We have written about the often contrary claims made by commentators about the current state of research on, and clinical understanding of, problematic internet pornography use (a.k.a. “pornography addiction”) and its effects. On one hand, a body of scientific literature appears to support the view that problematic pornography use qualifies as an addiction and often leads to sexual problems including, notably, erectile dysfunction. On the other hand, a vocal group of skeptics use words like “pseudo-science” and “moral panic” to dismiss research linking pornography to sexual dysfunction, and decry “porn addiction” as the invention of a treatment industry in search of a new and profitable problem to solve.
We at PornHelp overcame an addiction-like dependence on internet pornography, and as such tend to favor the former view. That said, we don’t claim to be able to vouch for the quality or reliability of scientific research that is beyond our learning. Often, we are only able to catch the general drift of articles in science journals, and compare the conclusions to our own admittedly anecdotal experiences in order to form a judgment. Still, regardless of how snowed we are by the technical minutiae, we take notice when an article captures the essence of what it was like for us to struggle with porn, particularly if it also makes tangible recommendations about ways to isolate and test factors that could contribute to internet porn becoming a source of distress and destruction in a person’s life, as it did in ours.
“Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports”, published earlier this month in the journal Behavioral Sciences, fits that bill. With seven United States Navy doctors among its co-authors, this new article pairs a review of the latest scientific research on internet porn use and sexual dysfunction with three case studies from the Navy authors’ clinical practices. It argues that current research supports the conclusion that internet pornography is a key contributor to the sharp rise in reports of sexual dysfunction among men under forty in the past decade. It also makes detailed and, we think, apt recommendations for future areas of study.
The article follows an analytical trajectory that will look familiar to anyone whose life has been consumed by problem porn use. The authors begin by proposing that research on internet pornography establishes it as a “super-normal” stimulus that is particularly effective in catching and retaining the brain’s attention, a quality known as “salience.” This is so, the authors contend, because internet porn is an “exaggerated imitation of something our brains evolved to pursue,” and because internet porn's near-infinite availability and variety feeds an equally hard-wired evolutionary preference for novelty. The authors next point to research that suggests “chronic Internet pornography use may become a self-reinforcing activity.” That is, the more you use, the more you want and need to use. If that sounds like an addiction process to you, it does to the authors also. Reviewing the symptoms reported by one of the authors’ patients, they draw a parallel between those symptoms and the criteria for internet gaming disorder, a widely accepted addiction diagnosis.
Finally, the authors review a large body of neuroscience research, including a study co-authored by one of the most prominent “skeptics” mentioned above, and posit that the findings support their hypothesis that sexual dysfunction results from “neuroadaptations” in internet pornography users’ brains. Things get a little complicated here, but the basic idea is that internet porn use can change the brain in two meaningful ways: it can make a user more sensitive to “cues” associated with using internet porn, while it also makes a user less sensitive to the “rewards” of normally rewarding activities, such as partnered sex. The authors propose that this combination of brain changes results in users’ desire to consume porn supplanting their desire to have partnered sex, and to a decline in sexual arousal from partnered sex.
People who struggle with problematic porn use know firsthand what these changes are all about. The first change is responsible for that sudden, insistent craving to use porn that arises after seeing a seemingly random image - say, an advertisement for a beach vacation. The second change is what builds up porn tolerance, prompting a need for more volume and variety to stay sexually excited and a loss of interest in real-life sexual situations. Now, as we’ve mentioned, we can’t speak to the specific evidence of “neuroadaptations” described in the research, much of which is, candidly, over our heads. But, we can say that hair-trigger cravings for porn (but not sex), an unquenchable thirst for more and different content, and a near complete loss of interest in and arousal from partnered sex, sums up the experiences of many former problem porn users pretty darn well. Ok, back to the article.
After reviewing the existing evidence, the authors suggest several avenues for future research that we think are well-tuned to advancing the discussion of how best to treat problematic porn use and associated sexual dysfunction. The authors push for more “intervention” studies, where a group of internet pornography users reporting sexual dysfunction have internet pornography removed from their lives for a period of time and are monitored to see if their sexual dysfunction dissipates. We find it surprising that only a few researchers have taken this approach, considering that widespread posts on internet forums such as NoFap.com and RebootNation.org report that refraining from internet pornography use restored sexual function and desire for partnered sex that had gone missing during a period of frequent porn use. The authors also suggest adding more nuance to correlative studies. Instead of simply using frequency of internet porn use as a variable (as many studies have thus far), the authors suggest evaluating more subtle and telling formulations, such as how many years a person has masturbated with porn compared to years masturbating without porn, the ratio of orgasms a user has with pornography to orgasms a user has in partnered sex over a given time period, and the age at which a user’s pornography use began.
We think these suggestions are on-target because they capture what many of us have experienced. Anecdotally, things take a turn toward the destructive when users isolate themselves from their lives and loved ones in order to find time to use internet porn. The variables the authors propose may help identify factors contributing to that turning point, and perhaps even prevent it.
“Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports” will not end the debate that continues to rage in the popular press about whether pornography addiction "exists" and whether pornography use can lead to problems like erectile dysfunction. But this article does make a sophisticated and hyperbole-free contribution to the discussion. For those who know firsthand the difficulty of struggling with a pornography use problem, and the frustration of trying to find useful information about their condition, that’s a welcome step in the right direction.
Longer-form writing from the PornHelp team on current topics relating to problem porn use and recovery.