What is porn-induced erectile dysfunction (PIED)?

Could Internet pornography really cause sexual dysfunction?

Porn-induced erectile dysfunction (or PIED) is specified as the inability to get or maintain an erection because of frequent viewing of pornography. It sounds strange at first: could pornography really be causing erectile dysfunction?

 

Erectile dysfunction commonly affects men above the age of 50 years. And until 2002, the rates of erectile dysfunction in men under the age of 40 years were around 2%. But by 2011, rates had increased to 14% to 28% in European men aged 18 to 40 years. Researchers were initially puzzled by the findings. Erectile dysfunction is traditionally age-dependent and associated with medical conditions such as diabetes, obesity, cardiovascular disease, hypertension, and depression. But many of the young men studied weren’t presenting with such symptoms. Why, then, were they suffering erectile dysfunction?

 

Researchers noticed that the majority of young people suffering from erectile dysfunction also experienced emotional stress, anxiety, and depression. In other words, the majority of erectile disorders in young men are because of psychological factors, not physical conditions.

In 2007, scientists at the Kinsey Institute noticed that study participants who were exposed to pornography as part of their jobs were less able to get an erection under the laboratory conditions when viewing porn.

 

The problem with porn for healthy erections

High exposure to pornography numbs viewers over time. If a man or woman frequently masturbates to porn, their expectations of what sex should be like in real life become distorted and they need more ‘extreme’ materials to become aroused. Pornography is not a reflection of the real world. Unfortunately, many viewers believe it to be which can leave them unsatisfied and anxious when engaging in sex with a real person. “Stimulation is coming externally, which can make it very hard to be in your body,” Mary Sharpe of the Reward Foundation previously told The Guardian.

 

A survey among high school students in 2015 found that among those who consumed porn once a week, 16% felt sexually unsatisfied. Another survey of 434 men in 2016 found a positive correlation between reduced sexual satisfaction and sexual function and frequent porn consumption.

 

The biological basis for these changes is linked to the brain’s reward systems. Similar to drug abuse, regular overconsumption of porn can affect the activity of neurotransmitters in the brain. When you watch porn and become sexually aroused, your brain releases dopamine – the important brain chemical involved in motivation and reward behavior. If you watch porn often, eventually, these dopamine bursts aren’t going to be enough to satisfy sexual arousal and you’ll need ever kinkier experiences to get an erection. Some experts have called for porn addiction to be associated with Internet addiction.

 

Interestingly, the fact that most men are able to masturbate when viewing porn shows that they are able to get an erection. Hence, they are physically able to have an erection but not psychologically.

 

Treatment options

If you experience PIED, the good news is that it can be reversed. Giving up or reducing pornography consumption drastically has been shown to be successful in treating PIED. Cognitive-behavioral therapy approaches can assist patients in refraining from pornography and regaining satisfactory erectile function over time.

 

If you suffer from depression and anxiety, it may be worth seeking the help of a counselor or consider medical treatments such as selective serotonin-reuptake inhibitors. Importantly, ‘retraining’ your brain will take time so be patient. 

 

The key to healthy pornography use is to not let it interfere with real social bonds and intimacy in our lives. Porn should never become a substitute for human contact nor be used as a way to manage stress.

 

References

  1. Park, B. Y., Wilson, G., Berger, J., Christman, M., Reina, B., Bishop, F., … Doan, A. P. (2016). Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behavioral sciences (Basel, Switzerland), 6(3), 17. doi:https://doi.org/10.3390/bs6030017
  2. Janssen, E., Bancroft, J. (2007). The dual control model: The role of sexual inhibition and excitation in sexual arousal and behaviour. In Janssen, E. (Ed.), The psychophysiology of sex (pp. 197–222). Bloomington, IN: Indiana University Press.
  3. Fleming, A. (2019). Is porn making young men impotent?. the Guardian. Retrieved October 21, 2019, from <https://www.theguardian.com/lifeandstyle/2019/mar/11/young-men-porn-induced-erectile-dysfunction>
  4. Wéry A., Billieux J. Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men. Comput. Hum. Behav. 2016;56:257–266. doi: https://doi.org/10.1016/j.chb.2015.11.046
  5. Brookshire, B. (2019). Explainer: What is dopamine?. Science News for Students. Retrieved October 21, 2019, from <https://www.sciencenewsforstudents.org/article/explainer-what-dopamine>
  6. de Alarcón, R., de la Iglesia, J. I., Casado, N. M., & Montejo, A. L. (2019). Online Porn Addiction: What We Know and What We Don't-A Systematic Review. Journal of clinical medicine, 8(1), 91. doi:https://doi.org/10.3390/jcm8010091

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