Ask the Doc :: Porn-Induced ED

Masturbation and porn are once again a divisive topic of debate within the sexual health community, and even experts disagree on the potential health impacts of pornography.

In this edition of Ask the Doc, sexual health expert and physician in residence at Roman Health, Dr. Michael Reitano, puts the relationship between masturbation and porn in the hot seat. He looks at the health impacts of porn and tackles an important question for men everywhere: Can pornography cause erectile dysfunction?

Are Masturbation, Porn, and Erectile Dysfunction Connected?

Q: Can masturbating to porn have a negative effect on my sex life or my ability to get an erection?

A: Pornography has never been more available or more easily accessed than it is today. Nearly 12% of sites online contain porn and research shows that the average child is exposed to pornography by the age of 11.

The connection between porn and masturbation is obvious, but the connection to negative consequences may be a bit less clear. First, let's discuss what's normal. Masturbation, with or without pornography, diminishes a man's capacity to have sex for some period of time after reaching orgasm. This is why most men cannot continue to have sex after they orgasm. It's called a refractory period, and it's normal. What isn't normal is when a man compulsively masturbates to pornography.

Exhausting your sexual capacity and sex drive-with or without visual stimulation-will reduce a man's desire to create the normal bonds that could lead to sex. The question is whether pornography makes that more likely to happen.

Visual sexual stimulation (VSS), or pornography, has become readily available in the past 15 years, which correlates precisely to the time that a rise in the prevalence of ED in younger men has been noted. It seems logical that viewing pornography and not being able to get an erection should be related. Maybe yes, but maybe not. Let's take a look at both sides.

How Can Porn Cause ED?

Q: Does watching (and masturbating) to a lot of porn desensitize you? Can porn create unrealistic expectations that lead to ED?

A: Watching a myriad of naked people entwined in an unending variety of sexual interactions creates a tolerance to sexual stimulation. Think of it this way: The first time someone sees their partner naked that novelty is exciting in and of itself. Compare that initial excitement to the same exposure a year into the relationship. That's desensitization in a nutshell and, for some, porn can accelerate it.

Porn also affects sexual expectations. Professional actors getting paid to have sex on camera work to create extraordinary visual experiences. Men who interact with a large amount of porn may become accustomed to stimulation from these sexual gymnasts, and a real world partner can't compare. This would clearly be an unrealistic goal. If a man watched "Star Wars" movies and expected his life to imitate the art seen on screen, we could easily acknowledge the absurdity of his expectations. Nevertheless, some men feel their sex lives are less than optimal if the sex they have is unlike the sex they view.

So, Does Porn Induced Erectile Dysfunction (PIED) Even Exist?

A few logical conclusions aren't proof that porn is responsible for ED. The question is whether there's any scientific evidence that pornography causes ED. And that theory begins to weaken when we look at the evidence.

In one study, over 25% of the men who came into a clinic with ED were under 40. In fact, their mean age was just 32 and, worse yet, nearly 50% had severe ED. What's fascinating is that what distinguished these men from older individuals were lifestyle issues known to affect erections: smoking, illicit drug use, and alcohol consumption-not pornography.

Another Swiss study found that approximately 30% of young men experienced erectile dysfunction. However, they noted that "ED was directly linked to medication without a prescription, length of sexual life, and physical health." Again, "Multiple health-compromising factors are associated with ED and premature ejaculation. These should act as red flags for health professionals to encourage them to take any opportunity to talk about sexuality with their young male patients."

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4498826|One study of healthy young men (without ED) explored whether viewing more pornography each week affected a man's ability to achieve an erection and orgasm-not only with masturbation, but with a partner.

When they compared three groups-men who watched no porn, men who watched up to 2 hours/week, and men who watched more than 2 hours/week-they found all three groups were identical in terms of performance with a partner.

Moreover, men who watched the greatest amount of pornography had the greatest desire not just for masturbation but for partnered sex. Granted, it examined a group of men who did not experience ED, but it does support the idea that those who suffer from ED and view a great deal of pornography may have other social, medical, or psychological conditions contributing to their difficulties.

Porn & ED: It's Always Going to be Complicated

For many people (men and women), masturbation is a healthy exploration of human sexuality. The key is that it doesn't become a substitute for sexual intimacy, or that consuming it interferes with normal social activities. If you experience ED and also compulsively masturbate to pornography, there's a full spectrum of psychological and physical explanations to evaluate with your doctor. The reason for compulsive masturbation must be explored, whether it occurs with pornography or without. If the drive is accelerated by using pornography it may seem like the pornography is the culprit but that would ignore many of the other issues that might be in play.

Pornography is a sexual tool, and as with any tool, it can be misused. Though for some the relationship is quite real and harmful, blaming porn as the cause for erectile dysfunction ignores all the very real underlying physiological and psychological issues that should be considered.

Dr. Michael Reitano is currently the Physician in Residence for Roman Health, a men's health company based in New York. He is a nationally recognized physician who specializes in sexual health and wellness.

Dr. Reitano graduated in 1979 from NYU Medical School. He is an expert across a wide variety of conditions including erectile dysfunction (ED), herpes, HIV, gonorrhea, sexual function issues, and premature ejaculation.
His clinical research has been published in prestigious medical journals, he is an author of several books on STD'S, and was the founding editor of Sexual Health Magazine.