Middle-aged and older men have been the primary focus of the vast majority of research on erectile dysfunction. Dr. Najah S. Musacchio, a fellow at Children's Memorial Hospital in Chicago, wondered if ED could be an issue for the young men she might encounter in her practice.
Musacchio and fellow researchers conducted a small survey of college-age males in Chicago to begin to answer the question.
The results they found surprised them. Thirteen percent -- or about 30 men out of 234 -- reported having erectile dysfunction, while 25 percent said they lost an erection while putting on a condom, and another 6 percent said they had used drugs like Viagra, Cialis or Levitra to help out.
While the findings point to problem not usually associated with young men, Dr. Irwin Goldstein, a Boston-based urologist specializing in sexual medicine, said more younger men suffer from ED than people might think.
Goldstein estimates that between 20 percent and 25 percent of college-aged males have some sort of sexual problem. And he said that if you were to study men who use alcohol, the number is probably higher.
"If you flip the coin to females, the prevalence of sexual dysfunction is over 30 percent," Goldstein added.
The young men in the survey who described a history of sexual dysfunction said they didn't discuss this problem with their health care providers. This concerned survey authors because ED is associated with a number of adverse health outcomes such as depression, anxiety and decreased sexual satisfaction.
The survey also shed light on how and why young men use drugs that affect sexual performance. Most of those who used ED medications said they did so to overcome the negative effect that illicit drugs and alcohol can have on sex. Sixty-four percent of those who used ED medications said they did so in combination with alcohol, marijuana, GHB, methamphetamine or cocaine.
Nearly one-third of survey respondents said they used the medications simply to enhance sexual performance.
Dr. Ira Sharlip, a clinical professor of urology at the University of California at San Francisco, said that healthy young men using drugs to enhance sexual performance might find themselves disappointed.
"You cannot make a superman out of a normal man," Sharlip said. "If a young man is having normal erections, taking one of the meds will not do anything because you can't have more than a 100 percent erection."
Only one of the men using an ED medication got a prescription from his doctor. Most of the other men reported getting their supply through friends or the Internet.
"It is not good medicine for these drugs to be available over the Internet, but they are. There's definitely a black market for it," Sharlip said, but he also pointed out that 6 percent reporting using ED drugs was "pretty low."
Sharlip also said that while taking these drugs weren't good practice, they likely wouldn't be fatal in this age group, unless the men were taking "gigantic doses or if any of them takes a nitrate."
The survey is limited by its small sample size and its restriction to a relatively select population of men, factors pointed out by Musacchio herself.
While one survey isn't enough information to apply the findings to the general population, the finding suggest that erectile dysfuction is not unique to middle-aged and elderly men. And perhaps more importantly, the survey suggests that young men who do experience sexual difficulty are not seeking medical advice or treatment.