Historical ED rates
What about other historical rates of ED in peer-reviewed literature using various instruments? First, here are results from the 2 major cross-sectional studies on ED in sexually active American men. Both predated heavy internet penetration.
- In the 1940s, the Kinsey report concluded that the prevalence of ED was less than 1% in men younger than 30 years, less than 3% in those 30–45.
- A 1999 cross-sectional study (based on data gathered in 1992) published by the Journal of the American Medical Association reported erectile dysfunction rates of only 5%, and low sexual desire in 5%. In that study, the ages of the men surveyed ranged from 18 to 59, so a third of them were over 40, which means the rates for sexually active men under 40 were lower.
In 2002 Dutch researchers did a
meta-analysis of 6 high-quality ED studies. All of the studies reviewed from Europe (5) reported ED rates for men under 40 of approximately 2%. The sixth was the one reported immediately above.
Note: Keep in mind that ED rates for all men in every age group are higher than rates for sexually active men. For example, in the
1992 data for sexually active men 18-59, the average ED rate was only 5%. However, the rates for men (both sexually active and not) were 7% in men 18-29, 9% in men 30-39, 11% in men 40-49, and 18% in men 50-59. In order to compare “apples to apples,” we, like most researchers, focus on rates for sexually active men. This unfortunately fails to count ED problems in young men who avoid sex due to p**rn-induced sexual dysfunctions.
Before we turn back to recent studies, it’s important to understand a bit more about the pathology of erectile dysfunction. ED is usually classified as either psychogenic or organic. Traditionally, psychogenic ED is associated with psychological factors (e.g., depression, stress, or anxiety) while organic ED is attributed to physical conditions (e.g., neurological, hormonal, or anatomical.) The most common diagnosis for guys under 40 is psychogenic ED.
Studies investigating ED risk factors in men under 40
typically fail to find the causes commonly associated with ED in older men, such as smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, and hyperlipidemia. Be very skeptical if you read that the preceding causes of
organic ED in older men are also the cause of a sharp rise in youthful ED. It takes years for various lifestyle factors to manifest as vasculogenic or neurogenic ED. Indeed, a
2018 paper that looked at ED risk factors in young men found no differences in the usual ED risk factors between those with ED and those with no problems (average age 32). The only difference was that those with ED had low sexual desire. The researchers didn’t ask about p**rn use.
Recent studies on young men
Now, we turn to other recent studies on young men (~40 and under). Using the IIEF-5, a
2012 cross-sectional study of Swiss men aged 18-24 found ED rates of 30%, and a 2010
Brazilian study of men 18-40 reported ED rates of 35%. A
2013 Italian study reported one in four patients seeking help for new onset ED were younger than 40. Astonishingly, the
rate of severe ED was nearly 10% higher in younger men than in men over 40. The
University of Florence urology clinic reported that first time ED patients under 40 comprised about 5% of the total patient population. By 2014-2015 men under 40 seeking help for ED comprised 15% of first time patients. Also, a 2015
paper about 4,211 Italians who sought outpatient help for sexual dysfunction found that compulsive masturbators were
younger than the other men and had higher rates of ED (and were likely masturbating to internet p**rn).
A
2014 study of new diagnoses of ED in active duty servicemen reported that rates had more than doubled between 2004 and 2013. Rates of psychogenic ED increased more than organic ED, and rates of unclassified ED remained relatively stable. A
2014 cross-sectional study of active duty, relatively healthy, male military personnel aged 21-40 found an overall ED rate of 33.2%, using the IIEF-5. About half of them also had PTSD (a known risk factor for ED). In a further
military study published in 2015, the researchers found that ED was associated with
sexual anxiety and
genital self-image, both of which could easily be tied to heavy internet p**rn use.
Erectile dysfunction has implications for safe condom use. A
2015 study on problematic condom use, which sampled 479 men (mean age 20.43), reported unexplained erection difficulties during condom use in a total of 62% of the young men:13.8% during condom application, 15.7% during penetrative sex, and 32.2% during both. (This was not a cross-sectional study; researchers noted that they over-sampled those with problems.)
The next studies reveal that abnormally low sexual desire is also cropping up in young men.
- A 2014 study on Canadian adolescents reported that 53.5% of males aged 16-21 have symptoms indicative of a sexual problem. Erectile dysfunction was the most common (27%), followed by low sexual desire (24%), and problems with orgasm (11%). The authors were baffled why rates were so high, and were surprised that sexual dysfunction rates for males surpassed females, unlike in earlier published literature.
- The same Canadian researchers published a 2-year longitudinal study in 2016, in which they found that, over several checkpoints during the 2 years, the following percentages of 16-21 year old males reported:
- low sexual satisfaction (47.9%)
- low desire (46.2%)
- problems in erectile function (45.3%)
While females’ sexual problems improved over time the males’ sexual problems did not: “Unlike for male adolescents, we found a clearer picture of improvement over time for female adolescents, suggesting that learning and experience played a role in improving their sexual lives.” And, “The only factor that emerged as a strong predictor was relationship status: Adolescents who were not in a sexual relationship were approximately three times more likely to report a problem in sexual functioning compared to those who were in a sexual relationship.” [All subjects were sexually active, but who would be using the most p**rn?]
- A 2015 study on Italian high school seniors (18-19) found that 16% of those who use p**rn more than once per week reported abnormally low sexual desire. Non-p**rn users reported 0% low sexual desire.
- A 2014 survey of Croatian men under 40 and under reported ED rates of 31% and low sexual desire rates of 37%.
A 2015 study, which asked Canadian men using p**rn 7 or more hours per week about their sexual functioning, found that 71% had sexual dysfunctions, with 33% reporting difficulty orgasming. Average age 41.5.
This
2018 article about UK a study reported that one in two men in their 30s struggle getting and maintaining an erection!
Together, these studies suggest a recent increase in ED in men ~40 and under, as well as startling rates of anorgasmia and low sexual desire, starting quite young (as does internet p**rn use).
None of these studies had young men remove p**rn use to investigate internet p**rn’s effects on their sexual performance, despite the fact that its use represents a drastic change in men’s sexual environment in the digital age. However, the peer-reviewed evidence supporting internet p**rn as the culprit in youthful sexual dysfunction continues to accumulate. See this list of
37 studies linking p**rn use or p**rn addiction to sexual dysfunctions and lower arousal to sexual stimuli. The first 7 studies in this list demonstrate causation as participants eliminated p**rn use and healed chronic sexual dysfunctions.
