Porn-induced ED: Empirical Evidence

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What I say to "skeptics"

All studies assessing young male sexuality since 2012 report a tremendous rise in erectile dysfunction and low libido. See - Research confirms enormous rise in youthful ED If we compare recent research to earlier studies, young men today are experiencing anywhere from a 600% to 3000% increase in ED since the advent of the internet. No, that is not a misprint. Erectile dysfunction rates ranged from 27 to 33%, while rates for low libido (hypo-sexuality) ranged from 24% to 37%. The lower ranges are taken from studies involving men 25 and under, while the higher ranges are from studies involving men 40 and under.

limp switchThese alarmingly high rates are a recent phenomenon, as can be seen by comparing them with two earlier studies - the only major cross-sectional studies on ED in American men:

  1. In the 1940s, the Kinsey report concluded that the prevalence of ED was less than 1% in men younger than 30 years, less than 3% in those 30–45.
  2. A 1999 cross-sectional study published by the Journal of the American Medical Association reported erectile dysfunction rates of only 5%, and low sexual desire in 5%. In that study, the ages of the men surveyed ranged from 18 to 59, so a third of them were over 40.

Ask yourself - What variable has changed in the last 15 years that could lead to such a dramatic rise in youthful ED? Only Internet porn.

In 2011, the head of the Italian Society of Andrology and Sexual Medicine (SIAMS) warned that porn-induced ED exists. SIAMS, the largest urology organization in Italy, was the first group of medical doctors to address this emerging phenomenon via a survey. Their president reported that the clinics had guys eliminate porn use for 2-3 months. At the time of Dr. Foresta's announcement we had been writing articles about porn-induced ED for about 4 years.

Dr. Foresta has continued to research the effects of porn use on sexuality. In 2014 he published a lecture describing the results of several surveys, and an upcoming study on men age 19-25. Since 2011 many other experts have jumped on the bandwagon. This page contains articles and videos by about 60 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.

Naysayers suggest that we need "peer-reviewed studies" to confirm the existence of porn-related ED before we can say it exists. However, it's painfully obvious that no researcher can conduct a study where one group of young healthy men use Internet porn for 10 years, and a comparable control group does not, with erectile function assessed through masturbation to sensation only (no porn). There's only one way to confirm whether erectile dysfunction is porn-induced (PIED) or not: Eliminate porn use for a extended period of time and see if the sufferer regains normal erectile functioning.

In other words, it may be that the only experiment possible is well under way - with thousands of results now reported. Only one study had a subject with suspected porn-induced sexual problems abstain from porn. Guess what? In 8 months the man recovered from anorgasmia, low libido and porn-related fetishes, and resumed normal sexual relations with his girlfriend. That's one for one on studies assessing porn-induced sexual problems

In the last few years many other studies have found relationships between porn use in young men and ED, anorgamsia, low sexual desire, delayed ejaculation and lower brain activation to sexual images (below).

In addition, this page contains articles and videos by about 90 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who have successfully treated porn-induced ED and porn-induced loss of sexual desire

Multiple studies have found relationships between porn use or porn/sex addiction and erectile dysfunction, delayed ejaculation, anorgasmia, low libido, and lower brain activation to sexual stimuli:

1) Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016) - An extensive review of the literature related to porn-induced sexual problems. Involving US Navy doctors, the review provides the latest data revealing a tremendous rise in youthful sexual problems. It also reviews the neurological studies related to porn addiction and sexual conditioning via Internet porn. The doctors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions.

2) The Dual Control Model - The Role Of Sexual Inhibition & Excitation In Sexual Arousal And Behavior (2007) - Newly rediscovered and very convincing. In an experiment employing video porn, 50% of the young men couldn't become aroused or achieve erections with porn (average age was 29). The shocked researchers discovered that the men's erectile dysfunction was,

"related to high levels of exposure to and experience with sexually explicit materials."

The men experiencing erectile dysfunction had spent a considerable amount of time in bars and bathhouses where porn was "omnipresent," and "continuously playing". The researchers stated:

"Conversations with the subjects reinforced our idea that in some of them a high exposure to erotica seemed to have resulted in a lower responsivity to "vanilla sex" erotica and an increased need for novelty and variation, in some cases combined with a need for very specific types of stimuli in order to get aroused."

3) Neural Correlates of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviours (2014) - This fMRI study by Cambridge University found sensitization in porn addicts which mirrored sensitization in drug addicts. It also found that porn addicts fit the accepted addiction model of wanting "it" more, but not liking "it" more. The researchers also reported that 60% of subjects (average age: 25) had difficulty achieving erections/arousal with real partners as a result of using porn, yet could achieve erections with porn. From the study (CSB is compulsive sexual behaviours):

"CSB subjects reported that as a result of excessive use of sexually explicit materials.....[they] experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material)"

"Compared to healthy volunteers, CSB subjects had greater subjective sexual desire or wanting to explicit cues and had greater liking scores to erotic cues, thus demonstrating a dissociation between wanting and liking. CSB subjects also had greater impairments of sexual arousal and erectile difficulties in intimate relationships but not with sexually explicit materials highlighting that the enhanced desire scores were specific to the explicit cues and not generalized heightened sexual desire."

4) Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men (2016) - This Belgian study from a leading research university found problematic Internet porn use was associated with reduced erectile function and reduced overall sexual satisfaction. Yet problematic porn users experienced greater cravings. The study appears to report escalation, as 49% of the men viewed porn that "was not previously interesting to them or that they considered disgusting." Excerpts:

"This study is the first to directly investigate the relationships between sexual dysfunctions and problematic involvement in OSAs. Results indicated that higher sexual desire, lower overall sexual satisfaction, and lower erectile function were associated with problematic OSAs (online sexual activities). These results can be linked to those of previous studies reporting a high level of arousability in association with sexual addiction symptoms (Bancroft & Vukadinovic, 2004; Laier et al., 2013; Muise et al., 2013)."

In addition, we finally have a study that asks porn users about possible escalation to new or disturbing porn genres. Guess what it found?

"Forty-nine percent mentioned at least sometimes searching for sexual content or being involved in OSAs that were not previously interesting to them or that they considered disgusting, and 61.7% reported that at least sometimes OSAs were associated with shame or guilty feelings."

Note -  This is the first study to directly investigate the relationships between sexual dysfunctions and internet porn use. Two other studies claiming to have investigated correlations between porn use and erectile functioning cobbled together data from earlier studies in an unsuccessful attempt to debunk porn-induced ED. Both were criticized in the peer-reviewed literature: paper 1 was not an authentic study, and has been thoroughly discredited; paper 2 actually found correlations that support porn-induced ED. Moreover, paper 2 was only a "brief communication" that did not report important data.

5) Adolescents and web porn: a new era of sexuality (2015) - This Italian study analyzed the effects of Internet porn on high school seniors, co-authored by urology professor Carlo Foresta, president of the Italian Society of Reproductive Pathophysiology. The most interesting finding is that 16% of those who consume porn more than once a week report abnormally low sexual desire compared with 0% in non-consumers (and 6% for those who consume less than once a week). From the study:

"21.9% define it as habitual, 10% report that it reduces sexual interest towards potential real-life partners, and the remaining, 9.1% report a kind of addiction. In addition, 19% of overall pornography consumers report an abnormal sexual response, while the percentage rose to 25.1% among regular consumers."

6) Patient Characteristics by Type of Hypersexuality Referral: A Quantitative Chart Review of 115 Consecutive Male Cases (2015) - Study on men (average age 41.5) with hypersexuality disorders, such as paraphilias and chronic masturbation or adultery. 27 were classified as "avoidant masturbators," meaning they masturbated (typically with porn use) one or more hours per day or more than 7 hours per week. 71% reported sexual functioning problems, with 33% reporting delayed ejaculation (a precursor to porn-induced ED). What sexual dysfunction do 38% of the remaining men have? The study doesn't say, and the authors have ignored requests for details. Two primary choices for male sexual dysfunction are ED and low libido. The men were not asked about their erectile functioning without porn. If all their sexual activity involved masturbating to porn, and not sex with a partner, they might never realize they had porn-induced ED.

7) Altered Appetitive Conditioning and Neural Connectivity in Subjects With Compulsive Sexual Behavior (2016) - "Compulsive Sexual Behaviors" (CSB) means the men were porn addicts, because CSB subjects averaged nearly 20 hours of porn use per week. The controls averaged 29 minutes per week. Interestingly, 3 of the 20 CSB subjects mentioned to interviewers that they suffered from "orgasmic-erection disorder," while none of the control subjects reported sexual problems.

8) Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn (2014) - A Max Planck study which found 3 significant addiction-related brain changes correlating with the amount of porn consumed. It also found that the more porn consumed the less reward circuit activity in response to brief exposure (.530 second) to vanilla porn. In a 2014 article lead author Simone Kühn said:

"We assume that subjects with a high porn consumption need increasing stimulation to receive the same amount of reward. That could mean that regular consumption of pornography more or less wears out your reward system. That would fit perfectly the hypothesis that their reward systems need growing stimulation."

A more technical description of this study from a review of the literature by Kuhn & Gallinat - Neurobiological Basis of Hypersexuality (2016).

"The more hours participants reported consuming pornography, the smaller the BOLD response in left putamen in response to sexual images. Moreover, we found that more hours spent watching pornography was associated with smaller gray matter volume in the striatum, more precisely in the right caudate reaching into the ventral putamen. We speculate that the brain structural volume deficit may reflect the results of tolerance after desensitization to sexual stimuli."

9) Sexual Desire, not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images (2013) - This EEG study was touted in the media as evidence against the existence of porn addiction. Not so. In line with the Cambridge University brain scan studies, this EEG study reported greater cue-reactivity to porn correlated with less desire for partnered sex. To put another way - individuals with more brain activation and cravings for porn would rather masturbate to porn than have sex with a real person. Study spokesman Nicole Prause claimed that porn users merely had high libido, yet the results of the study say something quite different. Three peer-reviewed papers expose the truth: 1, 2, 3. Also see the extensive YBOP critique.

10) Modulation of Late Positive Potentials by Sexual Images in Problem Users and Controls Inconsistent with "Porn Addiction" (2015) - Another Nicole Prause EEG study. This time comparing the 2013 subjects from the above study to an actual control group. The results: compared to controls, "porn addicts" had less response to one-second exposure to photos of vanilla porn. The lead author, Nicole Prause, claimed these results debunk porn addiction. However, these findings align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Put simply, frequent porn users were desensitized and needed greater stimulation to achieve the same buzz. Four peer-reviewed papers say that Prause findings indicate desensitization, and addiction-related phenomenon: 1, 2, 3, 4 (also see this extensive YBOP critique). By the way, another EEG study found that greater porn use in women correlated with less brain activation to porn.

11) Unusual masturbatory practice as an etiological factor in the diagnosis and treatment of sexual dysfunction in young men (2014) – One of the 4 case studies in this paper reports on a man with porn-induced sexual problems (low libido, fetishes, anorgasmia). The sexual intervention called for a 6-week abstinence from porn and masturbation. After 8 months the man reported increased sexual desire, successful sex and orgasm, and enjoying “good sexual practices. This is the first peer-reviewed chronicling of a recovery from porn-induced sexual dysfunctions. Excerpts from the paper:

"When asked about masturbatory practices, he reported that in the past he had been masturbating vigorously and rapidly while watching pornography since adolescence. The pornography originally consisted mainly of zoophilia, and bondage, domination, sadism, and masochism, but he eventually got habituated to these materials and needed more hardcore pornography scenes, including transgender sex, orgies, and violent sex. He used to buy illegal pornographic movies on violent sex acts and rape and visualized those scenes in his imagination to function sexually with women. He gradually lost his desire and his ability to fantasize and decreased his masturbation frequency."

In conjunction with weekly sessions with a sex therapist, the patient was instructed to avoid any exposure to sexually explicit material, including videos, newspapers, books, and internet pornography.

After 8 months, the patient reported experiencing successful orgasm and ejaculation. He renewed his relationship with that woman, and they gradually succeeded in enjoying good sexual practices.

12) Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries (2015) - Survey reported a strong correlation between erectile dysfunction and measures of hypersexuality. The study omitted correlation data between erectile functioning and pornography use, but noted a significant correlation. An excerpt:

Among Croatian and German men, hypersexuality was significantly correlated with proneness to sexual boredom and more problems with erectile function.

13) Masturbation and Pornography Use Among Coupled Heterosexual Men With Decreased Sexual Desire: How Many Roles of Masturbation? (2015) - Masturbating to porn was related with decreased sexual desire and low relationship intimacy. Excerpts:

"Among men who masturbated frequently, 70% used pornography at least once a week. A multivariate assessment showed that sexual boredom, frequent pornography use, and low relationship intimacy significantly increased the odds of reporting frequent masturbation among coupled men with decreased sexual desire."

"Among men [with decreased sexual desire] who used pornography at least once a week [in 2011], 26.1% reported that they were unable to control their pornography use. In addition, 26.7% of men reported that their use of pornography negatively affected their partnered sex and 21.1% claimed to have attempted to stop using pornography."

14) Use of pornography in a random sample of Norwegian heterosexual couples (2009) - Porn use was correlated with more sexual dysfunctions in the man and negative self perception in the female. The couples who did not use porn had no sexual dysfunctions. A few excerpts from the study:

In couples where only one partner used pornography, we found more problems related to arousal (male) and negative (female) self-perception.

In those couples where one partner used pornography there was a permissive erotic climate. At the same time, these couples seemed to have more dysfunctions.

The couples who did not use pornography... may be considered more traditional in relation to the theory of sexual scripts. At the same time, they did not seem to have any dysfunctions.

Couples who both reported pornography use grouped to the positive pole on the ‘‘Erotic climate’’ function and somewhat to the negative pole on the ‘‘Dysfunctions’’ function.

15) Lecture describing upcoming studies - by Urology professor Carlo Foresta, president of the Italian Society of Reproductive Pathophysiology - The lecture contains the results of longitudinal and cross-sectional studies. One study involved a survey of high school teens (pages 52-53). The study reported that sexual dysfunction doubled between 2005 and 2013, with low sexual desire increasing 600%.

  • The percentage of teens that experienced alterations of their sexuality: 2004/05: 7.2%, 2012/13: 14.5%
  • The percentage of teens with low sexual desire: 2004/05: 1.7%, 2012/13: 10.3% (that's a 600% increase in 8 years)

Foresta also describes his upcoming study, "Sexuality media and new forms of sexual pathology sample 125 young males, 19-25 years" (Italian name - "Sessualità mediatica e nuove forme di patologia sessuale Campione 125 giovani maschi"). The results from the study (pages 77-78), which used the International Index of Erectile Function Questionnaire, found that regular porn users scored 50% lower on sexual desire domain and 30% lower of the erectile functioning domain.

16) (not peer-reviewed) Here's an article about an extensive analysis of comments and questions posted on MedHelp concerning erectile dysfunction. What's shocking is that 58% of the men asking for help were 24 or younger. Many suspected that internet porn could be involved as described in the results from the study -

The most common phrase is “erectile dysfunction” – which is mentioned more than three times as often as any other phrase – followed by “internet porn,” “performance anxiety,” and “watching porn.”

Clearly, porn is a frequently discussed subject: “I have been viewing internet pornography frequently (4 to 5 times a week) for the past 6 years,” one man writes. “I am in my mid-20s and have had a problem getting and maintaining an erection with sexual partners since my late teens when I first started looking at internet porn.”


 

THE EXPERIMENT - "UNEXPLAINED CHRONIC ED IN YOUNG MEN AND REMOVAL OF A SINGLE VARIABLE"

This ongoing experiment examining porn-induced ED is valid, reproducible, and empirical.

The Subjects:

  1. Thousands of otherwise healthy young men (ages 16 -35), with only one variable in common: Years of masturbation to Internet porn.
  2. The subjects differ in backgrounds, ethnicity, diets, exercise regimens, religious beliefs, moral beliefs, country of origin, education, economic status, on & on.
  3. These young men cannot achieve an erection without porn use, and gradually, some can no longer achieve an erection with porn use.
  4. Many have seen multiple health-care practitioners and all have tried a number of approaches to cure their copulatory ED with no results.
  5. Most state that they cannot believe that porn use could have caused ED. Some are very skeptical prior to starting their experiment of giving up masturbation to porn.
  6. The cause of their ED was not performance anxiety as they failed to achieve full erections while attempting to masturbate without porn (How do I know if my ED is porn-related? (TEST)

The regimen:

  1. All eliminate porn use.
  2. Most (but not all) eliminate, or drastically reduce, the frequency of masturbation.

The results:

Nearly every subject reports a similar constellation of physical and psychological symptoms when they stop porn use/masturbation, and a similar time-frame for the appearance of symptoms such as agitation, cravings, complete loss of libido. Recovery times vary: Between 2006-2010 most only needed 2-3 months, but length of recoveries have steadily increased over the last few years. Some now need 6-12 months or longer. All this suggests a very specific set of physical brain changes, and not a psychological "issue." The usual pattern of recovery is as follows:

  1. Subjects experience varying withdrawal symptoms that parallel drug/alcohol withdrawal, such as cravings, anxiety, lethargy, depression, brain fog, sleeping abnormalities, restlessness, agitation, aches, pains, etc.
  2. Within 1-2 weeks, most subjects experience what is called "the flatline": low libido, perceived changes in genital sensation or size.
  3. The flatline slowly abates and libido gradually increases, morning erections and spontaneous erections often show up, attraction to real partners increases, etc. Bursts of hyper-arousal are not uncommon before their libido regains its balance.
  4. If the men stick to the regimen, nearly all regain erectile health.
  5. Lengths of full recovery vary from a few weeks to several months. Most are in the 2-9 months range for chronic, long-standing ED.

Summary:

Young healthy men, with unexplained ED and only one variable in common (Internet porn use), attempt multiple regimens and treatments with no success. The subjects remove the one variable they have in common and almost all experience the same results - remission of their medical condition.

That's an experiment with unequivocal results. This is empirical evidence, and probably the best empirical evidence available under the circumstances.

Bottom line:

I have yet to see one naysayer address the ACTUAL FACTS as described. In debating the existence of porn-induced ED, doubters go no further than this point:

  • Some guys who watch Internet porn develop ED - so - "correlation does not equal causation."

They refuse to venture into the rest of the facts, such as:

  1. All subjects had been using porn for years with no problems getting erections to porn.
  2. Few report any moral or religious misgivings, or guilt, surrounding their porn use.
  3. Subjects experienced a gradual decline in sexual function - often over the course of years.
  4. Subjects could not attain an erection without porn, but many could with porn.
  5. Many subjects had seen medical professionals, and had tried various therapies or regimens - with no success.
  6. When they abstained, nearly all subjects experienced similar psychological and physical symptoms - many of which mimic withdrawal from an addiction.
  7. The clincher: All had only one variable in common. When that single variable was removed (masturbation to porn) - nearly all regained erectile health.  (If they did not regain erectile health and libido, the cause of their ED was likely not porn use.)
  8. Subjects who recover and regain erectile health and then return to regular porn use eventually report a return of ED, once again demonstrating causation.

 

Comments

The phonies trying to look sophisticated by saying, "It's not a real study" don't even understand science to begin with. They're not arguing in good faith, they're just trying to maintain the pro-porn status quo and look smart. As soon as I hear the words, "peer review", I tune out because I know the people saying it don't understand it. (Peer review in theory is perfect: all studies are subject to eternal disproving and scrutiny. Peer review in the pop science community ranges from weak to outright bunk for too many reasons to cite here.)

I predict that, ultimately, as the great work of Gary and others continues to spread through grassroots communication, I'm sure that our good friends in the mainstream media will be forced to come up with some trick - some "peer reviewed scientific" study from the Harvard Medical School or what-have-you - which will "prove" that porn is good and healthy (they'll use misdirection to pacify porn critics and say something like, "Porn of variety ABC is bad, but studies show that all other porn helps spark sex lives and prevent prostate cancer.")

When these bogus "scientific studies" start getting airplay, the gullible, fearful useful idiots now mocking YBOP and NoFap will just always point to that. "Here is REAL science!" (As a parallel, last year there was a hugely-publicized HMS study revealing how "deadly" red meat was. The study was totally bogus, but it has the veneer of "real science", and most don't bother investigating beyond that.)

But what is happening right now with NoFap is indeed a REAL experiment. And, of course, the most important experiment that the average male can do is the n=1 experiment on himself.

And, of course, the most important experiment that the average male can do is the n=1 experiment on himself.

This what we say over and over again. What is the possible harm in eliminating porn for 90 or 180 days...or?

This is not a new post. It's just the tail end of the ED & Porn start here article: START HERE: Porn-Induced Sexual Dysfunction

I got so tired of the empty "Pseudoscience" rhetoric surrounding porn-induced ED, that I thought I would give this section its own page.

Any guys out there who feel bewildered and wary should read this article when they're feeling down. It inculcates a sense of assurance which is what we all need....repetition, repetition to remind us all that PMOing will just continue to be a setback....even though relapses are common.