Erectile Dysfunction and Porn Video Series

Anatomy & physiology teacher Gary Wilson explains the physiology of erections, how overstimulation via today's Internet porn can create erectile dysfunction (even in young men), and how others have recovered. For more information see Is my erectile dysfunction (ED) related to my porn use?

Update: Dr. Oz Show addresses porn-induced erectile dysfunction January 31, 2013

Transcripts of the following talk are available: Part 1, Part 2, Part 3 and Part 4.

PART TWO

PART THREE

PART FOUR

What Viewers Say

It can be a relief to understand the causes of porn addiction-related ED

  • I found these videos the other day and found them to be very interesting. I actually read the brain book mentioned in the videos, and it's great as well. Everything adds up. Personal testament: I quit porn a few months ago. Since then haven't cheated or looked at porn. I've seen a few images by accident (i.e. opening a link with naked girls), but didn't watch any vids intentionally. Two weeks after I quit, I had sex with a girl for the second time (note: second time with her, not in my life) and I was able to maintain erection, ejaculate with a condom on (unheard of for me!) and then go for seconds 20 minutes later!
  • Excellent ! Thank you very much for uploading this video. This is exactly what I was searching for. Almost all my previous searches about porn addiction ended up in sites explaining it on the basis of religious faith.This explains about the addiction and the ways to get out of it on pure scientific and rational basis. Once again thank you very much. Hoping that more such good initiatives come from you in future.
  • It helps a lot to watch supporting material because, believe me, there is a lot out there that says porn isn't the problem at all. When I get The Urge, I come on here to read an article or video you posted. By the end of it the urge is gone. I'm going on almost two weeks now with no porn watching. I've masturbated maybe twice in those two weeks, but tried to think of real life situations. I've noticed small changes already like having morning erections again and random erections when I see a pretty girl. I seriously didn't have those for almost 2 years during the worst times.
  • I've seen Gary's slide show and really like it. Clients have been benefiting from it too! --Wendy Maltz, LCSW DST (sex therapist and author)
  • Your work is invaluable. --Mark Chamberlain, PhD (sex therapist and author)
  • Thanks for the simple rational reasons. No crazy religious insanity. This helped me greatly.
  • This is a truly educational piece of work, which flies in the face of conventional reasons for erectile dysfunction! Doctors should prescribe this series to all those who complain of ED. It really could save relationships, marriages and morality, too!
  • I have come to realize that porn addiction affects your brain physiologically, I can't explain it because I'm not a psychologist, biologist, or even graduated. But this guy can! This video series really, really, REALLY explained a lot of things with regards to porn and the brain and he completely covers nearly every topic. ... This series has convinced me that my porn days are over.
  • Since my last (failed) sexual encounter a few weeks ago, I've been tearing myself up wondering why I was having ED, questioning my sexuality, my health, and even wondering if I could ever be intimate with another human again. My physician gave me a prescription to Levitra, but I knew in my heart this was just treating a symptom and not the problem. And now reading your site, I realize the drug probably wouldn't have helped either. I guess I knew on some level that porn & masturbation were causing a problem, but I never connected it all together. When I read your material, I was immediately excited to run home and throw out my porn collection and scrub my computer. So far, it has been the easiest thing I've ever done. I AM SO RELIEVED TO HAVE FOUND AN ANSWER. So I just wanted to let you know that your website has helped change my life. I know I have a way to go, but I can see a better future already!
  • I watched your videos again, and I always seem to pick up something I didn't hear before. It's really condensed with information.
  • I want to thank you for the great videos on this subject. I'm trying my best to keep away from the gross heavy porn and not masturbate as I've noticed a profound difference.
  • It's been a week since I stopped. I made the choice to abstain from porn and masturbation. I had no choice to do this because I firmly (ironic choice of words) believe that my porn addiction caused ED. I am 19, had every test a urologist or primary care physician had in their arsenal, workout 5 days a week, eat a veggie-centric (though not vegetarian) diet, and I take pretty damn good care of my privates. I confirmed this [truth] not through conventional medical professionals, they either don't want to acknowledge or don't know that it is a serious problem, but through this amazing resource http://yourbrainonporn.com/Anyways, physically, I have been getting some serious morning wood, which is kind of refreshing to know that it is still working, but I have yet to control and command erections like in my high school years. According to testimonials full recovery ... is highly variable depending on exposure, chemistry, etc. But for anyone else feeling like this is really wearing you down, eating at your confidence: I know how you feel, and you are not alone. Mentally, it has been a rough week. ...So yes, I am getting better, but my goodness it is tough. And yes, I can't overemphasize how much yourbrainonporn.com's videos have brought a peace of mind to know what has happened physiologically.
  • I watched this video series with rapt attention. Gary did a wonderful job with it. A great teacher and a pretty good entertainer :). You all are so good at what you do. The straight information without judgement. That is a rarity. I'm so thankful I discovered your articles and site. Thanks once more.
  • Had a serious porn addiction and when I started noticing ED when sleeping with women, I started getting really worried (I'm in my early 20's). I looked it up and found this website, watched all the videos, that documentary included and after only 2 weeks I can safely say that it has changed my life. I feel more confident than ever, women are more attracted to me, I'm seeing great improvement in the bedroom. Every day it gets better and I'm noticing how ridiculous I was being by being so attached to porn.
    I never thought of myself as someone with an addictive personality because I eat well, almost no junk food, I never got hooked on any drug or anything but it's fascinating to me that I never -ever- considered my usage of porn as addictive. Watch this documentary, it'll bring positive change in your life and if not yours, at least the ones around you. I've shared this with close friends and we're all doing the 'challenge', it's amazing the amount of positivity it brings.
  • I watched the "Your Brain on Porn" and the "Erectile Dysfunction and Porn" video series, and I was very impressed by how science-based the videos are, and like any good scientific explanation, I got to the end of the series thinking "Duh! That's obvious" even though I had never even considered the hypothesis before. This problem is something that really needs to be studied properly and made common knowledge. You're not going to talk most guys out of porn with any of the arguments I've ever heard, but impotency is something that guys will do just about anything to avoid. Again, thank you very much for the info.

Erectile Dysfunction & Porn (Part 1)

To understand the content of this post, start with the six-part video series called, "Your Brain On Porn.”

Please know that we are for free speech and free will. We don’t want to ban porn and don’t care what people do with their genitals. We have another website, on relationships. It has nothing to do with porn. However, it has articles on the neuroscience of orgasm and love, on the evolution of sexuality and addiction. It also has a forum where people can discuss topics on sexuality. About five years ago, thanks to Google, porn users began showing up and sharing their experiences. Years later, porn users, in various stages of recovery make up a big percentage of the forum.

As a consequence, we have learned a lot about porn addiction and porn-induced erectile dysfunction. Here are the words of a heavy porn user.

I’ve been using porn heavily since my teens, and I have had ED problems since my twenties—though it’s only recently (in my thirties) that is has become total copulatory ED. I’ve blamed it on the (un)attractiveness or newness of my partners, on my fitness level, my diet, my age, stress, performance anxiety…lots of things. But when I realized I could no longer even masturbate to orgasm without Internet porn, something clicked. The source of my problems seems blindingly obvious now, of course.

It’s very common for heavy porn users not to see that the cause of their sexual dysfunction is porn-related. Here’s another typical quotation:

"I am 24 and have been battling erectile dysfunction for years now—and only recently attributed it to porn addiction. I was on an emotional roller coaster while trying to figure out what the problem was. What makes the whole thing so difficult is that you know you should be aroused by real women, but for some reason you’re not. Then you try to force yourself into arousal, which fails, and you spiral into depression and anxiety. Experts really need to be more aware of this issue."

We have even heard from teens with erectile dysfunction. This is not normal. Sure, occasional anxiety can occur, but not chronic impotence—unless, of course, someone has a serious medical condition.

It’s very clear the problem for these guys is heavy Internet porn use, because when they stopped, and stayed off porn for an extended period, their erections and desire returned.

With continued heavy porn use, the brain can change. Here are some of the ways these brain changes show up:

  • No spontaneous erections. (Guys love it when their ‘morning wood’ comes screaming back.)
  • No longer aroused by static porn, or previously seen porn. Often guys need to escalate to more extreme material just to get aroused—which is a sign of addiction.
  • Decreased penile sensitivity—an indication that the brain is actually somewhat numbed to pleasure.
  • Delayed ejaculation, or the inability to orgasm during sex with a real partner. In fact, men are now faking orgasm with partners.
  • Copulatory impotence—the inability to maintain an erection with a real partner. (Very common.)
  • ED drugs are losing their effect. The problem is in the brain, not the penis.
  • Eventually can’t get it up, even using extreme porn.

Why do we hear so little about Internet porn causing dysfunction?

  • An obvious reason is that free, streaming Internet porn is a relatively new phenomenon, and fast moving in terms of increasingly extreme stimulation.
  • It takes some time for the dysfunction to develop. Everyone is different, but now that endless extreme porn is available, it sometimes takes only a few years for a guy to develop erectile dysfunction, whatever his age. It can come on quite suddenly, although deterioration is usually gradual.
  • Users tend not to notice they are developing problems because they can so easily escalate to more stimulating online erotica. (“Extreme” is not a value judgment; the definition of “hot” lies entirely in the reaction of the individual user’s brain.)
  • Men don’t talk to each other about this problem. Who wants to admit he has ED at twenty-something? Also, they simply haven’t been considering Internet porn use as a possible cause of their problems.
  • Widespread advertising of sexual enhancement drugs has created an impression that chronic erectile dysfunction is normal. In fact, before Internet porn, chronic ED was very rare under the age of forty, and virtually unheard of in one’s teens or twenties.
  • Healthcare providers can be unaware of how Internet porn, with its constant novelty and endless variety, can affect the brain.

Good advice is dependent on being current with the latest neuroscience. To understand how Internet porn can change the brain, you have to know that excessive gambling, video gaming and food addiction can cause brain changes that mimic drug-addiction. For many of us, sex is even more compelling than those other activities, according to Dutch researchers.

Historically, experts were trained that impotence is due to shame or guilt. If that were the cause of today’s youthful ED sufferers, their symptoms would have shown up when they started masturbating.

Experts are also in the dark because no research has been published on porn use and erectile dysfunction. Brain scans would be needed to reveal what’s really going on. Although they have been done on gamblers, video gamers, overeaters and drug users, they haven’t been done on today’s porn users. Studies or not, youthful ED is increasing.

[Since the source presentation of this piece was recorded, an association of Italian urologists sponsored a 28,000 person survey, and learned that heavy porn use is indeed associated with sexual dysfunction. The president of the association, Carlo Foresta, who is also a professor at the University of Padua, estimates that seventy percent of the young men he sees for erectile dysfunction have been using Internet porn heavily.]

Consider the New York Times bestseller The Brain That Changes Itself, by psychiatrist Norman Doidge. It’s on brain plasticity and rewiring of the brain. He has treated heavy porn users. He’s clear that.

1. Porn addiction is real, the result of structural changes occurring in the brain.
2. Porn viewing can cause erectile dysfunction. Doidge writes,

"I’ve treated or assessed a number of men who all had essentially the same story: They reported increasing difficulty in being turned on by their actual sexual partners, spouses or girlfriends, though they still considered them objectively attractive. When I asked if this phenomenon had any relationship to viewing pornography, they answered that it initially helped them get more excited during sex but over time had the opposite effect. Now, instead of using their senses to enjoy being in bed, in the present, with their partners, lovemaking increasingly required them to fantasize that they were part of a porn script."

This was in the late nineties. What has happened in the last decade? This headline says it all “Young Men, Couples Shunning Sex.” Thirty-six percent of teenage boys are not interested in sex. Are you kidding? A few decades ago, a teenager who wasn’t interested in sex would have been sent to a psychiatrist!

It’s well known that porn is huge in Japan. The Japanese are tech-savvy, and shame around porn use isn’t an issue. Notice that it has doubled in two years. These men have no interest in sex with real women, because real women are no longer stimulating enough. They can’t compete with the superstimulation of Internet porn.

A 2008 study found that twenty percent of young Frenchmen are not interested in sex. The French? You know something’s wrong.

Here is the medical definition of erectile dysfunction: Consistent inability to obtain and/or maintain an erection sufficient for satisfactory sexual relations. (National Institute of Health, 1992)

Getting statistics on how many people suffer from ED is difficult. If you look at the famous Kinsey study in 1948, you’ll see that for age twenty and under, less than one percent has ED. Under 45, less than three percent. And many of these cases were related to anxiety.

Clearly, ED is not a disease of healthy young men. At least not until recently.

Let’s look at the causes of erectile dysfunction. Expert opinions have dramatically changed over time. Up until the 1970s, it was thought that roughly ninety percent of ED was psychological, and only ten percent had organic or biological causes. One of the primary psychological “causes” was frigid wives.

Today, psychological factors such as stress, anxiety, shame, or even the fear of sexual failure, are thought to make up only about ten percent of the causes. Ninety percent of ED problems are caused by organic problems, such as nerve problems, blocked arteries, effects of alcoholism, diabetes, and, of course, something called aging.

If you’re under forty, it’s rare to have an organic cause, but of course it’s always good to get checked by a doctor.

As we can see, it can take quite a while for science to catch up with reality. In the sixties, the “cause” of ED was psychological, the neurosis of the man, or maybe his mate. In the nineties, things switched. When researchers saw that drugs like Viagra worked, they changed their diagnosis to “organic causes.”

Incidentally, the discovery of sexual enhancement drugs was accidental. The drug was being tested for blood pressure problems when an unexpected, but very profitable, effect was reported. These days, science is lagging behind again. It’s behind on the effects of Internet porn because brain scientists haven’t wanted to study it.

If the cause of youthful ED is porn-related, then the source of the problem is once again the brain—but it is still organic. Porn-induced ED is not psychological, it has a physiological cause. It’s a symptom of an addictive process that has altered the brain. Specifically, the structure and function of the brain centers that control erections.

Your problem isn’t in your penis. It’s in your brain, and it can heal. Next we’ll look at erections.

Erectile Dysfunction & Porn (Part 2)

Penis cross-sections

As always, there’s more to learn—even about the physiology of erections. Yet the mechanics are pretty simple. The arteries leading into the penis get wider. The penis then fills with blood, which compresses the veins leading out of the penis.

Basically, you have a traffic jam involving blood flow. Notice this picture, showing both a flaccid and rigid penis. To get from one to the other, two key events must occur. First, widening or dilating of the arteries bringing the blood to the penis. Second you need the smooth muscles of the penis to relax and allow itself to become engorged with blood. You literally need to relax to get an erection.

These two events are controlled by nerves. In this picture, the nerves that cause erections are yellow. They send messages to the blood vessels and smooth muscle of the penis. There’s a separate set of nerves for sensations, so messages are constantly go back and forth between the penis and the nervous system.

Penis nerves

The nerves that control erections come from the spinal cord. Actually, nerves in the brain activate nerves in the spinal cord, which activate spinal nerves going to the penis, and the penis responds—although it’s a bit more complex than this description. In other words, there are links in the erection chain.

Brain >>>> Spinal cord >>>> Spinal nerves >>>> Penis

If you have ED caused by porn use, the problem is in the brain, and only the brain. That is your weak link. Not the spinal cord, not the nerves, not the penis. In contrast, aging-related ED is generally a problem within the penis.

Here’s where all the action is (not) happening in a youthful ED sufferer. The “lightening bolt” in this picture is supposed to be the electricity flowing down the nerve. When the electric impulse travels down the nerve it causes a release of chemicals, here called “Neurotransmitter Molecules,” at the end of the nerve. It’s the chemical messengers that tell the receiving cells what to do, not the electrical impulse.

Nerve synapse

Chemical messengers control all functions, including erections. The chemical messenger for erections is called nitrous oxide (NO). It’s released from the nerve endings in the penis whenever there is a nerve impulse. The more impulses, the more nitrous oxide released, and the stronger the erection.

At the risk of overcomplicating this, nitrous oxide actually triggers the release of another chemical (cGMP), which does all the work. cGMP dilates the blood vessels and relaxes the smooth muscle, so the penis can fill with blood and become erect.

Spinal nerves >>>> Nitric Oxide >>>> cGMP >>>> Penis engorged with blood

Here’s the important point. These chemicals quickly disappear. That’s why the brain needs to keep sending nerve impulses to sustain an erection.

So where do sexual enhancement drugs come into play? They all inhibit the breakdown of cGMP. Accumulation of cGMP leads to further dilation of the blood vessels and stronger erections. ED drugs do not trigger erections. They sustain them. They work at the level of the penis. Again, their target audience is aging baby boomers and Hugh Hefner.

Sexual enhancement drugs

To trigger erections, you must have nerve impulses causing the release of nitrous oxide. This means the brain needs to register sexual stimulation or arousal of some kind. This is the weak link for heavy porn users with sluggish erections and declining attraction to real women. Men with porn-induced ED suffer from a numbed pleasure response, which occurs in the reward circuitry of the brain (More later). In addition, heavy porn users’ brains are now wired for the superstimulation of Internet porn, as Dr. Doidge described. The biological result is that there are not enough impulses traveling from the brain down the spinal cord to the penis.

The area outlined in red is critical to both libido and orgasm. Here is where the erectile dysfunction of heavy porn users arises. Let’s say you use ED drugs so you can keep continue masturbating to porn. You are actually making your ED worse in the long run, because you are continuing to desensitize this part of the brain.

Orgasm in brain

Porn-induced ED is structural and biochemical. The simple answer is that Internet porn overstimulated your brain, and, over time, your brain adapted. The key point is that these brain changes are similar to those that occur with all addictions. One characteristic of addiction is the need for more and more stimulation to get the same, or usually a lesser, effect. Experts call this tolerance. It’s why you need more porn, or more extreme genres of porn, to get aroused.

The part of your brain where you get aroused is the same place where you get addicted: the limbic system. It’s a group of brain structures we share with all mammals. It’s job is all about survival and, very important, urging you to make more babies: sex and orgasm. Your limbic system perceives that the two-dimensional hotties on your screen are valuable genetic opportunities—because you find them so arousing.

How does your limbic system keep you fertilizing your computer monitor? It uses a brain circuit that is the centerpiece of your limbic system: your reward circuitry. This is where you experience desire, sexual pleasure, libido. It’s also where you decide what you like and don’t like. This circuitry is small, but mighty. You never make a decision without consulting it. In a sense, it’s your inner compass. If you are addicted to anything, here is where it happens.

Reward circuit

To do anything, you must be rewarded. This circuit is activated whenever we do anything that furthers our survival, or, more important, the propagation of our genes. It motivates you to seek out pleasure, whether you actually get pleasure or not. Its evolutionary purpose is to drive you to eat, have sex, fall in love and take risks. These drives are all hardwired into the reward circuit.

Chemical messengers turn on and off parts of the brain, just as they activate changes in blood vessels in the penis. The primary neurochemical, or neurotransmitter, that turns the reward circuit on is dopamine. Think of the reward circuit as the engine, and dopamine as the gas. The higher your dopamine, the more you want something, or the more you crave it.

The more sexually excited you are, the higher your dopamine. Dopamine peaks at orgasm, but the experience of orgasm itself has more to do with the release of other chemicals in your brain, known as opioids. Dopamine is more the motivation to attain your desires. It drives you toward orgasm, and it urges you to watch porn.

Dopamine is vital for both sexual desire and for erections. If your dopamine signals are low, or your reward circuitry isn’t responding to dopamine, say “goodbye” to your libido, and “hello” to ED. Addictions of all kinds dysregulate, that is, screw up, your dopamine system.

Most men think testosterone is the key to their libido and to their erections. In fact, testosterone affects desire primarily by stimulating dopamine in the reward circuitry. If you’re horny, it’s not testosterone, but dopamine, you’re feeling.

Testosterone supplementation only helps with ED when you are deficient in testosterone. Experts suggest that testosterone supplementation helps only about 5-10% of men, and nearly all are over 45. You need testosterone to maintain penile structures and encourage erections. Keep in mind, however, that baby boys get erections and they have very little testosterone.

Another dopamine nickname is the “molecule of addiction.” Cocaine, alcohol and nicotine all feel different, but they all flood the reward circuitry with dopamine. All addictive chemicals, and exciting activities (such as gambling and video games), raise dopamine levels. It’s what makes them potentially addictive. Of course, you need continued use to produce the physical brain changes that lead to an actual addiction.

But how could something like masturbating to Internet porn lead to brain changes that could cause erectile dysfunction?

Erectile Dysfunction & Porn (Part 3)

So, how could something like masturbating to Internet porn lead to brain changes that could cause erectile dysfunction?

The first part of the answer is that our brains didn’t evolve to handle heavy porn use. We have hunter-gatherer brains, even if we’re living in a modern world. Our brains have barely evolved over the last sixty thousand years. Hunter-gatherers didn’t sit in front of computers for hours a day, masturbating to Internet porn.

Second, Internet porn is a superstimulus because of the endless novelty and the constant hunting and seeking. Dopamine surges with novelty, especially sexual novelty. It also surges when hunting—in this case for the “perfect” porn. The dopamine released for novelty and seeking evolved to make your ancestors inquisitive, so they sought new territories, new food sources, and perhaps even on occasion novel mates.

With each click, you get another spike of dopamine. A heavy porn user views more hot babes, or guys, or whatever than our ancestors would have met in several lifetimes. Internet porn is a dopamine-producing machine. With Internet porn you can keep dopamine surging for hours at a time.

Here the yellow lines represent dopamine surges. Internet porn hijacks our innate seeking-hunting mechanism, and tricks the brain into hunting for two-dimensional novelty—and registering them as “really, really valuable.”

Dopamine surges

Dopamine surges with each novel person or scene. So, if your dopamine starts to drop, or your erection starts to fade, all you have to do is click to scene after scene to pump yourself up. There is no way a magazine or rented DVD could ever match the dopamine-goosing novelty of Internet porn.

Here’s a quotation from musician John Mayer,

"Internet pornography has absolutely changed my generation’s expectations. How could you be constantly synthesizing an orgasm based on dozens of shots? You’re looking for the one…out of 100 you swear is going to be the one you finish to, and you still don’t finish."

He has also said something about viewing 300 vaginas before rising from bed in the morning. That’s a lot of dopamine.

Another way to keep your dopamine buzzing is to explore new flavors, or categories of porn. The issue here isn’t the content of the porn you watch, but rather the degree to which it stimulates your brain with dopamine. Whatever your tastes, there’s always something online that is more stimulating or shocking just around the corner.

When you combine novelty with intense emotions, such as shock, fear, or even shame, it can really blast the reward circuitry of your brain by raising dopamine and norepinephrine (an adrenaline-like chemical).

As erectile dysfunction develops, you may find yourself seeking more and more extreme flavors of porn just to get you going. Here’s an example from our forum:

"The past eight or so months, I have become extremely aware of my lack of control over masturbation and porn use. I have degraded into more extreme stuff—a lot of ___________ lately. I am not at all attracted to “that” other than the porn, and once I am done, I am actually disgusted by the thought of it. It was a relief reading some of the articles on here that explain it does not really matter what porn’s content is. It is just the stimulation of it, and the need for more extreme and odd things. I am attracted to women, but have felt no real sex drive toward them for years."

So, how does all this overstimulation affect the brain? It causes a numbing of the reward circuitry. This is what happens with all addictions. The more you over stimulate the reward circuitry by jacking up your dopamine…the less it responds.

Think of a flashlight with fading batteries. In simple terms, your reward circuitry isn’t providing enough electricity to power your erections.

This picture represents the way sexual arousal normally works in the brain. The red arrow represents the nerves sending a message from the reward circuitry to the very, very important hypothalamus. It’s the “erection control center.” However, it gets its instructions, or stimulating impulses, from the reward circuit.

Brain activation for libido

The reward circuit gets its stimulation from sights, sounds, touch, scent and so forth. In other words, from other parts of the brain. Now, the message here from the reward circuit to the hypothalamus is, “Hey! I really want this. Can you help me out here?” That message is dopamine spurts.

If the message from the reward circuit is weak, so are your erections. In a numbed reward circuit, the nerve signals are very weak—represented in this image as dotted lines. Your reward circuit just can’t get fired up because it has undergone physical changes. (The same changes seen in other addictions.)

Weak signals in brain

This is why you need the superstimulation of Internet porn to get your penis going.

To understand how a numbed reward circuit can cause ED, you need to know how nerve cells communicate with each other to transmit messages. It happens in the tiny space between them, called the synapse. In the reward circuit, electricity flows along a nerve and when it reaches the end, it causes the nerve to release dopamine into the synapse.

These nerve cells use dopamine to communicate or bridge the gap. The sending cells squirts dopamine into the synapse, where it attaches to dopamine receptors on the receiving nerve cell. If there’s enough dopamine, the receptors “hear” the message, like little ears. The recieving nerve cell “fires,” and you have an experience, such as arousal, or hopefully an erection.

Nerve cell communication

Just as important, you need plenty of receptors on the receiving nerve or it won’t “hear” the message. In addiction, and erectile dysfunction, the number of dopamine receptors decline. Due to overstimulation, nerve cells say, “Enough! I can’t handle this flood of dopamine signals.” If someone screams at you, you cover your ears. Nerve cells accomplish this by removing dopamine receptors.

Here’s the problem - the strength of the message is determined by how many receptors are activated by dopamine. With fewer receptors activated, you have fewer electrical impulses traveling down the nerves, which translates into less sexual excitement. It’s like your eight-cylinder engine is now running on two cylinders…or less.

Your brain is crying, “I need more dopamine to get an erection.” In reality, you need more dopamine receptors. This is the basis of a numbed pleasure response. The reward circuit becomes less sensitive to dopamine.

For normal erectile function, you need your receptors to return to their previous levels.

In addition to receptor changes, overstimulation can drop levels of dopamine. That, too, alters the levels of excitement experienced. With less dopamine, there’s a weaker response. In effect, you are not only missing some cylinders; you are now running low on gas, too.

Nerve cell communication

These nerve cells are located in the hub of the reward circuit (the nucleus accumbens). It decides if something is exciting or not. It is the weak link in your erection chain. A numbed pleasure response means weak signals to the hypothalamus. Now, the hypothalamus can’t send a strong signal down to your penis.

The reward circuit is not experiencing enough neurochemical stimulation to function normally. So what do you do?

If you have access to the Internet, you go hunting for something that can excite you, even though you’re somewhat numbed to pleasure. Here, the top picture represents manual stimulation alone, or your wife…or even viewing yesterday’s porn. Not enough stimulation to trigger an erection.

Nerve cell signals

So you search for novel porn, and get yourself a big blast of dopamine. This might be enough to get your penis going. But keep in mind that you’re also low on dopamine receptors. So if novelty isn’t enough, you may move on to more extreme porn to jolt your reward circuitry into action.

In addition to a numbed pleasure response, you have also rewired your brain. In this image, you can see that the nerve cells grow more red as they wire together. “Nerve cells that fire together wire together.” This is how we remember things or acquire skills—or habits, including bad habits.

Brain wiring

You have circuits in your brain for typing, riding a bike and masturbating to Internet porn. The more you use these pathways the stronger they become—and the easier it is to do things without thinking.

At some point in the past, you could easily get an erection with so-called normal stimuli: touching your penis, fantasizing about sex, or an encounter with a live potential partner. You didn’t need any porn. In other words, your reward circuitry was at normal sensitivity.

With continued porn use, things changed. You numbed your reward circuitry, and you needed more and more stimulation to get aroused. Eventually, you formed a very strong porn pathway in your brain. It’s stronger than the older pathways associated with normal stimuli. Think of a deep rut on a hillside, into which all the rainwater eventually flows.

For you, when it comes to sex, this is where your thoughts automatically flow. Internet porn is now a powerful memory that calls to you at a subconscious level—because it’s the most reliable source of dopamine, erections and relief from your cravings.

Erectile Dysfunction & Porn (Part 4)

Here’s psychiatrist Norman Doidge again:

"The back pages of men's risque magazines and Internet porn sites are filled with ads for Viagra-type drugs—medicines developed for older men with erectile problems related to aging and blocked blood vessels in the penis. Today young men who surf porn are tremendously fearful of impotence, or “erectile dysfunction” as it is euphemistically called. The misleading term implies that these men have a problem in their penises, but the problem is in their heads. … It rarely occurs to them that there may be a relationship between the pornography they are consuming and their impotence. (emphasis added)"

If you have a porn-induced ED problem, you have altered your brain. It’s that simple. So, what do you do? You need to stop all porn use.

That said, recovery from any addiction is complex, and involves changes on many levels. So please consider any support resources that feel right for you. For most guys, it’s tough to give up porn.

To reverse ED, you need to rebalance your brain. This has two aspects, which we think of as rebooting and rewiring.

“Rebooting” means to restore your reward circuit’s sensitivity to normal. You need time and a radical reduction of stimulation for your dopamine receptors to bounce back to normal (for you). “Rewiring” means allowing your habitual porn pathways to weaken from disuse, and your executive control pathways to strengthen.

Brain signals

Remember, overstimulation caused the nerve cells to reduce the number of their dopamine receptors. “Restoring reward circuit sensitivity,” means increasing the number of dopamine receptors. As time passes without porn use, you will sprout more and more receptors.

As you heal your brain, you will become more easily aroused and have more sensitivity in your penis. As time passes, your dopamine levels should bounce back. Expect increasing interest in real sexual partners. You may also experience more pleasure from everyday activities, such as a walk in nature, petting a dog, or a friendly smile from a stranger.

However, the healing process is not linear. Expect both ups and downs before you arrive at your ideal balance. The most common “downs” are drops in mood or bothersome cravings. At such times, relapse is a very real possibility, due to the deep porn-rut you have created in your brain.

What makes this porn pathway so inviting during recovery is that your reward circuitry is still numb. You’re craving anything that will jack up your dopamine. The good news is that it becomes easier to avoid porn as your reward circuitry bounces back—and you replace porn with the real-life pleasures it evolved to pursue.

As the porn pathways weaken and your reward circuitry regains its sensitivity, your libido will return. After a withdrawal period, you won’t have to depend upon porn for erections or sexual satisfaction.

But as you can see from this image, the porn pathway remains. Although it may fade, it’s unlikely to disappear. That’s why it’s best not to return to porn use. “Let sleeping dogs lie.”

Brain pathways

Here are suggestions from men who have recovered from porn-related ED. You will have to figure out what works best for you.

1. No porn
2. No porn fantasies
3. No masturbation (temporarily)
4. No orgasm (temporarily)
5. Human contact, socializing (ASAP)
6. Replacement activities (ASAP)

The best way to recover is to give your brain a long rest from all intense sexual stimulation. At first, most recovering users find both masturbation and sex tightly linked to porn fantasy. As a consequence, they have to avoid both to keep from activating their existing porn brain pathways.

How long? It varies. In fact, the length of time needed for the entire process is highly variable. It’s somewhat dependent upon your health, age, and the extent to which you have changed your brain.

If you do decide to masturbate during this period, try to focus on physical, sensual sensations. Skip the fantasizing. Masturbation tends to increase cravings and chances for relapse, and some men believe it sets them back. We have not seen anyone recover from ED who regularly masturbated.

The most important factor in recovery is human contact. This is because all addictions hijack our love and bonding brain mechanisms. In fact, scientists think of love as a sort of addiction, also based on dopamine.

It’s a good idea to get your dopamine surging in the way nature intended—via friendly interaction with humans, or maybe even a pet. Another key to recovery is finding rewarding activities to replace porn use.

Be prepared to feel worse (and to have less libido) before you feel better. Here’s what one man said:

"Apart from mild headaches and restless sleep, I haven't had the withdrawal symptoms many people mention. Instead, I feel nothing. It's like I just don't have a libido. No morning wood. No wet dreams. No spontaneous erections. No cravings. Haven't been horny."

Most guys with ED have exactly this response. They “flatline,” or have no libido for weeks. They’ve stopped their “drug” of choice, but their brains need time to recuperate.

Other withdrawal symptoms can be highly variable. Common ones include: anxiety, insomnia, headaches, mood swings, anti-social feelings, concentration problems and often flashes of intense cravings. Here’s what another guy said:

"I am currently beginning day 22 of abstinence (no P,M or O) and I can certainly say that I feel better. But as many others have mentioned, it’s definitely not a linear recovery. Also my libido is very low. I’ll go to the bar and not feel turned-on at all, though I can tell the women I’m seeing are very attractive."

(You can read the recovery stories of these two men here and here.)

Again, recovery takes time, and it is not linear. Two months is not unusual, and potency may even continue to improve thereafter. Meanwhile, some days will be better than others for both your libido and your penis.

During recovery, trying to cope with cravings by using porn doesn’t help. Said one guy,

"I get these feelings in my head that literally say, “Come on! Don’t you want to see what’s going on in the porn world??” Just writing that triggers something in my mind.

I’d have to say that those articles on how the mind can rewire itself, and how it needs to detach itself from the many connections it has made to porn by not feeding it any more, make sense. The process is definitely real. I can feel it."

Because your libido typically drops during recovery, you may have an urge to test using porn to see if you can trigger a response. That is counterproductive because your brain hasn’t healed. “Use it or lose it” does not apply to a recovering reward circuit. Your penis will be just fine.

Suppose you sprained your ankle such that you couldn’t put any weight on it. Would it make sense to test it by skydiving? Going back to porn will only reactivate your brain’s porn pathways. “Two steps forward, one step backward” makes for a much tougher journey.

No one has all the answers to this challenge. Only you know your brain and body. It’s important for you to experiment and find out what works for you. Take the information here, and elsewhere, and learn how to navigate your own ship.

Finally, here’s one other man’s thoughts on recovery. (He had been using porn, and escalating to all kinds of extreme material for twenty years, with increasingly severe ED.)

"The more I go without porn, masturbation, fantasy and orgasm, the more difficult it becomes to not get an erection. LOL. No ED problems or weak ejaculations like I had just a few months ago. My body has healed. So, if you stay away from porn and masturbation your sexual desire will go up. It will go up in a good way."

If you want to learn more, visit www.yourbrainonporn.com, a science-based, non-commercial site with resources supporting the points made in this series of articles as well as stories and tips from recovering users, FAQs, and relevant articles.