Does Porn “Re-Wire” Your Brain and Cause Erectile Dysfunction?
There’s a lot of “information” – actually, misinformation – out there about the effects of porn on the human brain and sexual response, and much of it is not based in fact. Let me try to clear things up.
One of the most common storylines about the effect of porn on sexual functioning is that it causes erectile dysfunction. If you’ve ever had trouble getting aroused, and freaked out and looked on the internet to see what the problem could be, you’ve probably come across all kinds of dark and sobering rhetoric about porn “re-wiring” your brain to make you less responsive to in-person sexual experiences. You may have come across the NoFap movement, a surprisingly large community of people who believe that abstaining from masturbation has physical and mental health benefits, and is a route to recovering optimal sexual function. I could write a whole other post on this topic. Short version, none of this is based on good scientific evidence.
What do we know about the effects of porn on the brain?
Porn, or visual sexual stimuli (VSS) as it’s called in the research, produces a brain response in multiple areas of the brain including the dopamine-responsive “reward centers,” the visual cortex, and prefrontal cortex. If you want more detail, here are some of the brain’s main players in the sexual arousal game, and their roles:
Nucleus accumbens – Processes expected or actual reward. Particular interest in erotic vs. other emotion-provoking stimuli.
Amygdala – Involved in processing both negative and positive emotional states, may have role in sexual inhibition.
Striatum / Caudate nucleus – Approach and attachment behaviors, goal-directed action, response to visual beauty, learning, memory, & motor functions.
Hippocampus – Encodes, consolidates, and retrieves memories; influenced by valence / intensity of emotion.
Ventral tegmental area – Contains dopamine-releasing neurons that fire in response to future reward.
Putamen – Reinforcement learning and implicit learning, perception of contempt & disgust, directed motor behavior.
Visual cortex – Identifies and organizes visual stimuli.
Prefrontal cortex – Involved in organizing information, planning, controlling behavior.
Despite the air of certainty on the internet about brain “re-wiring,” scientific evidence does not support this idea. There have only been a few actual studies of the human brain and porn. Functional MRI (fMRI) is the main tool we have nowadays to measure brain activity in response to a stimulus. Two recent fMRI studies (1,2) have shown some specific differences between males reporting high or compulsive use of porn compared to controls:
Lower gray matter volume in caudate nucleus (2)
Less functional activation of putamen with sexual images (2)
Greater amygdala activation in response to sexual images (1)
Less connectivity between caudate & prefrontal cortex (1,2)
So what does this mean? It could mean a lot of things. Despite appearances, brain science is actually fuzzy work with a lot of educated guessing involved. We don’t always know exactly what this or that brain activation means. But here are some possibilities:
Lower gray matter volume in caudate nucleus: Habituation? In other words, less response over time to novelty, beauty, or reward? OR a pre-existing predisposition to need more stimulation to experience pleasure?
Less functional activation of putamen with sexual images: Habituation? Less disgust or less reinforcement?
Greater amygdala activation in response to sexual images: Registering higher emotion? Or anxiety or inhibition related to porn?
Less connectivity between caudate and prefrontal cortex: Less regulation of pleasure-seeking behavior? Or something else?
Btw, habituation means “getting used to” something. Our brains habituate to things that happen often, meaning they don’t warrant such a big response as novel things. If you eat a bunch of cookies, the part of your brain that registers sugary deliciousness probably lights up less at the 12th cookie than it did at the 1st. If you live in LA, your brain may light up less at the 100th beautiful sunny day in a row than it would if you lived in Oregon and were dazzled at the first sunny day after months of rain. Similarly, if sex is a common stimulus, your brain might not bother to mount quite such a big response to it, because it’s used to it happening. But that does not mean that habituation to naturally rewarding things – like sex and food – is permanent.
Since fMRI studies are expensive and time-consuming, they tend to include a relatively small number of research subjects, and tend to measure them at only one point in time, or maybe twice a short time apart. For this reason, we don’t have evidence to support the idea that porn changes the brain, because there aren’t good longitudinal data to back this up. The brain differences in these studies between people who view a lot of porn and those who don’t may be pre-existing differences that influence people’s sexual interest, desire, attention, impulse control, or other characteristics, rather than the other way around.
So does porn cause erectile dysfunction (ED)?
There is no evidence to back up this claim. In my clinical experience, here are some of the ways that porn can be related to ED:
Anxiety. While people don’t usually experience anxiety while watching porn and masturbating, it is very common to experience anxiety with a partner. So you might get super aroused with porn but less so with a partner, because anxiety gets in the way of sexual arousal and erectile function. Don’t blame the porn for this one; instead, work on relaxing, remind yourself to focus on pleasure, not performance, and redirect your attention to what’s arousing in the situation rather than on the anxious thoughts in your head.
Attention / Distraction / Impatience. Building and sustaining arousal during sex requires maintaining attention on what’s going on. With porn, it’s possible to very pleasantly shift attention from one scene to the next in a way that’s not usually possible in partnered sex. You can watch a few seconds of one clip then switch to something else if that’s boring or just not quite right, then on to something even hotter, and so on. I don’t think this is inherently bad, but you do have to practice focusing in a different way for partnered sex. You have to be able to focus on what is arousing in the actual situation you’re in, and ride the ups and downs of arousal, in order to stay engaged and turned on.
Refractory period. The refractory period is the amount of time a guy needs between having an orgasm and getting his next erection. This varies widely depending on age and individual differences. For some guys, masturbating the same day as having sex, or the day before, or even a couple days before, does result in more difficulty getting or maintaining an erection during the next sexual experience. Get to know your body so you’ll know how much time you need between experiences.
This is not an exhaustive list of all things that could be affecting erectile function besides porn, but it’s a start. The point is to start thinking about porn and sexual function in a more complex way, and not to fall into the trap of following oversimplified (and dare I say Puritanical) internet explanations of how porn affects you.
References
Klucken, T., Wehrum-Osinsky, S., Schweckendiek, J., et al. (2016). Altered appetitive conditioning and neural connectivity in subjects with compulsive sexual behavior. Journal of Sexual Medicine, 13, 627-636.
Kuhn, S. & Gallinat, J. (2014). Brain structure and functional connectivity associated with pornography consumption: The brain on porn. JAMA Psychiatry, 71, 827-834.
