Men who struggle with their use of pornography also tend to experience a higher rate of erectile dysfunction, according to new research that surveyed thousands of young adults. But the study, which appears in JMIR Public Health and Surveillance, found no evidence that pornography use by itself was associated with erectile problems.
“As an adolescent urologist, I see an increasing number of young patients with sexual dysfunctions, especially erectile dysfunctions (ED),” said study author Gunter De Win, an associate professor at the University of Antwerp Belgium and coordinator of the SWYPPe Lab. “For many, the typical medications that we prescribe, or sexology treatment for performance anxiety was often not effective. Some of my students asked me during a class I was giving if pornography can have an effect on ED. Some patients also confronted me with this question.”
“But good scientific studies about this topic were scarce and often biased. Some studies indicated that problematic pornography consumption existed, but none of them did a large-scale study to find associations between erectile scores and porn consumption habits.”
“Therefore, we started a large cross-sectional study about male sexual health,” De Win explained. “The main reason to do the study was to see if we, as clinicians, should make pornography consumption one of the topics we have to assess in young patients who present with sexual dysfunctions. Currently, most urologists (and even many sexologists) are not doing this automatically.”
The study was based on an online survey of 3,419 men between 18 years old and 35 years old, who completed questionnaires regarding their demographic information, medical history, alcohol and drug use, sexual preferences, erectile dysfunction, masturbation, pornography consumption, and partner satisfaction.
“Nearly every young person masturbates regularly and watches porn regularly,” De Win said. Nearly the entire sample (98.98%) consumed pornography during masturbation and the participants reported spending about 39 minutes per week watching pornography on average.
The researchers found that approximately 21% of participants who had attempted sexual intercourse during the past 4 weeks had some degree of erectile dysfunction. Neither the frequency of pornography use or the frequency of masturbation was associated with erectile dysfunction.
But there was “a clear association” between problematic pornography consumption and erectile dysfunction, De Win said. Scoring high on the Cyber Pornography Addiction Test resulted in a higher probability of erectile dysfunction. (Those who scored high on the test agreed with statements such as “I neglected my partner or my family because I had to watch porn sites”, “I told myself to stop using online pornography but I didn’t succeed,” and “I watch porn sites in contexts where I should not.”)
“This ED is often situational,” De Win told PsyPost. “Often when masturbating while watching porn there is no ED; but when having sex with a partner without pornography these patients can experience some ED. The more a patient experiences problematic pornography consumption, the more chance he has to experience problematic ED.”
The researchers also found that those who started watching pornography at a younger age were more likely to score high on the Cyber Pornography Addiction Test. Among those who started watching pornography before the age of 10, more than 50% had a score in the highest range.
De Win and his colleagues controlled for factors such as libido, relationship status, use of antidepressants, partner satisfaction, and performance pressure. But it is still unclear whether problematic pornography use causes erectile dysfunction or whether erectile dysfunction causes problematic pornography use.
The underlying mechanisms linking problematic pornography consumption to erectile dysfunction are also unclear, De Win said. “Is this because of moral incongruence? Is there a central effect on the brain because of overstimulation of the reward center? Is it because of unrealistic expectations? Dependence? The answer is probably different in every single patient.”
“Studies to find a causal link are difficult,” he explained. “It is difficult to find a proper control group and follow them up over time. Most young men already watch pornography on a regular basis when they are 14.”
The widespread use of pornography is a contentious social issue, and De Win noted that “both pro-pornography and anti-pornography groups interpret our results in their own way.”
“Pornography can have positive effects on a person’s sexual development and self-acceptance, but in some it can become problematic,” he explained. “But telling everybody that they should stop watching porn because it causes ED is totally wrong. Only a minority will experience some negative effects. Pornography is the most used masturbation aid, and masturbation has a positive effect on wellbeing.”
The researcher added that blaming erectile dysfunction on pornography can be counterproductive for some men.
“A young person who experiences some situational ED due to performance anxiety, and then starts looking on the internet and finds that his ED is caused by his porn watching (which often isn’t problematic) might immediately stop watching porn, have more difficulties during masturbation, then start to doubt himself and fall into a negative spiral,” De Win said.
“Much more research is needed to understand the possible relationship between one’s porn consumption habit and the effect on their sexual function. And these effects will be different in different people.”
“We should not ban pornography consumption, but we should find a way to deal with it in a ‘healthy’ way,” De Win added. “We should give correct information to young people about the effects and the often unrealistic situations in these movies (and not just about the sex itself but also about the genitals shown in these movies), we should get to know warning signals that can lead to problematic consumption and we should not only study the effect on sexual function but also on sexual development and relationship expectations.”
“But most of all, we should be open about this topic of research. For too long, this area of research belonged to two opposite groups. Many years are lost by not approaching this topic in an open multidisciplinary way.”
The study, “Associations Between Online Pornography Consumption and Sexual Dysfunction in Young Men: Multivariate Analysis Based on an International Web-Based Survey“, was authored by Tim Jacobs, Björn Geysemans, Guido Van Hal, Inge Glazemakers, Kristian Fog-Poulsen, Alexandra Vermandel, Stefan De Wachter, and Gunter De Win.