Erectile Dysfunction in Your 20s: Causes and Treatment Options

Question

Hello, I am a 24-year-old male.

Until last year, I had no issues with erections during intercourse and had a strong sex drive. However, recently, I feel like my libido has decreased—possibly due to hair loss medication (I’ve been taking it for about 4 months). I also feel like I’m not able to achieve a full erection during intercourse.

When my partner stimulates me, I can get a full erection, but after penetration, it tends to lose firmness toward the end.

Would this be considered erectile dysfunction? I usually sleep about 6–8 hours a day. I don’t drink much, but I smoke about a pack of cigarettes a day (for 7 years), and I don’t exercise.

Compared to before, I feel like I can’t achieve a very firm erection anymore. Even when I do get an erection, it’s not as rigid as before and tends to go away quickly.

Although I suspect the hair loss medication, I did have mild symptoms even before starting it. Could this be due to psychological pressure, since I feel like I’m not performing well?

When I am alone, I don’t seem to have much of an issue.

Should I visit a hospital? I would really appreciate your help.

Ryu Kyung-ho · Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

You may be very concerned about the cola-colored urine and visible blood in your urine after heavy drinking. Visible hematuria (blood in the urine) should always be carefully evaluated to determine the underlying cause.

In middle-aged men, painless hematuria can raise concern for urinary tract tumors, including bladder cancer. However, there are also various other possible causes, such as temporary inflammation after excessive alcohol intake, severe fatigue, or urinary stones. In particular, the presence of small clots in the urine and changes in urine color depending on fluid intake may indicate ongoing bleeding somewhere in the urinary tract.

Although you may be worried about cancer, there is also a significant possibility that the bleeding is due to inflammation or stones. Therefore, it is important to visit a clinic for proper evaluation. Hematuria itself is an important signal from the body, and even if the symptoms appear to improve, the underlying cause should always be identified.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully assess each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment, so if your symptoms persist, we strongly recommend visiting a urology clinic for proper evaluation.

We hope this information is helpful. Thank you.