Since 2016, an audacious red herring has insinuated itself into the tweets and blogs of some AASECT sexologists: the notion that PIED (porn-induced erectile dysfunction) is caused by masturbation. Without offering any scientific support, this band of porn-apologists has determined to persuade us that porn is not behind the recent rise of coital ED in online porn enthusiasts (Gotta be anything but porn, right?). So far off the mark is the suggestion that waxing the one-eyed wonder weasel is the culprit, that if you see anyone proposing it as the cause of youthful ED you can be confident that you’re dealing with a propagandist pushing a pro-porn agenda (or someone who has been misinformed by such a person).
Why is this claim so, well, fishy? First, true sexuality experts never claim that tugging the slug causes youthful ED. Certainly urologists, the frontline experts in men’s sexual health, don’t. The fact is, virtually no one in the history of modern sexology (save these few brash sexologists) has ever suggested masturbation causes chronic erectile dysfunction in young men.
While these propagandists are purposely vague in describing exactly how stroking the poker might produce chronic ED in otherwise healthy young men, the only logical conclusion is that they’re suggesting that masturbation is causing trauma so severe that those injured cannot achieve an erection. In effect, the propagandists are blaming the tremendous rise in youthful ED on traumatic masturbation. Trouble is, trauma so severe that young men cannot achieve an erection is a type of organic ED (easily diagnosed by healthcare givers). While there are several studies indicating a 500-1000% increase in ED in men under 40, no study suggests severe tissue damage is behind this tremendous rise. There’s absolutely no evidence for such a claim.
Most men with porn-induced ED can still get an erection with porn
Most men with porn-induced ED can achieve an erection and masturbate to climax just fine…as long as they’re viewing internet porn. This fact alone debunks the fairytale that traumatic masturbation habits are behind the tremendous rise in inexplicable ED. If a guy can achieve an erection with porn, but goes limp without it, that’s porn-induced ED. It’s not organic ED.
If you are wondering if your (or your partner’s) sluggish or absent erections during partnered sex are a consequence of porn use, try a test recently proposed by doctors for men under 40 with otherwise unexplained ED:
Observe your erection when masturbating alone with internet porn. On another occasion, try it without porn. If you can easily achieve your goals with internet pornography, but not without it, then your sexual dysfunctions may be associated with its use.
How could “masturbation habits” produce withdrawal symptoms or the “flatline”?
Nearly every man with porn-induced ED reports a similar constellation of physical and psychological symptoms when they stop porn use/masturbation. Most report varying degrees of withdrawal symptoms such as agitation, anxiety, insomnia, lethargy, depression, mood swings, brain fog, and severe cravings to view porn.
Within 1-2 weeks, most men experience what is called the “flatline”: severe loss of libido accompanied by perceived decreases in genital sensation or size. The flatline can last a few weeks to several months. In young men the flatline can be intermittent. In the last 2 years some young men have reported “flatlines” that linger for 1-3 years. How could such symptoms be caused by masturbation? They can’t.
ED isn’t caused by masturbation, but delayed ejaculation might be related to certain habits
Although many young porn users have never cranked the shank without porn, masturbation and porn use must be considered separately in order to reveal the correct etiology (cause) of particular sexual dysfunctions. Delayed ejaculation (difficulty climaxing with a partner), as contrasted with ED, may be partially related to masturbation style, such as edging for hours or death-grip without lube.
However, absent underlying organic or psychological problems, erections and sexual arousal are not problems in youthful masturbators unless they are using porn. Similarly, regardless of masturbation style, conditioning one’s sexuality to aspects of porn viewing can lead to difficulties climaxing with a partner.
It’s vital to keep separate the origins of today’s sexual dysfunctions, lest sufferers overlook the role of supernormally stimulating porn in their difficulties.
Although masturbation has been touted as beneficial for decades, 15 years ago erectile dysfunction rates (with partners) were negligible (2-5%) in sexually active men under 40. Since the advent of streaming porn, researchers report rates as high as 30% in this same age group. Rates of low libido and research correlating porn use with sexual and relationship problems have also soared.
Younger men, who presumably have been polishing the rocket for fewer years than older men, often need longer to recover normal desire for real partners and normal sexual function than men whose sexual template formed prior to the advent of streaming porn in 2007 (regardless of masturbation frequency). This suggests that porn-conditioning, especially in youngsters, is contributing to youthful sexual dysfunctions. A striking bit of evidence that internet porn is the key variable comes from an Italian study in which high school seniors were asked about low sexual desire. 16% of those who used Internet pornography more than once a week reported low sexual desire, compared with 0% in non-consumers.
When has masturbation ever caused a 9-month refractory period in twenty-somethings?
Never. Undaunted by reality, some porn-apologist sexologists assert that unprecedented youthful ED is “just a refractory period” (the brief, natural downtime after ejaculation). Really? Why then are some young men needing months and months without masturbation to porn to recover? Why are they reporting abnormally low attraction for real partners? Why can they get erections to internet porn, but not without it?
Still other sexologists doggedly parrot the outdated assumption that all youthful ED with partners is solely “performance anxiety.” Yet if a young man cannot masturbate without porn in private – but can perform just fine masturbating privately with internet porn, isn’t it a bit premature to conclude his issue is “anxiety about performance?” Is he “anxious when performing” with his own hand?
Where is the scientific evidence to support either of these bald assertions?
Yet another AASECT sexologist writes that to find out what’s really going on he, “would like to see a study where young men watch porn and don’t masturbate.” What can he be thinking? If the goal is to find out what’s really going on, wouldn’t a better study design compare internet porn users with ED to men who have never (or very rarely) used internet porn when masturbating?
Or even better, have young porn users with unexplained ED eliminate porn use for an extended time and monitor the results (compared with porn-using controls). If their ED remits, then porn is the cause. That’s what researchers did in the first few studies on this page. In line with these studies, YBOP has collected thousands self-reports by men who have healed sexual dysfunctions by giving up internet porn.
There is no support whatsoever for the claim that the “real” problem behind unprecedented youthful ED is masturbation rather than online (or VR) porn. Physiologically, how could good ole do-it-yourself pleasuring explain changes in some users’ sexual templates that are so profound that encounters with real partners are no longer arousing? How could they explain the alarmingly long recovery times some young men are reporting?
Stubborn, undesired alterations to biological arousal patterns indicate the presence of alterations to the sexual centers of the brain. Masturbation mechanics alone can’t account for them. Those affected have, in effect, inadvertently re-conditioned their sexuality (retrained their brains) by means of today’s supernormally stimulating streaming (and virtual reality) porn.
In contrast to the “masturbation causes ED” theory, there’s considerable scientific support for the “sexual template altered by supernormally stimulating porn” hypothesis. See the next section, and the list on this page.
What do responsible experts say?
Medical doctors around the world are addressing the reality of porn’s influence, reporting the difficulties their patients are facing, and theorizing about how such grave, unprecedented sexual dysfunctions could develop in men under 40. Consider the following:
- In a 2016 paper published in Sexologies psychiatrist Robert Porto, MD, President of the European Federation of Sexology, stated (repeatedly) that masturbation is, “harmless and even helpful.” However, when excessive and accompanied by cyber-pornography use, it “has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation.” Porto’s study reports on 35 patients with these severe sexual dysfunctions, 19 of whom regained satisfactory sexual activity after extensive treatment. Incidentally, porn users who are not addicted are also at risk for developing porn-related sexual dysfunctions.
- Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016), a team of doctors, including both urologists and psychiatrists, reviewed extensive scientific literature as well as three case reports. Citing internet porn’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) they proposed that it may be potent enough to condition sexual arousal to aspects of internet porn use that do not readily transition to real-life partners. The doctors suggested further study of key brain changes associated with addition/sexual conditioning using comparisons of viewers with abstaining viewers. (Note: this paper also formally critiques two sexology papers purporting to “debunk” porn-induced ED.)
- Urologist Tarek Pacha delivered a presentation to his fellow doctors at the American Urological Association’s 2016 annual conference in San Diego, CA, entitled, “Pornography induced erectile dysfunction (PIED): Understanding the scope, science, and treatment.”
- To date, 100+ studies link porn use to sexual problems, lower arousal to sexual stimuli, and poorer sexual and relationship satisfaction.
- In addition to the above studies, this page contains articles and videos by over 140 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.
- Below this piece, you can see an excerpt and discussion about a review by a neuroscientist/MD, which demonstrates why “controlling for masturbation” is unnecessary.
Growing evidence suggests that men under 40 with unprecedented, otherwise unexplained ED have conditioned their climaxes to aspects of internet/virtual-reality porn that have little to do with partnered sex. Again, porn characteristics such as effortless escalation to more extreme material during a viewing session, unending novelty, hyper-arousing delivery formats and so forth, are altering some brains’ sexual templates in ways that cause major sexual dysfunctions, and are challenging to reverse.
There’s also growing evidence that heavy porn users show more evidence of “desensitization,” that is blunted sexual responsiveness. In fact, it’s not unusual for those who recover (by leaving digital porn behind) to report that orgasm and sexual activity begin to feel more pleasurable. Before they quit, it’s likely much of their arousal comes from anticipation of using (in response to cues associated with porn use) and seeking sexual novelty – rather than masturbation itself (which many report is easier to quit than porn-viewing). In addicts, dopamine rises higher for cues than it does for actual use. This can drive escalation in digital porn users.
In short, it’s the search for a buzz that drives overuse (and related problems). And that buzz increasingly comes from porn cues and porn-seeking – not from masturbation (in heavy users). This reality reveals the shortsightedness of the suggestion that “whacking it is the problem.”
This current campaign to confuse porn consumers about the underlying cause of their ED is being carried out by pro-porn sexologists, including some trained at the Kinsey Institute. Ironically, it was Kinsey sexologists who first recognized and publicized the phenomena of porn-induced low desire and reduced sexual responsiveness!
In 2007, Kinsey researchers reported that half of subjects recruited from bars and bathhouses, where video pornography was “omnipresent,” were unable to achieve erections in the lab in response to video porn. In talking to the subjects, researchers discovered that high exposure to pornography videos apparently resulted in lower responsivity and an increased need for more extreme, specialized or “kinky” material to become aroused. The researchers even redesigned their study to include more varied clips and permit some self-selection. A quarter of the participants’ genitals still did not respond normally.
The researchers in that study certainly did not suggest that masturbation style or frequency explained the weak erections! They pointed instead to the omnipresent porn and variety – which was uniquely present in the bars where they gathered their subjects even before streaming online porn was widely available. Sadly, and irresponsibly, they chose not to investigate this unsettling, novel phenomenon further.
Were they and their colleagues so firmly persuaded that “sex positivity” requires pro-porn denial of severe sexual dysfunctions like chronic ED and abnormally low desire that they not only refused to research this phenomenon, but now try to mislead us by insisting that bopping the bologna, not porn use, causes sexual dysfunction?
Bottom line: Humanity urgently needs researchers who will use sound science (and neuroscience) to investigate human sexuality and the effects of today’s unique sexual environment. Not propagandists serving up red herrings.
For now, common sense (and the existing solid research) must serve. As a recovery forum member commented:
How are people so unaware of Porn-Induced ED? 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 pro-porn PhD’s who concocted this unsupported talking point
Plus, this study hasn’t been peer-reviewed or formally published yet, says Nicole Prause, Ph.D., founder of Liberos, a sex research and biotechnology company in Los Angeles.
And there really is no distinction between whether actual porn is causing sexual dysfunction or if the physical act of masturbation is, she points out.
“People aren’t eating popcorn when they watch porn—they’re masturbating. What that means is, whenever you have a behavior that always occurs with another behavior, you cannot separate the effects of the two,” she explains. “They have no reason to say that the effects they observed are due to porn. They could just as well be due to masturbation. They would have to study that specifically, either in an experiment or statistically remove the effects of masturbation.”
On the same day David Ley tweets the following about the same study:
Frequent use of Porn & masturbation CAN affect your Sex life. But cannot “take control” of you. YOU control you.
Ley followed up with another tweet normalizing chronic ED in young men. Ley was responding to a Guardian article about the tremendous rise in youthful erectile dysfunction (porn being alluded to a possible cause):
“Amen. When I treat ED I invite men to consider the world of sex that doesn’t revolve around their dick.”
Unfortunately for Ley’s clients he refuses to consider porn use as a possible cause of ED in young healthy men. Anything but porn.
What’s going on here with Ley and Prause?
Prause is a former academic with a long history of harassing and defaming authors, researchers, therapists, reporters, men in recovery, Journal editors, multiple organizations, and others who dare to report evidence of harms from internet porn use. Prause is obsessed with debunking PIED, having waged a 3-year war against this academic paper, while simultaneously harassing and libeling young men who have recovered from porn-induced sexual dysfunctions. See: Gabe Deem #1, Gabe Deem #2, Alexander Rhodes #1, Alexander Rhodes #2, Alexander Rhodes #3, Noah Church, Alexander Rhodes #4, Alexander Rhodes #5, Alexander Rhodes #6, Alexander Rhodes #7, Alexander Rhodes #8, Alexander Rhodes #9.
She appears to be quite cozy with the pornography industry, as can be seen from this image of her (far right) on the red carpet of the X-Rated Critics Organization (XRCO) awards ceremony. (According to Wikipedia the XRCO Awards are given by the American X-Rated Critics Organization annually to people working in adult entertainment and it is the only adult industry awards show reserved exclusively for industry members.). It also appears that Prause may have obtained porn performers as subjects through another porn industry interest group, the Free Speech Coalition. The FSC subjects were allegedly used in her hired-gun study on the heavily tainted and very commercial “Orgasmic Meditation” scheme. Prause has also made unsupported claims about the results of her studies and her study’s methodologies. For much more documentation, see: Is Nicole Prause Influenced by the Porn Industry?
Nicole Prause, by her own admission, vehemently rejects the concept of porn addiction. For example, a quote from a Martin Daubney article about sex/porn addictions:
Dr Nicole Prause, principal investigator at the Sexual Psychophysiology and Affective Neuroscience (Span) Laboratory in Los Angeles, calls herself a “professional debunker” of sex addiction.
In addition, Nicole Prause’s former Twitter slogan reveals that she lacks the impartiality required for scientific research:
“Studying why people choose to engage in sexual behaviors without invoking addiction nonsense“
It should be noted that Nicole Prause offered (for a fee) her “expert” testimony against “sex addiction”.
It seems as though Prause has been selling her services to profit from the claimed anti-porn addiction conclusions of her two EEG studies (1, 2), even though numerous peer-reviewed critiques say both studies support the addiction model (Steele et al., 2013: 1, 2, 3, 4, 5, 6, 7, 8. Prause et al., 2015: 1, 2, 3, 4. 5, 6, 7, 8, 9.).
David Ley religiously denies both sex and porn addiction, and has written 30 or so blog posts attacking porn-recovery forums, and dismissing porn addiction and porn-induced ED. In a blatant financial conflict of interest, David Ley is being compensated by porn industry giant X-hamster to promote their websites and to convince users that porn addiction and sex addiction are myths! Specifically, David Ley and the newly formed Sexual Health Alliance (SHA) have partnered with a X-Hamster website (Strip-Chat). See “Stripchat aligns with Sexual Health Alliance to stroke your anxious porn-centric brain“:
The fledgling Sexual health Alliance (SHA) advisory board includes David Ley and two other RealYourBrainOnPorn.com “experts” (Justin Lehmiller & Chris Donahue). RealYBOP is a group of openly pro-porn, self-proclaimed “experts” headed by Nicole Prause. This group is currently engaged in illegal trademark infringement and squatting directed toward the legitimate YBOP. Put simply, those trying to silence YBOP are also being paid by the porn industry to promote its/their businesses, and assure users that porn and cam sites cause no problems (note: Nicole Prause has close, public ties to the porn industry as thoroughly documented on this page).
In this article, Ley dismisses his compensated promotion of the porn industry:
Granted, sexual health professionals partnering directly with commercial porn platforms face some potential downsides, particularly for those who’d like to present themselves as completely unbiased. “I fully anticipate [anti-porn advocates] to all scream, ‘Oh, look, see, David Ley is working for porn,’” says Ley, whose name is routinely mentioned with disdain in anti-masturbation communities like NoFap.
But even if his work with Stripchat will undoubtedly provide fodder to anyone eager to write him off as biased or in the pocket of the porn lobby, for Ley, that tradeoff is worth it. “If we want to help [anxious porn consumers], we have to go to them,” he says. “And this is how we do that.”
“Disclosure: David Ley has provided testimony in legal cases involving claims of sex addiction.”
In 2019 David Ley’s new website offered his well-compensated “debunking” services:
David J. Ley, Ph.D., is a clinical psychologist and AASECT-certified supervisor of sex therapy, based in Albuquerque, NM. He has provided expert witness and forensic testimony in a number of cases around the United States. Dr. Ley is regarded as an expert in debunking claims of sexual addiction, and has been certified as an expert witness on this topic. He has testified in state and federal courts.
Contact him to obtain his fee schedule and arrange an appointment to discuss your interest.
Ley also profits from selling two books that deny sex and porn addiction (“The Myth of Sex Addiction,” 2012 and “Ethical Porn for Dicks,” 2016). Pornhub (which is owned by porn giant MindGeek) is one of the five back-cover endorsements listed for Ley’s 2016 book about porn:
Note: PornHub was the second Twitter account to retweet RealYBOP’s initial tweet announcing its “expert” website, suggesting a coordinated effort between PornHub and the RealYBOP experts. Wow!
Finally, David Ley makes money via CEU seminars, where he promotes the addiction-deniers’ ideology set forth in his two books (which recklessly ignores hundreds of studies and the significance of the new Compulsive Sexual Behavior Disorder diagnosis in the World Health Organization’s diagnostic manual). Ley is compensated for his many talks featuring his biased views of porn. In this 2019 presentation Ley appears to support and promote adolescent porn use: Developing Positive Sexuality and Responsible Pornography Use in Adolescents.
The above is just the tip of the Prause and Ley iceberg.
Review by neuroscientist/MD demonstrates why “controlling for masturbation” is unnecessary
As the excerpt below explains neurologically, watching porn is the same as having sex – even if you are not masturbating. This debunks 2 major claims by Prause/Ley:
1) That “porn studies must control for masturbation.” No need to ask about masturbation frequency when watching porn is neurologically akin to masturbation.
2) That “watching porn is really a cue for masturbation.” This is the claim that porn viewing is not the addictive behavior in question; masturbation is the addiction. Why does this matter? Prause’s 2015 EEG study “debunking porn addiction” reported slightly less brain activation in the frequent porn users when viewing images of vanilla porn. Prause said this was the opposite of the addiction model, claiming that watching porn was a cue for masturbation. (Addicts typically have greater brain response to cues for using – e.g., cocaine addicts seeing white powder will respond with more brain activation relative to healthy controls than they will to actual use.) Nine peer-reviewed papers have disagreed with Prause about her conclusion, saying that viewing porn is the addiction, and that Prause’s frequent porn users were desensitized or habituated to vanilla porn – hence reduced brain activation. They were bored. One study disproved her theory directly: Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use.
In the current conceptual framework, where sexual arousal is part of sexual consummation, having sex does not require physical genital contact either with another individual or masturbatory. Take the example of pornography. Thinking about ways to gain access to it, or actively searching for it, and perhaps experiencing desire during the process, is considered sexual wanting. Watching selected pornographic material, even without masturbation, can be considered “having sex” when there is genital arousal. Likewise, when individuals achieve sexual arousal or even orgasm by sheer mental force (with no external physical contact), this also qualifies as “having sex” (Komisaruk and Whipple, 2011).