Erectile Dysfunction in America: Where Are Men Struggling to Get (and Keep) It Up?

With Men’s Health Month (June) just around the corner, Innerbody Research decided to conduct a study of geographic trends of over 1.25 million relevant monthly searches to see where men in the U.S. are suffering the most from erectile dysfunction (ED).

Quick Highlights

• Mississippi ranks number one for ED-related searches. The state also ranks high for obesity prevalence and low for mental health support, both of which can contribute to erectile dysfunction.
• Men in the District of Columbia may be the least likely to struggle with erectile dysfunction.
• Ten out of the top 15 states where search data indicates men are struggling the most are located in the South and West South Central regions.
• Eight out of the top 15 states (Mississippi, Alabama, West Virginia, Arkansas, Oklahoma, Kentucky, Louisiana, and Tennessee) are in an area dubbed “Tobacco Nation” due to a nearly 50% higher rate of smoking, a habit that can cause or worsen ED.
• Many of the states with the lowest expression of ED-related issues in search are those with cooler climates.
• Both the top and bottom states in our list underscore that the picture of erectile health can’t be reduced to something as simple as age.

Studies suggest that one-third of men are affected by erectile dysfunction (ED). In America, the prevalence of ED among the adult male population was found to be 18.4% of men ages 20 and older are impacted by the condition — that’s roughly 18 million people.

While age is a risk factor, ED doesn’t just happen to older men, with one study revealing that out of 439 cases, nearly 1 in 4 under the age of 40 years old are seeking help for new-onset ED.

Types/Causes of Erectile Dysfunction

According to the Cleveland Clinic, there are 4 main causes or types of ED:

1. Vascular erectile dysfunction: This is the most common variety of ED, and it’s caused by issues with penile blood vessels or valves. Vascular ED is “closely related” to conditions like cardiovascular disease and can be caused by obesity, smoking, diabetes, hypertension, or a lack of exercise.
2. Neurogenic erectile dysfunction: This form of ED occurs due to nerve-related issues, such as trauma, radiation therapy, stroke, multiple sclerosis (MS), or some surgeries.
3. Psychogenic erectile dysfunction: As the name implies, psychogenic ED involves a psychological cause, like depression or anxiety.
4. Hormonal erectile dysfunction: If your ED is related to a hormone issue, it’s likely due to either a testosterone deficiency or a problem with your thyroid gland.

Certain medications — like antidepressants, antihistamines, diuretics, and chemotherapy, among others — or even a poor diet can also cause erectile dysfunction. Additionally, too much alcohol or foods high in saturated fats, refined carbohydrates, sodium, or added sugar can increase your risk of developing diabetes, heart disease, or obesity, all of which can increase your chances of developing erectile dysfunction.

Top 15 States Struggling the Most With ED

1. Mississippi
2. Alabama
3. West Virginia
4. Arkansas
5. Oklahoma
6. Kentucky
7. Louisiana
8. South Carolina
9. Florida
10. Texas
11. New Mexico
12. Nevada
13. Georgia
14. Delaware
15. Tennessee

It is worth noting that of the top 15, these states are either in the South or the West South Central regions in America, with only three of the states (Delaware, New Mexico, and Nevada) not being located in either region.

Many of these 15 struggling states are ranked high for various risk factors that can influence erectile dysfunction as well:

• According to the CDC, Alabama, Arkansas, Delaware, and Florida are among the top ten states with the highest prevalence of obesity.
• Nevada, Oklahoma, Mississippi, and Texas rank among the bottom ten states for adequate mental health support.
• Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Tennessee, and West Virginia are all located in a region dubbed “Tobacco Nation” due to a nearly 50% higher prevalence of smoking.
• Florida, West Virginia, Delaware, and South Carolina are among the top ten states with the largest populations of adults aged 65 and older.
• Oklahoma, Mississippi, Alabama, Louisiana, and Arkansas are the top five states in the U.S. with the highest heart disease mortality rates

Some of these struggling states, interestingly enough, also ranked low for certain risk factors that can influence erectile dysfunction:

• Tennessee, Texas, and West Virginia are among the top ten states with the lowest obesity rates.
• Delaware and Kentucky rank fairly well in terms of access to mental health support.
• Texas, Georgia, Oklahoma, Louisiana, and Nevada have some of the lowest percentages of citizens 65 and older, further demonstrating that ED isn’t only something older men deal with. 

Top 15 States Struggling the Least With ED

1. District of Columbia
2. North Dakota
3. Massachusetts
4. Washington
5. New York
6. New Jersey
7. Oregon
8. Colorado
9. Virginia
10. Minnesota
11. Vermont
12. Maine
13. Wisconsin
14. Maryland
15. California

Many of the states struggling the least are in regions with relatively cooler climates compared to the states struggling with erectile dysfunction the most. Animal research suggests that higher temperatures can affect sexual behavior, including erectile function. Some experts also suggest that negative outcomes from heat exposure, like fatigue and dehydration, can impact testosterone production and alter blood pressure, which can impact erectile functioning. 

Some of these states, not struggling as much with erectile dysfunction, were also ranked well for various factors that help to prevent and/or treat ED:

• Minnesota, Massachusetts, and Colorado are three of the top five states with the lowest heart disease mortality rates.
• New York, New Jersey, Maine, Maryland, and Virginia are among the top ten states with both the lowest prevalence of mental illness and the highest rates of access to mental health care.

Despite ranking low in erectile dysfunction, some of these states ranked high for certain risk factors that can contribute to ED:

• California, Colorado, and the District of Columbia have some of the highest rates of obesity in the nation.
• Colorado, Oregon, and Washington have relatively limited access to mental health resources.
• Maine, Vermont, and Oregon are among the states where men appear least impacted by ED despite having some of the largest percentages of adult citizens over age 65

Addressing Erectile Dysfunction

While there is no cure, there are treatment options to effectively address erectile dysfunction, and a multi-pronged approach is often necessary. This includes addressing underlying health conditions, lifestyle changes, and potentially exploring counseling or medication options. The National Institutes of Health (NIH) and Mayo Clinic recommend a combination of treatments based on the individual’s needs and the cause of ED. 

1. Address Underlying Medical Conditions

• Treating underlying conditions: If ED is caused by a medical issue like heart disease, diabetes, or chronic kidney disease, managing those conditions is crucial. 
• Medication review: Evaluate any medications that might be contributing to ED and discuss alternative options with your doctor. 

2. Lifestyle Modifications 

• Healthy lifestyle: Adopt healthy lifestyle habits like quitting smoking, limiting alcohol, maintaining a healthy weight, and engaging in regular physical activity. 
• Balanced diet: Focus on a nutritious diet rich in fruits, vegetables, and whole grains. 
• Stress management: Implement stress-reducing techniques like exercise, meditation, or yoga. 

3. Counseling

• Psychosexual counseling: If ED is related to psychological factors, seeking professional help from a therapist can be beneficial. 
• Couples therapy: If relationship issues are contributing to ED, couples counseling can help improve communication and intimacy. 

4. Medications

• Oral medications: In many cases, oral medications like sildenafil (Viagra), tadalafil (Cialis), or avanafil (Stendra) can effectively improve erections. 
• Other medications: Depending on the specific cause, other medications like intracavernosal injections or intraurethral pellets may be considered. 

5. Non-Invasive Treatments

• Vacuum erection devices: These devices can help achieve and maintain an erection.
• Penile injections: Injections into the penis can help facilitate an erection. 

6. Surgical Options

• Penile implant: If other treatments are ineffective, a penile implant can be surgically implanted to restore erection. 

7. Other Considerations

• Testosterone therapy: If low testosterone is identified as a cause, testosterone therapy may be recommended. 
• Peyronie’s disease: If this condition is present, surgical correction or other treatments may be necessary. 

Important Considerations

• Consult with a healthcare professional: It’s essential to consult with a doctor or urologist to diagnose the cause of ED and discuss the best treatment options for your specific situation. 
• Patient education: Understanding the potential causes and treatments for ED is crucial for making informed decisions about your care. 
• Open communication: Discuss your ED with your partner and healthcare providers to develop a comprehensive treatment plan. 

By addressing the underlying causes, making lifestyle changes, and exploring available treatments, many men can successfully manage erectile dysfunction and improve their sexual health and overall quality of life. 

Takeaway

This report highlights that no matter the state rankings, erectile dysfunction is a concern that is felt across the country by men of all ages, and illustrates that the picture of men’s sexual health is complex.

*Note: One person’s experience with erectile dysfunction can be different than another’s. The information provided here is for general knowledge and should not be considered medical advice. Consult with a healthcare professional for personalized diagnosis and treatment options. 

This article was written by TJ Webber at the WHN News Desk, which was created using some of the data and graphs that were supplied by Eric Rodrigues, Co-Founder and CEO of Innerbody Research. 

As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. WHN does not agree or disagree with any of the materials posted. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement.  

Opinion Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy of WHN/A4M. Any content provided by guest authors is of their own opinion and is not intended to malign any religion, ethnic group, club, organization, company, individual, or anyone or anything else. These statements have not been evaluated by the Food and Drug Administration.