In recent years there’s been a lot written about porn induced erectile dysfunction. I’m often asked does this really exist? From a sex therapy perspective, when presented with a client’s erectile dysfunction, there’s a list of possible risk factors which can explain why there is an onset of erectile dysfunction.

These risk factors are traditionally age dependant and or because of surgery problems and are:

  • Prostate cancer and prostatectomy
  • Cardiovascular disease
  • Spinal cord injury
  • Hyperlipidaemia – cholesterol
  • Cigarette smoking
  • Depression
  • Atherosclerosis – plaque inside arteries
  • Hypertension/High blood pressure
  • Pelvic surgery/trauma
  • Medications
  • Arthritis
  • Peripheral vascular disease –restricted blood flow, veins narrower
  • Renal failure
  • Substance abuse
  • Endocrine abnormalities Type 1 Diabetes. Type 2 Diabetes. Osteoporosis. Thyroid Cancer. Addison’s Disease. Cushing’s Syndrome. Graves’ Disease. Hashimoto’s Thyroiditis.
  • Peptic ulcer disease

porn induced erectile dysfunctionPorn Induced Erectile Dysfunction PIED therefore has traditionally been identified as a secondary, not primary cause (primary as being with from the beginning).

However, as technology has progressed through an ease of access, anonymity and equally affordability, porn use is starting to show up as a correlation with erectile dysfunction. I am careful not to use the word causation as that cannot be proved scientifically, yet… Equally not everyone watching porn has erectile dysfunction (and as stated in my previous blog we’ve hardly standardised what actually is porn, given there are over 22000 genres).

One thing we do know that use of porn can create 20 dopamine receptors per synaptic connection verses four dopamine receptors per synaptic connection for “real” sex. Twenty vs. Four… I know who wins!

AKA conditioning and vaginal or anal penetration with a real person cannot happen because of ED. However, masturbating to porn, there’s no problem. Yet it’s not going to be so simple as that because anxiety with adrenaline and cortisol will result in blood leaving the penis. You can call that ED and then anxiety over a loss of erection causing more stress develops a negative feedback loop. Therefore, therapy is to help someone make sense of what is happening.

And what is happening is usually presented, when it is discovered, to be a problem for the individual (and the partner too) e.g.;

  • When discovered in real life and use of Tindr for example and when sex does not meet expectations
  • A self-diagnosis
  • No FAP and reading forums to discover there’s a Re – boot process of 10 weeks? or 90 days? or 9mths !!
  • A challenge within this is a change of lifestyle and choices to overcome ED meaning no porn, no orgasm, no masturbation

 

Here’s some research:

 

From 2017 the discussion about porn induced erectile dysfunction has grown around the associated pathways between pornography consumption and reduced sexual satisfaction being referred to as classical conditioning through the repeated pairing of online sexual activities with physical arousal. It then becomes conditioned to porn through ongoing engagement with the technology. And this can then flow into chat rooms, sexting etc.

Thus, whilst the debate from a scientific and academic stand point about porn being a direct cause of ED continues, in real life what is being presented (in the therapy room), is clear – the evidence is mounting that internet pornography may be a factor in the rapid surge in rates of sexual dysfunction in men and ever more so in younger men.

What began as an alternative to sexual intimacy with a person ends up out-competing the real thing – becoming unable to feel arousal upon seeing an attractive person.

Porn induced erectile dysfunction is roughly then defined as a dependence on pornography causing an inability to achieve and maintain erection required for partner sex, intercourse, anal, oral and manual stimulation. And what starts as an alternative to sexual intimacy with a person ends up out-competing the real thing. It may relate to extreme pornography but also relates on other online sexual activity. And there can be correlations related to novelty to transition to extreme & shocking. And finally habituation and the acclimatize effect reported across many studies demonstrates this.

This timeline of reports shows correlation in quite stark fashion:

  • 1940’s ED less than 1% for males under 30 and less than 3% for males between ages 30 to 45
  • 1999 Age range of men 18-59 and ED in 5% of sample and also there was low sexual desire 5% for men under 40
  • 2002 Age range of men under 40, ED was prevalent at under 2%
  • 2006First tube porn sites Affordable, anonymous and accessible
  • 2007 Kinsey Institute reported “”and the need for more novelty. In the word of sex therapy, they’re up there when it comes for guidance and insight
  • 2010 Age range 18-40 in Brazil and men were found to have ED running at 35% of population study
  • 2012 Age range 18-24. Men in Switzerland were found in a sample study to have prevalence running at 30%
  • 2013 Age range of men under 40 in Italy.   ED running at 25% and Men over 40 seeing a 10% increase in cases
  • 2014 Age range 16-21for men in Canada. ED running at 26% in sample size. With Low Sexual Desire running at 24% and difficulty with Orgasm at 11% (next blog will look at Porn induced delayed ejaculation. PIDE)
  • 2016 MNE reported in this survey, 48% with lower sexual satisfaction, 45% low desire and 45% had ED
  • 2018 UK survey found 1 in 2 men under 30 have ED. sample size was 2000 men

 

The result is that, for many young people, real sex — when it eventually arrives — is far less exciting than it should be. And why is that? This is where much of the work in sex therapy lies – to help someone discover the causes that traditionally are getting rarer to find. What cannot be denied is the use of porn is becoming increasingly more common. So the first step must be drop porn use for a while, does this help? Is it too difficult? If so are we actually looking a possible porn compulsivity disorder?

 

 

 

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