Alpha Reductase and Erictile Dysfunction

An Article published in the British Medical Journal in September 2016, based upon “two populations of men free of risk factors for erectile dysfunction and other sexual dysfunction or its treatment: men aged 40 or more with benign prostatic hyperplasia who received a prescription for a 5-alpha reductase inhibitor (finasteride or dutasteride) or alpha blocker, or both, and men aged 18-59 with alopecia”, suggests : “The incidence rate of erectile dysfunction was lowest among users of 5-alpha reductase inhibitors only (15.3 per 1000 person years, 95% confidence interval 14.3 to 16.5), and similar among users of 5-alpha reductase inhibitors+alpha blockers (19.2 per 1000 person years, 17.4 to 21.1) and alpha blockers only (20.1 per 1000 person years, 19.6 to 20.7). Compared with users of alpha blockers only, the adjusted incidence rate ratios for users of 5-? reductase inhibitors only and 5-alpha reductase inhibitors+alpha blockers were 0.92 (95% confidence interval 0.85 to 0.99) and 1.09 (0.99 to 1.21), respectively.” Of further note: “cases of erectile dysfunction were more likely than matched controls to be overweight or obese (as measured by body mass index) or to have a diagnosis of non-erectile dysfunction sexual dysfunction, hypertension, diabetes, hyperlipidemia, depression, orchitis, or alcohol misuse before the index date.”   Of course, this study was done in an older population that is prone to Erectile Dysfunction

https://www.bmj.com/content/354/bmj.i4823#:~:text=The%20risk%20of%20erectile%20dysfunction%20increased%20with%20increasing%20number%20of,odds%20ratios%20were%20statistically%20significant

Comment:  The risks of ED rises with age, so the groups tested were clearly at a higher risk of ED than younger men.  The statistics reported by this article suggest that in this higher-risk population, the risk of ED was 1.3%, less than was reported in the original Merck study or in the Propecia ED risk factors brochures. I am wondering why so many younger men are reporting ED, considering the above statistics?