Therapy Matters

Reflections of a young clinician

Does Porn Contribute to ED?

Growing evidence suggests that too much porn can diminish sexual performance.

I often see men in my practice who are referred by their urologists for “sexual performance issues.”  Frequently, these men present with erectile dysfunction (ED), premature ejaculation, or in some cases delayed ejaculation.  By the time they reach me, most of them have undergone all kinds of medical tests, only to be told that their “plumbing is just fine” and so their problems must be in their heads.  Maybe in some cases this is true, but often I find the problem is more complicated.  In fact, I’m starting to see a growing number of men whose ED appears to stem from a combination of both physiological and psychological factors. 

Several male clients have asked me whether I think their ED might be related to their frequent reliance on pornography when masturbating.  Like many health professionals who work with sexual dysfunction in men, I use to think that a man’s ability to get an erection and orgasm while viewing pornography was by definition a rule out for ED.  “If you can get it up and climax during porn than the problem can’t be physical,” I erroneously concluded; but anecdotal evidence has got me thinking otherwise.

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In researching this topic, I quickly discovered that my male clients are not alone.  A cursory search of the Internet unearthed dozens of websites and message boards inundated with personal accounts of men who attest to the fact that excessive masturbation to online pornography has seriously interfered with their ability to be sexually intimate with a partner.

Pornography on the Internet has gone viral, with large numbers of men (and women) taking advantage of the ease, affordability, and anonymity that comes with watching pornography online.  And the type of pornography available on the Internet is astounding.  This is not your father’s Playboy magazine.  “Soft-core” erotic images have been replaced with a dizzying array of material depicting all kinds of kinky themes and fetishes.  This imagery is not only more graphic but it’s also available through video streaming which can provide the viewer with instantaneous sexual gratification.  The ease and immediacy with which one can view pornography is part of the problem say experts.

The study of pornography has been an area of interest for academics for decades but the impact of chronic pornography viewing on sexual performance has only recently been taken up by the medical field.  A preliminary search of medical journals found very few citations directly referencing pornography and ED, although, I suspect this is likely to change as more men (and women) present with pornography-induced sexual dysfunction.

One such study I am aware of was conducted by a group of medical experts affiliated with the Italian Society of Andrology and Sexual Medicine.  According to a survey of 28,000 Italian men, researchers found “gradual but devastating” effects of repeated exposure to pornography over long period of time.  According to the head of the study, Carlos Forsta, the problem “starts with lower reactions to porn sites, then there is a general drop in libido and in the end it becomes impossible to get an erection.”

So what accounts for the correlation between pornography and erectile dysfunction?  In an excellent blog post in Psychology Today (“Why Do I Find Porn More Exciting Than a Partner?”), Gary Wilson, an anatomy and physiology teacher breaks down the neurophysiological links between pornography and ED.  Wilson explains that there is a detrimental feedback loop that can emerge between the brain and the penis when men rely heavily on pornographic images to masturbate.  With Internet pornography, Wilson writes “it’s easy to overstimulate your brain.”  Specifically, overstimulation brought on by viewing pornography can produce neurological changes—specifically, decreasing sensitivity to the pleasure seeking neurotransmitter dopamine—which can desensitize a person to actual sexual encounters with a partner.  These neurochemical changes not only contribute to a person becoming “addicted” to pornography but they can also make it incredibly difficult to abstain from viewing pornography entirely.

Men who rely excessively on pornography to reach orgasm will often complain of withdrawal-like symptoms when they decide to go cold-turkey.  Such men describe feeling “sexless,” leading many to become anxious and depressed about their diminished libido.  Evidence suggests, however, that libido does eventually return—usually within 2-6 weeks of continued abstinence—as evidenced by the gradual return of morning erections as well as spontaneous erections throughout the day.  “Recovery” is possible and many men have reported going on to experience extreme physical pleasure during intercourse with their partners after abstaining from pornography.

So, if you are finding the only way that you can climax is through porn, it might be time for you to consider abstaining and consulting a professional.  As many men are painfully discovering, real sex involves touching and being touched by another person, not simply touching a mouse and then yourself.

 

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Tyger Latham, Psy.D. is a licensed clinical psychologist practicing in Washington, DC.  He counsels individuals and couples and has a particular interest in sexual trauma, gender development, and LGBT concerns.  His blog, Therapy Matters, explores the art and science of psychotherapy.

Dr. Tyger Latham is a clinical psychologist practicing in Washington, D.C., where he specializes in men's issues, trauma, and LGBT concerns.

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