Rising erectile dysfunction among men: The role of mental health, pornography and lifestyle

Once considered a problem mostly for older men, erectile dysfunction (ED) is increasingly being reported among younger men in India. Doctors note a sharp rise in cases among those in their 20s and 30s, driven by mental health struggles, changing lifestyles, and the easy availability of pornography. India, often dubbed the “impotence capital of the world,” is seeing numbers climb in tandem with lifestyle diseases and stress-related conditions. By 2025, global cases of ED are expected to touch 322 million, with a significant rise in Asia, including India. Here’s a closer look at why ED is becoming more common, and what men can do about it.

1. Mental Health Matters: When it comes to sexual health, the brain is just as vital as the body. Chronic stress, anxiety, and depression are some of the most potent psychological triggers for eating disorders. Performance anxiety is common in India and is frequently brought on by social pressure to "prove" one's masculinity. Research indicates that many men who seek treatment for erectile dysfunction also experience anxiety or depression. It is more difficult to sustain sexual function when stress hormones like cortisol suppress testosterone.

2. Pornography’s Hidden Influence: Younger Indians' sexual behavior has changed as a result of the widespread availability of online pornography. Overuse can lead to self-doubt in genuine relationships by generating irrational expectations of sex. Porn-induced erectile dysfunction (PIED) is a condition that some men have that enables them to have sex while viewing porn but not with a partner. According to research, this could be because the constant novelty of the internet overstimulates the brain's reward system, which lessens the stimulation of in-person intimacy. Urologists and andrologists in India confirm that they are seeing more and more young men report these problems, even though the causality is up for debate.

3. Lifestyle Habits Taking a Toll: Modern lifestyles have created a perfect storm for sexual health problems.

● Sedentary living: Desk jobs and long commutes limit activity, reducing blood flow that is crucial for erections.

● Obesity and poor diet: Indian diets high in refined carbs and fried foods contribute to diabetes and high cholesterol—both risk factors for ED.

● Alcohol and smoking: Tobacco damages blood vessels, while excessive alcohol lowers testosterone. Both are widespread among urban Indian men.

● Poor sleep: Late-night work or screen time reduces quality rest, affecting hormone balance.

A 2023 Indian study linked inadequate physical activity and obesity directly with higher rates of ED, underscoring that lifestyle changes can make a tangible difference.

4. Cultural Silence and Stigma: One of the biggest barriers in India is that men hesitate to seek help. Sexual health is still taboo, and many suffer in silence rather than consult a doctor. Some even resort to unverified home remedies or self-medication. This not only delays treatment but can worsen the problem. Doctors emphasize that ED is not a personal failing but a medical issue that can be managed with the right guidance.

5. What Men Can Do: The good news? ED is treatable. Experts recommend a comprehensive approach.

● Seek medical evaluation to rule out underlying conditions.

● Address mental health through counseling or therapies like CBT.

● Adopt lifestyle changes such as regular exercise, a balanced diet, and better sleep hygiene.

● Consider therapy with a partner to reduce performance anxiety and build intimacy.

Final Word

ED is no longer limited to "older men." It's a wake-up call for younger Indian men as well regarding the negative effects of stress, pornography, and lifestyle choices. Effective management of ED can restore not only sexual health but also confidence and quality of life through education, candid discussions, and prompt medical attention.

The writer is Men’s Health & Andrology Expert | Founder, IASH (Institute of Andrology and Sexual Health)

Views expressed are personal