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IN June, 2019, the World Health Organization elected to include Compulsive Sexual Behavior Disorder (CSBD) in the 11th edition of the International Classification of Diseases. (ICD 11). [CSBD] is characterized by:
[1] a persistent pattern of failure to control intense, repetitive sexual impulses or urges,
[2] resulting in repetitive sexual behaviour over an extended period (e.g., six months or more)
[3] that causes marked distress or impairment in [:]
personal, family, social, educational, occupational or other important areas of functioning.
THE use of pornography is very often associated with CSBD. Nevertheless, the mental health sciences in the United States have been extremely reluctant to acknowledge that the use of pornography is in itself problematic.
While there has been grudging admission that the notion of sexual compulsion/addiction may possibly be included (or at least suggested as a subject for further study) in future iterations of the DSM, the problem of pornography is only hinted at as a ubject for further study in a potential subgroup within the subset of Internet Addiction.
THE question when the use of pornography may be regarded as a compulsion or addiction is rendered more complex by a tendency on the part of religious or moral persons to regard themselves as "addicts" even though they do not fulfill relevant diagnostic criteria. (Discussion: Religious, Moral Beliefs May Exacerbate Concerns About Porn Addiction, APA News February 6, 2020; [Original Article] ).
PASTORAL RESOURCES
COSA:
Twelve Step
recovery program for those whose lives have been affected by compulsive sexual
behavior.
https://cosa-recovery.org/
SEXAHOLICS ANONYMOUS: A fellowship with
a solution to the problems of lust, sex, and pornography addiction!
https://www.sa.org/
COVENANT EYES: With Covenant
Eyes, you choose someone you know and trust to walk with you as your ally and
hold you accountable for your online behavior. The Covenant Eyes app tracks
activity on your devices. The Victory app shares your activity feed right to
your ally’s phone[...] Patented Artificial Intelligence monitors your device and
scans for concerning activity. ($16.99/month or $183.99
annually)
https://www.covenanteyes.com/
X3 WATCH: (Analogous to Covenant
Eyes): ($89 Yearly Plan $119 Yearly Plan)
https://x3watch.com/
USCCB on Pornography and Addiction:
ARTICLE (2016): “Wash Me Thoroughly”: Healing from Pornography Use and Addiction (2016) https://www.usccb.org/issues-and-action/human-life-and-dignity/pornography/wash-me-thoroughly-healing-from-pornography-use-and-addiction
STATEMENT (2025) “Create in Me a Clean Heart A Pastoral Response to Pornography” https://www.usccb.org/resources/Create-in-Me-a-Clean-Heart-Statement-on-Pornography.pdf
COURAGE APOSTOLATE
https://couragerc.org/
MAYO CLINIC WEBSITE on Compulsive Sexual
Disorder
https://www.mayoclinic.org/diseases-conditions/compulsive-sexual-behavior/diagnosis-treatment/drc-20360453
Kaplan and Saddock Synopsis as Standard textbook on sexual addiction
Images of brain structure and intercellular
connections (pathways)
https://www.ted.com/talks/antonio_damasio_the_quest_to_understand_consciousness
(from 2:02)
NEUROLOGY and ADDICTION
The Addicted Brain - Neurochemistry (Harvard, 2009) DOC; pdf
NEUROLOGY and SEXUAL ADDICTION
Neural Correlates of Sexual Cue Reactivity in
Individuals with and without Compulsive Sexual Behaviours
(PLOS 2014)
pdf
http
(1) common neural pathways in compulsive sexual behaviour and
drug addictions; (2) CSBs want more and enjoy less
Intense, Passionate, Romantic Love: A Natural
Addiction?
(Frontiers in Psychology, 2016)
pdf;
doc;
http
Romantic attraction and rejection employ neural pathways and
centers common to addiction and drug-craving
NEUROLOGY/PSYCHOLOGY and PORNOGRAPHY
Brain Structure and Functional Connectivity
Associated With Pornography Consumption (JAMA 2004)
http;
pdf
Higher hours of pornography consumption correlates with (1) lower
gray matter volume in the right caudate (P
< .001); (2) lower functional activity
during a sexual cue–reactivity paradigm in the left putamen
(P
< .001); and (3) lower functional
connectivity of the right caudate to the left dorsolateral prefrontal cortex was
negatively associated with hours of pornography consumption.
Meta-Analysis: Pornography and Satisfaction
(Human Communication Research, 2017)
pdf
http
lower interpersonal satisfaction for male users of pornography
This Webpage was created for a workshop held at Saint Andrew's Abbey, Valyermo, California in 2002
https://www.psychologytoday.com/blog/women-who-stray/201308/erectile-dysfunction-myth
2013
A review of Pubmed, the largest online database of medical literature, reveals that there is not a single published study linking pornography and erectile dysfunction. A search for the terms “erectile dysfunction pornography” yields 52 publications. Of these, the bulk are studies that use pornography, or “visual sexual stimuli” (VSS) to test erectile dysfunction. In fact, urologists and researchers have found that pornography viewing is an effective, noninvasive and reliable test for psychogenic erectile dysfunction. One fascinating study identified that the brain activities of men watching pornography are not significantly different in men with and without erectile dysfunction.
UPDATE (3-27-15): Two recent studies have been published by researchers who examined whether there truly is a potential epidemic of porn related erectile dysfunction. Prause and Pfaus published this study in Sexual Medicine, finding that porn use did not predict sexual dysfunction, but instead, predicted higher levels of sexual responsiveness.
Landripet and Stulhofer studied European men from Croatia, Norway and Portugal, and found that there was no reliable connection between porn use and sexual dysfunction. Indeed, there was no statistical relationship between men who use higher rates of pornography, and reports of sexual dysfunction. There were inconsistent but weak associations with moderate use of pornography. However, such inconsistent associations suggest most likely that porn use may only be related to sexual dysfunction as an indirect variable. In other words, porn use is not a valuable marker to use or address, and rates of sexual dysfunction in young men are still best explained by the issues described above.
These two studies actually address the frequent complaints by those who cry out that there's no evidence that porn causes E.D. simpoly becase there's been no study of erectile dysfunction, which considers the high levels of Internet porn use among young men today. Now, there are two studies, both conducted independently, by respected researchers. And neither find any evidence to support this myth. Alas, I'm sure that rather than accept these data and findings, true believers will find ways to discount this evidence, and remain committed to the belief that porn [caused erectile dysfunction]
Posted April 26, 2021 Reviewed by Hara Estroff Marano
For many healthy adolescent and adult males, an unexpected consequence of heavy porn use is sexual dysfunction. Most often, this manifests as erectile dysfunction (ED), but porn-using males also sometimes struggle with delayed ejaculation (DE) and anorgasmia (the inability to reach orgasm). Depending on the research, anywhere from 17% to 58% of men who self-identify as heavy/compulsive/addicted users of porn struggle with some form of sexual dysfunction. Basically, research tells us that the more porn one uses, the more likely sexual dysfunction is.
Simply stated, growing numbers of physically healthy male porn users, including adolescents and men in their sexual prime, are struggling with various forms of sexual dysfunction—especially if/when they attempt to be sexual with a real-world partner. Numerous studies back this up, including a large-scale (more than 2,000 participants) study published in 2020.[i] This study found:
· 90% of men fast-forward to watch the most arousing pornographic scenes—i.e., the scenes most likely to be neurochemically rewarded with an intense dopamine and adrenaline rush.
· Heavy porn users take significantly longer than other men to reach orgasm with a real-world partner.
· 23% of the men under age 35 (i.e., in their sexual prime) reported some level of ED when having sex with a real-world partner.
· The amount of porn a man watches is linked to ED. More porn equals more ED.
· Heavy porn use is also linked to dissatisfaction with real-world sex.
· 20% of male porn users find that over time they need to watch more extreme porn to achieve their desired level of arousal.
Based on this and other studies, it appears that for many porn-using males, sexual dysfunction is neither physical in nature nor related to the frequency of masturbation and orgasm (i.e., the need for a sexual refractory period in which males reload, so to speak). Instead, problems with ED, DE, and anorgasmia are increasingly related to the fact that when a male spends 80, 90, or even 100% of his sexual energy viewing and masturbating to pornography—endless images of sexy, exciting, constantly changing partners and experiences—he is, over time, likely to find a lone real-world partner less stimulating than the endless variety and intensity he experiences online.
Stated another way, the infinite variety and ever-increasing intensity offered by online pornography create, especially in heavy porn users, a dopamine/adrenaline baseline that a single real-world partner, no matter how attractive, simply cannot match. Even worse from a relationship standpoint, the constant fantasy/satisfaction cycle that occurs with heavy porn use leads to an emotional and psychological disconnection with even the most loving and valued of partners. In combination, these neurochemical and psychological issues seem to manifest physically in many males as sexual dysfunction with their in-the-flesh partners.
The most common signs of porn-induced male sexual dysfunction include:
· A man is able to achieve erections and orgasms with pornography, but he struggles with one or both when he’s with a real-world partner.
· A man is able to have sex and achieve orgasm with real-world partners, but reaching orgasm takes a long time and his partners complain that he seems disengaged.
· A man is able to maintain an erection with real-world partners, but he can only achieve orgasm by replaying porn clips in his mind.
· A man increasingly prefers pornography to real-world sex, finding it more intense and more engaging.
Thanks to heavy porn use, growing numbers of men are suffering from sexual dysfunction, be it ED, DE, or anorgasmia. Even worse, male sexual dysfunction affects not just men but their romantic partners. After all, if a guy can’t get it up, keep it up, and reach orgasm, then his partner’s sexual pleasure is also likely to be diminished.
References
Fog-Poulsen*, K., Jacobs, T., Høyer, S., Rohde, C., Vermande, A., De Wachter, S., & De Win, G. (2020). PD28-09 CAN TIME TO EJACULATION BE AFFECTED BY PORNOGRAPHY? The Journal of Urology, 203(Supplement 4), e615-e615.
Robert Weiss, Ph.D., MSW, is the author of Out of the Doghouse: A Step-by-Step Relationship-Saving Guide for Men Caught Cheating.
