My colleague and I leaned anxiously towards our computer screens late one night. Our automated vibrator was bringing a woman to climax next door, and we were sweating every tiny jump or dodge in her biosignal. Finally, she pressed the button indicating the start of her orgasm. We waited another second. The biological trace stayed flat. There was no physical evidence from her genitals that an orgasm had happened. She was not the only one.
This mismatch of sexual experience and physiology is very common in sex research. Men with rapid ejaculation claim to not last as long as we observe in the lab, women deny experiencing arousal while their genitals are engorging to aggressive porn, and men measure their penis size a smidge bigger than what a scientist’s measurement will find.
Perhaps nowhere is this mismatch between experience and physiology more in the news than reports of erectile dysfunction attributed to pornography. Seven independent labs have been unable to find an association between time spent viewing sex films and experiencing more erectile difficulties with a partner. So why are men reporting porn effects that studies cannot find?
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As a neuroscientist and clinician, I was skeptical when men started claiming this link. Not only are people poor reporters of their bodies' own physical response (see above), but neuroscientifically it seemed very unlikely that merely viewing sex films would transfer to partnered sexual experiences. Perhaps our first clue should have been that, after showing people porn in a lab, they run home more likely to have sex with their partner (you’re welcome)!
Sex and Porn Are Different
Guillaume Sescousse, PhD, a researcher at the Lyon Neuroscience Research Center in France, studies the brain differences between primary rewards and secondary rewards. This is science-speak for the thing you want (primary) and the thing that helps you get the thing you want (secondary). For example, money (secondary) is desirable only because we have agreed that it can be traded for chocolate chip cookies (primary).
Sescousse found that a more anatomically recently developed portion of the brain involved in understanding rewards (right anterior orbitofrontal cortex) used more oxygen when receiving money than viewing images of sex or food. Put another way, the brain network that anticipates future pleasures and the brain network that consumes those pleasures are distinct. In other studies, noradrenergic medicines messed up the brain’s anticipation of sexual images, but anticipation of money did not change. However, pictures of sex are not sex. So we measured the brains of people while they played a game to win money, then to win vibration of their genitalia. Money and actual sexual stimulation also showed different brain responses.
There is still one link missing. Actual sexual stimulation and sexual images have yet to be directly compared in the same study. That could really settle what is distinct about secondary (film) and primary (sex) rewards. All these hints from published studies just made it stranger that people were claiming the more they viewed sex films, the less they responded sexually to a partner.
Those studies don’t even touch on touch. Human erotic touch turns out to be really unique. Only slow stroking of the skin… by a human other than yourself… not wearing a glove… activates the C-tactile afferents in the skin that makes touch feel sexy. These C-afferents are slow fibers found only in hairy skin that are specially tuned to respond to stroking touch in the 1–10 cm/s range (i.e., sexy). What is really unique about these C-afferents is that they transmit uniquely to social/emotional areas of the brain known to promote social sexual response. Watching someone else being stroked does not activate these afferents.
All together, the partnered intimate experience is physically distinct from merely viewing sex films. Viewing sex films was unlikely to, and has not been demonstrated to, cause erectile difficulties with a partner.
Weak Science
This year, Samuel Perry, PhD, published a study based on a simple idea: If people always masturbate when they view sexual films, how do we know masturbation is not causing the effects being misattributed to sex films? In fact, that is just what he found.
“It’s always seemed obvious to me that people who watch porn by themselves (which is how most people, and men especially, watch porn) aren’t watching it for entertainment purposes... Once I accounted for how often someone was masturbating, the relationship between pornography use and relationship happiness completely disappeared,” Perry described.
Perhaps when partnered sex is not an option for whatever reason, including non-sexual problems in a relationship causing anger or anxiety nor conducive to sex, we turn to manual self-stimulation (i.e., masturbation) to take up the pleasure slack. Prof. Perry believes “professional clinicians, scientists, the media, and the general public need to think about the context in which people view sex films and not feed into the false narrative that viewing images on a screen is itself the kiss of death for relationships.” His just-released book Addicted To Lust dives in to these issues in depth, focusing on religious moral conflicts with pornography, in depth.
Importantly, this means any study on pornography has to prove their effects are not actually due to masturbation. For example, one small study assigned 10 people to abstain from porn for three weeks and pronounced their level of commitment to their partner was higher than 10 people who continued viewing pornography. Measures of masturbation? Zero. I get why the public sometimes think scientists lack real world perspective. Ask 10 people who masturbate to stop for three weeks and they will be crawling the walls to be with their partner! Porn doesn’t look so magical when you realize these are just effects of masturbation.
The Way Forward
I met Jason Rogers after he just finished telling a packed house in Los Angeles about his fight for the silver medal at the Beijing Olympics in fencing, all the while privately struggling to find his footing in the bedroom. We had both encountered strong pushback for not acquiescing to this popular myth that porn was responsible for ED.
“I don’t think porn had a direct role in my previous experiences with ED or induced the disorder on neuro/biological level as some claim,” Jason said. “And later in my life, it proved to be a helpful tool after I began the difficult emotional work of recultivating my relationship with my own sexuality.”
He is working on a book describing these contrasting triumphs and struggles in his personal life. His story is a compelling argument for the science-based interventions therapists use successfully with clients struggling in this domain.
“I'm sure that being an athlete played some role in my approaching sex with this kind of goal-oriented mindset. But it caused this reaction in me where, when I struggled, I would just try harder,” the Olympian described. “Performance anxiety begins to take root when you step from the innocuous observation that things didn’t go as planned to the general belief that it will happen again.”
This anxiety building from early, normal variability in erections is a well-characterized etiology of ED treated by sex therapists effectively for decades. My greatest concern is that this myth of ED being caused by porn will exacerbate men’s difficulties. I wish we could catch young men the first few times their erections are not perfectly on-demand, and give them Jason’s message: “Most men think they should be able to snap their fingers, immediately get an erection, and perform like a champ. But sex is a complicated physiological and psychological process and virtually all men have struggled with this in the past. So cut yourself some slack.”
Alcohol, medications, tiredness, and, most commonly, anxiety, are all major, known causes of erectile variability. The sexual partner also can have a major role between men’s health or dysfunction, by valuing non-penetrating types of sex and not blaming the guy or projecting their own insecurities on him. If guys notice erectile variability with a new partner, Rogers suggests being up front about it. “I found it helpful to say that my body felt ‘sleepy’ or ‘grumpy.’ This kind of playful language often served as a better jumping off point for an honest conversation that not only helped me relieve the stress I felt, but also prevented my partner from self-blame (I’m not sexy enough, he doesn’t like me, etc).”
The porn-broke-my-penis myth arose from a few sources. There was bad science and political misrepresentation. Many were boys told by Viagra commercials that their penis can never falter, mistakenly believing that their first instance of erectile variability is a dysfunction. But my sense is that this myth is mainly persistent because sex is scary and embarrassing for most people.
Men have long resisted framing their erectile difficulties as having a psychological origin. Yet, there are many very effective and novel talk therapies that improve erectile function. These sex therapies take more time, courage, and effort to find and address the real source of difficulty. Having open conversations about sex, admitting unusual sexual preferences, finding a partner who is supportive, and exploring fears about our own sexual body can be terrifying. Rather than confront our underlying anxieties of not being hard enough, man enough, or disappointing our partner, we look for a comforting, superficial, uncomplicated story we can tell ourselves: “I’ll just stop watching porn.”