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Psychogenic ED has been related to psychological factors (e.g., depression, stress, generalized anxiety, or performance anxiety) while organic ED has been attributed to physical conditions (e.g., neurological, hormonal, anatomical, or pharmacologic side effects) [17].For men under 40 the most common diagnosis is psychogenic ED, and researchers estimate that only 15%–20% of cases are organic in origin [18].However, none of the familiar correlative factors suggested for psychogenic ED seem adequate to account for a rapid many-fold increase in youthful sexual difficulties.

The results took the authors by surprise, “It is unclear why we found such high rates overall, but especially the high rates among both male and female participants rather than female participants alone, as is common in the adult literature” [10] (p.638).

In 2001–2002, it was administered to 13,618 sexually active men in 29 countries [5]. Based on the findings of historical studies cited earlier, older men would be expected to have far higher ED rates than the negligible rates of younger men [2,7].

A decade later, in 2011, the same (yes/no) question from the GSSAB was administered to 2737 sexually active men in Croatia, Norway and Portugal [6]. However, in just a decade, things changed radically.

A 2013 Italian study reported one in four patients seeking help for new onset ED were younger than 40, with rates of severe ED nearly 10% higher than in men over 40 [9].

A 2014 study on Canadian adolescents reported that 53.5% of males aged 16–21 had symptoms indicative of a sexual problem [10].

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