Porn-induced ED: Empirical Evidence (what we say to "skeptics")

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Introduction

Studies assessing young male sexuality since 2010 report historic levels of sexual dysfunctions, and startling rates of a new scourge: low libido. Documented in this lay article and in this literature review by the US Navy. Erectile dysfunction rates in these recent studies range from 14 to 33%, while rates for low libido (hypo-sexuality) range from 16% to 37%. The lower ranges are taken from studies involving teens and men 25 and under, while the higher ranges are from studies involving men 40 and under.

Prior to the advent of free streaming porn, cross-sectional studies and meta-analysis consistently reported erectile dysfunction rates of 2-5% in men under 40. That's nearly a 1000% increase in youthful ED rates in the last 15 years. What variable has changed in the last 15 years that could account for this astronomical rise? Only internet porn. The extensive recent US Navy review "Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports" addresses all the other suggested causes for this tremendous rise in youthful ED. It also takes on the research that claims to "disprove" the existence of porn-induced sexual dysfunctions.

Its authors warned that that internet pornography’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of porn use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal drops.

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.

Since 2011 more than 100 other experts have jumped on the bandwagon. Urology professors, urologists, psychiatrists, psychologists, sexologists, MDs and others now acknowledge (and many have successfully treated) porn-induced ED and porn-induced loss of sexual desire. In 2016, Belgian researchers reported that problematic porn use was associated with more cravings, but lower overall sexual satisfaction, and lower erectile function.

One of the most interesting papers to come out since the above-mentioned US Navy review was by a French psychiatrist and president of the largest European sexology organization Robert Porto, MD. Doctor Porto noted that masturbation accompanied by cyber-pornography use, “has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation.” And that, "masturbation in its excessive and pre-eminent form, generally associated today to pornographic addiction, is too often overlooked in the clinical assessment of sexual dysfunction it can induce."

He reported on 35 patients with these dysfunctions. 19 of them experienced improvements after treatment to “unlearn” their masturbatory habits. According to Dr. Porto, “The dysfunctions regressed and these patients were able to enjoy satisfactory sexual activity.” Interestingly, even porn users who are not addicted can be at risk for developing porn-related sexual dysfunctions. Only one quarter of his patients were assessed as addicts.

Urologists are also speaking up. In 2016 Dr. Tarek Pacha delivered a presentation to his fellow doctors at the American Urological Association’s annual conference, entitled “Pornography induced erectile dysfunction (PIED): Understanding the scope, science, and treatment.” And in 2017, Navy doctors presented at the American Urological Association's annual conference warning that young men who prefer pornography to real-world sexual encounters might find themselves caught in a trap, unable to perform sexually with other people when the opportunity presents itself.

An extensive list of relevant studies are briefly described below.

Naysayers suggest that we need more 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 the ideal study, in which 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 practical 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, as has been done in multiple case studies, as reported above. See this peer-reviwed paper by Gary Wilson: Eliminate Chronic Internet Pornography Use to Reveal Its Effects (2016).

This eliminate-porn-and-see experiment is the one that is being conducted informally by thousands of guys in internet recovery forums across the world - with thousands of results now reported.  Regardless of what you may read in some journalistic accounts, multiple studies reveal a link between porn use and sexual performance problems, relationship and sexual dissatisfaction, and reduced brain activation to sexual stimuli.


The experiment - "unexplained chronic erectile dysfunction in young men and the 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.

Is your sexual dysfunction caused by your porn use?

First, get checked out by a urologist to rule out organic problems (vascular, neurological, hormonal, etc.).

Next, from the US Navy review "Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports":

One simple test healthcare providers might employ is to ask, “whether the patient can achieve and sustain a satisfactory erection (and climax as desired) when masturbating without using Internet pornography”. If he cannot, but can easily achieve these goals with Internet pornography, then his sexual dysfunction may be associated with its use. Without employing such a test, there is a risk of false diagnoses of “performance anxiety”, and a consequent risk of prescribing needless psychoactive medications and (ultimately perhaps ineffective) phosphodiesterase-5 inhibitors. Other indications of Internet pornography-related performance difficulties may be loss of nocturnal erections and/or spontaneous erections. Additional  research in this area is warranted.


Studies linking porn use/porn addiction to sexual problems and lower arousal

The first 4 studies demonstrate causation as participants eliminated porn use and healed chronic sexual dysfunctions:

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. Two of the three men healed their sexual dysfunctions by eliminating porn use. The third man experienced little improvement as he was unable to abstain from porn use. Excerpt:

Traditional factors that once explained men’s sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use.

2) Male masturbation habits and sexual dysfunctions (2016) - It's by a French psychiatrist who is the current president of the European Federation of Sexology. While the abstract shifts back and forth between Internet pornography use and masturbation, it's clear that he's mostly referring to porn-induced sexual dysfunctions (erectile dysfunction and anorgasmia). The paper revolves around his clinical experience with 35 men who developed erectile dysfunction and/or anorgasmia, and his therapeutic approaches to help them. The author states that most of his patients used porn, with several being addicted to porn. The abstract points to internet porn as the primary cause of the problems (keep in mind that masturbation does not cause chronic ED, and it is never given as a cause of ED). Excerpts:

Intro: Harmless and even helpful in his usual form widely practiced, masturbation in its excessive and pre-eminent form, generally associated today to pornographic addiction, is too often overlooked in the clinical assessment of sexual dysfunction it can induce.

Results: Initial results for these patients, after treatment to “unlearn” their masturbatory habits and their often associated addiction to pornography, are encouraging and promising. A reduction in symptoms was obtained in 19 patients out of 35. The dysfunctions regressed and these patients were able to enjoy satisfactory sexual activity.

Conclusion: Addictive masturbation, often accompanied by a dependency on cyber-pornography, has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation. It is important to systematically identify the presence of these habits rather than conduct a diagnosis by elimination, in order to include habit-breaking deconditioning techniques in managing these dysfunctions.

3) 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.

4) How difficult is it to treat delayed ejaculation within a short-term psychosexual model? A case study comparison (2017) - A report on two "composite cases" illustrating the causes and treatments for delayed ejaculation (anorgasmia). "Patient B" represented several young men treated by the therapist. Interestingly, the paper states that Patient B's "porn use had escalated into harder material", "as is often the case". The paper says that porn-related delayed ejaculation is not uncommon, and on the rise. The author calls for more research on porn's effects of sexual functioning. Patient B's delayed ejaculation was healed after 10 weeks of no porn. Excerpts:

The cases are composite cases taken from my work within the National Health Service in Croydon University Hospital, London. With the latter case (Patient B), it is important to note that the presentation reflects a number of young males who have been referred by their GPs with a similar diagnosis. Patient B is a 19-year-old who presented because he was unable to ejaculate via penetration. When he was 13, he was regularly accessing pornography sites either on his own through internet searches or via links that his friends sent him. He began masturbating every night while searching his phone for image…If he did not masturbate he was unable to sleep. The pornography he was using had escalated, as is often the case (see Hudson-Allez, 2010), into harder material (nothing illegal)…

Patient B was exposed to sexual imagery via pornography from the age of 12 and the pornography he was using had escalated to bondage and dominance by the age of 15.

We agreed that he would no longer use pornography to masturbate. This meant leaving his phone in a different room at night. We agreed that he would masturbate in a different way….

Patient B was able to achieve orgasm via penetration by the fifth session; the sessions are offered fortnightly in Croydon University Hospital so session five equates to approximately 10 weeks from consultation. He was happy and greatly relieved. In a three-month follow-up with Patient B, things were still going well.

Patient B is not an isolated case within the National Health Service (NHS) and in fact young men in general accessing psychosexual therapy, without their partners, speaks in itself to the stirrings of change.

This article therefore supports previous research that has linked masturbation style to sexual dysfunction and pornography to masturbation style. The article concludes by suggesting that the successes of psychosexual therapists in working with DE are rarely recorded in the academic literature, which has allowed the view of DE as a difficult disorder to treat remain largely unchallenged. The article calls for research into pornography usage and its effect on masturbation and genital desensitisation.

5) 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."

6) 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."

7) 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." (See studies reporting habituation/desensitization to porn and escalation of porn use) 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 problematic 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.

8) 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."

9) 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.

10) The effects of sexually explicit material use on romantic relationship dynamics (2016) - As with many other studies, solitary porn users report poorer relationship and sexual satisfaction. Employing the Pornography Consumption Effect Scale (PCES), the study found that higher porn use was related to poorer sexual function, more sexual problems, and a "worse sex life". An excerpt describing the correlation between the PCES "Negative Effects" on "Sex Life" questions and frequency of porn use:

There were no significant differences for the Negative Effect Dimension PCES across the frequency of sexually explicit material use; however, there were significant differences on the Sex Life subscale where High Frequency Porn Users reported greater negative effects than Low Frequency Porn Users.

11) 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.

12) Men's Sexual Life and Repeated Exposure to Pornography. A New Issue? (2015) - Excerpts:

Mental health specialists should take in consideration the possible effects of pornography consumption on men sexual behaviors, men sexual difficulties and other attitudes related to sexuality. In the long term pornography seems to create sexual dysfunctions, especially the individual’s inability to reach an orgasm with his partner. Someone who spends most of his sexual life masturbating while watching porn engages his brain in rewiring its natural sexual sets (Doidge, 2007) so that it will soon need visual stimulation to achieve an orgasm.

Many different symptoms of porn consumption, such as the need to involve a partner in watching porn, the difficulty in reaching orgasm, the need for porn images in order to ejaculate turn into sexual problems. These sexual behaviors may go on for months or years and it may be mentally and bodily associated with the erectile dysfunction, although it is not an organic dysfunction. Because of this confusion, which generates embarrassment, shame and denial, lots of men refuse to encounter a specialist

Pornography offers a very simple alternative to obtain pleasure without implying other factors that were involved in human’s sexuality along the history of mankind. The brain develops an alternative path for sexuality which excludes “the other real person” from the equation. Furthermore, pornography consumption in a long term makes men more prone to difficulties in obtaining an erection in a presence of their partners.

13) 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."

14) 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. Shockingly, study spokesperson Nicole Prause claimed that porn users merely had "high libido", yet the results of the study say the exact opposite (their desire for partnered sex was dropping in relation to signs of addiction). Five peer-reviewed papers expose the truth: 1, 2, 3, 4, 5. Also see the extensive YBOP critique.

15) 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 (contrary to caims no studies falsify the porn addiction model). 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 to static images of vanilla porn. They were bored (habituated or desensitized). See this extensive YBOP critique. Six peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (a sign of addiction): 1, 2, 3, 4, 5, 6. By the way, another EEG study found that greater porn use in women correlated with less brain activation to porn.

16) 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."

17) 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.

18) 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.

19) An Online Assessment of Personality, Psychological, and Sexuality Trait Variables Associated with Self-Reported Hypersexual Behavior (2015) – Survey reported a common theme found in several other studies listed here: Porn/sex addicts report greater arousabilty (cravings related to their addiction) combined with poorer sexual function (fear of experiencing erectile dysfunction).

Hypersexual" behavior represents a perceived inability to control one's sexual behavior. To investigate hypersexual behavior, an international sample of 510 self-identified heterosexual, bisexual, and homosexual men and women completed an anonymous online self-report questionnaire battery.

Thus, the data indicated that hypersexual behavior is more common for males, and those who report being younger in age, more easily sexually excited, more sexually inhibited due to the threat of performance failure, less sexually inhibited due to the threat of performance consequences, and more impulsive, anxious, and depressed

20) Study sees link between porn and sexual dysfunction (2017) - The findings of an upcoming study presented at the American Urological Association's annual meeting. A few excerpts:

Young men who prefer pornography to real-world sexual encounters might find themselves caught in a trap, unable to perform sexually with other people when the opportunity presents itself, a new study reports. Porn-addicted men are more likely to suffer from erectile dysfunction and are less likely to be satisfied with sexual intercourse, according to survey findings presented Friday at the American Urological Association's annual meeting, in Boston.

"The rates of organic causes of erectile dysfunction in this age cohort are extremely low, so the increase in erectile dysfunction that we have seen over time for this group needs to be explained," Christman said. "We believe that pornography use may be one piece to that puzzle".

21) - Associative pathways between pornography consumption and reduced sexual satisfaction (2017) - This study is found in both lists. While it links porn use to lower sexual satisfaction, it also reported that frequency of porn use was related to a preference (or need?) for porn over people to achieve sexual arousal. An excerpt:

Finally, we found that frequency of pornography consumption was also directly related to a relative preference for pornographic rather than partnered sexual excitement. Participants in the present study primarily consumed pornography for masturbation. Thus, this finding could be indicative of a masturbatory conditioning effect (Cline, 1994; Malamuth, 1981; Wright, 2011). The more frequently pornography is used as an arousal tool for masturbation, the more an individual may become conditioned to pornographic as opposed to other sources of sexual arousal.

22) “I think it has been a negative influence in many ways but at the same time I can’t stop using it”: Self-identified problematic pornography use among a sample of young Australians (2017) - Online survey of Australians, aged 15-29.  Those who had ever viewed pornography (n=856) were asked in an open-ended question: ‘How has pornography influenced your life?’.

Among participants who responded to the open-ended question (n=718), problematic usage was self-identified by 88 respondents. Male participants who reported problematic usage of pornography highlighted effects in three areas: on sexual function, arousal and relationships. Responses included “I think it has been a negative influence in many ways but at the same time I can’t stop using it” (Male, Aged 18–19). Some female participants also reported problematic usage, with many of these reporting negative feelings like guilt and shame, impact on sexual desire and compulsions relating to their use of pornography. For example as one female participant suggested; “It makes me feel guilty, and I’m trying to stop. I don’t like how I feel that I need it to get myself going, it’s not healthy.” (Female, Aged 18–19)

23) Exploring the Relationship Between Erotic Disruption During the Latency Period and the Use of Sexually Explicit Material, Online Sexual Behaviors, and Sexual Dysfunctions in Young Adulthood (2009) - Study examined correlations between current porn use (sexually explicit material - SEM) and sexual dysfunctions, and porn use during "latency period" (ages 6-12) and sexual dysfunctions. The average age of participants was 22. While current porn use correlated with sexual dysfunctions, porn use during latency (ages 6-12) had an even stronger correlation with sexual dysfunctions. A few excerpts:

Findings suggested that latency erotic disruption by way of sexually explicit material (SEM) and/or child sexual abuse may be associated to adult online sexual behaviors.

Furthermore, results demonstrated that latency SEM exposure was a significant predictor of adult sexual dysfunctions.

We hypothesized that exposure to latency SEM exposure would predict adult use of SEM. Study findings supported our hypothesis, and demonstrated that latency SEM exposure was a statistically significant predictor of adult SEM use. This suggested that individuals who were exposed to SEM during latency, may continue this behavior into adulthood. Study findings also indicated that latency SEM exposure was a significant predictor of adult online sexual behaviors.

24) 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.

25) (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.”

Article about the latest spin campaign: Sexologists Deny Porn-induced ED by Claiming Masturbation Is the Problem (2016)

Dubious studies find no such correlations between ED rates and recent hours/frequency of porn use, and make exaggerated claims that their authors have thus "disproven" the existence of porn-induced sexual dysfunctions. It remains to be seen which aspects of porn use are most predictive of sexual dysfunctions. Frequency of use may not be as predictive as some constellation of years of use, age use started, weekly hours of use over time, percentage of climaxes to internet porn, escalation to novel porn genres, development of porn-induced fetishes, gaps in partnered sex, genetics, etc.


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.