High-speed Internet pornography users in their twenties are increasingly developing sexual performance problems (erectile dysfunction, delayed ejaculation). Said one young man,
“Lots of guys, 20s or so, can’t get it up anymore with a real girl, and they all relate having a serious porn/masturbation habit. Guys will never openly discuss this with friends or co-workers, for fear of getting laughed out of town. But when someone tells their story on a health forum, and there are 50-100 replies from other guys who struggle with the same thing, this is for real.”
Italian urologists recently confirmed the impotence-porn use connection via a large survey. Italian men suffer ‘sexual anorexia’ after Internet porn use. When interviewed about the survey, urologist Carlo Foresta (head of the Italian Society of Andrology and Sexual Medicine and professor at the University of Padua) mentioned that 70% of the young men seeking clinical help for sexual performance problems had been using Internet pornography habitually.
No one yet knows the percentage of Americans affected. However, youthful impotence has implications for condom use and safe sex.
Of those who ultimately recover by terminating pornography use, many had previously been to doctors, undergone numerous tests, and been declared “just fine” physically. Neither they nor their health care providers considered excessive porn use as a potential cause of their continued performance problems.
Most were assured that “masturbation cannot cause erectile dysfunction.” This was no doubt sound advice before masturbation was coupled with the constant novelty and hyperstimulation of today’s Internet erotic possibilities. However, it may no longer be valid given the effects of superstimuli on the brain.
Among those who recover, progression is surprisingly similar. When the users completely stop using pornography (and masturbation as well for a time, because it is initially so closely associated with porn fantasy), here’s what occurs:
1) Withdrawal symptoms and cravings: Immediately
2) Complete loss of libido and erections: Begins towards the end of week one.
3) Absence of libido and erections, increased flaccidity (“shrinking or lifeless penis”): Continues for 2-6 weeks, dependent upon age and severity of porn use.
4) Gradual return of morning erections, libido and spontaneous erections at other times, no more “semen leakage” during bowel movements, etc.
5) Complete recovery of erectile health, sexual desire for real partners, reports of extremely pleasurable sex, contented condom use even if it was once a problem.
Sufferers typically recover within eight weeks. Those in their late teens generally require a shorter period of avoiding sexual stimulation to bounce back, but they also tend to relapse more often, which extends their recovery. Older men may need a longer period without stimulation in order to recover, but are typically more disciplined. Either way, reports are encouraging:
“I am a 25-year old male, masturbating a lot from 13 and using porn from 14. Gradually, it took more to turn me on: bigger fantasies or harder porn, and I stopped getting hard without touching. During sex I would struggle to get an erection or keep it, especially for intercourse. Over the past 7 years I haven’t held down a relationship, and the main reason for me has been this problem. Now the good news: When I realized the cause, I immediately gave up porn. Over the last 6 weeks I held off masturbating as much as I possibly could. (My best record was 9 days!) It all paid off. I just went away with a girl for the weekend and it was the best ever. I don’t think I’m out of the woods yet. I still get pretty anxious from all the bad experiences over the years. But I just wanted to tell you all it can work, and it’s well worth it!”
“Week 12, age 36 – I’m actually totally impressed how HUGE I get. It has been kinda hard to ignore. I mean, my erections are ROCK HARD and ENORMOUS. I remember asking other guys who went before me about when they noticed the return of their full erections. Well, I think I got mine back.”
Those affected report that escalating pornography tastes preceded their symptoms. Escalation, their withdrawal symptoms during recovery, and the sequence and time-dependence of their recovery all point to a common cause of their impotence, namely overstimulation of the reward mechanism in the brain.
Animal models have established that the mesolimbic dopamine pathway dopaminergic neurons activate the hypothalamic erection centers. It’s likely that porn-induced ED is tied to desensitization of the mesolimbic dopamine pathway. This is a hallmark of all known addiction processes. For a science teacher’s explanation of the science behind porn-related erectile dysfunction, see this video presentation: Erectile Dysfunction and Porn.
Most men are astonished to learn that pornography use can be a source of sexual performance problems. Only after they experiment for themselves do they become fully convinced that pornography use was indeed the source of their dysfunction.
The debate about widespread use of Internet porn tends to revolve around social concerns and conflicting surveys. Is today’s porn improving marriages? Causing erectile dysfunction leading to unsafe sex? Simply enabling people to meet normal sexual needs more conveniently? Inflating cravings for novelty and extreme sexual behaviors? Only a problem of disapproving mates? Decreasing youthful viewers attraction to real mates and increasing social anxiety?
Everyone is convinced of his/her point of view—and can usually point to surveys to ‘prove’ it. Yet what if the porn debate could be moved to another playing field and resolved using hard science?
Good news. Non-invasive tools now exist for peering into the brains of Internet porn users. The techniques have already been used extensively to examine the brains of pathological gamblers, overeaters and drug users.
If use of Internet porn is indeed harmless, such research will settle the matter definitively. On the other hand, if Internet porn causes addiction-related brain changes in otherwise healthy users, such information is equally vital. Users could learn which symptoms are problematic and make informed choices. Society could better shield and educate youngsters. So,
What exactly what would brain researchers be looking for in porn users’ brains?
Why hasn’t this research been done already?
And why do diagnostic labels matter anyway?
What could we learn from brain research?
Researchers spent the last eight years running dozens of objective tests on the brains of pathological gamblers. They discovered that excessive gambling causes the same brain changes as substance addictions. Accordingly, psychiatrists are re-categorizing pathological gambling from ‘disorder’ to ‘addiction’ in the upcoming Diagnostic and Statistical Manual of Mental Disorders, DSM-5.
The diagnosis of gambling as an addiction confuses those who associate addiction with heroin needles or crack pipes. However, chemical and behavioral addictions are very similar physiologically. After all, chemicals don’t create novel processes in the body; they merely increase or decrease existing processes.
Although cocaine, nicotine and gambling feel quite different to a user, they share the same brain pathway and mechanisms. For example, all increase dopamine in the hub of the reward circuit, the nucleus accumbens. To be sure, substance addictions often have toxic effects that natural rewards do not. And some, such as cocaine and meth, cause the sudden release of more dopamine than rewarding behaviors such as gambling. But whether you drive or jog, all these roads can lead to Rome.
Some people also confound “addiction” with “passion,” such as a passion for golf or sex. They imagine that any activity a person finds compelling is “addictive,” rendering the term so meaningless that no activities can be considered addictive. In fact, ‘addiction’ is no longer an amorphous concept, at the mercy of such reasoning. Already, three defining characteristics of addiction can be measured objectively in the brain. Moreover, cognitive tests, and even blood tests, have been developed to check for the presence of such physical changes, without the bother of brain scans.
Here are simplified descriptions of these three key, measurable addiction characteristics:
Numbed pleasure response: Among other changes, dopamine (D2) receptors dropin the brain’s reward circuitry, leaving the addict less sensitive to pleasure, and “hungry” for dopamine-raising activities/substances of all kinds. The addict then tends to neglect interests, stimuli, and behaviors that were once of high personal relevance.
Sensitization: Dopamine (the “gotta get it!” neurochemical) surges in response to cues related to the addiction, making the addiction far more compelling than other activities in the addict’s life. Also, ΔFosB, a protein that rises with sexual activity and helps preserve intense memories, accumulates in key brain regions.
Hypofrontality: Frontal-lobe gray matter and functioning decrease, reducing both impulse control and the ability to foresee consequences.
No matter how passionate non-addicts are about an activity, these “hard-wired” changes don’t occur. Non-addicts can stop at will. Addiction, in contrast, is uncontrolled, compulsive behavior arising from a brain that is neither functioning nor registering satisfaction normally (and therefore suffers symptoms, such as cravings and withdrawal discomfort).
Each of the three phenomena has repeatedly shown up in the brains of pathological gamblers. More recently, scientists have begun to examine the brains of fervent video gamers. They have discovered evidence of substance-addiction-like brain changes and sensitivity to cues, again indicating addiction processes at work. Similar phenomena have been seen in overeaters.
Why are we studying gambling and not porn?
As yet, we know of no studies on the brains of porn users using today’s non-invasive, relatively inexpensive imaging tools. One reason that scientists are not checking Internet porn users for dysregulated brains is that Internet porn is so new. Static porn has been around for a long while, but high-speed Internet has been widely available for the blink of an eye in academic terms. Research always lags behind reality.
Another reason is that it generally takes increasing extremeness, or greater availability, for people to slip into addiction to natural rewards like porn or junk food. Only recently have heavy Internet porn users in their teens and twenties begun complaining of symptoms that suggest addiction processes may be at work in healthy brains: concentration problems, increases in social anxiety, mood changes, escalation to anxiety-producing material, morphing sexual tastes, erectile dysfunction and so forth. Many used Internet erotica for a decade or more—and only became aware of symptoms (and inability to control use) since the advent of highspeed Internet.
Finally, there is resistance to such investigation from a vocal cadre of academic, and other highly regarded, sexologists—the very experts one would expect to lead the charge in demanding, or conducting, the hard science now needed. Consider the following statements by a prominent sexologist. (His remarks elsewhere make it clear that his statements encompass heavy porn use.)
The concept of “sex addiction” is a set of moral beliefs disguised as science. Virtually no one in the field of sexology believes in the concept.
He’s not alone in his convictions. A research professor, when informed that a recent survey commissioned by Italian doctors showed that Internet porn use is causing impotence in young men, asked:
Why are so many silly news stories generated on this topic? Hmm, does it represent excessive concern about something that doesn’t exist, like excessive concern about unicorns?
Spokesmen such as these mechanically frame the Internet porn debate around type of stimulation (“sexual”), and see it as a dispute about sexual freedom. In fact, however, the critical issue may be degree of neurochemical stimulation. Checkers wasn’t a risk; hours of “World of Warcraft” have proven fatal. Hunter-gatherer diets were unlikely to lead to obesity; today’s flood of cheap junk food has already helped make 79% of Americans unhealthily fat. Dad’s static Playboy was pretty innocuous; superstimulating, ever novel Internet porn may be drug-like in effects.
Many sexologists equate masturbation (normal stimulation) with Internet porn use (abnormal stimulation). As porn use has grown more excessive and hyperstimulating, they have simply redefined ‘normal.’ Yet what if users are seeking more extreme stimulation because abnormal, addictive processes are numbing their satisfaction from less intense pleasures? What does ‘sexual freedom’ look like in a brain chained to ever-increasing stimulation because it is, in fact, addicted?
Perhaps one day soon this influential chorus of experts will get behind the effort to uncover exactly what is, or isn’t, going on in the brains of today’s porn users. As it is, they are losing credibility with those who experiment with giving up porn, go through withdrawal, and experience unmistakable improvements in mood, concentration, sexual performance, ability to socialize, and so forth:
I confirmed [that porn use caused my ED] by giving up porn, not through conventional health professionals. They either don’t want to acknowledge, or don’t know, that it is a genuine problem. Physically, I have been getting some serious morning wood. It’s refreshing to know that it is still working.
It gets very disheartening hearing the likes of Dr. ______, Sex therapist ______, and Kinsey researcher ______ continuously stick up for [Internet porn], which has directly affected my life and psychological wellbeing so negatively. To see such accredited experts defend an industry that has never taken any steps to safeguard vulnerable individuals [kids] is sickening. I hope that someday these guys are held accountable for their ignorance or personal allegiances [to erotica producers], if any exist, as well.
The pro-masturbation sentiments in the medical community for the past 40 years or so approach the level of criminal irresponsibility. Whole generations of adults have been warped by this nonsense. After years of increasing porn use, it took me months to get back to normal.
What difference does a diagnostic label make?
The current DSM doesn’t specifically mention porn use. The upcoming DSM characterizes compulsive porn use as a disorder, not an addiction. Labels have implications for treatment, as this eighteen-year old discovered:
I’ve been a compulsive porn user for about a year now, and I can confirm the rise of severe, sometimes unbearable, social anxiety and problems with concentration. It’s why I screwed up my first of year Uni (pretty much failed all my subjects), and can now barely walk down the street without hyperventilating. I’m still living at home, so my parents are really worried. They took me to this psychiatrist who, after listening to me for literally 10 minutes (and $280), diagnosed me with BIPOLAR TYPE 2, and started talking about pills. I told him about my porn/masturbation problem but he insisted that wouldn’t have any sort of an effect on me.
In private correspondence, one of the psychiatrists behind the new DSM informed me that if a patient is normal, he can’t get addicted to porn no matter how intense the stimulation or how frequent its use. Therefore, if someone does get hooked, it means he had other issues, namely a pre-existing unrelated, condition—such as ADHD, social anxiety, depression or shame.
This reasoning is circular. If the patient’s static, faulty brain is always the culprit, no other possible path to distress can be considered. The patient is presumed to have been on the road to a psychiatrist’s office from the get-go, and degree of stimulation is irrelevant. Yet as they recover, users are concluding that heavy porn use alone was the apparent cause of an array of symptoms that mirror the conditions listed in the previous paragraph.
For now, many of today’s healthcare providers are bound by strict protocols. Until porn addiction is an official possible diagnosis, caregivers may have little choice but to diagnose and treat its many symptoms as unrelated disorders (anxiety, depression, concentration problems, ED, etc.).
Despite the ruling paradigm, there are signs of a sea change. For example, renowned addiction researcher Eric Nestler PhD says:
It is likely that similar brain changes occur in other pathological conditions which involve the excessive consumption of natural rewards, conditions such as … sex addictions, and so on.
Other scientists well versed in the neurobiology of addiction are calling for excessive use of Internet porn/cyber sex to be investigated as a possible addiction—in both France (“Sexual Addictions“) and the States (“Pornography Addiction: A Neuroscience Perspective“). Yet as far as we know, the sole step in this direction was taken by a German team. The team employed cognitive tests to measure Internet porn’s effects on users’ brains. Sure enough, they found that problems with porn use correlate with degree of stimulation (measured in number of applications the user engaged and intensity of experience), indicating an addiction process at work. It didn’t correlate with personality facets, or even time spent viewing.
Despite the existing hurdles, researchers now have the power to investigate whether or not porn is altering users’ brains. Anyone else want to see an end to The Porn Debate?