Erectile dysfunction is extremely common. The most widely cited study on the topic, the Massachusetts Male Aging Study, found that 52% of men between ages 40 and 70 experienced some degree of ED. That includes mild, moderate, and severe cases. Globally, prevalence estimates range widely depending on how ED is defined and measured, but the condition affects hundreds of millions of men worldwide.
How ED Rates Change With Age
ED becomes more common with each decade of life, but it is not exclusively an older man’s problem. A large U.S. study using claims data and electronic health records found that ED diagnoses increase steadily from the late teens through the 60s. Among men aged 18 to 29, the rate of ED diagnosis or treatment was roughly 1.4 to 1.7%. By the 30s, that figure climbed to 5 to 7%. In the 40s, it jumped to 16 to 20%, and by the 50s and 60s, it reached its peak, with rates around 30% or higher in some datasets.
Interestingly, diagnosed ED rates appear to drop after age 70 in medical records. That doesn’t mean older men stop having the problem. It more likely reflects that men in their 70s, 80s, and 90s are less likely to seek treatment for it or bring it up with their doctor.
Most Cases Are Mild
Not all ED is the same. A 2021 population-based survey of U.S. men used a standardized scoring system to classify severity, and the results are reassuring for many. Mild ED was the most common form across every age group, reported by 57% of young adults and adults with the condition. Only about 6.5% of younger men with ED had severe symptoms, compared to roughly 25% of elderly men.
Moderate and severe ED combined affected less than a third of younger and middle-aged men with ED symptoms (around 24 to 28%). In the oldest age group, that proportion rose to about 42%. So while the condition becomes both more common and more severe with age, the majority of men who experience it have a milder form, particularly earlier in life.
ED in Younger Men
Men in their 20s and 30s can and do experience ED, though the causes tend to differ from those in older men. Research on younger adults suggests that roughly half of ED cases in this age group are psychogenic, meaning they stem from psychological factors like anxiety, stress, depression, or relationship issues rather than a physical problem with blood flow or nerve function. About 45% still have an identifiable physical cause.
The practical takeaway: if you’re under 40 and experiencing ED, it’s not unusual, and the cause may be treatable without medication. Performance anxiety, in particular, can create a cycle where worrying about ED makes it worse.
Diabetes and ED
Diabetes is one of the strongest risk factors for ED. Men with diabetes are about 3.5 times more likely to develop ED than men without it. The numbers are striking: a meta-analysis found that 52.5% of men with diabetes overall experienced ED. Among men with type 1 diabetes, the rate was about 37.5%. For type 2 diabetes, it was 66.3%.
An umbrella review of multiple studies put the pooled global figure even higher, at 65.8% of diabetic men experiencing ED symptoms. The connection makes biological sense. Diabetes damages small blood vessels and nerves over time, both of which are essential for erections. Poorly controlled blood sugar accelerates that damage.
The Heart Disease Connection
ED often shows up years before a heart attack or stroke. Researchers now consider it a sentinel symptom of cardiovascular disease because the same process that narrows arteries in the heart also restricts blood flow to the penis, and the smaller penile arteries tend to show problems first. ED typically precedes chest pain by 2 to 3 years and major cardiovascular events by 3 to 5 years.
The data backs this up. In one study of over 1,500 men with cardiovascular disease, those with ED had 1.6 times the odds of dying from a cardiac event, having a heart attack, or being hospitalized for heart failure or stroke compared to men without ED. A population-based U.S. study found that men with ED had average 10-year cardiovascular risk scores more than double those of men without ED (about 20% versus 8%). Men in the highest cardiovascular risk category were over 7 times more likely to have ED than those in the lowest risk group.
This doesn’t mean ED guarantees heart disease, but if you develop ED, especially in your 40s or 50s without an obvious psychological cause, it’s worth having your cardiovascular health checked.
Medications That Contribute to ED
Prescription drugs account for up to 25% of all ED cases. Several common medication classes are linked to erectile problems:
- Antidepressants (SSRIs): Sexual dysfunction affects an estimated 50 to 70% of users, making this one of the most common drug-related causes.
- Blood pressure medications: Certain older beta-blockers cause ED in up to 29% of users, though newer options have much lower rates (as low as 3.4%). Some centrally acting blood pressure drugs are worse, with ED reported in up to 70% of users on certain formulations.
- Antipsychotics: Between 48 and 75% of patients on these medications experience some form of sexual dysfunction.
- Opioids: Chronic use is associated with ED rates of 21 to 52%, often at younger ages than typical.
If you started a new medication and noticed a change in erectile function, the timing is probably not a coincidence. Switching to a different drug in the same class can sometimes solve the problem.
Most Men Don’t Seek Help
Despite how common ED is, more than half of men who experience it never bring it up with a doctor. A study of men attending primary care clinics found that only 46.9% had consulted a healthcare professional about their erectile difficulties. The main barriers were social stigma and a preference for self-medicating.
That gap between how many men have ED and how many get help for it means the condition is almost certainly underreported in medical data. The true prevalence is higher than what shows up in claims databases and health records, particularly among older men who may have stopped seeking treatment and younger men who feel uncomfortable raising the topic.