Erectile dysfunction is a medical condition that can be caused by a variety of factors. Too much stress, performance anxiety, physical health, mental health, and substance abuse — all of these are reasons why up to 40% of men experience erectile dysfunction at some point in their life [1].
Poor sexual performance or lack of sexual appetite can fill a man (and his partner) with a great deal of worry.
This is an area of concern for many sexually active men. In fact, a study in the International Journal of Impotence published in 2021 found erectile dysfunction (and the causes of erectile dysfunction) to be the most-searched topic on Google Trends over the last 5 years in the United States [2].
Porn-induced erectile dysfunction (or PIED for short) refers to erectile dysfunction that is caused by excessive viewing of pornography, which can, in turn, skew your sexual expectations.
This can result in decreased sexual satisfaction in your real-life sexual encounters and even sexual dysfunctions.
Is problematic pornography use a cause for concern among sexually active men? Is there a point where you can watch too much pornography? Is it causing or contributing to erectile dysfunction? Let's take a look.
The hard truth about porn and ED
Despite the massive number of people who watch it in private, pornography is a divisive topic. And it always has been.
Today, with high-speed internet making pornography more readily available than ever, movements like NoFap and YourBrainOnPorn espouse all kinds of facts and figures about the negative effects of porn and masturbation, on everything from your sex drive, neuroanatomy, testosterone levels, and more.
Additionally, there are claims that ridding your life of porn and taming the snake a little less often can result in some real-life positive changes including higher testosterone levels, increased happiness, boosted confidence, higher energy levels, muscle growth, and better sleep.
While lots of the NoFap claims are serious, they are also mostly anecdotal, which is to say, not very scientific.
There are also less serious assertions, often with a bit of tongue-in-cheek humour interspersed (claims of levitation and telepathy are probably exaggerations) making it difficult to discern what they truly believe and what effectively amounts to an elaborate inside joke.
What’s certainly true is these websites act something like online support groups, dedicated to helping others ditch the on-screen action in favour of the real deal.
And among the pseudoscience, there are some sobering facts — ones backed by proper scientific studies.
Especially on sites like YourBrainOnPorn, which has compiled reams of evidence to support the argument that porn is not only addictive but that it is also linked to sexual problems like lower arousal to sexual stimuli.
Can porn cause erectile dysfunction?
The science is a little conflicting here. There have been epidemiological studies that show a causal link between intense watching of internet pornography and an inability to maintain an erection.
However, there have also been several studies that show watching a sex film is completely unrelated to erectile function [3]. Is watching pornography impacting men's sexual health?
Empirical research published in Dignity: A Journal on Sexual Exploitation and Violence suggests a link among young men between porn consumption and erectile dysfunction [4].
The research interviewed young men who were introduced to pornography during adolescence.
Many of these men made porn watching a daily activity, which eventually resulted in watching more and more extreme content — meaning content with elements of violence — as necessary to sustain an erection.
The men then faced an inability to maintain an erection with a real-life partner, which suggests porn-induced ED.
Erectile dysfunction is also becoming much more common in younger men under the age of 40 [5]. Since the rise of internet porn streaming sites, a study from 2016 found a big increase in young men reporting erectile dysfunction [6].
Although we can't say for sure that there is a definitive link, it does suggest sexual stimulation or sexual arousal from watching pornography is having an impact on men (and their erectile dysfunction).
How can porn cause erectile dysfunction?
The internet is a limitless space with a seemingly never-ending list of media content and porn genres widely available.
Some research suggests it's a cycle of watching porn daily and needing to find new content and stories to stay excited and engaged. This can lead to watching increasingly extreme and unrealistic content that a real-life interaction simply cannot live up to.
The inability to sustain the fantasy you have watched online makes it incredibly hard to sustain an erection with a partner, which in some cases, can lead to porn-induced ED.
If you find yourself unable to stop watching porn, then it may be time to explore chatting with a doctor, psychologist or medical professional about pornography addiction or porn-induced erectile dysfunction.
Another aspect is the use of masturbation when porn-watching. There is a unique and specific style of masturbating often used alone in viewing porn.
Known as an idiosyncratic masturbatory style, which uses firmness, friction and pressure, this type of masturbation, when used frequently, is hard to replicate through oral or vaginal sex.
A urology study found that many of the male participants who masturbated quite frequently using fantasy and the idiosyncratic style were predisposed to "retarded ejaculation" (the persistent inability to ejaculate) as part of erectile dysfunction [7].
In the study, many of the men failed to communicate their fantasies to their partner during sex, and without the ability to recreate the same conditions as their consistent masturbating in a real-life sexual encounter; they often failed to finish.
Sydney-based GP Dr Mathew Vickers suggests that the issue is a lot more complicated than we think.
“There are a number of studies going back quite a few years that suggested there was a link between erectile dysfunction and pornography, but there’s actually a more recent study, that looked back at lots of these studies and combined the results for further analysis,” he says.
“They found there is a common link that showed it wasn’t pornography that was causing erectile dysfunction for everybody, but more for the people with problematic pornography use.”
This makes perfect sense — the majority of the population is using pornography to some extent, but only a small portion seem to be experiencing serious issues because of it.
What is "problematic pornography use"?
“It’s difficult to put a number on it,” says Dr Vickers. “Is it something that is required every time someone masturbates in order to achieve an erection or to complete ejaculation? Is the use increasing over time?
"Are you building a tolerance to it, and are you going out of your way to try and seek it out? These are the sorts of factors that we would use to determine things like drug addiction and pornography addiction.
“Most of the time, people are self-identifying that it is a problem. If they’re asking the question, ‘Am I watching too much porn’, they probably already know the answer.”
Vickers is also careful to point out that while there is no clear link between pornography and failing to get a rise downstairs, there are connections between too much screen time and forms of sexual dysfunction and relationship problems.
“Overuse of pornography may change expectations either from what they expect from their partner or in terms of anxiety caused by expectations of themselves. We know that performance anxiety and relationship issues are some of the major causes of loss of libido, which can compound the problem and lead to further difficulties.”
The porn and ED link does exist
So, does porn directly cause ED? Well, as we touched on earlier, it's complicated. Short answer — no. Long answer — sort of.
It’s a classic chicken and egg scenario. Lots of people who watch too much pornography may already be dealing with an underlying form of sexual dysfunction.
The porn use is both a symptom of this as well as an aggravating factor. That is to say; not only does “problematic” porn use show you might be dealing with unresolved sexual issues — it also can actively make them worse.
The truth is, the causes of ED are many and varied.
What are other causes of erectile dysfunction?
Erectile dysfunction or sexual dysfunction can be caused by a number of risk factors. The inability to keep an erection firm on occasion isn't a cause for concern.
However, if sexual problems like ongoing erectile dysfunction during sexual intercourse are impacting your partnered sex, it's worth investigating the reasons and factors that influence your sexual appetite.
The lack of physical stimulation with a sexual partner compared to your personal masturbation technique may be a contributing factor, particularly if you require much more physical stimulation than you have communicated to your partner.
Alongside porn-induced erectile dysfunction, here are a few other factors that can be responsible for your erectile dysfunction.
Physical causes
Some physical causes of erectile dysfunction can be your physical weight, for example, if you are overweight or obese. Physical health becomes a greater risk factor for erectile dysfunction the older you get.
Other health problems damage the nerves or narrow the blood vessels, which can cause erectile dysfunction. When the blood vessels narrow, it becomes harder for the penis to fill with blood and enlarge.
If you experience erectile dysfunction and an overlapping health concern, it might be time to seek professional medical advice to discover the underlying cause of your erectile dysfunction.
Psychological causes
There are also a number of psychological causes for difficulties with sexual functioning or erectile dysfunction. These include mental health conditions, including performance anxiety or stress.
You may have difficulties with sexual interaction with your real-life partner, which could put a strain on your relationship.
Lifestyle factors
And did we mention smoking and alcohol? Excessive use of substances can also be a risk factor for erectile dysfunction.
So, if you want to keep things smoking hot in the bedroom then you might want to consider the link between tobacco and sexual functioning, as well as the use of illicit drugs.
Some pharmaceutical medications can also have an impact on sexual functioning [8].
Treating porn-induced ED
Like all types of erectile dysfunction, there is help available to treat porn-induced erectile dysfunction and improve your sex life.
Erectile dysfunction is a complex health issue and it can take a while to find the right treatment for your particular sexual dysfunction.
Some clinical reports suggest quitting internet pornography is enough to re-set or re-program your brain and reverse the conditioning of limitless pornography consumption to maintain your erection [6].
In these cases, the erectile dysfunction will often dissipate on its own.
Take some time away from the screen to allow your pleasure and sexual desire to build with your partner.
Sexual arousal or what turns you on can be difficult to talk about with your sexual partners, but it's important to try and have an open and honest discussion as the first step to treating sexual difficulties. Erectile dysfunction happens to the man but it impacts the couple.
There are also medical treatments you can combine with the advice above to help with the symptoms of erectile dysfunction. If you're looking for a discreet option that doesn't involve a face-to-face appointment with your doctor, Pilot has you covered.
Take our online consult and an Australian health practitioner will create a personalised erectile dysfunction treatment plan just for you.
Where to seek help
If you feel like your relationships are struggling and your porn use is out of control, there are some really important steps you should take.
According to Dr Vickers:
- Speak to someone who can help, like a doctor or a psychologist;
- If you’re comfortable with it, talk to your friends to get a general idea of what other’s consumption level is;
- Try to abstain from viewing pornography as much as possible, if not entirely.
“Over time things will get better, it’s not something that’s likely to be permanent,” he says.
And remember, it’s fine to enjoy pornography from time to time. As Dr Vickers points out, adult content has been a tremendous help to many for whom it is their only sexual outlet, and for couples whose relationships have been galvanised by mutual enjoyment of erotic material in the bedroom.
But if you notice an issue, or you’re going back for more and more, and your relationships are suffering as a consequence, then it’s probably time to put the porn away for a bit.
And — as always — if you think need help, don’t hesitate to reach out and talk to a health practitioner, if for nothing else other than peace of mind.
Photo credit: Voltage Pictures