Porn-Induced Erectile Dysfunction: The Science, Stats, and Stories of PIED

June is Men’s Health Awareness Month, so it’s time to talk about everybody’s favorite topic: porn-induced erectile dysfunction.

“If you are under 40, and not on specific medications, and don’t have a serious medical or psychological condition, your copulatory ED almost certainly arises from performance anxiety or internet porn—or a combination of the two.” –Gary Wilson, Founder of yourbrainonporn.com

Do I have porn-induced ED? Is it possible that my ED is caused by watching too much porn? Does masturbation cause ED? Can watching porn negatively impact my sex life? Why do I just feel worse after watching tons of porn?

If you’re easily offended, stop reading. To have a meaningful discussion about porn and erectile dysfunction, we have to talk about a lot of uncomfortable things. This is your warning!

What Is Porn-Induced ED? (PIED)

Porn-induced erectile dysfunction is the inability to maintain an erection during sex—and sometimes masturbation—because one’s sexual appetite has been changed by frequent porn use. Porn-induced ED often sounds like, “I watch a lot of porn, and I can’t maintain an erection during partnered sex.”

Some symptoms of porn-induced ED  include:

• Difficulty maintaining an erection when putting on a condom
• Losing an erection the moment actual penetration occurs
• Difficulty reaching orgasm with a partner
• Decreasing penis sensitivity
• Needing to fantasize about your favorite porn to maintain an erection during partnered sex
• Escalating to more extreme forms of pornography in order to maintain an erection during masturbation
• Depression, lack of libido, decrease in energy, and overall lack of enthusiasm for daily tasks¹

Why Does PIED Occur?

“In very laymen terms, whenever these young men are trying to have sex with a partner…their brain is saying ‘What is this? I don’t really know what’s in front of me. I’m not used to this. This isn’t a computer screen. It doesn’t compute for me. I don’t know what’s going on.’”  –Alexander Rhodes, Founder of www.nofap.com

In order to understand what is happening between the legs, it’s necessary to understand what is happening between the ears. After all, there’s no such thing as an erection if the brain isn’t telling the penis, “Hey, it’s time to move!”

Neurons are cells that send and receive messages between the body and the brain. Stimuli from the outside world picked up by the body’s senses elicit a neurological response, whereby neurotransmitters begin sending signals between the neurons, setting off a chain reaction of activity throughout the body.

Probably the best-known neurotransmitter is dopamine. It’s a critical player in a massive list of functions and conditions, ranging from Parkinson’s Disease, the release of breast milk, psychosis, attention, nausea, and kidney and heart function.

But, dopamine’s celebrity status is often attached to its role in motivation, addiction, and lust, as part of the mesolimbic pathway.

The theory behind PIED goes like this:

1. Internet porn from online video sites is a supernormal stimulus, which means the brain’s reward center is bombarded with an amped-up version of a normal stimulus. Today’s online porn floods the brain with rush after rush of high levels of on-demand dopamine.
2. Drug addiction studies have shown that the repeated dopamine influx causes a decrease in D2 (dopamine) receptors. This is referred to as “desensitization,” as the brain’s reward circuitry fatigues from processing all of the dopamine and begins pruning away dopamine receptors in the same way you might cover your ears when someone next to you yells. Although not proven, it’s possible the same D2 pruning occurs in porn addicts.²
3. As a result, in order to achieve the same neurological “high” as last week, more dopamine (ergo, more stimulation, often in the form of more extreme genres of porn) is required. Over time, this attachment to porn creates a neurological expectation that is vastly different from the “regular” (boring) human sexual experience.

And, according to Gary Wilson, “When expectations are not met, dopamine drops, and so do erections.” Or, as feminist author Naomi Wolfe says, “Real, naked women are just bad porn.” ³

Why Porn Is a Supernormal Stimulus and Conditions Us to Prefer Porn Over a Real Person)

The material for this segment/section has been provided by NoFap, a leading pornography addiction recovery organization.

The human brain responds to the world around us using a complex network of 50-100 billion neurons to send electrical signals throughout the body. But, not all stimuli impact the brain equally.

Our reward system motivates us to engage in activities beneficial for survival.

Within the brain, there is a cluster of neural structures called the “reward system.”⁴ The reward system, true to its name, gives us neurochemical rewards for engaging in activities that are beneficial for our survival.

It is critical to humanity for us to survive and produce offspring with a mate. So, whenever people eat food or have sex, the reward system releases neurochemicals that provide feelings of pleasure. The person starts to associate the pleasure with the activity and is encouraged to eat more food and have more sex in order to experience more feelings of pleasure.

The reward system doesn’t just reward you. It also motivates you to do those things which are good for your survival. This motivation is mediated by the neurochemical called dopamine.⁵ Dopamine is released whenever your brain encounters a stimulus in the environment that it knows to be beneficial.

Say you visit a friend and smell some delicious food cooking. Your brain releases dopamine, and you suddenly crave the food. Or say your partner has just treated you to a candlelit dinner and has invited you to bed. Your brain releases dopamine, and you experience sexual desire.

Our brain learns to associate these beneficial stimuli with certain cues.

How does the brain know which stimuli or activities are beneficial for your survival and which are not? The brain has a feedback system that allows it to learn about new stimuli and activities. This process is called sensitization.

In sensitization, the brain wires together sights, sounds, feelings, aromas, tastes, and even thoughts associated with a certain beneficial stimulus. It does this through the operation of a protein called DeltaFosB, which accumulates in the brain when dopamine is released. DeltaFosB correlates certain memories of beneficial stimuli with the environmental and mental contexts in which these stimuli appear.

The brain thus “learns” to associate certain cues, such as the smell of hamburgers on the grill, with something good. When the brain encounters such cues in the future, it releases dopamine, encouraging you to interact with that stimulus again and again.

Though sensitization helps us survive by encouraging us to do those things that are good for our survival, it can also make us crave stimuli and activities which are detrimental to our health.

Porn exploits one of the most pleasurable natural rewards.

Pornography exploits one of the deepest desires that a human can experience and offers one of the most pleasurable natural rewards for engaging in it—an orgasm.

Today, pornography can provide its users with sexual hyperstimulation, unlike anything their ancestors would have encountered.

In the past, sexually attractive mates came in limited quantities throughout a person’s life. Now, with pornography, there is a virtually endless novelty in not only different sexually attractive “mates” but also different angles, focuses, lighting tricks, makeup, airbrushing, and editing—not to mention the impossible proportions and hyper-erotic situations available in animated porn.

Today’s porn, available in virtually endless amounts, can goose the reward system beyond anything sex with a real person could provide. Through continual exposure, the brain can be conditioned to prefer pornography over sex with real people.

What Doctors Say About Porn-Induced Erectile Dysfunction

According to Dr. Mary Anne Layden, a psychotherapist and Director of Education at the Center for Cognitive Therapy at the University of Pennsylvania, this continual conditioning eventually rebuilds the porn viewer’s sexual template—a pattern of thinking built by a repeated experience. She explains,

“Sexual arousal is very rewarding. So anything we hook to something that rewarding can become learned very easily. We’ve even found that, like with fetishes, if you show men pictures of women who are nude except for a high-heeled boot, they get sexually aroused by that image of that woman who’s nude with a high-heeled boot on. Very quickly, if you just show them a high-heeled boot, they’ll have an erection. Like, okay, that’s not natural that you would get an erection to a boot. But, we can teach you to have an erection to a boot by just hooking it to a naked woman. So, when they look at pornography, all the things they see get hooked to sexual arousal and those all become a part of their sexual template.”

So what does it mean when a man can get an erection from a shoe but not from his own partner? Layden explains,

“[Porn users] notice they can function fine as long as they’re with a screen but they can’t when they’re with a person. Part of it is what they’re learning from the pornography. They’re learning to interact with women who are not physically natural. Many of the woman are surgically changed and men are thinking, ‘Oh, this is what women should look like.’ Well, most women don’t look like that. So, now men get aroused for only surgically changed women, not to the real women in their lives.”

Dr. Abraham Morgentaler, the Director of Men’s Health Boston, Associate Clinical Professor of Urology at Harvard Medical School and Beth Israel Deaconess Medical Center, stated ⁶:

“I’m worried, I’m worried about the impact of porn on men and on women. I see young men coming in who are really confused about what normal is because all they know about sex is what they’ve seen on porn.”

“Once upon a time in the Victorian age when women wore long gowns…it was considered to be really sexy when a man saw a turn of an ankle. That was enough for men to go and write sonnets and all of these other things. Then, we went through the mini-skirt phase in the 60s and all that and we talked about, the apocalypse is coming, and oh my God, this is so sexualized. Now we have it where everybody’s got a computer or even a smart phone and you’re on the Internet and can see whatever you want. There’s no surprises…I think that the concern is, what porn has figured out is what really works for the brain of the guys. It’s the maximum stimulus.”

Dr. Dudley Danoff, MD, world-renowned urologist and founder of the Cedars-Sanai Medical Center Tower Urology Medical Group in Los Angeles, has observed a growing number of young men who speculate that their early viewing of streaming porn is the cause of their lack of sexual interest with their real-life partners. In a 2016 podcast with Diana Wiley, Ph.D., Dr. Danoff concludes that “porn is bad for sex.”

“By watching porn 3-4 times/day, these men are creating a perfect recipe for erectile dysfunction. When young people are exposed to porn early in adolescence, they begin to ask, ‘Is this the norm? Is this to be expected? Is this how I want my mate to act?’ It [pornography] really is mind-distorting.”⁷

Peer-Reviewed Studies on Porn-Induced ED

Many naysayers claim that porn use can be correlated with ED, but it doesn’t cause ED. However, there’s a growing number of peer-reviewed studies that make a strong case that porn does in fact cause erectile dysfunction. Check out these articles for more details on those studies:

• Porn and ED: 3 Peer-Reviewed Studies You Need to Read
• Does Porn Cause Erectile Dysfunction?

Erectile Dysfunction in Young Men and Teens

Supporting Dr. Danoff’s observations, a number of studies and forums show an increasing amount of erectile dysfunction in teens and young men. This increase in ED showed up during the decade that internet use and porn-streaming sites became common.

ED Rates Before Online, Streaming Porn

In 1999, a major cross-sectional study reported “trouble maintaining or achieving an erection” in 7% of men ages 18-29 in the United States.⁸ In 2002, a meta-analysis of 23 erectile dysfunction studies from Europe, the USA, Asia, and Australia reported consistent ED rates of 2% in men under 40 (except for the preceding study).⁹

It is widely accepted that streaming pornography began in 2006. For reference, Pornhub, the largest pornographic website in terms of number of videos and viewers, launched in 2007.

ED Rates “A.T.” [After Tube]

Now that “tube” sites are the norm (sites that allow users to upload content), a 2016 study on Canadian adolescents showed that 45.3% admitted to problems in erectile functioning.¹⁰

The Global Study of Sexual Attitudes and Behavior (GSSAB) administered a yes/no questionnaire about ED to 13,618 sexually active men in 29 countries from 2001 to 2002. This first group was aged 40-80.

A decade later, in 2011, the same “sexual difficulties” (yes/no) questionnaire from the GSSAB was administered to 2,737 sexually active men in Croatia, Norway, and Portugal. This second group was 40 and under.

Based on the findings of prior studies, one would predict the older men would have far higher ED scores than the younger men, whose scores should have been negligible. Not so. In just a decade, things had changed radically. The 2001-2002 ED rates for men 40-80 were about 13% in Europe. By 2011, ED rates in young Europeans, 18-40, ranged from 14-28%.

Although none of the content is peer-reviewed, an analysis of questions asked on “MedHelp.org ED Forums” showed that nearly 60% of visitors who mentioned their age were younger than 25. “Porn” was the most prominent word used in the forum by these participants when describing their current erectile dysfunction situation.¹¹

Young, healthy men with unexplained ED and only one variable in common (internet porn use) attempted multiple regimens and treatments with no success. The subjects removed the one variable they have in common, and almost all experience the same results: remission of their medical condition.

How Porn-Induced ED Is Impacting Real People

There are thousands of posts in forums related to PIED, and they show an overwhelming sense of hopelessness and despair among those suffering. Here are just a few quotes:

“I do look at porn on a regular basis during masturbation and I can climax without it (porn). I used to masturbate between 1-3 times a day, sometimes four. That being said, while with real women, my erection goes away completely. If I can climax at all, it takes forever. What’s wrong? Please tell me that I’ll be able to have successful sex with a real woman at some point?”

“I started watching porn at 11, maybe 12, and started masturbating around the same time. Since then I’ve been consistently masturbating at least once a week and at most three times a day. I’m 17 now. I had no idea what porn was doing to me, until I tried having sex a month ago with my girlfriend and my penis felt like a deflated balloon hanging between my legs.”

“I’m 36, fit and healthy, married with two kids, secure job, no debt or other major stress in my life.  I have been watching porn since I was age 12 or 13 (VHS back then). I can’t seem to get an erection during intercourse or even by myself in the shower (where I would sometimes masturbate). I even managed to get some Viagra which didn’t seem to help. From my story, does it sound like porn-induced ED?”

If any of these quotes sound like your story, you’ve probably felt discouraged and alone. Please understand that there is hope—it’s possible to recover from PIED.

We’ve profiled three men who suffered from porn-induced ED, have recovered, and are now helping others. Check out the real stories of three pioneers in PIED recovery–Noah Church, Gabe Deem, and Alexander Rhodes.

Important note: Porn-induced erectile dysfunction also impacts the spouse. If you think your husband or significant other has PIED, there are steps you can take too.

Can You Recover From Porn-Induced ED?

Absolutely. Though thousands of guys struggle with PIED, thousands have also been able to recover.

The problem isn’t just your penis. Your most important sex organ isn’t between your legs. It’s between your ears. And it might need a reboot. If you think your ED is porn related, here are a few steps you can take:

1. Continue to educate yourself.

Remember, we aren’t doctors, so please check with a medical professional before coming to any conclusions about your erectile dysfunction in order to eliminate a serious health issue. Here are a few questions that might give you a better idea if your ED is porn-induced.

2–Get on the fast track to recovery today.

It’s easy to lie to yourself and believe, “Hey, I’m in control. I can stop whenever I want,” but be honest–you’ve said that 1,000 times. Maybe you said it last night. Recovery is possible, and there’s no better time to start than today.

Most guys who follow certain steps regain their ability to maintain an erection during partnered sex. Those who are most successful don’t just STOP a few habits; they also ADD a few new habits as part of the rewiring process.

Are you ready to begin your recovery from PIED? To help you on your journey, we’ve created RecoverED: 10 Days on the Road to Healing from Porn-Induced Erectile Dysfunction.

¹ Your Brain on Porn, “Porn-Induced Sexual Dysfunctions” accessed May 6, 2022. https://www.yourbrainonporn.com/porn-induced-sexual-dysfunctions/

² Your Brain on Porn, “Differences in D2 dopamine receptor availability and reaction to novelty in socially housed male monkeys during abstinence from cocaine”, accessed May 6, 2022. https://www.yourbrainonporn.com/relevant-research-and-articles-about-the-studies/dopamine-receptors/differences-in-d2-dopamine-receptor-availability-and-reaction-to-novelty-in-socially-housed-male-monkeys-during-abstinence-from-cocaine-2010/

³ Naomi Wolfe, “The Porn Myth,” New York Magazine, October 9, 2003. http://nymag.com/nymetro/news/trends/n_9437

⁴ Wolfram Schultz, “Neuronal Reward and Decision Signals: From Theories to Data,” Physiological reviews 95 (2015): 853-951. doi:10.1152/physrev.00023.2014

⁵ Roy Wise, “Dopamine, learning and motivation” Nature Reviews Neuroscience 5 (2004): 483–494. https://doi.org/10.1038/nrn1406

⁶ Hannah James and Sean O’Shea, “Porn causing erectile dysfunction in young men” Global News, March 30, 2014. https://globalnews.ca/news/1232726/porn-causing-erectile-dysfunction-in-young-men/

⁷ Dr. Diana Wiley, “Love, Lust, and Laughter,'” Aug. 23, 2016. https://drdianawiley.com/dr-dudley-danoff-author-of-the-ultimate-guide-to-male-sexual-health-aug-23-2016/

⁸ Edward O. Laumann, Anthony Paik, Raymond C. Rosen, “Sexual Dysfunction in the United States: Prevalence and Predictors,” JAMA 281 (1999): 537–544. doi:10.1001/jama.281.6.537

⁹ J. Prins, M. Blanker, A. Bohnen, A. et al., “Prevalence of erectile dysfunction: a systematic review of population-based studies,” International Journal of Impotence Research 14 (2002): 422–432. https://doi.org/10.1038/sj.ijir.3900905

¹⁰ Lucia F. O’Sullivan, E. Sandra Byers, Lori A. Brotto, Jo Ann Majerovich, and Jason Fletcher, “A Longitudinal Study of Problems in Sexual Functioning and Related Sexual Distress Among Middle to Late Adolescents,” Journal of Adolescent Health 59 (2016): 318-324. https://doi.org/10.1016/j.jadohealth.2016.05.001

¹¹ Superdrug Online Doctor, “A Semantic Analysis of An Erectile Dysfunction Forum,” accessed May 6, 2022. https://onlinedoctor.superdrug.com/semantic-analysis-erectile-dysfunction/