title: Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports.
abstract: Traditional factors that once explained men's sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography's unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.
authors.affiliation: Flight Surgeon, Fleet Logistics Support Squadron 40, Norfolk, VA 34800 Bob Wilson Drive, San Diego, CA 92592, USA. brian.y.park4.mil@mail.mil.
authors.forename: Brian Y
authors.initials: BY
authors.lastname: Park
authors.affiliation: The Reward Foundation, 5 Rose Street, Edinburgh EH2 2PR, Scotland, UK. GWilson@rewardfoundation.org.
authors.forename: Gary
authors.initials: G
authors.lastname: Wilson
authors.affiliation: Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA. Jonathan.Berger@med.navy.mil.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Berger
authors.affiliation: Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA. matthew.christman@med.navy.mil.
authors.forename: Matthew
authors.initials: M
authors.lastname: Christman
authors.affiliation: Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA. bryn.reina@med.navy.mil.
authors.forename: Bryn
authors.initials: B
authors.lastname: Reina
authors.affiliation: Department of Ophthalmology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA. frank.bishop@med.navy.mil.
authors.forename: Frank
authors.initials: F
authors.lastname: Bishop
authors.affiliation: Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA. warren.p.klam.civ@mail.mil.
authors.forename: Warren P
authors.initials: WP
authors.lastname: Klam
authors.affiliation: Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA. andrew.p.doan.mil@mail.mil.|Department of Ophthalmology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA. andrew.p.doan.mil@mail.mil.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Doan
keywords: Internet pornography; PIED; delayed ejaculation; erectile dysfunction; low sexual desire; low sexual satisfaction; pornography; sexually explicit material