Porn Induced Erectile Dysfunction (PIED)

Most people are aware that porn is widely viewed on the internet (roughly a third of all searches are porn related). Women certainly view porn but it’s unknown how widespread it’s use is with women as there seems to be greater shame attached to sex in general, let alone porn. What is being increasingly documented is a surprising and unfortunate fallout from even moderate porn use – that of Porn Induced Erectile Dysfunction or PIED.

GP’s are seeing a rise in men presenting with unexplained erectile problems and many men are so ashamed that they again rely on the internet for information rather than get this checked out. There are an increasing number of men accessing Viagra (no prizes for guessing where from!) in order to self medicate and keep their problem secret even from partners. In fact advertising for Viagra “pops up” on porn sites – the equivalent of a doughnut shop selling slimming pills.

If you are under 40, and not on specific medications, and don’t have a serious medical or psychological condition, your copulatory ED almost certainly arises from performance anxiety or Internet porn—or a combination of the two.” – Gary Wilson (see – http://yourbrainonporn.com/porn-induced-ed-start-here)

How do I know if it’s Performance Anxiety or PIED?

Gary Wilson says, “You cannot have anxiety with your own hand”. If you can get erections with porn but not your partner then it’s PIED. It’s important to note though that lots of men who have developed severe PIED can’t even get an erection with porn, which is why it’s so important to visit your GP to rule out Organic Erectile Dysfunction.

PIED is just one of the signs that changes are occurring in the brain in response to porn use. The signs are:

  • Penis is less sensitive (not helped by masturbating with a “death grip”)

  • Can only maintain an erection by fantasising

  • Vanilla porn is no longer doing it for you

  • Loss of erection at penetration/while putting on a condom/while changing position

  • Not feeling turned on by a partner

  • Delayed ejaculation (sometimes justified by, “I like to please you”)

  • Ejaculating with a partial erection

  • Only getting fully erect at ejaculation

  • Stronger, more reliable erections with porn rather than with a partner

So how do these brain changes occur?

  1. Conditioning

Your brain has been trained to expect a specific level and type of sexual stimulation. When this isn’t delivered it responds to the loss by dropping the levels of dopamine.

  1. Reward Circuitry Desensitisation

The intensity and novelty of porn creates sharp spikes in dopamine, a neurotransmitter involved in your experience of pleasure. Too much dopamine is unhealthy for your brain so a safety mechanism is the shutting down of dopamine receptors and downgrading of the dopamine. This leaves you craving more.

  1. Changes in the Hypothalamus

Enough dopamine is needed in the reward circuits and the hypothalamus for signals to be sent to the penis to tell it to become erect.

So, it’s easy to see that erectile problems happen in the brain not the penis. This is contrary to what porn has taught you – that it’s all about your penis!

I think I do have a problem, what can I do about it?

There are 2 things needed for recovery from PIED. The first is to cut out porn or any kind of artificial stimulation. As with most things in life there is good news and bad news, perhaps we should talk about the bad news first. You will probably experience some form of withdrawal. Common reported symptoms are:

  • Depression

  • Absence of sexual urges (*Flatline)

  • Lack of motivation in general

  • Anxiety

  • Irritability

  • Penis appearing smaller and shrivelled

A *Flatline is an unknown amount of time where you will feel no sexual desire whatsoever. If you have been using porn to (either consciously or unconsciously) avoid thinking about all the difficult things in your life, those difficult things haven’t gone away just because you’ve decided to stop using porn. Your stress hormones will increase. Norepinephrine (a type of adrenaline) increases heart rate and blood pressure. Levels of corticotropin factor will rise and this is associated with major depression. It’s tempting at this stage to test out your sexual response by watching porn again but this is likely to put you back to the beginning. You may convince yourself that just watching a bit of porn without masturbating (Edging) would be ok – this will put you back to the beginning. Remember this is about your brain, not your penis.

Older guys seem to experience shorter Flatlines and a quicker recovery, whereas younger guys’ brains have been wired to porn and they may never have had any successful sexual encounters with a partner (http://yourbrainonporn.com/adolescent-brain-meets-highspeed-internet-porn). Older guys’ brains were wired to real partners before high speed broadband made free porn available in every home. Imagine that you were dropped in a forest with no map or compass. You would look around you to see if there were any obvious, well worn pathways and follow the most obvious one. There are less obvious pathways which will get you to where you want to go but you will still follow the obvious one. Rewiring is about finding new paths, even if they are more overgrown and harder to navigate. If you use the new path often enough it becomes easier and the old path becomes overgrown. Neural pathways in the brain are no different, which brings me on to the second task of recovery – building new neural pathways. This might be connecting with your body better by perhaps going to the gym, improving your diet or masturbating while thinking of a real person (minus the death grip). It might be re-connecting with the friends you have neglected or meeting new people, especially potential partners. If you are already in a relationship it might be making time to share enjoyable activities (including sexual contact) with your partner. Anything that fits with your vision of how you want your life to be and reduces fears will help.

And on to the good news…..reported recovery benefits include:

  • Better erections

  • Return of “Morning Wood”

  • Less anxiety

  • Increased energy

  • More motivation

  • Clarity of thinking

  • Better confidence

  • Feeling more connected to people

  • Deeper voice

  • Sense of direction

  • More time

Many recovered porn users report feeling alive. Withdrawal symptoms and the dreaded Flatline don’t last forever and even after normal sexual functioning returns/begins life continues to improve.

The best news is that the human brain is plastic and PIED is reversible.