START HERE: Porn-Induced Sexual Dysfunction
YBOP suggests you see a competent medical professional to rule out psychological issues, dietary deficiencies, hormonal imbalances, or other organic causes.
- If you haven't already, watch this video by Gabe Deem: The Basics Of Rebooting
- Watch this 13 minute video blog: Porn-Induced ED Reboot Advice Vlog: Gabe Deem (9 months to have sex, 15 months to get an erection by my own touch alone)
- A 3-minute video - "Did Porn Cause My Erectile Dysfunction? TAKE THE TEST!" (by Gabe Deem)
- You should also read Rebooting Basics.
- Many experts are starting to recognize this recent phenomenon. See - Experts who recognize porn-induced sexual dysfunctions, including PIED which contains studies, articles, blog posts, and radio & TV interviews.
- Peer-reviewed review of the literature - Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016)
Are you a porn user who is developing erectile dysfunction? There may be a connection between the two. When we first started chronicling men recovering from porn-induced erectile dysfunction we witnessed two main patterns of recovery:
- A few men bounce back in a relatively short time: about 2-3 weeks. Perhaps their ED is due to mild sexual conditioning accompanied by increasing habituation to online porn. Perhaps high levels of masturbation (fueled by porn), played a role.
- The vast majority of guys we encountered needed only 2-3 months to fully recover.
Around 2011 - 2012 things started to change. That's when men in their twenties, who grew up using internet porn, reported needing several months to fully recover. Some needed up to a year to regain normal erectile functioning. A few need even longer. We suspected that the invention of porn tube sites, circa 2006, may have been the game changer. Aligning with what young men were reporting on forums, studies assessing young male sexuality since 2010 have reported historic levels of erectile dysfunction, and startling rates of a new scourge: low libido.
Most "long-rebooters" experience a variety of withdrawal symptoms, including the dreaded flatline. It's likely that men in this group have experienced addiction-related changes that reduce stimulation of the brain's erection centers. Without a doubt, sexual conditioning is the second mechanism responsible for PIED, especially among young guys who started early on Internet porn
Many men cannot believe that Internet porn has caused their ED—until they stop using it and recover completely. Instead, men tend to assume their ED with a sexual partner is caused by anxiety, low testosterone, the fact the person is not their "type," or lifestyle factors such as smoking or poor diet. If you are under 40, and not on specific medications, and don't have a serious medical or psychological condition, your copulatory ED almost certainly arises from performance anxiety or Internet porn—or a combination of the two.
Note: We use the term porn-induced sexual dysfunction because porn-related performance problems encompass far more than just ED (see the list below). However, porn-induced erectile dysfunction has emerged as the most common term with PIED as the favored acronym.
Wondering if your problem is porn-related?
Forum member: How are people so unaware of PIED? There are ads for boner pills all over every page of every porn website. The porn company profits on every click you make along the way to breaking your dick (and they KNOW you are breaking your dick, thus all the boner pill ads everywhere) and then they profit off your boner pill clicks as well. It's rather like Philip Morris, while profiting off of your online cigarette orders, having ads for Chronic Obstructive Pulmonary Disease meds and lung transplants all over the same pages that are selling you the cigarettes, and then profiting again off the clicks you make on behalf of your ruined lungs.
The first bit of advice is to see a good doctor to rule out any medical abnormality. If you have done so, try this simple test. It will help to distinguish between porn-induced ED and performance anxiety-induced ED (the most common diagnosis):
- On one occasion masturbate to your favorite porn (or simply remember what it was like).
- On another masturbate with no porn/porn fantasy. Try masturbating to sensation only (no fantasy), with the same speed and pressure you would experience during intercourse.
Compare one and two: quality of your erection, the time it took to ejaculate (if you can). A healthy young man should have no trouble attaining a full erection and masturbating to orgasm without porn or porn fantasy.
- If you have a strong erection on #1, but erectile dysfunction on #2, then you likely have porn-induced ED.
- If #2 is strong and solid, but you have trouble with a real partner, then you likely have anxiety-induced ED
- If you have problems during both 1 & 2, you may have severe porn-induced ED, or an organic problem. When in doubt, see a good doctor.
The above test is helpful to differentiate porn-induced ED from performance anxiety: You cannot have anxiety with your own hand. However, it cannot always differentiate between organic ED (hormonal, structural) and severe porn-induced ED - as many men with porn-induced ED cannot maintain an erection even with porn. This test cannot assess if your ED arises from severe psychological issues such as clinical depression. Nor is the above test meant to assess whether you have recovered from porn-induced ED or not. (See How do I know when I'm back to normal?).
Other symptoms may be associated with porn-induced brain changes:
- Difficulty maintaining an erection when putting on a condom
- Difficulty reaching orgasm with a partner (delayed ejaculation)
- Experiencing greater sexual excitement using porn than with a partner
- Decreasing sensitivity of penis
- Ejaculating when you are only partly erect, or getting totally erect only as you climax
- Needing to fantasize to maintain erection or interest in sexual partner
- Earlier genres of porn are no longer "exciting"
- Declining sexual arousal with a sexual partner(s)
- Losing erection while attempting penetration
- Can't maintain erection or ejaculate with oral sex
Internet porn use can cause chronic ED; "excessive masturbation" or "sexual exhaustion" do not.
Internet porn (or rather its constant novelty) is the cause of chronic porn-induced ED. Excessive ejaculation and "sexual exhaustion" are not. Urologists agree that masturbation cannot cause chronic ED in healthy young men, unless one employs a serious "death grip" or traumatic masturbation techniques. Another myth is that masturbation or orgasm depletes testosterone leading to what many call "sexual exhaustion." All evidence suggests that porn-induced ED has absolutely nothing to do with low blood testosterone levels. (See: Any connection between orgasm, masturbation, and testosterone levels?) A few websites declare that "over-masturbation" leads to sexual exhaustion and fabricate convoluted physiology to convince the reader. I address these claims in Isn't my ED caused by 'sexual exhaustion?'
On the other hand, it's possible that masturbation and orgasm could play an indirect role in porn-induced ED. Frequent ejaculation in animals leads to several brain changes that inhibit dopamine, and thus libido, for several days. Under normal circumstances, sexual satiety (defined differently for each species) leads to males taking a time out from sexual activity. Sexually satiated porn users may override these inhibitory mechanisms by escalating to new genres of porn, or spending more time watching. Using porn to push past "I'm done" signals may lead to desensitization, or eventually the accumulation of DeltaFosB, and resulting epigenetic changes. Without the lure of Internet porn, how many guys would just give it a rest? For more see: Does Frequent Ejaculation Cause A Hangover?
Why now? How different is Internet porn of today from porn of the past? We know of a healthy young man who rarely masturbated, but developed ED by just watching Internet porn: his schedule was to watch porn every day, but to masturbate only once every ten days. Others have developed ED by edging to porn every day, yet only ejaculating every few months.
Internet porn, with or without penile stimulation, keeps dopamine surging. Continued highspeed porn use, not masturbation, is what causes tolerance and escalation to more stimulating genres. Porn is what allows you to override your natural sexual satiation mechanisms and continue to masturbate or edge.
One guy comparing himself to his buddy:
My friend masturbates like 10-15 times a day. Not even exaggerating. He seriously has an addiction, but he thinks its normal. He also doesn't have Internet access, so he never really gets to watch porn either. And he's never had a problem keeping it up in bed. On the other hand, I can't remember the last time I masturbated without looking at porn. But I might masturbate only 4-5 times a week on average. And I have tremendous issues staying hard. At first I thought it was nerves, but after getting more acclimated with sex, I actually found sex to be tiring and boring. Unless the girl was deepthroating me and telling me to choke her, I don't really find sex to be all that great. I'm very desensitized to the female anatomy.
Strictly speaking, you don't have to be watching porn to develop ED:
I know with me I think I got so used to being almost hypnotized by girls online and masturbation, that real girls that I had to interact with in bed just threw me off and I couldn't perform. I'm not even talking about porn, I don't use porn but still look at clothed pictures of women online. Like a lot of other people here, I have relapsed plenty of times. I personally think it DOES have to be all or nothing, no 'little bit here and there.' You may not relapse if you start looking at girls online again, but I'm sure it slows down your reboot. I thought the same thing, that if I look just a little bit every once in awhile it would cumulatively fix me, it didn't.
In the last 20 years, I used to masturbate an average of more than once a day. I was never into porn. And yet, I experience all the symptoms that you guys do.
The problem isn't in your penis, so Viagra won't stop the deterioration even if it can temporarily mask the problem. The solution for PIED is to reboot your brain. For a psychiatrist's explanation of what's going on, here's an excerpt from The Brain That Changes Itself by psychiatrist Norman Doidge.
During the mid- to late 1990s, when the Internet was growing rapidly and pornography was exploding on it, I treated or assessed a number of men who all had essentially the same story. ... They reported increasing difficulty in being turned on by their actual sexual partners, spouses or girlfriends, though they still considered them objectively attractive. When I asked if this phenomenon had any relationship to viewing pornography, they answered that it initially helped them get more excited during sex but over time had the opposite effect. Now, instead of using their senses to enjoy being in bed, in the present, with their partners, lovemaking increasingly required them to fantasize that they were part of a porn script.
Lately we have seen more females describing porn-induced sexual problems:
Porn causing ED in Men/Causing loss of sex drive in women
I am female and I used to watch porn all the time. Mainly because my boyfriend could not get turned on without watching porn first. So he had me watch it with him.For a long time I could not get turned on without watching porn first and then having sex or masturbating. After a while I could not get turned on at all without porn and I could get an orgasm only when I masturbated, but not from sex. I have talked to female friends and some of them can not orgasm from sex but they can when they watch porn. So this does not only affect guys it affect women also.
What's happening in the brain to cause chronic porn-induced ED?
If you prefer a video, watch the YBOP PIED presentation from here up to the 41:00 mark. Three mechanisms appeared to be involved in the development of PIED:
- Conditioning your sexual arousal template to everything associated with your porn use (this occurs with probably everyone)
- Desensitization of the reward system structures (i.e. nucleus accumbens, VTA)
- Alterations regions of the hypothalamus that control erections (i.e. medial preoptic area,paraventricular nucleus)
1) Sexual Conditioning: Chronic porn use conditions your arousal to everything associated with your porn use, such as: being in the position of a voyeur; constant searching and seeking; wanting a endless parade of novel "sexual partners"; clicking from video video to maintain sexual arousal; or the never-ending list of porn-induced fetishes users report. Porn-induced sexual conditioning can manifest as escalation to genres that don't match your original sexual tastes.
With Internet porn you can control your sexual arousal with click of a mouse or a swipe of the finger. However, this doesn't match real sexual encounters. The discrepancy between masturbating to online porn and real sex plays a huge role in PIED. Real sex is touching, being touched, smells, connecting and interacting with a person, all without a voyeur's position. Internet porn is 2-D voyeurism, clicking a mouse, searching, multiple tabs, while only interacting with your hand. To use a sports analogy, which event has your brain been training for? Years of Internet porn use can create a mismatch between what your brain expects, and what you actually encounter during real sex. When expectations are not met, dopamine drops, and so do erections.
Both sexual conditioning and addiction share the same key brain change, occurring in the same structure, which is initiated by the same biological signal. The brain change is called ‘sensitization’ (but full blown addiction involves additional brain changes as well). Sensitization occurs when the brain wires together the sights, sounds, smells, sensations, emotions, and memories associated with a big reward, such as masturbating to porn - creating nerve pathways that can blast our reward center in the future. When activated by cues or triggers, this pathway creates powerful, hard to ignore, cravings. Our most complete article describing this - Why Do I Find Porn More Exciting Than A Partner? (Studies reporting sensitization in porn users: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
One major job of the adolescent brain is to learn all about sex: to rewire itself to the sexual environment. If this sexual environment is primarily masturbating to internet porn, then that's what the brain expects to experience during sexual encounters. Wiring one's sexual response to Internet porn before wiring to real partners (starting early with porn) is a major factor in long reboots for young guys. It's likely that this unfortunate trend is the natural outcome of highly malleable adolescent brains colliding with highspeed (i.e., hyperstimulating) porn. Recent research, revealing both how scientists can condition mammalian sexuality and the unique vulnerability of adolescent brains, supports this hypothesis.
- Watch Adolescent Brain Meets High-speed Internet Porn for more details on adolescents conditioning their sexual arousal to porn
- The following radio shows explain rewiring & escalation: Porn, escalation, tolerance and morphing sexual tastes (show #16) and Porn, sexual conditioning and the adolescent brain (show #17).
2) Reward circuitry desensitization. Both sexual desire and erections are powered by dopamine arising from the brain's reward circuitry. To produce an erection, the dopamine-producing nerve cells in the reward circuitry activate the sexual (libido) centers of the hypothalamus, which in turn activate the erection centers in the spinal cord, which send nerve impulses to the genitalia. With desensitization the reward circuitry becomes the weak link in the erection chain.
With desensitization dopamine and opioids decline, as do certain dopamine receptors and opioid receptors. This leaves the individual less sensitive to pleasure, and "hungry" for dopamine-raising activities/substances of all kinds. Desensitization often manifests as the need for greater and greater stimulation to achieve the same buzz (‘tolerance’). Some porn users spend more time online, prolonging sessions through edging, watching when not masturbating, or searching for the perfect video to end with. Desensitization can also take the form of escalating to new genres, sometimes harder and stranger, or even disturbing. Remember: shock, surprise or anxiety can jack up dopamine. Desensitization can occur without the presence of a full blown addiction - this Max Planck study reported desensitization even in moderate porn users.(Studies reporting desensitization in porn users: 1, 2, 3, 4, 5)
3) Alteration of the hypothalamus sexual centers, which doesn't appear to occur with other addictions. The loss of nocturnal erections (morning wood) suggests the hypothalamic erection centers may be altered in severe PIED, or chronically low libido.
Although all rewards intertwine into overlapping circuits, each natural reward (food, water, love and sex) has its own devoted micro-circuits. With porn-induced ED, I suspect that male sexual centers (hypothalamus) and limbic circuits devoted to sexuality are also affected. Erections require adequate dopamine in the reward circuit and the male sexual centers. Could it be that years of overstimulation down-regulate dopamine signaling and rewire innate sexual circuits? Porn-induced ED in healthy young men, which takes months to reverse, suggests this is likely.
Further support for the "hypothalamus hypothesis" can be extrapolated from a 2012 fMRI study on men "psychogenic ED". Those with psychogenic had atrophy of the reward center (nucleus accumbens) and the male sexual centers within the hypothalamus.
What do guys who successfully recover suggest?
Always keep in mind that about porn-induced ED is on a spectrum. You must judge what's right for you based on your history, symptoms and current situation. Be flexible in your approach. The two main suggestions
1) Eliminate porn, porn substitutes, and recalling the porn you watched. Or to put it another way, eliminate all artificial sexual stimulation.
By artificial I mean pixels, audio and literature. No porn substitutes allowed, such as: surfing pictures on Facebook or dating sites, cruising Craigslist, underwear ads, YouTube videos, "erotic literature", etc. If it's not real life, just say 'no.' It's not so much content as whether you are mimicking the behaviors that wired your brain to need novel, artificial stimulation. See - What stimuli must I avoid during my reboot?
2) Rewire your sexual arousal to real people. While this helps everyone recover, it may be a key component for young men with little or no sexual experience. This does not mean that you need to have sex to "rewire." In fact, slowly getting to know someone is probably the best path. Snuggling, smooching, hanging out, whatever you can do to connect sexual arousal and affection to a real person, may be essential to your recovery. Said one young guy who recoverd from PIED:
Rewiring is just as important as avoiding porn. While it appears that a certain amount of time away from orgasm is needed, this number is not as great as most people think it is.
You see, a common mistake is that people try and tackle the reboot as if it's two separate pieces: reboot, THEN rewire. It's not. You can start rewiring whenever you want. The more rewiring you do, the faster you'll be cured of ED. Some guys have successfully employed fantasizing about sex as a form of rewiring One guy even pretended that his pillow was his girlfriend. See the following:
Sex can be beneficial, although orgasm may cause cravings. Some guys suggest gentle intercourse with no ejaculation, while others mix in ejaculation. If you have ED and decide to orgasm regularly, do not compare yourself to rebooting accounts where guys abstained from orgasm. If you are trying to reboot and have sex with a partner see the following FAQs:
"To Masturbate, or Not to Masturbate, That is The Question"
Short answer - you need to figure this one out for yourself. Logic indicates that you need only eliminate porn to regain erectile health. However, most of the men who recovered from porn-induced ED - and posted rebooting accounts - temporarily eliminated masturbation and drastically reduced frequency of orgasms (even with a partner).
There's also an established history of temporary sexual abstinence by men with porn addiction and those in recovery from sex addiction. Some suggest 90 days, see - No Sex For 90 Days?? - The Sex Fast, Part 1, by Terry Crews. And many rebooters claim that a temporary timeout helps reset their sexual arousal template.
It's possible that men who continue to regularly masturbate and orgasm during their recovery become frustrated at their lack of progress and give up. Maybe ejaculation induces cravings sending them back into porn binges. Since we have very little data on those who continue their previous rate of ejaculation, we can only report the success stories we have.
- Key point 1: Our information comes from those who have posted rebooting accounts. There may be many guys who easily recover while continuing to regularly orgasm
- Key point 2: Longer is not necessarily better, when it comes to complete abstinence from ejaculation. You need to be flexible and monitor the effects of orgasm as you progress in your reboot.
- Key point 3: Some guys with porn-induced ED eventually need to orgasm in order to jump-start their brains after a reboot or extended flatline.
The reality is that some men continue to masturbate or have orgasms with a partner and make decent progress. What makes these guys different? Nearly all started late on Internet porn and had a steady diet of sex or masturbation to fantasy for years before Internet porn. For example:
I'm married, like you. I gave up the P and the M...but not the O's with my lovely wife. We had regular sex throughout my reboot. I still healed just fine. I no longer suffer from ED or PE at all, and my sex life is getting better all the time.
I'd never say my way is the only way. I just know it worked for me. And I ALSO think that I might have healed faster if I had abstained from the O's with my woman for a while...though I will never be sure. In my mind, it was a tradeoff I was willing to make. And it worked out well.
Another way to view porn-induced ED: Sometimes healing involves more than just removing the original cause of the problem. If you break your leg in three places, it takes more to heal than simply avoiding further accidents. You need to cast, immobilize, and not put stress on that leg until the bone is strong. Sexual contact is great, but ejaculation can slow your progress, especially in the beginning.
Back to the analogy: when the leg starts to feel better you don't test it by playing tackle football. In other words, having several orgasms in a row, following months of rebooting, may set you back. Ease into ejaculation. Although you may be functioning OK, most guys report continued progress after erection return.
YBOP is NOT an anti-masturbation website. I need to shout this, because I've read this nonsense on many forums, where discussions over Internet porn causing ED quickly devolve into pro/con masturbation debates. The name of the site is "Your Brain On Porn." Confusion occurs because: 1) this generation sees masturbation and porn use as synonymous, 2) men who recover best from ED do so by also eliminating masturbation/orgasm (temporarily). It's real simple: few men heal porn-induced ED while continuing on a regular masturbation schedule. We do not advocate abstinence as a permanent lifestyle. Note: Those with obsessive compulsive disorder or OCD tendencies who abstain from masturbation may experience increased symptoms. Even temporary abstinence may not be for you.
The last thing you want to do is to become so "anal" that you never attempt to give up porn. Check out this thread on The Orgasm Reboot, and this thread on a cult being developed around masturbation being unhealthy. The take away from both threads is that guys quit trying because they believe that rebooting is all or none. This is complete nonsense. If you fall back into porn use, you have not lost all your gains. Simply begin the process again.
Additional note: Although rebooting and rewiring your brain seem to be the keys, it may also be helpful to keep blood and nitric oxide flowing in the penis. Here's what this man's urologist suggested:
It's part of the same protocol they give to patients who have had a prostectomy. This can also be achieved with the use of a vacuum erection device and probably through kegels and reverse kegels as well. I don't know how important this is for someone with PIED vs vascular forms of ED but it's what my doctor recommended and it seems to be helping. Taking them at a low dose over a period of time also helps to establish a baseline level of nitric oxide to help make erections stronger but that can also be achieved through diet and exercise which I recommend strongly. [NOTE: The longer term effects of becoming reliant on ED meds may not yet be established.)
- Eliminate all artificial sexual stimuli: porn, chat rooms, erotic stories, surfing for pictures, etc.
- Contact with a partner may be essential. It doesn't have to be sexual intercourse, but there is nothing wrong with that.
- Orgasms may slow the process in the beginning, but this depends on multiple variables.
- There comes a point in the process where you need to rewire to real partners or consider masturbation.
- Longer is not necessarily better when it comes to complete abstinence from ejaculation. You need to be flexible and monitor the effects of orgasm as you progress in your reboot.
The return to full erectile health can take 2 - 6 months or longer, so be patient. For more, see How long will it take to recover from Porn-Induced Sexual Dysfunction? Be aware that men report continued improvement long after their initial reboot. Since 2010 a disturbing pattern has emerged: Young men who have been using Internet porn since they began masturbating are requiring a longer recovery period. See the following links:
- Young Porn Users Need Longer To Recover Their Mojo
- Why Shouldn’t Johnny Watch Porn If He Likes?
- Radio Show: Interview - age 25, Porn-induced ED, 9 months to recover.
- Video: TEDx talk by a young man who recovered from PIED and reclaimed his sexuality
In other words, older men who spent years climaxing before delving into highspeed Internet porn recover faster. The older men used their imaginations to wire to real girls, whereas, younger guys have spent years wiring to computer screens and whatever. When it comes to porn-induced ED, waiting and waiting may not be sufficient. As mentioned above, young guys may need to rewire their sexual circuits to flesh and blood humans. This FAQ has many suggestions for those who reboots are taking a long time - Started on Internet porn and my reboot (Erectile Dysfunction) is taking too long.
Some men who have experienced a decline in their sexual responsiveness (without realizing its true cause) are afraid that avoiding masturbation and porn will make their libido disappear completely. It may disappear at first. The process of returning to full erectile strength often involves a decline before it gets better. See HELP! I quit porn, but my potency, genital size, and/or libido are decreasing (Flat-Line)
However, as their brains come back into balance, people tend to become more sensitive and sexually responsive, not less. People also notice that little things turn them on, such as a mere smile from a real woman. Older blog posts which address this phenomenon:
- Porn-Induced Sexual Dysfunction Is A Growing Problem
- Are Porn Tube Sites Causing Erectile Dysfunction?
- As Porn Goes Up, Performance Goes Down?
- How I Recovered from Porn-related Erectile Dysfunction
What is understandably confusing is that guys can get an itch to masturbate while they are experiencing erectile problems. The urge to jerk off is similar as the urge to eat junk food when you are obese. It may be addiction response to 1) reduced dopamine signaling which leaves you unsatisfied, plus 2) sensitized addiction pathways bombarding the reward circuit with "do it" messages. In a guy with porn-induced ED, this buzzing of your reward circuit isn't true libido; it's a cue-induced, drug-like craving. For years, have simply ignored their true libido (when it signaled, "Enough!"). The urge to use was an urge triggered by cues revving up sensitized porn pathways.
Is an obese person who finished a large meal 2 hours ago truly hungry? No. But they still have room for dessert. Would a severely overweight person eat as many calories if she had only a hunter-gather diet of wild game, nuts and occasional berries? Of course not. When porn users remove the superstimulus (Internet porn) and go through a full reboot, they eventually discover their true libido,
For first-hand accounts of erectile dysfunction recovery see the links here. See Rebooting Accounts Page 1 and Rebooting Accounts Page 2 many more longer recovery stories. The "Benefits" PDF document contains many mini-self-reports, and we update it periodically. Here's a pep talk from a guy who recovered to another guy who, 15 days into recovery, had "absolutely no sex drive or erections":
This is normal. Hang in there. You probably are getting night erections (and morning erections) you just don't realise. If you wake up to an alarm, try waking up naturally. This will make sure you wake up just after the REM cycle and you'll still have your nocturnal wood. This might restore some faith in your penis. Best thing you can do though is give it time. Your body is amazingly adaptable and will restore balance eventually.
Porn-related erectile dysfunction, copulatory impotence (can get erect with today's porn, but not with partner) and delayed ejaculation are becoming more and more common, probably due to the extreme stimulation of the brain inherent in Internet porn. (See: He’s Just Not That Into Anyone.) Yet these conditions are certainly not "normal" in young men.
Here are signs that you are coming back to normal. Said one guy,
I think a sign that your equipment will start to work right, is when you see sexual images or semi-sexual images of folks on TV, and you feel tinglings in your brain, that's a sign you are starting to re-sensitize yourself to normal.
Please note: People here often recover their erectile health and can have healthy sex with a partner. However, recovery does not mean you will be able to go back to using porn without desensitizing your brain anew. As one forum member said:
My story began with porn-related ED: going soft inside a woman or after changing positions. Once I hit 3-4 weeks, my morning and random erections became very hard and frequent. I thought I must "test" myself to make sure everything is working. Trust me when I say, "There is no need to test; it is indeed working." I tested myself and ended up relapsing. First it was MO, then PMO... then the vicious cycle began all over again.
ADDENDUM: My response to those who doubt the existence of PIED
In 2011, the head of the Italian Society of Andrology and Sexual Medicine (SIAMS) stated that porn-induced ED exists. SIAMS is the largest urology organization in Italy. More important, their president reports that the clinic he's part of cures the disorder by having guys stop porn use for 2-3 months. For the record, we were writing articles about porn-induced ED years before SIAMS statements appeared. 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.
Second, recent studies show a dramatic increase in ED and low sexual desire among young men. Since the advent of the internet ED rates in men under 40 went from 2% in 1992 to around 30% today. Rates of low libido have also soared. All documented in this article - Research confirms sharp rise in youthful ED.
Third, 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, 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:
1) "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, yet could achieve erections with porn. From the study:
"CSB subjects reported that as a result of excessive use of sexually explicit materials..... 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."
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 correlated with less reward circuit activity in response to brief exposure (.530 second) to vanilla porn. Again, lead author Simone Kühn remarked on the uncharacteristic sluggish response to sexual stimuli seen in heavy porn users-
"That could mean that regular consumption of pornography more or less wears out your reward system."
Simone Kühn continued:
"We assume that subjects with a high porn consumption need increasing stimulation to receive the same amount of reward. That would fit perfectly the hypothesis that their reward systems need growing stimulation."
3) "Modulation of Late Positive Potentials by Sexual Images in Problem Users and Controls Inconsistent with "Porn Addiction" (2015)" - An EEG study comparing the subjects from an earlier study by the same research lab 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, claims 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. In other words, "porn addicts" appear to be desensitized and to need greater stimulation than non-addicts to become aroused. Three peer-reviewed papers agree with this analysis of the study.
4) "Adolescents and web porn: a new era of sexuality (2015)" - An Italian study analyzed the effects of Internet porn on high school students, 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).
5) "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. What sexual dysfunction do 38% of the remaining men have? The study doesn't say, and the authors have publicly dismissed requests for ED rates. The two other primary choices for male 'sexual dysfunction' are ED and low libido.
6) 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.
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 suffered from "orgasmic-erection disorder," while none of the control subjects reported sexual problems.
8) (not peer-reviewed) Here's a popular 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 in their dysfunction, as described in the results from the study -
EXCERPT: 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 ONGOING EXPERIMENT: "UNEXPLAINED CHRONIC ED IN YOUNG MEN AND ALTERATION OF A SINGLE COMMON VARIABLE"
This ongoing experiment examining porn-induced ED is valid, reproducible, and empirical.
- Thousands of otherwise healthy young men (early 20s at the moment...) with only one variable in common: years of masturbation to Internet porn.
- The subjects differ in backgrounds, ethnicity, diets, exercise regimens, religious beliefs, moral beliefs, country of origin, education, economic status, on and on.
- These young men cannot achieve an erection without porn use, and gradually, some can no longer achieve an erection with porn use.
- Many have seen multiple health-care practitioners and most have tried a number of approaches to cure their copulatory ED with no results.
- 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.
- 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)
- All eliminate porn use.
- Most (but not all) temporarily eliminate, or drastically reduce, the frequency of orgasms.
Nearly every subject reports a similar constellation of physical and psychological symptoms when they stop porn use/masturbation, a similar time-frame for the appearance of symptoms such as agitation, cravings, complete loss of libido, gradual recovery, and need 2-6 months (or longer) to regain erectile function. This suggests a very specific set of physical brain changes, and not a psychological "issue." The usual pattern of recovery is as follows:
- 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.
- Within 1-2 weeks, most subjects experience what is called "the flatline": low libido, perceived changes in genital sensation or size.
- The flatline slowly abates and libido gradually increases, morning erections and spontaneous erections often show up, attraction to real partners increases, etc.
- Lengths of full recovery generally vary from a few weeks to over 12 months. Most are in the 2-9 month range for chronic, longstanding ED.
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.
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:
- All subjects had been using porn for years with no problems getting erections early on.
- Few report any moral or religious misgivings, or guilt, surrounding their porn use.
- Subjects experienced a gradual decline is sexual function, often over the course of years.
- Many subjects had seen medical professionals, and had tried various therapies or regimens, with no success.
- Subjects could not attain an erection without porn, but many could with porn.
- When they abstained, most subjects experienced similar psychological and physical symptoms, which mimic withdrawal from a substance addiction.
- 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.)
- Men who regain erectile health and then return to regular porn use, experience a return of ED, once again settling the issue of causation.