Dr. Oz Show Investigates Porn-Induced ED

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UPDATES: Much has occured since the Dr.OZ episode.

Peer-reviewed paper by US Navy doctors - Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016) - It’s an extensive review of the literature on porn-induced sexual problems. The review provides the latest data revealing a tremendous rise in youthful sexual problems. The paper also examines the neurological studies related to porn addiction and sexual conditioning. The doctors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions.


 

ARTICLE: Porn-induced ED diagnosis receives medical legitimacy

Dr. Oz ShowA quiet storm, which has been brewing for several years, has finally burst into mainstream awareness. Regular Internet porn users have increasingly been complaining of erectile dysfunction, delayed ejaculation and inability to orgasm without porn. Sexual enhancement drugs didn't offer much relief, because the problem was originating in the desire circuits of the brain, not below the belt where sexual enhancement drugs work. But caregivers hadn't realized this until now.

We blogged about the porn-related sexual performance phenomenon here on "Psychology Today" in 2011, and the post has received close to a million views. Clearly many men are deeply concerned about this issue. Alarmingly, the lion's share of those reporting problems are in their twenties—much younger than the typical, historical ED sufferer. Nor do they suffer from the kinds of conditions traditionally associated with ED: diabetes, cardiovascular disease, use of specific medications.

Now, Dr. Oz and a team that included a urologist (Director of Reproductive and Sexual Medicine, and member of the University of Maryland Medical School faculty) and psychiatrist have explained how viewing Internet porn can cause sexual performance problems—and why users can reverse it themselves by quitting porn and masturbation.

Watch the show

All new protocol - and a better test

The reason this is such big news, is that until now, medical doctors—including psychiatrists and urologists—appear to have had only one protocol for ED: They inquired whether the patient could get an erection while masturbating. A "yes" ruled out the medical conditions named above. Conclusion? Only "performance anxiety" could be causing the problem. The patient was given a trial pack of Viagra or Cialis and a referral to a counselor to discuss the psychological reasons behind his sexual performance problems. (Inability to get an erection while masturbating might also result in a diagnosis of "psychological issues" in a young guy.)

In short, according to the standard protocol, ED problems were either plumbing-related or strictly psychological. Here are some sample reports about what guys experienced when they sought help:

First guy: I've seen multiple doctors and have wasted thousands on office visits, drugs and tests. Now, I've experienced my first successful intercourse w/o meds in 7 years...after only 17 days of no porn. This works.

Second guy: A year before I started giving up PMO, I even went to see psychiatrists and psychologists who diagnosed me with severe social anxiety disorder and depression, and wanted to put me on antidepressants, which I never agreed to. When I found out that the central problem of my life (ED, lack of responsiveness to real women) that was on my mind 24/7 can be reversed, the heaviest rock was lifted from my heart. When I went on my first NoFap streak (cca 80 days) I started noticing similar super powers as reported by others.

Third guy: I tried all the ED drugs. I went to a urologist 5-6 times and they all said, "Nothing wrong physically." I tried sex therapists, they said it was sexual anxiety. Yeah, didn't work out well there either. Turns out the truth as we know now was the dulled pleasure response perpetuating impotency perpetuating the anxiety.

Fourth guy: I told my therapist about my porn/masturbation addiction before I was able to deal with it myself. He denied that such a thing could exist and recommended that I just watch porn and masturbate once every day.

Fifth guy: (Age 38) Over the last ten years or so I've had various scans (like MRI), cerebro-spinal fluid analysis, endocrine analysis, nerve conduction studies (electromyograms), consulted a urologist, a sexologist and a psychologist. Not a single one has asked me about porn usage. I think there's a real problem here. I'm now doing what I can in my own way to spread the word too.

Sixth guy: (Age 51) I'm 65 days porn free now and seeing results. I've had ED since 2007. It had steadily gotten worse to the point that even Viagra didn't help. I was getting depressed and desperate. I've searched for ED remedies for months. I've tried everything, quitting caffeine, DHEA, vitamins and minerals, losing weight, adding muscle mass, increasing my cholesterol, herbs. I was starting to think it was something that I was going to have to live with, that it was just a part of aging. I stopped cold turkey on the porn and I haven't missed  a bit. If porn robs me of real sex then it's not worth it. My recovery's been up and down. But my morning erections have been very  consistent the past couple of weeks and the last two times I've had sex I got the rock hard erections I hadn't had in years and I maintained them the entire time. And ejaculations are coming more easily and feeling so much better. The sensation of sex is coming back too. Before when I was able to get a hard enough erection for sex it felt like my penis was almost numb. It feels WONDERFUL.

Seventh guy: Porn CAN alter a person's sexual tastes. This happened in my case lightning fast. Porn badly knocked me out of sexual norms. I asked a few professionals along the way, "Is porn safe?" and "Can porn change your tastes"? And just only got a "Nah, you're just kinky my friend. That's normal. It's good for ya!"

Eighth guy: In the back of my mind I always felt like too much masturbation and porn was causing these problems (social anxiety and erection issues). I even asked the doctors at medhelp.com. They all laughed at me and insisted masturbation is healthy and that you can't masturbate too much.

It's evident that healthcare givers generally did not consider the possibility that the changes were physical, yet in the brain, and related to desensitization of the porn user's sexual pleasure response as a consequence of overstimulation made possible by highspeed porn's supernormal stimulation. (See the "Erectile Dysfunction and Porn" video series for details of the physiology behind the phenomenon. )

The obvious question for assessing Internet porn problems is, "How is your erection when you masturbate without porn, or porn fantasy?"  An inability to maintain an erection without porn, yet maintain an erection with porn, reveals that porn use is the culprit, as opposed to performance anxiety. (See full test)

Today's users may be rewiring their sexuality to need a specific form of stimulation (visual novelty and a voyeur's perspective). Moreover, the advent of readily available supernormal stimulation in the form of highspeed porn may override natural satiety in some users, fostering problems.

Guy with EDIt's also worth noting that some doctors didn't realize that when younger guys inquired about masturbation as a potential cause of their ED, they were really asking about Internet porn+masturbation. For the young guys these terms are often synonymous. So the real culprit (highspeed porn) went undetected. Then, when Viagra and counseling didn't work—because neither addressed the fundamental cause (physical changes in the brain)—guys were devastated, fearing they were broken for life.

Thankfully, that is now changing. In fact, the doctors on the show do quite a good job of explaining the physical mechanics of how desensitization arises from overstimulation and contributes to porn-induced ED. All agree that overstimulation deadens response to sexual pleasure in the synapses of the brain. That said, other neuroplastic changes, including sensitization and hypothalamus alterations, must also be at work in order to alter a guy's sexual response so profoundly. Desensitization is seen in all addictions, but these symptoms are unique to sexual stimuli.

Weaknesses in the segment

Despite its many strengths, there are some weaknesses in the show:

Age-dependent advice - The couple on the show are married, and not in their early twenties. The doctors assure them that the man will recover his sexual performance within a month of no porn/masturbation. This may be so—assuming the man hasn't developed an addiction. However, most guys need more than a month, and guys who started early on Internet porn can need six to nine months to regain their sexual performance. See Young Porn Users Need Longer To Recover Their Mojo

No mention of addiction - The show ignores the possibility of addiction and its more stubborn, longer-lasting brain changes. Indeed, the sexologist on the panel irresponsibly, and without anything to back up his advice, encourages couples to return to porn use once the man has recovered. Unbelievable. Guys heal from a medical condition caused by Internet porn use, and a porn-loving sexologist tells them to return to its use? As a doctor familiar with addiction noted privately,

"As far as trying to control porn use, it's like trying to control cocaine use. Porn is not evolutionarily developed sex; it is, like cocaine, a supranormal stimulus. As such, it doesn't share well or leave easily. It likes to be the only camel in the tent."

Encouragingly, although the doctors on the panel didn't mention addiction, their explanations about "desensitization" accord with the public statement of the American Society of Addiction Medicine. It's certainly possible that not every guy who experiences porn-related ED has slipped into addiction, but he has definitely experienced brain changes that are "on the addiction slippery slope." Desensitization is an addiction-related brain change.

In any case, if someone has become an addict, he will not only need far longer to recover from the addiction-related brain changes, he is also unlikely ever to be able to use porn safely. If his brain changed in response to extreme stimuli once, there's no reason to think he is bullet-proof if he turns to such stimuli again.

Possible confusion - Although the urologist's explanations were excellent for the most part, he didn't specifically warn guys to stop watching porn during their time-out. While viewers may think that's self-evident, we see guys all the time on r/nofap who willing forego masturbation, but continue watching porn—without seeing any improvement in their symptoms. Dr. Kramer also advised men to consider "masturbating with their non-dominant hand" to improve sensitivity. That is dated advice. Today's young porn users tell us that they all learn to masturbate with their non-dominant hand, so they can mouse with their dominant hand. This is perhaps another indication that their top priority (sexual wiring) is the porn, not masturbation/climax.

No "flatline" warning - As stated earlier, the show doesn't address the fact that most younger men need far longer than a month of no porn/masturbation to reboot their brains. This young guy, for example, discusses how he needed nine months to recover fully.  Worse yet, many young guys go through a "flatline" of no libido, no erections and "shriveled" genitals during their recovery from ED. It can last weeks, or months, and many will be in this phase after just a month. Watching the segment, they might well conclude that they are "broken," when they simply need more time to restore their brain's normal pleasure response.

No discussion of teen brains - Teen brains are hyper-reactive to stimulation, and hyper-plastic. That is, they easily wire to new stimuli. Hopefully, a future Dr. Oz segment will focus on the plight of younger porn users and their symptoms. It's likely that many of their unique problems are related to the fact that they start out on super-stimulating highspeed during a critical period of brain development, and use it for years prior to attempting real sex. In early adulthood, as their brains grow less plastic, some find it tough to respond to real partners.

Loss of attraction to real partnersSexual conditioning - Animal models are demonstrating that high-arousal states (produced by drugs that mimic dopamine) can alter an animal's sexual behavior—even to the point of changing his apparent sexual orientation. Today's highspeed porn encourages overconsumption as never before, and overuse appears to keep dopamine surging to the point of dysregulation in some users. Sure enough, some users are reporting escalation to erotica that doesn't match their sexual orientation. Interestingly, Parkinson's patients who have been prescribed drugs that mimic dopamine also report unexpected sexual tastes and fetishes

Other symptoms ignored - The show, of course, also doesn't address the many other symptoms guys reverse as they restore their brains to normal: depression, social anxiety, lack of attraction to real partners, concentration problems, lack of motivation, escalation to unexpected porn tastes, and so forth. It is important for those affected to know that Internet porn use may be a factor in diverse symptoms.

Bravo, Dr. Oz!

Science marches on, and it's great to know that guys—who didn't need Viagra or implants, and whose problems didn't stem from performance anxiety or other emotional issues—are being diagnosed correctly and recovering their sexual performance and peace of mind.


 

A September 2015 TEDx talk by a young man who need extra time and relearning/rewiring to overcome porn-induced ED and anorgasmia - 

Also 

  1. Porn-induced Erectile Dysfunction (2014)
  2. Adolescent Brain Meets Highspeed Internet Porn (2013) (half-hour presentation on sexual conditioning and the adolescent brain)