erectile dysfunction.

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Before, people used to just live with it, but because of all the commercials out there, now it’s OK to talk about it. There are treatments for it. Their friends are taking medications for it. Now, on the horizon we have generically available ED medication, so I think that’s going to open the doors wide.

We also are seeing obesity rates increase as an organic component, so that could be considered a legitimate contributing factor. Rising diabetes rates parallel these organic disorders and you’re watching ED rates rise because the penis is a vascular organ-anything that affects blood flow can affect that.

Pornography could be a factor, but I couldn’t really say because my patients don’t tell me about that. I would think that addiction to online pornography could have more of an impact on premature ejaculation due to habitual masturbation. There are also increased rates of stress and we see that put pressure on relationships-guys who were exhausted and wiped out.”

Koushik Shaw, MD

Austin, TX

Next: "I personally see young guys who use anabolic steroids who have significant problems both with fertility and ED."

 

Dr. Fallick“We know some of these men use anabolic steroids. Steroids and testosterone therapy can affect their hormone system and pituitary gland function, which can negatively impact their function both from a fertility standpoint and also from an erection standpoint.

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I personally see young guys who use anabolic steroids who have significant problems both with fertility and ED. Steroids have a risk of shutting down sperm production and fertility, and to some extent normal function because the body gets used to these supraphysiologic doses of hormones and even normal levels of testosterone may not be adequate after they are used to that.

I haven’t seen men presenting with ED due to pornography, although certainly there can be environmental issues that may impact it and I think there is a significant connection between low testosterone and erectile dysfunction.

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I certainly think there is an emotional component, whether or not it is a physical cause that then creates an emotional stress which feeds into it. I see a lot of that where there is an overlap between men who have function problems and stress. Relationship stress and work routine can all play into erectile dysfunction as well. If that happens, then there certainly is a psychological component which can become problematic. I’m sure to some extent, some of it is psychological or emotional to start with.”

Mark Fallick, MD

Voorhees, NJ

Next: "My gut tells me it has a little bit to do with the prevalence of the discussion of testosterone."

 

Dr. Hedges“I would say were probably seeing a slight increase in younger men here in Oregon. My gut tells me it has a little bit to do with the prevalence of the discussion of testosterone. There are a lot more of these universal men’s clinics that are not really run by physicians. Men come in saying their erections aren’t working as well as [before] and they want their testosterone checked.

Also see: What impact has the ‘Surgeon Scorecard’ had on your practice?

I have had some younger patients who presented who had become obsessed with pornography and they found it difficult to keep and maintain an erection in an actual physical relationship. I think it has a bit to do with arousal speed. With excessive exposure to pornography, it changes their level of arousal and in their own personal relationship, they may not be getting that type or level of arousal. I haven’t seen tons but I’ve definitely seen it within the last year.

I don’t think their testosterone is actually low, but they feel it should be higher because they’re experiencing symptoms which sometimes are attributed to low testosterone but can also be attributed to life stresses, such as jobs or relationships.”

Jason Hedges, MD, PhD

Portland, OR

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