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More on Porn: Guard Your Manhood—A Response to Marty Klein

Marty Klein wrote a reaction to our original post on how porn is shaping young men’s sexual response. Klein suggested that science doesn’t empirically support our assertion of unprecedented rates of sexual dysfunctions in young men. In fact, all studies assessing young male sexuality since 2010 report historic levels of sexual dysfunctions and startling rates of low libido. Erectile dysfunction (ED) rates range from 27 to 33 percent, while rates for low libido (hypo-sexuality) range from 16 to 37 percent. The lower ranges are taken from studies involving teens and men 25 years old and under, while the higher ranges are from studies involving men 40 years old and under.

Prior to the advent of free streaming online porn, cross-sectional studies and meta-analyses consistently reported ED rates of 2 to 3 percent in men under 40. That’s about a 1000 percent increase in youthful ED rates in the last 20 years. Klein dismisses this rising tsunami of empirically documented sexual dysfunction in young men as normal teenage performance anxiety, which raises the question: if not high speed Internet porn, what variable changed that could account for this astronomical rise?

Incidentally, if you cannot achieve an erection without using online porn or fantasizing about porn you have watched (but can get an erection and climax with porn), you should consider the possibility you may be part of this unfortunate swell.

Before we address the scant “null results” research Klein cites to exonerate online porn, you should know that he hasn’t told you about a growing list of studies that do find associations between solo porn use and arousal, attraction, and sexual performance problems. Findings include difficulty orgasming, diminished libido or erectile function (1, 2, 3, 4, 5, 6), negative effects on partnered sex, decreased enjoyment of sexual intimacy (1, 2, 3), less sexual and relationship satisfaction (1, 2, 3, 4), a preference for using Internet pornography to achieve and maintain arousal over having sex with a partner, and greater brain activation in response to pornography in those reporting less desire for sex with partners. Online porn use even correlates with abnormally low sexual desire in high school seniors.

The most interesting of these items is a 2007 chapter by Kinsey Institute researchers who were among the first to report porn-induced ED and low libido. Half of subjects were recruited from bars and bathhouses where porn was “omnipresent” and continuously playing. These subjects had difficulty achieving erections in the lab in response to video porn. In talking with the subjects, the researchers discovered that high exposure to porn videos apparently resulted in lower responsivity and an increased need for novelty and “kink.” Two recent brain studies found that more porn use correlated with less brain activation to sexual images (1, 2). A third brain study found that porn addicts’ brains habituated faster to sexual images.

Ignoring all of the above evidence, Klein cites only heavily criticized research by Prause and Pfaus, and inconclusive research by Landripet & Stülhofer. Let’s take a closer look at their papers.

The Prause and Pfaus paper wasn’t a study at all, and no actual erections were assessed in its making. Prause claims to have gathered data from four of her earlier studies, none of which addressed ED. However, the data in Prause and Pfaus doesn’t match the data in the earlier studies. The discrepancies are not small and remain unexplained. A comment by researcher Richard A. Isenberg MD highlights some (but not all) of the flaws, which also include unsupported claims, poor methodology and conclusions in opposition with data.

Landripet and Stülhofer surveyed men in Norway, Croatia and Portugal. In addition to drawing formal criticism from Danish pornography expert Gert Martin Hald, this paper actually found correlations between ED and porn use. For example, the abstract doesn’t mention a rather important correlation. Only 40 percent of the Portuguese men used porn “frequently,” while the 60 percent of the Norwegians used porn “frequently.” The Portuguese men had far less sexual dysfunction than the Norwegians. Elsewhere in the paper, Landripet & Stülhofer acknowledge a statistically significant association between more frequent porn use and ED, but claim the effect size was small. Hald pointed out that, “In pornography research — even small effect sizes may carry considerable social and practical significance.”

What else did the authors overlook to generate their “null results” claims? For example, what variables should have been considered if their objective was to investigate porn’s role in sexual dysfunctions? Hald emphasized the need to assess more variables (mediators, moderators) than just frequency per week in the last year.

Truth is, researchers can’t “disprove” porn’s potential role in soaring sexual dysfunctions in men under 40 by comparing only a single variable such as “frequency of use in the last year” with only ED (rather than with the full range of sexual performance problems today’s porn users typically report). They need to investigate a combination of variables. For example: ratio of masturbation to porn versus masturbation without porn, ratio of sexual activity with a person versus masturbation to porn, gaps in partnered sex (where one relies only on porn), virgin or not, years of use, age regular Internet porn use started, escalation to new genres, novelty per session (i.e. compilation videos, multiple tabs), and presence of hypersexuality/porn addiction.

As we explained in our original post, there’s only one practical way to confirm whether erectile dysfunction, delayed ejaculation or abnormally low desire for sex with a partner is porn-induced or not: eliminate porn use for an extended period and see if normal sexual response returns.

So far, only one published study had a subject with suspected porn-induced sexual problems abstain from porn. Guess what? In eight months the man had recovered from anorgasmia, low libido and porn-related fetishes, and was enjoying satisfying sexual relations with his girlfriend. That’s one-for-one on studies truly assessing porn-induced sexual problems. In addition, this page contains articles and videos by about 60 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED or porn-induced loss of sexual desire. My (Gary’s) website, YourBrainOnPorn.com, has documented the experiences of a few thousand men who removed online porn from their lives and recovered from chronic sexual dysfunctions.

Klein would have us believe that any perceived rise in erectile problems is due to widespread requests for sexual enhancement drugs. However, the ED-rate studies summarized above do not rely on percentages of men requesting medications from their doctors. They rely on peer-reviewed studies (usually anonymous) of population-wide sexual dysfunction rates.

For the “Viagra hypothesis” to be true, it would have to be the case that young male participants consistently lied about their erectile functioning in every study published between 1948 and 2010, worldwide. Then, suddenly, in 2010 all the young men (and only the young men) began to tell the truth about their ED problems. This is highly unlikely.

Klein implies the evidence we presented of online porn’s effects on users is scarce and isolated, with “tiny sample sizes.” In our article we cited twenty-four recent neuroscience studies on porn users, along with five recent reviews of the literature. The complete up-to-date list is here. Every study listed suggests that overuse of online porn has measurable adverse effects on some brains. Some of these effects could help explain rising sexual dysfunctions. All competent scientists add caveats to their studies. However, the authors of every paper listed at the above link state that their findings mirror the findings seen in drug addiction studies. This is not disputable. We merely reported their conclusions.

All addiction is one condition, and “sexual behavior addiction” not only exists but involves the same fundamental mechanisms and brain changes as substance addiction.

fMRI studies tend to be far smaller than online surveys due to their high cost, but Klein’s claim that some studies had 10–15 subjects is false. The lowest number of subjects was 19 (plus matched controls), while the highest was 67. Moreover, these neuroscience findings align with more than 140 recent brain studies on internet addicts. And all of those studies are consistent with decades of addiction neuroscience research on both substance and behavioral addiction, a reality codified in the American Society of Addiction Medicine’s new definition of addiction. All addiction is one condition, and “sexual behavior addiction“ not only exists but involves the same fundamental mechanisms and brain changes as substance addiction.

Klein supports his argument almost entirely with a 2012 Salon.com article. By inviting his readers to travel back in time, Klein avoids addressing the flood of recent studies on online porn users’ brains described above. The studies have found the precise brain changes that Salon.com’s experts, Rory Reid, Bruce Carpenter and Barry Komisaruk, said don’t exist.

Klein tries to assure readers that the brain activation in porn users is no different from the brain activation for viewing sunsets or watching the NBA play-offs. This familiar talking point endeavors to paint the false picture that all brain changes are equal. In reality, brain changes caused by addiction are specific and have profound negative consequences. These include hyper-reactivity to porn related cues, a numbed pleasure response to everyday rewards (often leading to desire for more extreme stimulation), reduced impulse control and ability to foresee consequences, and a dysfunctional stress response.

There are multiple biological reasons we experience other pleasures differently from a mind-blowing orgasm. Sexual stimulation releases higher amounts of dopamine and opioids than any other natural reward. Also, sexual stimulation and addictive drugs activate the exact same reward system nerve cells, which are distinct from those for other natural rewards. This helps explain why prolonged edging to porn and using cocaine can both be so compelling, and why other non-drug rewards are less so. Not too many “sunset addiction” recovery forums on the web.

Klein takes us to task for not ascribing these young men’s difficulties to masturbation rather than online porn use. Is Klein seriously suggesting that masturbation leads to chronic sexual dysfunctions that require months to heal (as reported by many of today’s young porn users)? Where’s the data for that far-fetched assertion? Second, does he realize that today’s porn users often watch porn when they’re not masturbating? Think libraries, during class, buses, Starbucks.

Klein concludes by telling us not to “imagine that without porn, young men will go back to some mythical pre-Internet time when their ideas about sex were realistic, their erections were always firm, and their desire always high.” Yet that is exactly what is happening in men who quit using online porn. Former porn users report sexual dysfunction reversal and real partners looking “hot” again. In short, young men once again perform with the prowess of any healthy mammal.

In the end, you have nothing to lose by experimenting for yourself and laying off porn for a while. Don’t let sexology hype encourage you to give up on healthy sexual responsiveness. END

About the authors

Philip Zimbardo is internationally recognized as the “voice and face of contemporary psychology” through his widely viewed PBS-TV series, Discovering Psychology, and his classic research, The Stanford Prison Experiment. Noted for his personal and professional efforts to actually “give psychology away to the public,” Zimbardo has also been a social-political activist, challenging the Government’s wars in Vietnam and Iraq, as well as the American Correctional System. Zimbardo has been President of the American Psychological Association (2002), President of the Western Psychological Association (twice), Chair of the Council of Scientific Society Presidents (CSSP), and now Chair of the Western Psychological Foundation.

Gary Wilson is the author of Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction, presenter of the popular TEDx talk “The Great Porn Experiment” and host of the website “Your Brain On Porn,” which was created for those seeking to understand and reverse compulsive porn. He taught anatomy and physiology for years and has long been interested in the neurochemistry of addiction, mating and bonding.

Nikita Coulombe is a writer and artist who co-authored Man Interrupted with social psychologist Philip Zimbardo. She also assisted Warren Farrell with his upcoming book, The Boy Crisis. Passionate about understanding human nature, she co-founded the sex ed blog, BetterSexEd.org.

67 Comments

  1. Jakob Krarup says:

    “In eight months the man had recovered from anorgasmia, low libido and porn-related fetishes, and was enjoying satisfying sexual relations with his girlfriend.”

    You base your claim on a single test with a *single* person…?
    No control group? How would we know if he might have gotten over his ED without abstaining from porn?

    • Gary Wilson says:

      No, we don’t base porn-induced ED on a single study. That was simply an example of the only study that has removed the variable of porn use. We base our claims about porn-induced ED (and low libido, delayed ejaculation) on thousands of recovery stories which are linked to in the article. The link – http://yourbrainonporn.com/erectile-dysfunction-question#recovery

      Each page listed has hundreds to 2,000 such documented stories where healthy young men with chronic sexual dysfunctions removed a single common variable (porn) and healed their sexual dysfunction.

      In addition we linked to this page – http://yourbrainonporn.com/porn-induced-ed-media
      – which contains 12 studies associating porn use with ED, anorgasmia, DE, low libido, and less arousal to sexual images. The page has 60 articles by experts who recognize porn-induced ED (urology professors, MDs psychiatrists, sexologists, etc.)

      • Michael Miller says:

        Seriously, quoting a propaganda outlet as proof your propaganda is true simply won’t fly
        Yourbrainonporn is a well documented propaganda site.
        Get real, do research not paid for by religious fundamentalists

        • Mark says:

          Gary Wilson is secular. Do your research. . .

          • Sandra says:

            It seems like Gary only publishes findings that fit for his book sales. Why can’t there be people who are non-religious OR non-monetary focused releasing unbiased research?

  2. Ray Madison says:

    I don’t recall reading anything in these articles as to what the sex lives of these porn addicts were like before they started watching porn. Did any of this improvement to their functional capacities when they stopped the habit reflect a similar improvement with respect to the activities of their pre-porn days?

    • Gary Wilson says:

      To ray – In essence, the entire article is based upon young men who had normal sexual functioning and arousal – who over time experienced declining erections, libido, anorgsmia, and morphing porn tastes. If the sexual problem was full-blown ED, they could no longer achieve an erection without porn. That means no erection when attempting to masturbate without porn, so it wasn’t performance anxiety.

      The article linked to 3000 or more such stories were young men regained normal sexual functioning after eliminating porn use. It took months and sometimes a year or two for the men to acheive a normal erection without porn. The link to the recovery stories – http://yourbrainonporn.com/erectile-dysfunction-question#recovery

  3. Ryan says:

    I am a recovering heroin and cocaine addict with 12 years of recovery in a 12 step program (complete abstinence). I am also a devout skeptic.

    I realize that my particular case is an anecdote and not data, and that the thousands of addicts I have known over the past 12 years through NA are just a collection of anecdotes. Nonetheless I submit to you that based on these personal experiences I conclude that these authors know what they are talking about. Their inquiries are far more on target about the nature and manifold manifestations of addiction than was the response to their original post.

    I’ve seen hundreds of men come thru the NA program and exchange their substance addiction for sex/porn addiction. The consequences shared are precisely those outlined above, among others. These individuals see their attraction to their partners severely diminished, experience difficulty with intimacy and becoming aroused, etc.

    I’m casting my lot with the position of the authors. What I read above is a good start to the inquiry with directional correctness and an acceptance of the need to study this obvious problem further.

    • NameIsNotBoyd says:

      I have traveled in similar circles and can speak from experience. Sex addiction and drug addiction are seen together quite often, especially with meth addicts. I have not seen them interchanged, one for the other, but rather as two separate addictions/preoccupations that can feed off each other and are complex impulses in and of themselves.

  4. Susan Steffan says:

    Thank you for your substantial corrections on the obvious superficial, agenda-laden idiocy of the previous article.

  5. Michael H. Standart says:

    You start with: ” In fact, all studies assessing young male sexuality since 2010 report historic levels of sexual dysfunctions and startling rates of low libido.”

    My response: So what? Correlation is NOT causation. What you call pornography and what others call “erotica” depending on your point of view has in one form or another been around for literally thousands of years and so has the sort of fear mongering you’re promoting here and all cloaked in the name of science.

    The REALITY is that NOBODY has ever been able to show a clear link to all the sort of pathologies you claim to the exclusion of all other possible causes, and it’s been tried.

    • Gary Wilson says:

      We agree. Correlation doesn’t equal causation. Our point was that Klein, nor anyone else, has suggested a plausible explanation for a 1000% increase in ED in men under 40 (400% increase in low libido) This tremendous rise has occurred almost exclusively in young men. These days, ED rates are often higher for young men than for old men (who obviously used less internet porn growing up). The 2014 Canadian study reported that 53.5% of males aged 16-21 have symptoms indicative of a sexual problem. Erectile dysfunction was the most common (27%), followed by low sexual desire (24%), and problems with orgasm (11%)

      Klein’s only suggestion was that Viagra caused ED in only young men. There is no empirical support for his claim that the introduction of Viagra (1997) led to men finally tell the truth in studies on sexual dysfunction.

      As we explained, these are not the rates of men visiting their doctors to request ED medication. The ED rates cited refer only to peer-reviewed studies (usually anonymous surveys) on population wide rates of sexual dysfunction. To put it another way, the ‘Viagra hypothesis’ is claiming that in every single study published between 1948 and 2010, in countries all over the world, the young male participants consistently lied about their erectile functioning. Then, all of a sudden, in 2010 all the young men (and only the young men) began to tell the truth about their ED problems. This is absurd.

  6. craig gosling says:

    Nowhere did I read exactly what the author’s definition of porn is. Is it, “I’ll know it when I see it” ? Porn to one person may not be to another. Did porn exist a hundred years ago, or a thousand years ago, and if so what was it? Did it screw up the sex lives of following generations? At what point in history does one compare contemporary porn with historical porn? I was under the impression that most medical researchers agree that porn, whatever it is, may be useful during sexual therapy sessions and in helping certain couples achieve full excitement and gratification during sex. Sexual imaging has been found to be a useful technique. While Portugeses men used less porn and had less dysfunction, no mention of female satisfaction was mentioned. Porn may improve a couple’s sexual enjoyment. Concerning the dangers in viewing excessive porn, excess attention to any activity can become destructive and habitual but not necessarily addictive. The connections between drug addiction and porn may be actual but further studies are required before it is fully understood.

    • David says:

      Porn has exisited for hundreds of years and if you consider drawings and pictures of sexual activity to be porn then the Egyptians were pornographers too. The level of of its effect on society has increased exponentially with our ability to depict such acts; from scratchings on a cave wall to ink and papyrus to black and white photos to full hd streaming. Hope this helps😏

  7. NameIsNotBoyd says:

    The moral disdain just oozes from this rebuttal of sorts. I was shocked to see the authors were not named Deacon Zambrano and Rabbi Wilson. Who is to say yet that for some people a robust fantastical solo sex life might be preferential to a traditional monogamous relationship? Who is to say yet whether pent up sexual frustration might be better resolved alone having cyber sex rather than thru drunken passes at the local singles bar? How can young men’s ED be magically caused by porn and not by other new social complexities of the digital age? Why is it okay to laugh at the thin evidence presented by your adversary but feel it’s fine to throw out without citation absurdities about how common consuming porn has become in non-sexual situations. I find it almost pathetic that ‘eskeptic’ thought this diatribe fit to print. Nothing skeptical about it, sounds like ‘eskeptic’ is firm and resolute in its unyielding disdain for online pornography.

  8. Mike Colyar says:

    And sexual disfunction is a problem? This is the first good news I have heard about the horrible excess of humans in many, many years. The more young men (and, better yet women!) who’s sex lives consist of masturbating to whatever stimulus, the fewer pregnancies. Who, other than a religious lunatic, can think that this is anything but a wonderful trend?

    Stay in your parent’s basements and have fun!

  9. Geoff Archer says:

    Hats off to Gary on a successful defense of the original article.

    Marty Klein, in the words of Mythbusters, you are “busted”.

  10. Ken says:

    Sex and scandal. More low-hanging fruit. Great work you’re doing for the cause of science, Michael.

  11. Adolf Verloc says:

    As VR, tactile feedback and sexbots advance in sophistication, things will get worse or better, depending on your perspective. If people enjoy their sex lives with computers or robots, more power to them! Many people find other humans boring and puerile.

  12. Art Goldman says:

    One very obvious thing that could account for the “tsunami” of ED reports among young men is the sheer number of advertisements for
    ED remedies, not to mention the availability of the products themselves. The more popular these products are, and the more acceptable it may be to raise this issue with physicians, could easily account for the added reports.
    When I grew up, it was impossible to even discuss ED with one’s closest friends — let alone discuss virility-related issues with a doctor.

    • Nothing rebutted and fake expertise says:

      Wow, these authors are so caught in selling a book, they even have puppets posting book and web links in the comments. Neither of these guys are neuroscientists…one has no credentials whatsoever. It’s not wonder they confuses anecdotes with data. Klein completely refuted them and they are rightfully embarrassed. To claim “all” or “everyone” is characteristic pseudoscience.

  13. DanVignau says:

    Let’s see now. I can use porn to masturbate more often than normal, then should be surprised that when an opportunity arises, (The opportunity, not me) I am less horney and cannot perform as well. Take away the porn and my libido returns, possibly because I masturbate less? Hmmmm?
    Besides, It is so much easier to get off without having to chase a possible unwilling partner. Let’s talk about love, not just sex.

  14. Jon says:

    I could be wrong, but I seem to remember Klein making a correlation between ED, low sexual desire, etc., and the rise of smart phones and personal electronic devices in the last decade.

    I am a musician, and I used to play music in my local Punk and Metal scene, but now, I play more Folk and Indie Rock. In 2004, before anybody had a smartphone, people came to concerts and participated in the event. Nobody was disengaged, and it seemed that there was no place the audience wanted to be, but right there in that venue. Now, when I play concerts and when I go to concerts, almost no audience members are present or conscious of their surroundings. At some point, almost everyone is staring at their phone as if there was something more important online than an artist or group of artists, in-the-flesh, physical human beings pouring out their hearts in front of you. It seems that the closest thing to actual audience engagement is when an audience member raises a phone in the air to snap a picture or take a video that interestingly, no one cares to see except for that particular audience member.

    I know this is anecdotal, and it sounds like a bit of biased ranting, but I don’t think you have to be a scientist to notice that an overwhelming majority of people seem disengaged, egotistical, and disinterested in social situations and physical interactions with others. Do any scientific studies address the factor of technology and smartphones (and not just porn) when it comes to ED, low sexual desire, etc.?

    • 123elle says:

      Wow, how discouraging and dismaying it must be to perform before an audience of distracted people staring at their phones! The whole trend toward having vicarious experiences really has an impact on those whose creative contributions demand attentive and supportive viewers/participants. It would be like having a conversation with somebody who is looking elsewhere than at you — or even worse, whose mind and passion are elsewhere.

      • Jay says:

        ‘Tis, ask any highschool teacher. There’s another link to smartphones right there: kids today are constantly multitasking -phone + talking to friends, phone + eating etc. They seem to have stopped being able to focus on any one thing at a time, and sex may well be one of the things that suffer from that. Excessive porn use may well damage people’s sex lives, and channels have been proposed. But other factors mustn’t be ignored, and the smartphone line is important, I think.

  15. OldNassau says:

    ” if not high speed Internet porn, what variable changed that could account for this astronomical rise? ”

    How about “Loss of Shame”? A decade ago, or earlier, young men were too ashamed to partcipate or seek help
    These men didn’t lie:They were simply silent

    Or “Improved Technology”. Brain scans, fMRI’s, improved access through the internet.

    Why only men?

  16. Ryan says:

    I fully expect eSkeptic to allow a rebuttal to the rebuttal. This is such obvious moralistic BS that I’m ashamed to see it on eSkeptic.

  17. Mr. Rothach says:

    I think it’s official, folks: the Porn Wars have begun!

  18. NameIsNotBoyd says:

    Another ridiculous element is the claim about porn being watched at all times, in all places, in non masturbatory environments. I’m just wondering where these guys get such imaginations…..maybe -they- are the ones looking at porn zipping up the elevator to work….or in the cab. Or maybe they’re simply jealous b/c back in the day they had to jump from nudie booth to nudie booth down in the Tenderloin District, 25 cents for 60 seconds. I have no idea, but this retort to the retort is impossibility asinine.

  19. Michael Soileau says:

    Seems like one important variable is missing, at least in the US and the rest of the World. The Great Recession was 2009 – 2010. Many men feel worthless having lost their jobs, high levels of debt, low levels of home ownership, etc. What’s the correlation there between other forms of anxiety and sexual dysfunction?

    • Jay says:

      Plus, as another post reminds us, ads for supposed ed remedies, penis enlargement pills and so on are everywhere. The past decade or so has also seen a vast surge in the extent to which people interpret minor problems as pressing medical or psychological issues. “I don’t always get it up the way I want” may well become “I have ED” under such circumstances. Combined with a downturn in the overall level of self esteem, this may indeed explain a very relevant increase in self-reported ED, with or without porn. And precisely the Portuguese are slower to report issues in that specific area than Northern Europeans. The correlations, in a word, are inconclusive, and the rise in self-reported ED may really be an artifact.

  20. Jody says:

    This response was terrible. It can be summed up perfectly by correlation does not equal causation. All the studies correlating ED with porn use fail to rule out possible confounds such as spousal disapproval of internet porn use, other marital or relationship stresses, as well as sexual dissatisfaction with your partner, among others. It also is not credible to rely on survey data to suggest that ED has increased 1000 fold. Is it not possible that men lie about their sexual functionality? Not only that… one of the surveys you posted asked people whether they have had ED before in the past… Well, who hasn’t failed to achieve an erection at least once? Does one incidence of ED mean that ED has increased over all? Better yet, if only 2 to 3 percent of young men under 40 suffer from ED… why is it that 97-98 percent of us can masturbate to porn and live perfectly fine and happy sex lives? Shouldn’t your conclusion be “How porn is messing with a small percentage of overall manhood”. And nice way to link sexual function to manliness as well.

  21. Maria says:

    Put your dog on a treadmill and it’ll stop jumping on visitors..lower libido is not necessarily a dysfunction. Just another way of functioning with different outlets?

  22. Bob Constans says:

    “All addiction is one condition” – sorry, but I just can’t accept that bald statement as fact. I CAN agree that it is all about brains, rather than the ‘substance’, but while the “what happens in a person’s brain” MAY be the same (a statement I’m not sure I accept either), too many other, different areas are affected by particular substances. It MAY be more true in a stricly Neurological sense, but Psychology plays a huge part. Not all people with addictions have what is typed as ‘addiciive personalities’, and the road to a particular addiction can be via a myriad of psychological and neurological and physical roads – people all differ. Some people easily switch from one addiction to another, others are strictly one-track. The statement is presented as a new, groundbreaking approach, but it’s the same thinking that has led to 12-Step Programs, all different but cookie-cut from the same mold.

  23. Kim says:

    Food ads are definitely shaping our appetites. In fact, all studies assessing hunger since 2010 report historic levels of appetite dysfunction (AD) in the developed world!

  24. a moron says:

    I like how Skeptic readers almost never challenge Science based claims published in Skeptic unless the science claims that something the Bible calls sin is somehow morally wrong or unhealthy.

  25. tpaine says:

    If the authors hypothesis is bogus, how would you explain the apparently large body of anecdotal evidence that they use to support their hypothesis?

    • Jay says:

      If someone spends too much time in front of the computer, with or without porn, other aspects of their lives are bound to suffer. If such a one discontinued their habit, the previously neglected aspects would likely return to normal if no lasting damage was incurred. I do think it highly probable that similar observations would be made if one looked at excessive gamers. Also, edging for hours is likely to lead, either to coming too soon, or to not accomplishing a full erection later that day. Coupled with doubts generated by being exposed to all those ads, you get a wrong impression that it was the porn, and that you have ED.
      If those porn addicts switched to gaming, I don’t think they’d notice any improvement. But if they left the computer for work and focused on their partner, things would look different.

  26. Mike D says:

    “Our point was that Klein, nor anyone else, has suggested a plausible explanation for a 1000% increase in ED in men under 40 (400% increase in low libido)”

    Several problems here:

    1) The content of porn varies dramatically, as does public opinion of what constitutes porn. You have to first offer an unambiguous definition of it for your conclusions to be valid. Can you show that porn was consistently defined across the studies you cite?

    2) Erectile dysfunction is itself relatively new to the lexicon of widely treated medical disorders, and no formal diagnosis for the condition exists. That means that its diagnostic criteria is not clearly defined. So you have a correlate – much of it apparently based on self-reported data – between two ambiguously defined phenomena. Whoopdee doo!

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125293/

    3) Even if the authors had demonstrated that clearly-defined porn resulted in an increase in clearly-defined ED, the most obvious other correlate is the sharp rise in obesity in the past 20 years.

    • Gary Wilson says:

      To mike D: Your link is not relevant. As we explained, these are NOT the rates of men visiting their doctors for ED or to request ED medication. I don’t know how many times we have to explain this.

      The ED (and low libido) rates cited refer only to peer-reviewed studies (usually anonymous surveys) on population wide rates of sexual dysfunction. To put it another way, the ‘Viagra hypothesis’ is claiming that in every single study published between 1948 and 2010, in countries all over the world, the young male participants consistently lied about their erectile functioning. Then, all of a sudden, in 2010 all the young men (and only the young men) began to tell the truth about their ED problems. This is absurd.

      Your claim about erectile dysfunction being a new entity is simply incorrect. Kinsey asked about in the 1940’s, and published ED rates in his 1948 report. A PubMed search for the phrase “erectile dysfunction” returns over 21,000 studies, dating back to 1940’s. Link – http://www.ncbi.nlm.nih.gov/pubmed/?term=erectile+dysfunction

      Suggesting that one needs to define porn is red herring. What turns one guy one may turn another guy off. Porn-induced ED occurs when a man conditions his sexual arousal to everything associated with his porn use. Not only the content (whatever turns him on in the moment), but to endless novelty at a click, the need to constantly switch videos, being in a voyeuristic perspective, searching the perfect scenes to finish with, etc.

      We have seen a few young men develop porn-induced ED using only swimsuit models. Few people would consider this to be porn. However, the 2 men clicked through 1,000 or more swimsuit models during each session. Real life could not match what they had trained their brain to expect – a 1000 different females to achieve orgasm.

      • Gary Wilson says:

        To Mike D – Forgot to address your obesity hypothesis accounting for a 1,000% increase in ED rates for men under 40. Several problems:

        1) Obesity rates in US men aged 20-40 increased only 4% between 1999 and 2008. Study – http://jama.jamanetwork.com/article.aspx?articleid=185235

        2) Obesity doesn’t cause ED, there is only a modest, or no correlation between ED and obesity in men under 40.

        3) The primary reason obesity is associated with ED is that it also associated with type 2 diabetes. Type 2 diabetes usually occurs past age 40, and it takes several years for diabetes to cause the blood vessel and nerve damage that leads to erectile dysfunction. Obesity is more related to ED in men over 40.

        4) The commonly cited risk factors related to ED in older men are often unrelated to ED in men under 40. A recent study “Erectile dysfunction and correlated factors in Brazilian men aged 18-40 years.” http://www.ncbi.nlm.nih.gov/pubmed/19889149
        EXCERPT

        Prevalence of ED in 1,947 men was 35.0% (73.7% mild, 26.3% moderate/complete)…. Also, no association was found between ED and smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, hyperlipidemia, depression or anxiety

        • Jay says:

          What about a) changes in the perception of occasional failure to get a full erection and b) a stronger tendency to report such matters as problems in surveys?
          Also, clicking through 1000 swimsuit models one-handed takes time. The subject must have been edging for quite a while, and that may lead to different outcomes than a quick one in the shower. We’d be talking about a situation where the pictures are circumstantial.
          The increase is simply too large to be explained the way you do. A shift in the perception of sex and what it means when it’s not perfect is quite a different story, I think.

  27. Steven Freedman says:

    Get out of academia into the real world. Perform an experiment using a”glory hole” configuration to perform sex in a manner unknown to the recipient, and ask the sex recipient Then which he or she prefers, intercourse, oral sex or masturbation. Then you will discover which provides the most pleasurable sensation, it is not intercourse. Intercourse ins necessary for making babies. Oral sex and masturbation provide greater sensational pleasure, for both men and women. What do people want? A psychological involvement or pure pleasure? We use intercourse as it is the historic way sex is performed. Our brain has devised other techniques that provide greater pleasure. Only Bonomos and humans have sex in the missionary position.Why? It is more rewarding than the rear entry animal position. Humans have experimented and learned of better ways to do things. Oral sex, preferred by the majority of men, is a human improvement and creates greater pleasure.Try it, you’ll like it! Applies to both men and women. Ask why do we/you engage in sex? Is it fo 1) make a baby, 20 have a most pleasurable experience, or, 30 to have a relationship with another person.

  28. Bob Pease says:

    there may indeed be a strong correlation.

    but this post hoc rave and backpatting is stunningly inappropriate to this forum,

    With this stuff, next , doofuses (dufi??)
    will be suggesting that porn causes folks to become mindless goons who need to be locked up!!

    Can we get back to the purpose of this forum which used to be the debunking of environmental pseudoscience or Magickal thinking

    Dr .S

  29. Jamie Farren says:

    I HAD been sympathetic to Zimbardo, et. al. …until
    reading the above comment in which one of the authors responded to one of the most valid criticisms yet made. Namely, what definition of “porn” is in use here? Is the definition consistent across the referenced studies? What about the ambiguities involved in the label “ED”?

    The original commenter was met with a response that, frankly, made my jaw drop: “That’s a red herring.” [paraphrase]

    Anyone who is attempting to convince me of a causal link between X and Y had better be ready with a (reasonably) rigorous definition of X and Y.
    Otherwise, how do I know we are even talking about the same things?! One of the many reasons we should be so careful about the meaning of our terms is that, without a clear boundary, a concept/phenomena under study is a magnet for our own biases and haphazard connotations.

    The old “bait and switch” doesn’t have to be a con; sometimes it’s just a fallacy.

    Apart from all of that, if one lacks clear definitions, then drawing valid inferences from one’s statistical analyses is dead in the water.

    • Jon says:

      Today’s definition of porn= HIGH SPEED INTERNET PORN. Let me speak on behalf of my generation. I am a 22 year old male. High speed Internet porn access became free and readily available on “tube sites” when I was 12 years old, somewhere around 2006-2008. In the beginning, my erections were as hard as a rock. I would masturbate to porn daily, probably 5 times a week as any horny young man going through puberty would. By the age of 19 I could no longer get an erection to my imagination and I noticed I started having weak erections.

      If you did not grow up in my generation, you would have NO CLUE what it is like to grow up with what a young man can see today. How does it not make sense to some of you people? When in the history of mankind has a 12 year old been able to see 1,000s of naked women, of all different colors, sizes and shapes with the simple click of a button. My point is, porn today (Internet porn) is over stimulating and addictive simply because we can see WHATEVER, WHENEVER and in ANY AMOUNT. A freaking wall painting thousands of years ago cannot be compared to what Internet porn today provides. The answer is so obvious and some of you people seem so against that porn is truly an addiction and can cause erectile problems. One girl in real life just isn’t going to supply the amount of rush and excitement a young man can get from seeing hundreds of different naked women a day. It just wont. Once again, this is coming from a man who is APART of this generation that grew up on Internet porn and I am telling you that it has extremely affected my life.

      • Jamie Farren says:

        @Jon:

        First – The definition of porn you offer is completely useless in a scientific context. It offers no clue as to the content or boundaries for “porn” other than to limit it to the internet. “High speed” is just another vague notion and adding it to the word “porn” does nothing to clear up the issue.

        Second – You may not speak for an entire generation any more than you may speak for all males, or all citizens of Uganda, or all regular consumers of picante sauce. The notion that you are somehow in a position to speak for an entire generation is, frankly, juvenile in the extreme.

        Third – In the interest of brevity, I will end with a response to this:

        “One girl in real life just isn’t going to
        supply the amount of rush and excitement a
        young man can get from seeing hundreds of
        different naked women a day. It just wont.”
        [quoted from Jon above]

        Asserting this will not magically make it true. I happen to disagree with you; what you say here doesn’t match my experiences. Now, there is nothing wrong with describing our personal experiences…but, if we are interested in describing what is true for the population under study, we need (just for starters) clear definitions for both “porn” and “ED”. Without them, we would be unable to draw any defensible inferences from our statistical analyses.

        • Jon says:

          @Jamie Farren

          I understand all your points and I’m not here to get into a scientific debate. Clearly my opinion is just my opinion and it can’t speak for anyone but only me. But I am just one example of thousands of guys who grew up on Internet porn that are experiencing problems because of it. Let me ask you, and I hope you will answer honestly, how old are you? If you didn’t grow up in my generation, the generation who grew up with access to high speed Internet porn, then I highly doubt you will know what we are experiencing.

          Secondly, “high speed” is not a vague term at all. It actually is one of the biggest reasons WHY porn today is so addictive and why it’s causing a lot of problems in today’s youth. Because of the fact that it’s high speed and that it can stream anywhere at any time for free, makes it a super normal stimulus. I don’t know why you can’t just see that. Playboy magazines and pictures cannot compare to the amount and the novelty you can see today with Internet porn. The fact that you said “high speed” is a vague notion shows me that you truly have no idea what your speaking of.

          My history is similar to thousands of other guys. Started early with high speed Internet porn. Watched it daily. Over time, experienced difficulties with erections and sexual dysfunctions. Removed porn. Healed over time. It is simply this, guys are conditioning themselves to get off to Internet porn because it is extremely powerful in quantity and content.

      • Chris Meisenheimer says:

        As a older man in his 60’s l agree with your opinion. Growing up in Northern Ontario in the 60’s l wasn’t living in a very happy home. l shutter to think what would have happened if l had access to internet porn. The closest thing to porn l had access to at 12 was the naked women in the National Geographic magazine at school and the odd nudity in a late movie on the french channel, (we had two english and one french channel back then).

  30. The Original D says:

    I agree that people getting hung up on the definition of porn are following a red herring.

    1. If you’re using it to get off rather than just entertainment, it’s porn.

    2. You can argue that “well that means Victoria’s Secret is porn.” On the margin that’s true. But n the main, you have to look at what has been growing in consumption. Victoria’s Secret has probably grown over the last 20 years, but not nearly as much online porn.

    3. I’ve been consuming porn since the early eighties and for the me the real shift happened in the early 2000s. It’s a much richer experience. I went from being able to see a few hot women having sex over and over (i.e. the three pictorials in a monthly Penthouse) to being able to see literally hundreds of them every morning.

    I don’t hate porn or pornographers. They do what they do, and if they enjoy or at least tolerate their work for a fair wage, I don’t see anything morally wrong.

    But I know my porn consumption has steadily gone up over the last 30 years and that it’s had a negative effect on both my sex life and my productivity. And when I abstain from porn for even two weeks it makes a significant difference in both.

  31. Mike says:

    Young women put out much more than they used to. Maybe these young men are having too much sex which is leading to longer refractory periods which seem like ED.

    But if there is any relationship to porn it is similar to my paragraph above: too many orgasms. Thus with porn use it is too much masturbation leading to long refractory periods, not the viewing of porn itself.

    • Jon says:

      Wrong once again. It IS the porn. I see you used “these young men” which is implying to me your older and did not grow up on today’s Internet porn. It’s hard to explain to the older generation. I’m done wasting my time here. All you older people can make all your false assumptions while the younger generation of men continue to suffer. You all have your heads up your ass

    • Gary Wilson says:

      To Mike. Re: refractory periods.

      Masturbation doesn’t cause chronic ED in young men, and refractory periods don’t last 6-24 months.

      It usually takes several months for men in their twenties to regain normal erectile functioning. In the last few years many young men have needed over one year to recover. In addition, the young men continue to see improvements (greater libido, firmer erections) long after sexual functioning returns. The article linked to about 3,000 such recovery stories, such as:
      http://yourbrainonporn.com/rebooting-accounts
      http://yourbrainonporn.com/rebooting-accounts-2

      What’s disturbing is that young men who grew up using porn tube sites are needing much longer to recover than older men who did not have access to internet porn during adolescence. Men in their 40’s and 50’s often need only 6-8 weeks to regain erectile functioning, whereas men in their twenties need 6-24 months to recover.

      The adolescent brain is highly malleable and one job of adolescence is to wire up to the sexual environment, so as to successfully reproduce. We are seeing the results of the highly adaptable adolescent brain interacting with porn tube sites.

      • Mike says:

        To Gary Wilson.

        The 6 to 24 months needed for recovery is familiar to me. For me it is not related to porn use but related to using a prescription drug: SSRI (specifically Lexapro). While using this drug I was an eunuch, it was an effective chemical castrator. After removing myself from the drug it took over a year before I could ejaculate. But I never returned to my previous self. Currently I am on testosterone therapy even though my testosterone was normal. This has brought me back to close where I was before the SSRI.

        I suggest here that the recent sexual problems experienced by young men has a confluence of causes. SSRI use must be a significant cause. These drugs are being prescribed to many young adults: male and female. Masturbation with porn viewing may be another. The recent increases in autism, with an unknown cause, is possibly another. Economic distress could be another. I only list a few here.

        • Gary Wilson says:

          To Mike. While SSRI use has increased somewhat since 2000, it cannot account for a 1000-1500% increase in ED in only young men.

          It cannot explain the Canadian study on men aged 16-21 which reported that 54% had sexual dysfunctions.

          We must also remember that Croatia reported the highest rates of ED and low libido, not the US, where SSRI’s use is far more prevalent. Or that matter Brazil where the rate was over 30%

          Finally, we must remember that all the recovery stories we link to are men who recovered from porn-induced sexual problems by removing a single variable – porn use.

  32. Mike says:

    To: Gary Wilson

    Thanks for the further details. I need to purchase a copy of your book so I can understand this better.

  33. Michael says:

    Gary, all I can say is thank god for people like you. As someone who has battled a serious dependency on porn for 30 yrs, I knew the information on YBOP rang true the day I tripped across the site. In reading other’s stories, hearing the scientific arguments laid out in your presentations (dopamine reward loop, PIED), reviewing the recent MRI results on porn users, it’s seems plain as day to me now. I only wish the information and documentation on your site got more national attention. There is a whole generation growing up not even knowing what normal is… or even was.

    Freud wasn’t far off the mark in asserting that sexual drive is behind all/most personal motivation. The single biggest thing I have noticed when quitting porn, even for short periods, was a dramatic shift upward in my motivation to DO things. Go out, talk to people, engage in the world/life. etc. It is completely biological I now understand. Only wish I had known 30 yrs ago.

    For the record, I’m an atheist and have no moral issue with porn. The science is what interests me, and I believe you are going to fall on the right side of the debate when all the cards fall.

  34. some guy says:

    This whole article implies that the only healthy outlet for sexual desire is by having sex with another person. It also implies that fetishes are symptom of addiction. Is a diminished sex drive even really a big deal? Our society really overvalues sex.

    • Michael says:

      No, it doesn’t actually imply that. Only say.. 200 years ago, you would probably only masturbate to mental images of women that actually were IN your life, or ones that you crossed paths with in a real life situations. Easy to argue that that type of masturbation might actually strengthen your resolve to out and get the real girl.

  35. Chris Meisenheimer says:

    Most of the porn that l have seen by accident while l was surfing the net for feminist based articles and location of the nearest church, are of such a poor quality and repetatively boring, l find it hard to explain why so many men get hooked on it. Porn is a two dementional world that involves two senses while reality is three dementional that involves 5 senses.
    You can no more learn how to deal with women sexually or not from porn than you can learn how to fight from watching so called professional wrestling.

  36. J.L.A. De La Garza says:

    Has it dawned on anyone that the occurrence of sexual dysfunction in teen and young adult males is possibly due to environmental factors, such as carcinogens? A number of those young men may also be suffering the effects of prescription drug-induced childhoods; where their parents – in response to neo-liberal psychology – believed that otherwise normal rambunctious behavior is aberrant and therefore must be medically controlled. This latter factor may also explain why so many young men are not entering or completing college. While porn addiction is a field demanding further study, placing the blame for e.d. in young males on that alone is almost facetious.

  37. Fair Witness says:

    Having read this comment section, it seems to be populated mostly by people who deny all evidence that smoking causes cancer.

    Well, that’s what they would’ve been a few decades ago, now it’s porn and ED.

  38. Larry S says:

    With great underlying irony, I must ask Dr. Zimbardo if he is famiar with the term “misattribution.” That is what he is espousing, not to mention misrepresenting much of the research he likes to cite. Wilson? Sorry to say you’re the biggest fraud of all. YBOP is a nice example of trying to sound smart by backing up your opinions with science. Nowhere in your blog do you explain that your fixation on dopamine and delta-fosB, for example, have nothing to do with human behavior but are based on other organisms like mice, fruit flies, and stickle back fish. You perpetuate a longstanding misconception (among the less-than-educated on neuroscience) that neurological mechanisms and brain pathways are linear systems; presuming that you can go from point A to point B. In fact, these are incredibly circuitous systems that we are nowhere near understanding to anything more than a superficial degree.

    Understanding the relationships between sexual function, gratification, fantasy, porn use, and relational sexuality is incredibly complex and multidimensional. “Addiction” is simply a lazy descriptor and shorthand reference point. ASAM is a joke (since there is no such diagnosis of “addiction” – ANYWHERE – how is it ethical to charge for treatment for something that isn’t considered medically legitimate?). Let’s be real, they made their bones on causing addiction in their patients then charging them further for treatment their addiction, which they are also abusing horrendously. Perhaps the discussion can be moved forward if you weren’t so quick to label everything as addiction and see the behavior more as symptomatic than primary; as more maladaptive coping mechanisms than a “disease.”

    You both also seem to miss the the whole point in scientific legitimacy: no singular study provides anything more than a direction of inquiry. You can’t even begin to consider the findings of any studies that have not been replicated several times, which most of what you cite have not been. And since none of those studies you rely on do not provide any within-subject comparisons, I wonder how you can be so confident in your assertions that a) any structural changes observed between users and non-users is indicative of pathology and b) use causes changes in the brain (rather than consider that atypical brain development/function in these individuals could lead to the behavior).

    While it is true that pleasure-inducing behaviors can be engaged in to an extreme, particularly when used to mitigate anxiety, it is overly simplistic and specious to call it an addiction. The fact is, the behavior is volitional. Perhaps one of the factors so conspicuously ignored is that the majority of those who claim PIED are immature, entitled 20-30-somethings who blame everyone/thing but themselves for their shortcomings. For the past 30 years, “it’s not my fault” has been something of an ethos, especially with the explosion of the self-help and recovery industries. The only thing we’re really addicted to is addiction!

  39. Russell J Stambaugh, PhD says:

    I’m sorry, guys! You need to go beyond porn blaming to account for ED rates. It’s just silly. Setting aside the old shibboleth that correlation is not causality, ED is mostly physiological, not psychological. And only about 5% has historically been found to be neural. Factors like circulatory disease and diabetes are about 60% of the picture. So for porn/adult content to be responsible for any big change I prevailing ED rates wecwould expect a huge spike in psychogenic causes. They remain at about 10-20% of ED.
    Furthermore, obesity rates are going up among youth.

    These results of young men complaining of porn-induced erectile difficulties can be easily explained by erotophobia and shame-based discomfort about variant sexual desires. People’s desires are much more variable than social norms license, and many people can’t discuss them with their partners. Changing one’s desire is difficult, but not proof of ‘addiction’.
    ASAM, from which you liberally quote, is an advocacy organization trying to legitimate widespread use of the term. But ‘addiction’ has been systematically excluded from the DSMs for years, including the 2013 DSM -5 precisely because the science you cite has not proved convincing to the American Psychiatric Association. Charges that their process is political are absolutely true, but so is my statement, and yours, and ASAM’s.
    Without a doubt, there are men out there who are masturbating so much to porn that they have reduced sexual responses to partner sex. I doubt they constitute a very big percentage of ED increases among youth.

    • Gary Wilson says:

      To Russell J Stambaugh, PhD. –
      The 6 recent studies cited that reported a tremendous rise in youthful ED did not consider porn use. Yet none could explain a 1000% rise in ED and a 400% rise in low libido. In fact, the authors of the Canadian study, which reported 54% rates of sexual dysfunction in males aged 16-21, were shocked by such high rates.

      Reality: 11 studies and 65 experts suggest that porn use can cause ED, low libido, anorgasmia, delayed ejaculation, less brain activation to sexual images (desensitization). List here – http://www.yourbrainonporn.com/porn-induced-ed-media

      You suggest “historical causes’ to explain ED rates in young men that are now higher than rates in men over 40 (24-33% for men under 40). The only valid variable you put forth, which may have changed in the last 20 years, is obesity. However, the obesity hypothesis has already been debunked above in the comments – http://www.skeptic.com/reading_room/guard-your-manhood-response-to-marty-klein/#comment-40929

  40. Gary Wilson says:

    To Larry S –
    It’s telling that you:
    1) Cite nothing to support your claims.
    2) Provide no excerpts or examples to demonstrate “misattribution.”
    3) Address none of the specific content presented in our two articles.
    4) Address none of the many studies cited in the two articles (or in the links).
    5) Make false statements.
    6) Resort to ad hominem.

    I’ll provide comments on a few of your “claims”.
    ———————
    LARRY: Nowhere in your blog do you explain that your fixation on dopamine and delta-fosB, for example, have nothing to do with human behavior but are based on other organisms like mice, fruit flies, and stickle back fish.

    RESPONSE: Unbelievable. Are you really suggesting that dopamine has nothing to do with human behavior, reward, sexual arousal, or addiction? Citations please. Are you suggesting that deltafosb is not involved with sensitization or addiction? Citations please. It seems as though you don’t believe in evolution or the conservation of biological mechanisms (i.e. reward system mechanism for reward). I guess scientists have had it all wrong for decades, because they continue to study biological mechanisms in animals in hopes of understanding basic biological mechanisms in humans.

    Fact: The mechanisms of reward and addiction (i.e. dopamine, DeltaFosB) that are well established in animal models have so far been confirmed in human studies.

    A note on DeltaFosB. Back in 2001, a paper by Nestler, et al. “ΔFosB: A sustained molecular switch for addiction” stated: “DeltafosFosB may function as a sustained “molecular switch” that helps initiate and then maintain crucial aspects of the addicted state.” Since then many studies have confirmed that accumulation of DeltaFosB in the reward circuit can causes addiction-like behaviors. (An update by Nestler – DeltaFosB: A Molecular Switch for Reward, 2013)

    The problem is that DeltaFosB can only be assessed after death. Thus, only one study has assessed reward center DeltaFosB in humans. It was done on cocaine addicts whose DeltaFosB levels were measured after sudden deaths. Researchers found high levels of DeltaFosB, confirming its role in addiction (in humans too). See “Behavioral and Structural Responses to Chronic Cocaine Require a Feedforward Loop Involving ΔFosB and Calcium/Calmodulin-Dependent Protein Kinase II in the Nucleus Accumbens Shell” (2013)
    —————————–

    LARRY: You perpetuate a longstanding misconception (among the less-than-educated on neuroscience) that neurological mechanisms and brain pathways are linear systems. In fact, these are incredibly circuitous systems that we are nowhere near understanding to anything more than a superficial degree.

    RESPONSE: False claim. Nowhere do we say that neurological mechanisms are linear or simple. The Skeptic articles are for the lay public, and not meant to be “reviews of the literature” for scientific journals.
    —————–

    LARRY: Understanding the relationships between sexual function, gratification, fantasy, porn use, and relational sexuality is incredibly complex and multidimensional. “Addiction” is simply a lazy descriptor and shorthand reference point.

    RESPONSE: This was not a review of the literature – it was response to Marty Klein, who falsely claimed that porn addiction has little science behind it. Our first article contained a very long section on sexual conditioning. Many young men who develop porn-induced ED claim not to be addicted. They have simply conditioned their arousal template to everything associated with their porn use (screens, constant novelty, voyeurism, etc).

    By the way Jim Pfaus is one of the world’s experts on sexual conditioning – and he studies rats and says dopamine is at the core of sexual conditioning. Do you think Pfaus is misattributing his findings? Why does Pfaus use rats? Why does Pfaus treat rats with dopamine to simulate sexual arousal?
    —————————————

    LARRY: ASAM is a joke (since there is no such diagnosis of “addiction” – ANYWHERE – how is it ethical to charge for treatment for something that isn’t considered medically legitimate?). Let’s be real, they made their bones on causing addiction in their patients then charging them further for treatment their addiction, which they are also abusing horrendously.

    RESPONSE: This is one of craziest things I have ever read. “No such thing as addiction”? There are definitions of addiction, and ASAM was around before the DSM. ASAM’s 3000 medical doctors are many of the addiction researchers that provide the hard data, such head of NIDA, Nora Volkow, MD. PhD, Director of the National Institute on Alcohol Abuse and Alcoholism Dr. George F. Koob, and Eric Nestler MD, PhD.

    By the way, psychiatrist Richard Krueger who has long served on the DSM sexuality workgroup recently published a peer-reviewed paper saying that the ICD-11 is likely to include “compulsive sexual behaviours” as a diagnosis. “Diagnosis of hypersexual or compulsive sexual behavior can be made using ICD-10 and DSM-5 despite rejection of this diagnosis by the American Psychiatric Association – Krueger – 2016”

    Krueger points out that the DSM’s actions don’t matter, because the World Health Organization’s ICD manual permits a diagnosis of “Compulsive Sexual Behavior Disorder.” And ICD diagnoses “trump” DSM diagnoses (a development that occurred in Oct., 2015). So the world’s experts recognize that compulsive sexual behavior is a diagnosable disorder. http://onlinelibrary.wiley.com/doi/10.1111/add.13366/full
    ————————

    LARRY: You both also seem to miss the the whole point in scientific legitimacy: no singular study provides anything more than a direction of inquiry. You can’t even begin to consider the findings of any studies that have not been replicated several times, which most of what you cite have not been.

    RESPONSE: We never said a single study proved anything. However, we did link to 24 neurological studies on porn users (and 5 reviews of the literature). http://www.yourbrainonporn.com/brain-scan-studies-porn-users

    All lend support to the porn addiction model. The results of these 24 studies are consistent with 140+ Internet addiction brain studies, many of which also include internet porn use. All support the premise that internet porn use can cause addiction-related brain changes. These studies align with decades of studies on other behavioral addictions (food addiction gambling addiction), which align with drug addiction studies. The vast preponderance of evidence supports the existence of internet porn addiction. It’s the isolated trickle of studies by agenda-driven nay-sayers that are out of alignment with science in this field.

    Speaking of those who claim a single study settles things: Former UCLA researcher Nicole Prause has consistently claimed that her lone 2015 EEG study debunks(!) porn addiction (Prause et.al 2015). Her results: compared to controls, porn addicts had less response to one-second exposure to photos of vanilla porn. These findings align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Kuhn stated that this most likely indicates densitization in heavy porn users. Put simply, frequent porn users were desensitized and needed greater stimulation to achieve the same buzz (tolerance, an indication of – you guessed it – addiction). Three peer-reviewed papers have analyzed Prause et al 2015 – and all say Prause actually found evidence of desensitization in heavy porn users.

    It’s quite interesting that many recent articles attempting to debunk porn addiction are nearly identical: the authors cite only Prause et al., 2015, while ignoring 23 other studies (+5 recent reviews) which support porn addiction. Because this is near epidemic I wrote the following to inform the public: “How to Recognize Biased Articles: They Cite Prause et al. 2015 (falsely claiming it debunks porn addiction), While Omitting Over 20 Neurological Studies Supporting Porn Addiction” http://www.yourbrainonporn.com/how-recognise-biased-articles-cite-only-prause-et-al-2015-falsely-claiming-it-debunks-porn-addiction
    ————————-

    LARRY: And since none of those studies you rely on do not provide any within-subject comparisons, I wonder how you can be so confident in your assertions that a) any structural changes observed between users and non-users is indicative of pathology and b) use causes changes in the brain (rather than consider that atypical brain development/function in these individuals could lead to the behavior).

    RESPONSE: The studies had control groups, and some within-subject comparisons (as if that matters – it doesn’t). It seems as though you didn’t read the studies. These were addiction experts who assessed in porn users the same brain changes caused by drug addiction.

    Reality: The mechanisms of addiction have been studied for nearly 60 years. The very specific brain changes caused by addiction have been elucidated down to the cellular, protein, and epigenetic levels. These brain changes have been correlated over and over with the behaviours collectively known as the “addiction phenotype.”

    Four major brain changes are involved with both drug and behavioral addictions, as outlined in this paper published recently in The New England Journal of Medicine: “Neurobiologic Advances from the Brain Disease Model of Addiction (2016)”. This landmark review by the Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) George F. Koob, and the director of the National Institute on Drug Abuse (NIDA) Nora D. Volkow, not only outlines the brain changes involved in addiction, it also states in opening paragraph that sex addiction exists:

    “We conclude that neuroscience continues to support the brain disease model of addiction. Neuroscience research in this area not only offers new opportunities for the prevention and treatment of substance addictions and related behavioral addictions (e.g., to food, sex, and gambling)….”

    In simple, and very broad, terms the major fundamental brain changes are: 1) Sensitization, 2) Desensitization, 3) Hypofrontality, 4) Dysfunctional stress circuits. All 4 of these brain changes have been identified among the 24 neuroscience studies on porn users.
    —————————–

    LARRY: Perhaps one of the factors so conspicuously ignored is that the majority of those who claim PIED are immature, entitled 20-30-somethings who blame everyone/thing but themselves for their shortcomings.

    RESPONSE: None of your spin matches reality.
    Reality check – all had one variable in common: years of porn use. The men removed that one shared variable (porn use) and eventually they healed chronic sexual dysfunctions. It can take 2-12+ months to heal and most experience a similar constellation of withdrawal symptoms.

    The recovery stories (about 4000 documented) have an age range from 14 -72. The vast majority were sexually experienced and all had strong and healthy erections prior to using porn. Many used porn for years (while having sex). Many describe first developing anorgasmia, delayed ejaculation, lower libido with real partners. Eventually they developed full blown ED. It was NOT performance anxiety, because they could not achieve an erection while trying to masturbate without porn (though most reported little problem when using porn).

    By the way a new study came along since our article: “Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men (2016)”

    It found that problematic Internet porn use is associated with reduced erectile function and reduced overall sexual satisfaction. Yet problematic porn users experienced greater cravings. The study appears to report escalation, as 49% of the men viewed porn that “was not previously interesting to them or that they considered disgusting.”

  41. Gary Wilson says:

    Relevant news – “Pornography induced erectile dysfunction (PIED): Understanding the scope, science, and treatment.” Delivered by Dr. Tarek Pacha at the American Urologic Association annual meeting in San Diego, May, 2016.

    10 minute video from a longer lecture by Urologist Dr. Tarek Pacha – https://youtu.be/M9xqIIWkP8M

    His conference bio page – http://www.aua2016.org/program/speaker.cfm?speakerID=2885

    Dr Pacha emphasized that it is time for his colleagues to wake up to existence of porn-induced sexual dysfunctions.

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