There’s a growing trend of healthy young men using medications like Viagra and Cialis, drugs intended for older men and those with health-related erectile dysfunction (ED).

Many of these young men (unknowingly?) use these drugs to treat a condition that is psychological rather than physiological: porn-induced erectile dysfunction (PEID).

Online social groups and websites such as Your Brain on Porn and Reddit’s “no fap” group (https://www.reddit.com/r/NoFap/) were founded to help men with PIED.

At the same time, studies that checked for a connection between watching porn and erectile dysfunction found no evidence associating the two. If that’s the case, what explains the sharp rise in ED cases in young men in recent years?

In 2012, Swiss researchers used the International Index of Erectile Function (IIEF-5), finding an ED rate of 30% in a cross-section of Swiss men aged 18 to 24. A 2013 Italian study reported that one in four patients who sought help for new-onset ED were younger than 40, with rates of severe ED nearly 10% higher than in men over 40.

We asked Takeesha Roland-Jenkins (MS in psychology and MS in neurology) a professional consultant for the Between Us Clinic, to weigh in. Takeesha is an expert in both psychology and neurology, and she has a unique insight into both the psyche and the brain.

In your opinion, can excessive porn consumption really cause a man to experience erectile dysfunction?

Yes, watching hardcore porn excessively, especially pornography with deviant and violent behavior can cause mental changes that may result in erectile dysfunction.

What happens in a man’s brain when he is exposed to extreme sexual stimuli (such as hardcore pornography) and how does this relate to ED?

Hardcore pornography is often graphic and generally displays deviant, violent, and abnormally kinky behavior. This is not typical for the average sexual encounter and it can create unrealistic mental perceptions of how a man should engage in sexual activity. Furthermore, a man may initially get a thrill from watching what he believes is an exotic encounter, but over time excessive porn watching desensitizes men to intense sexual stimuli and even sexual violence which sometimes occurs in the porn that is being viewed, thereby lowering the ability to engage in true intimacy.

Pornography, in general, causes intense mental stimulation that changes the way the brain views sexual activity and sexual violence in pornography exaggerates the alterations in the brain.

This phenomenon is similar to becoming more tolerant to a certain drug after prolonged use; meaning you eventually need higher and higher doses to experience the same feelings of euphoria. Repeatedly watching hard-core porn can have a similar effect on sexual performance. In other words, watching excessive porn changes the way the brain processes sexual arousal and activity, often leading to desensitization that lowers libido and causes psychological erectile dysfunction.

Some say that men who watch too much porn can develop performance anxiety. Why does anxiety affect the ability to get and maintain an erection?

In addition, because a man’s brain has now become accustomed to getting stimulated at the sight of intense pornographic images, an ordinary encounter will cause the man to wonder if he will be able to perform at a similar level (e.g., for extended periods) as what has been observed in a pornographic video. Therefore, the performance anxiety is still related to the changes that occur in the brain and wondering if he can satisfy his partner in the manner that the brain has become used to. In other words, the anxiety is a direct result of worrying about being able to re-enact the sexual scenes in porn; this unrealistic goal can lead to performance anxiety. Subsequently, a man may get an erection, but after beginning to worry about whether he can perform like the actors in porn, the erection may soften or stop altogether.

So, other than performance anxiety, is there another reason why porn could cause men to experience ED?

The changes that occur in the brain’s ability to lead to an erection contributes more to PIED than performance anxiety. Over time the brain needs increasing levels of stimulation from the pornography in order to initiate an erection. Performance anxiety can unfortunately worsen erectile dysfunction.

Does porn-induced erectile dysfunction cure itself if the man stops watching porn?

Discontinuing pornographic viewing does not automatically cure PIED. Furthermore, drugs such as Viagra or Cialis target the physical aspect of erectile dysfunction, not the psychological aspect. This means that a man will become completely dependent upon such drugs until the brain restores its ability to initiate an erection under ordinary sexual circumstances. A healthy relationship (e.g., marriage) with a patient partner can help a man overcome PIED over time.

What form of treatment would you recommend a man who suffers from PIED?

Beneficial treatment would be in the form of individualized therapy, which may vary in time (e.g., weeks, months) depending on the individual and the degree of PIED. As PIED is often the result of an addiction to pornography, this form of treatment should be viewed as the first step to addiction recovery.

The purpose of therapy is to begin to desensitize the brain to the pornographic images and to address some of the reasons that the addiction to porn more than likely started. Men are also encouraged to reconnect intimately with their partners in order to help the brain restore its ability to initiate sexual arousal during ordinary sexual encounters. Overall, a man must be willing to give himself time to gradually overcome PIED.

*Originally published on www.betweenusclinic.com

References

Prause N and Pfaus J. (2015), Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction. Sexual Medicine, 3: 90–98. doi:10.1002/sm2.58.

Landripet I and Štulhofer A. (2015), Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men?. The Journal of Sexual Medicine, 12: 1136–1139. doi:10.1111/jsm.12853.

Park BY, Wilson G, Berger J, Berger J, Christman M, Reina B, Bishop F, Klam WP, Doan AP. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Lane SD, ed. Behavioral Sciences. 2016;6(3):17. doi:10.3390/bs6030017.

Image via geralt/Pixabay.