In the prime years of youth, a stage often defined by vigour, ambition, and limitless potential, a growing number of young men in Nairobi are quietly grappling Erectile Dysfunction (ED), an ongoing inability to get or keep an erection firm enough for satisfying sexual activity.

Although ED has long being associated with ageing, a recent study by the Kenya Medical Research Institute (KEMRI) has revealed that the condition is now affecting men barely out of their teenage years.

According to the study, one in ten (10%) of Nairobi men aged 18-35 is struggling with erectile dysfunction.

A hidden reality

For many of these young men, the struggle remains hidden masked by societal expectations that equate masculinity with sexual prowess. As a result, most suffer in silence, avoiding conversations or medical attention due to shame, fear, or misinformation.

Contrary to popular belief, erectile dysfunction among young men is rarely caused by biological ageing. The KEMRI researchers, in the study released last month, argue that the condition is largely linked to psychological and lifestyle-related factors including anxiety, depression, chronic stress, physical inactivity, poor diet, smoking, alcohol consumption, and illicit drug use.

Mental health, in particular, emerges as a critical factor but the pressures of unemployment, economic uncertainty, academic demands, and relationship stress have left many young men battling anxiety and depression conditions that significantly interfere with sexual performance.

Urban living has also taken a toll. Sedentary lifestyles, fast food consumption, limited physical activity, and substance use are becoming increasingly common among Nairobi’s youth. These behaviours disrupt blood circulation, hormone balance, and overall cardiovascular health.

Alarmingly, the study also highlights unsafe self-medication practices, particularly the growing use of so-called “blue pills” without medical guidance. Many young men resort to these drugs as a quick fix, unaware of the potential long-term health risks.

A growing global concern

The findings mirror a worrying global trend with World Health Organisation (WHO) projections indicating that the number of men affected by erectile dysfunction worldwide is expected to be more than double, rising from approximately 150 million men in 1995 to over 320 million by 2025. Population growth, ageing, and lifestyle-related risk factors are driving this increase but the rising prevalence among younger men is particularly concerning.

As erectile dysfunction increasingly affects younger populations, the stigma surrounding male sexual health remains one of the biggest barriers to treatment.

Experts stress the need for open conversations, education, and youth-friendly health services that encourage men to seek help without fear or shame.

How is ED diagnosed?

A doctor can diagnose ED and determine its cause by reviewing your medical history, as well as perform a physical examination.

They can achieve this by asking you questions about your personal and sexual history.

According to Cleveland Clinic, some of the questions one may include;

• Are you currently taking any medications, including prescription drugs, over-the-counter drugs, herbal supplements, dietary supplements and nonmedical drugs?
• Has a healthcare provider ever diagnosed you with depression or anxiety?
• Do you often feel stressed?
• Are you experiencing any relationship problems?
• How often are you able to get erections?
• How hard are your erections?
• How long are you able to maintain an erection?
• Do you lose your erection because you ejaculate sooner than you would like?
• When did you first notice symptoms of erectile dysfunction?
• What exactly happened when you first had erectile dysfunction symptoms?
• Do or did you experience erections at night or during the morning?
• What sexual positions do you regularly engage in?

Often, these questions may make you feel embarrassed or akward. All in all, it is important for you to be honest with the doctor for accurate diagnosis.

After the healthcare provider suspects a particular cause for your ED, he or she may order the following tests;

• Blood tests.
• Complete blood count (CBC).
• Lipid panel.
• Liver function tests.
• Kidney function tests.
• Thyroid tests.
• Testosterone test.
• Urinalysis (urine test).
• Penile Doppler ultrasound.
• Tests that measure if the nerves in your penis respond to vibrations (penile biothesiometry).
• Drugs that temporarily make your penis erect (vasoactive injection).
• Magnetic resonance angiogram (MRA).

After diagnosing, the doctor may recommend one or a couple of the following treatment options, depending on the cause of the ED; Cardiovascular exercise, Quitting smoking, Talking to a sex therapist, Oral medications that help increase blood flow to your penis, Penile low-intensity focused shockwave therapy (LiSWT), Medications you inject directly into your penis to create an erection, and Vacuum constriction device.

Other treatment options include; Testosterone replacement therapy, and Penile implant procedure.

How one can prevent ED

Lifestyle changes can help one lower the risk of developing erectile dysfunction. The lifestyle changes include;

• Reducing your cholesterol.
• Being more physically active, especially doing cardiovascular exercises like running, jogging or bicycling.
• Maintaining a healthy weight for you.
• Getting high-quality sleep.
• Eating healthy foods with low saturated fats, such as fruits, vegetables and whole grains.
• Stopping smoking.
• Reducing or stopping drinking.