At What Age Does Erectile Dysfunction Start?

January 2, 2024
group of men

Erectile dysfunction is the inability to get and maintain an erection firm enough for satisfactory sexual performance. An isolated incident of ED is normal and is common; however, approximately 18 million U.S. men have more persistent symptoms.

Though the incidence increases with age and is more common in men over 40, ED can affect men in their 20s and 30s. In fact, researchers found that ED affects 8% of men in their 20s and 11% of men in their 30s.

Risk factors, such as poor diet, excessive alcohol use, smoking, and lack of exercise, increase the risk of developing ED. Therefore, taking steps earlier in life can help reduce the risk.

Average Age For Erectile Dysfunction

According to the Massachusetts Male Aging study, one of the largest studies ever focused on men’s health, over half of men aged 40 to 70 had at least some degree of ED. Depending on risk factors, men may experience ED at different periods in their life, either sporadically or continuously.

In a health care professionals (HCP) study that questioned almost 32,000 men between the ages of 53 and 90 about sexual function, physical activity, body weight, smoking, medical conditions, and medication use, researchers found:

  • One-third of men experienced ED in the past three months
  • Many aspects of sexual function decreased after the age of 50
  • Increased physical activity was associated with a lower risk of ED
  • Obesity was associated with a higher risk of ED
  • Smoking, alcohol consumption, and television viewing time were all associated with an increased risk of ED

In a National Health and Nutrition Examination Study (NHANES) in which just over 2,000 men were surveyed, about 5% of men 20 to 39 years old experienced ED compared to 70% of men over the age of 70. In addition, almost nine in ten men with ED had cardiovascular disease or a major risk factor for cardiovascular diseases such as high blood pressure, diabetes, high blood lipids or cholesterol.  

At What Age Does Erectile Dysfunction Start?

What Percentage Of Men Have Erectile Dysfunction, By Age?

The HCP study results showed a strong link between age and ED. Fewer than 2% of men with ED reported that it started before the age of 40, and 4% said it started between 40 and 49. There was a sharp increase in the percentage of men experiencing ED after the age of 50: 26% of men aged 50 to 59 and 40% of men aged 60 to 69.

For men under age 60 who had a comorbid health condition, the risk of ED was double that of healthy men. The greatest difference in the rate of ED between men with a comorbid condition and healthy men was in men between the ages of 65 and 79.

In a study of Turkish men that questioned over 2,700 men:

  • 17% of men between 40 and 49 had ED
  • 30% to 35% of men between 50 and 59 had ED
  • 68% of men between 60 and 69 had ED
  • 83% of men 70 and older had ED

What Causes Erectile Dysfunction?

Though getting an erection is a complex process involving the nervous, endocrine, and cardiovascular systems, the common denominator for most physical problems causing ED is damage to small blood vessels, which can decrease blood flow into the penis. As men age, they are more likely to have cardiovascular disease, which increases their risk of ED. In more than 90% of men over age 40 with ED, a physical cause would explain their ED symptoms.

Physical Causes of ED:

  • Kidney disease
  • Diabetes
  • Cardiovascular disease
  • High cholesterol
  • Hypertension (high blood pressure)
  • Heart disease
  • Prostate disease
  • Medications
  • Nerve damage
  • Obstructive sleep apnea
  • Low testosterone levels
  • Thyroid disease
  • Medication side effects
  • Prostate surgery
  • Nerve damage
  • Obesity

Psychological Causes of ED:

  • Depression
  • Anxiety
  • Past traumatic events
  • Relationship problems
  • Stress

Risk Factors For ED

There are several risk factors for ED, including:

  • Smoking
  • Alcohol use
  • Diabetes
  • Obesity
  • Taking medications such as some antidepressants and blood pressure medications
  • Lack of physical activity

Optimizing these modifiable risk factors can decrease the risk of ED. In fact, of the men surveyed in this study, men who exercised frequently have a one-third lower risk of ED when compared to those who did not exercise.  

Do I Have Erectile Dysfunction?

You can ask yourself several questions to help you and your doctor determine whether you have ED.

  1. Are you able to get and maintain an erection?
  2. Is your erection firm enough for sexual activity?
  3. Are you able to maintain your erection throughout intercourse?
  4. Do you lack desire for sex, or are worried that you lack desire?
  5. Are you satisfied by sex?
  6. Do you experience anxiety about your sexual performance?
  7. Do you wake up at night or in the morning with an erection?
  8. Does your ability to have an erection change depending on the circumstances, i.e., partnered vs. unpartnered sex?
  9. Are you able to orgasm?
  10. Do you experience pain with an erection?
  11. Are you concerned about depression or anxiety as a cause of your symptoms?

Some of these questions may indicate a potential physical cause of ED, such as decreased testosterone levels. To better understand your risk factors for ED, your doctor may suggest a hormone panel or series of lab tests to check your testosterone and other hormone levels.

Men’s Standard Hormone Panel

Men’s Advanced Hormone Panel

Is There A Cure For Erectile Dysfunction?

There are many reversible causes of ED, many treatable causes of ED, as well as a few irreversible causes. Regardless of whether there is a cure for ED, there are many options to improve your symptoms.

Let’s start with the many reversible causes of ED. Medications and lifestyle factors can increase the risk of ED. However, making the following changes in your life (if they apply) is a great way to improve the chances that ED can be cured.

At What Age Does Erectile Dysfunction Start?
  • Check your weight: if your BMI is over 25, consider ways to lose a few pounds, whether you increase exercise or improve your diet. Losing excess weight is associated with a decreased rate of ED.
  • Stop smoking: Nicotine constricts blood vessels, including those entering the penis. Cigarette smoke also decreases the release of nitric oxide, a molecule that dilates blood vessels and increases blood flow into the penis. Stop smoking to restore blood flow into the penis.
  • Moderate your alcohol use: Though the relationship between alcohol use and ED is not as clear-cut as some of the other risk factors. Heavy alcohol use and binge drinking both increase the risk of ED.
  • Manage your stress: Getting and maintaining an erection starts in the brain. If you are anxious or depressed, it will increase your risk of ED. Learn how to reduce stress and anxiety.
  • Check your cardiovascular health: Make an appointment with a healthcare professional to learn whether you have high cholesterol, blood sugar, blood lipids, or blood pressure, which are all risk factors for cardiovascular disease. In some men, ED is a warning sign of impending heart disease.
  • Check your hormone levels: Low testosterone, high prolactin, abnormal cortisol and thyroid hormones can all affect whether you can get and maintain an erection.  

What Treatments Are Available For Erectile Dysfunction?

There are many treatment options for ED. They can be classified into medications, penile injections, vacuum devices, and surgery.

Trimix Injections
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Trimix Injections

Trimix Injections are used as a second-line treatment when oral ED medications don’t work.

Learn About Trimix Injections


Medications can be used to restore testosterone levels or to increase blood flow into the penis. Men with hypogonadism, who have symptoms such as low libido, may need testosterone replacement therapy to resolve their symptoms.

PDE5 inhibitors are medications used to increase nitric oxide, which dilates blood vessels and increases blood flow into the penis.

Examples of PDE5 inhibitors include:

  • Sildenafil (Viagra)
  • Vardenafil (Levitra)
  • Tadalafil (Cialis)
  • Avanafil (Stendra)

Each medication has its own risk and benefit profile and, depending on the circumstances, may be the best medicine for erectile dysfunction.

Syringe and Vials of Medication

Penile Injections

Approximately 30% of men who have tried oral ED medications report that they did not work well for them. For these men, penile injections may be a good option. Injectable ED medications trigger increased blood flow into the penis. Unlike oral ED medications, they do not require sexual stimulation to work. Trimix injections are a combination of three medications that work synergistically to increase blood flow into the penis.

At What Age Does Erectile Dysfunction Start?

Vacuum Devices

Vacuum devices involve putting a tube over the penis and sealing it at the base. The vacuum pump pulls blood into the penis as air is sucked out of the tube. Once an erection is attained, a ring is placed at the base of the penis to keep blood in the penis.


When all other options have been exhausted, there are surgical options to consider, such as a surgically implanted penile prosthetic.

What Preventative Measures Are Good For Erectile Dysfunction? 

Other than moderating alcohol use and stopping smoking, having a healthy diet and engaging in regular physical exercise is the best preventative measure for ED. The Mediterranean diet and other similar diets are packed with antioxidants and vitamins along with lean sources of proteins and healthy fats. Since the incidence of ED increases over the age of 40, consider making some or all of these 11 dietary changes every man should make after the age of 40.

Though the rate of ED increases with age, it affects a significant number of younger men. The healthcare professionals at Invigor Medical can help you determine whether you have ED and discuss potential diagnostic and treatment options with you.

Start a Trimix treatment plan today!

Author: Leann Poston, M.D.
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