Erectile dysfunction ads are targeting young men. But many don’t need the meds, experts say

Dr. Jeff Campbell is no fan of online ads for erectile dysfunction (ED) medication targeting young men. 

“These internet sites that are basically advertising a product, which is usually medication or sometimes, a service, I think make men really question their own function,” said Campbell, a urologist at St. Joseph’s Health Care in London, Ont.

Euphemistic ads for ED medication are as old as the internet, but in recent years, direct-to-consumer pharmaceutical companies are using memes and unmistakable messaging to reach young men concerned about their sexual health on social media. The ads often tout prescription drugs as the solution for ED, a persistent inability to achieve and maintain an erection for sexual activity, but doctors caution young men often only need medication after other measures — like diet and exercise — haven’t improved sexual health and performance.

“I think a lot of the ads are looking to treat ‘desperate men’ who are looking for anything to try to improve relationships or self-esteem or sexual function,” Campbell said.

Psychogenic factors at play 

When it comes to connecting patients with medication, University of British Columbia urologist Dr. Ryan Flannigan says direct-to-consumer pharmaceutical companies can help reduce barriers as younger men can often grapple with shame.

“I think that creates a very convenient point of access for men, particularly young men,” he said.

A 2021 study in the U.S. found 14 per cent of men under 40 experience ED, with 11.3 per cent experiencing mild ED and 2.9 per cent reporting moderate-to-severe symptoms. 

Still, Flannigan says these services can sometimes offer care and treatments in “scenarios that really don’t need treatments,” particularly when ED is driven by psychological factors or lifestyle habits.

“You’re kind of leveraging people’s vulnerabilities and feelings of insecurity to kind of push a product,” Flannigan said.

CBC reached out to direct-to-consumer pharmaceutical companies Rocky Health Inc, Felix Health and Phoenix for comment, which advertise on social media, but did not receive a response in time for publication. 

According to a 2025 narrative review, ED in younger men can stem from performance anxiety and relationship issues, as well as watching porn or using drugs. 

Campbell says younger men often don’t recognize the impact of new relationships, previous sexual trauma, or work stress on sexual performance.

“They usually present thinking something is wrong with their penis.”

But he notes some cases of ED in younger men can also be physiological, like poor blood flow or hormonal deficiencies. It is also common in men with diabetes. 

He adds ED in men under the age of 50 without a clear cause for the condition could be a sign of a cardiovascular issue. 

“It can predate cardiac events or heart attack by about two to three years and it’s considered the canary in the coal mine, so to speak.”

As such, Campbell recommends consulting with a medical practitioner before trying treatments pushed online.

Strategic course of medication

Dr. Dean Elterman, a Toronto, Ont.-based urology surgeon, says he typically offers reassurance to younger men and referrals to psychological or sexual therapy before suggesting short courses of low-dose PDE-5 inhibitors like sildenafil — sold as Viagra — or tadalafil — sold as Cialis. 

For most men, PDE-5 inhibitors like sildenafil and tadalafil are prescribed to be taken when needed, usually before sexual activity. But physiological factors tend to need longer-term use, Elterman says.

“If a young healthy man were to take one of these medications … and don’t have contraindications or medications that will mix badly with it, they can, and it will improve their erections.”

Elterman says while he isn’t against non-medicinal options like herbal supplements, he cautions against purchasing such products on the internet.

“There is certainly a placebo effect to many of these,” he said.

“If you’re getting something over the internet, you don’t know what the ingredients are. You may be subjecting yourself to something that could potentially be a bit harmful to you.”

Lifestyle changes instead can have a positive influence on managing ED, Elterman adds, including reducing smoking, improving sleep and dietary habits, as well as exercising regularly. 

Risk of dependency 

Campbell says constantly relying on medication to achieve and maintain an erection can be harmful — especially for young men — because it can lead to dependency.

“If you take a couple of pills in your 20s and you have this great erection with it, you have this expectation of how things should continue, and then it sometimes affects the psychological impact of spontaneous sex,” he said.

“Now you think in order to perform, you need these pills, which you probably never needed in the first place.”

Elterman says he sometimes prescribes short courses of PDE-5 inhibitors to “help with confidence.”

“On the one hand, it could reduce performance anxiety if taken on occasion,” he said.

“On the other hand, if you become almost dependent upon it, like a crutch, you’re really not addressing some of those underlying psychological or biological reasons why you’re having erectile dysfunction.”

PDE-5 inhibitors also come with other risks — including headaches, nausea and dizziness, as well as more serious concerns like increased cardiovascular risks, especially for people who have pre-existing heart conditions. 

ED doesn’t need to be a source of shame

Elterman says it’s important to remember that ED is a treatable condition. 

“We have very good treatments that are available,” he said. “They’re safe and effective.”

Campbell says he sees young men tie their sense of masculinity to their ability to maintain an erection, when the reality is that fluctuating sexual function is normal for men of all ages.

“It’s just something that’s not talked about,” he said. 

“Most men are very reassured when I actually tell them how common it is and how normal it is, and that they realize that they’re not kind of alone.”