Psychotherapists dealing with sexual issues, in particular sex and porn addiction, have stated for several years that one of the consequences porn abusing male clients are commonly reporting is sexual dysfunction—most often erectile dysfunction (ED) but also delayed ejaculation (DE) and sometimes even a complete inability to reach orgasm (anorgasmia). Interestingly, many such clients say these issues do not arise when they’re looking at porn; they only seem to struggle when they try to be sexual with a real world partner. And the trouble occurs even when they find the other person wildly attractive. Moreover, these issues are not related to age, physical health, or even frequency of orgasm and the need for a refractory period after masturbating to porn.
Until recently, the link between heavy porn use (often to the level of porn addiction) and sexual dysfunction has been purely anecdotal. In the past couple of years, however, researchers around the world have started to examine the consequences of heavy and addictive porn use, and the results have consistently confirmed the correlation.
The most recent study, conducted by French researchers Aline Wéry and Joel Billieux, both with the Psychological Science Research Institute at Université Catholique de Louvain, is highly illustrative of this point. Wéry and Billieux recruited French speaking men through sexuality related forums, social networks, a messaging service, and research networks, amassing 434 qualified participants—male, 18 or older (mean age 29.5), users of one or more online sexual activities within the preceding three months. Participants answered a 91 question survey examining six distinct topics:
- Socio-demographic variables like age, education, occupation, sexual orientation, relationship status, etc.
- Type and frequency of online sexual activities, including time and money expended, plus questions about frequency of masturbation in conjunction with online sexual activities, escalation of these activities in terms of both time and content, and feelings about these behaviors (shame, depression, anxiety, etc.)
- Compulsivity/addiction related to online sexual activity, assessed via the 12 item Internet Addiction Test
- Motives for engaging in online sexual activity, such as sexual satisfaction, curiosity, mood regulation, etc.
- Sexual dysfunction issues, assessed via the 15 item International Index of Erectile Function (IIEF)
- Self-perceived problems with online sexuality, including questions about consequences and whether the subject had sought or thought about seeking professional help related to online sexual behavior
As an experienced sex addiction treatment specialist, the findings in this study confirm what I and others have been seeing in our practices, with increasing regularity, over the past five or six years. For starters, the study found that the most common online sexual behavior is looking at porn, with 99 percent of participants engaging in this activity. Moreover, subjects reported a wide range of pornographic interests—everything from vanilla to hardcore, kink, and fetish of every ilk imaginable. The amount of time spent engaging in online sexuality (usually using porn) was equally diverse, ranging from 5 minutes per week to 33 hours per week.
Findings about participants’ motivations for engaging in online sexual activity were also enlightening. Unsurprisingly, the most common impetus was a desire for sexual satisfaction (94.4 percent), sexual arousal (87.2 percent), and orgasm (86.5 percent). However, mood regulation was not far behind, with participants listing relax/decrease stress (73.8 percent), alleviate boredom (70.8 percent), forget daily problems (53 percent), alleviate loneliness (44.9 percent), and combat depression/sadness (38.1 percent) as common motivators. So a desire to escape and dissociate from emotional discomfort drives porn use and other online sexual activities almost as often as the desire for sexual satisfaction.
Interestingly, research looking at substance use disorders (alcoholism, drug addiction), behavioral addictions (gambling, spending, video gaming, sex, porn, relationships, social media), and even eating disorders (anorexia, bulimia, binging) show a similar escapist motivation. Basically, addicts and those with serious compulsivities don’t engage in their addiction/compulsion to feel good, they do it to feel less—to temporarily control and/or escape their emotional (and sometimes physical) discomfort and pain.
Given the above fact, it is unsurprising that this study also found a direct link between attempts at mood regulation and problems related to online sexual activity (both self-perceived and measured by the Internet Addiction Test).
Among test subjects whose online sexuality was perceived and/or measured as problematic, one of the most commonly reported consequences was sexual dysfunction, usually some form of ED. And this is hardly the only research linking heavy porn usage to sexual dysfunction. In an earlier study of 350 self-identified sex addicts, 26.7 percent of participants reported ED or another form of sexual dysfunction. In smaller studies the numbers range from 16.7 percent to 58 percent. So it’s pretty clear that heavy porn use, especially to the level of sex/porn addiction, leads to sexual dysfunction relatively often.
The authors of the French study suggest, as a way of explaining the link, that perhaps men with ED are less confident in their sexual abilities and therefore turn to porn. After many years of working with sex and porn addicts, however, I think a more accurate explanation is that men who spend the vast majority of their sex lives searching for, looking at, and masturbating to an endless and constantly changing supply of intensely arousing sexual imagery—getting a fresh jolt of adrenaline and dopamine with every new image or video—become conditioned to this unrelenting neurochemical rush. And then, regardless of whether their usage has risen to the level of addiction, they find that the “rush” created by a lone real world partner does not measure up. It’s just not enough to create and/or maintain arousal. Hence, their sexual dysfunction.
Typical signs of Porn Induced Erectile Dysfunction (PIED) include:
- A man has no sexual dysfunction issues with porn, but he struggles with a real world partner—no matter how attractive he finds that partner or how emotionally connected he feels to that partner.
- A man can achieve and maintain an erection with real world partners, but orgasm takes a very long time and he might only be able to climax when he replays clips of porn in his mind.
- A man prefers the rush of porn to real world sexuality, finding online activity more intense and arousing.
- A man’s real world partner complains that he seems disconnected during lovemaking, as if his mind is elsewhere.
Much of the time, males with PIED also qualify as porn addicts. They are preoccupied to the point of obsession with pornography, they’ve lost control over their use of pornography (generally evidenced by multiple failed attempts to quit or cut back), and they’re experiencing negative consequences related to their use of porn (not just PIED, but ruined relationships, depression, anxiety, isolation, trouble at work or in school, etc.)
Unfortunately, many porn addicted men do not seek help for this underlying issue, choosing instead to address their symptoms and consequences in a piecemeal fashion— seeking mental health counseling for depression, anxiety, relationship problems, and seeing medical doctors for antidepressants, anti-anxiety meds, and/or Viagra (which doesn’t work very well for them because it addresses physical rather than mental issues with arousal). Many see a therapist and take pills for long periods of time without ever addressing their issue with porn. Sometimes they’re too embarrassed to bring it up. Other times they just don’t intellectually connect their porn use to their other problems. (Those who are addicted often think of porn as the solution to rather than the cause of their many life issues.) As a result, their core problem, porn addiction, goes unaddressed and untreated, and their symptoms not only continue but grow worse.
For more information about porn addiction and recovering from this debilitating disorder, check out my recently published books, Sex Addiction 101 and Sex Addiction 101, The Workbook. Therapist and treatment referrals for sex and porn addiction can be found here and here. I also conduct an open-ended discussion about sex, porn, and love addiction at InTheRooms.com, Friday nights at 6 p.m. PST.
Robert Weiss LCSW, CSAT-S is Senior Vice President of National Clinical Development for Elements Behavioral Health, creating and overseeing addiction and mental health treatment programs for more than a dozen high-end treatment facilities, including Promises Treatment Centers in Malibu, The Ranch in rural Tennessee, and The Right Step in Texas. An internationally acknowledged clinician, he has served as a subject expert for multiple media outlets including The Oprah Winfrey Network, The New York Times, The Los Angeles Times, The Daily Beast, and CNN, among many others. He is the author of several highly regarded books. For more information please visit his website at robertweissmsw.com or follow him on Twitter, @RobWeissMSW.
Robert Weiss PhD, MSW, CEO of Seeking Integrity LLC, is a digital-age sex, intimacy, and relationship specialist. Dr. Weiss has spent more than 25 years developing treatment programs, educating clinicians, writing, and providing direct care to those challenged by digital-age infidelity, sexual addiction/compulsivity, and other addictive disorders. He is the author of several highly regarded books on sex and intimacy disorders including Prodependence, Out of the Doghouse, Sex Addiction 101, and Cruise Control, among others. He also podcasts (Sex, Love, & Addiction 101) and hosts a free, weekly interactive sex and intimacy webinar via SexandRelationshipHealing.com. His current projects are: SexandRelationshipHealing.com, an extensive online resource for recovery from sex and intimacy disorders; and Seeking Integrity Los Angeles, an Integrated Intensive Program for Sex and Intimacy Disorders (Opening in Feb, 2019). For more information or to reach Dr. Weiss, please visit his websites, RobertWeissMSW.com and SexandRelationshipHealing.com, or follow him on Twitter (@RobWeissMSW), LinkedIn (Robert Weiss LCSW), and Facebook (Rob Weiss MSW).
