When it comes to erectile dysfunction, men in North Carolina are neither struggling more than most nor are they doing particularly better than men anywhere else in the country. According to new data from Innerbody Research, North Carolina ranks 24th out of 51 in a nationwide analysis of ED-related search behavior, which means the men in the state are squarely in the middle of the pack in this regard.

According to broader studies, about one-third of all men experience this type of dysfunction, and nearly one in five adult men in the US — around 18 million— are affected by the condition.

That’s roughly equivalent to the population of the entire state of New York.

The new study analyzed a year’s worth of Google search data for 40 different ED-related terms. States were ranked based on how frequently people searched for these terms as well as how direct or serious their search intent appeared to be. While search volume isn’t the same thing as a clinical study, it does provide a real-time glimpse into where men are concerned most about erectile health – and, by implication, where those problems are likely to be more prevalent.

Mississippi ranked number one in having trouble in this regard, with Alabama, West Virginia, Arkansas, and Oklahoma very close behind. Ten of the 15 states with the most ED-related searches were located in the South or West South-Central regions of the country.

 Many of those states are part of what researchers have called “Tobacco Nation,” an area with a significantly higher rate of smoking – a known contributor to erectile dysfunction. Other contributing factors that are more common in these regions include high obesity rates, poor mental health access and high rates of cardiovascular disease.

While ED is often associated with aging, the reality is more complex. Risk factors include obesity, smoking, diabetes, hypertension, and mental health conditions such as anxiety and depression. The Cleveland Clinic categorizes ED into four main types: vascular, neurogenic, hormonal, and psychogenic. Vascular ED, the most common, is linked to poor blood flow and it’s often related to lifestyle and chronic health conditions.

Medications can also play a role: Antidepressants, antihistamines, diuretics and certain cancer treatments have been associated with ED. Diet and alcohol consumption are also risk factors. Foods high in sugar, refined carbs and saturated fat, along with excessive drinking, can increase the risk of heart disease and diabetes – both of which are closely tied to erectile dysfunction.

One study cited in the report notes that nearly one in four men seeking treatment for new-onset ED were under 40 years old. That data goes against the popular notion that ED is primarily an issue for older men. In some states with younger populations — such as Texas, Georgia, and Nevada — ED search rates remain high. This suggests that age alone doesn’t explain the trends.

By contrast, states with lower ED-related search rates tended to be ones with cooler climates.

The men in the nation’s capital have the least trouble performing. The District of Columbia had the lowest search volume, followed by North Dakota, Massachusetts, Washington, and New York.

While the researchers noted some weak evidence that extreme heat may affect sexual behavior and hormone levels, another likely culprit is a lack of public health access. These states where the men had the least trouble tend to have better access to mental health care, lower rates of heart disease, and healthier populations overall.

North Carolina’s middle-of-the-road ranking in this category doesn’t mean the state is free of concern – just that it almost perfectly reflects the national average.

It’s important to note that in many cases erectile dysfunction is both treatable and manageable.

The complete results can be found at https://www.innerbody.com/erectile-dysfunction-trends-analysis.