Erectile dysfunction in young men
Erectile dysfunction in young men
And how young men are solving it
Disclaimer: This newsletter speaks directly about erectile dysfunction. If that’s not an interest, this dispatch is not for you.
Erectile dysfunction (ED) in young men is skyrocketing. This is not scientific fact, as there’s not a lot of solid studies on this. But it’s everywhere I look.
hims and Roman, two of the largest online providers of ED pills, focus on young men in their marketing.
When I’ve talked to Gen Z women about their experiences with men and ED, the vast majority mention they see it on the regular.
Sex therapists I’ve talked to and who publish online are seeing a big increase in young men with ED.
And then there are the surveys. While they’re kind of all over the place, they certainly show that it’s a thing.
A 2013 study found that 26% of young men under the age of 40 regularly experience ED.
A 2017 study in Brazil showed 11% of men aged 18-25 reported experiencing ED.
A 2019 Cosmopolitan survey found 80% of millennial men have experienced at least some level of ED.
I used to facilitate weekly circles for men with ED for a company called Mojo. I’d estimate over 500 men, mostly under the age of 50, shared their experience in those circles. I also talked to Mojo’s staff and sex therapists about what is going on. This newsletter is about what I learned.
Who can we blame
First off, let’s chat about the #1 issue most men blame for this phenomenon: porn. A lot of people, including popular scientists like Andrew Huberman, cite it as the problem. I fell into this camp too.
But the science seems to oscillate between inconclusive and showing that ED does not induce ED. Here are a few studies on that.
At first I thought science was just not sciencing hard enough. But between the weekly circles and conversations with experts, two main issues rose to the top.
Anxiety
Masturbation technique
Emotions and physics
Let’s unpack these a wee bit more.
Anxiety isn’t much of a surprise. As this chart below shows, young folks are feeling at record levels.
Both anxiety and medications used to treat anxiety/depression cause erectile dysfunction. Neither is tied to porn.
But some anxiety is tied to porn - usually when shame is involved. For example, a lot of men feel less confident about their bodies after watching porn. This causes anxiety in the bedroom. Other men view porn as morally wrong, but do it anyways, which can lead to anxiety and depression that cause ED.
The real surprise was masturbation technique. It turns out a huge percentage of young men are masturbating like idiots. Here’s what I mean.
Masturbation in 2024 largely looks like this:
Sit in bed with a laptop. Peruse a few porn videos (9 pages on average) before settling on one.
Squeeze one out over the course of a few minutes (10 minutes total time on site).
Go to sleep.
Repeat 2 - 7x times a week for 20 years.
It is extremely routine, and that's exactly the issue. Quickly masturbating in the exact same way for decades on end is a recipe for ED. The sameness trains dicks to be aroused in only the most specific of ways. Regular sex just doesn’t match it.
Porn is not directly causing ED, but for a subset of men, the ways they masturbate to porn definitely is.
At Mojo, I learned how folks were treating their psychological ED. Here’s a very rough sketch of what treatment often looked like.
For anxiety: learn to turn the “inner critic” into an “inner coach.” Breathwork, communication with partners, and dealing with negative self-talk are core components of this.
For desensitized folks: make masturbation about enjoying sensation again. Here’s what that looks like:
Masturbate for 20 minutes before cumming. This is a long time. Practice taking the most scenic of routes.
Do it looking at the mirror (not at a screen) so you get comfortable with yourself
Practice touching all areas of your body so you can refamiliarize yourself with touch, and learn which areas feel good
Do pelvic floor exercises, which make you feel muscles down there.
Is this sad?
This is a problem that can vastly improve with a single Joe Rogan podcast. But there’s a larger theme here which makes me sad and angry.
As technology marches on, basic human health requires more and more conscious effort. Here’s what I mean by that:
A lot of us now need to learn how to masturbate. This feels…new.
We often need strict gym routines and nutrition education to be in good physical health. This is in contrast to previous generations. Gyms and nutrition advice were less of a thing, and everyone at the beach appears in weirdly good shape.
We often need therapy to process basic emotions like anger, shame, fear, and sadness. That used to happen without needing insurance and a weekly appointment.
What does this look like 50 years from now? I’m sure young folks will need coaching for stuff we never dreamed of needing help with. Or maybe we can dream of them. Coaching for social media addiction, basic executive functioning, and basic relationship skills have already become industries in themselves.
And for those afflicted folks who can’t afford coaches and can’t coach themselves, life is going to get very dark and very weird.
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