Hi Anita,

I have been following TinyBuddha for a while now and I am really getting hope and pleasure in reading the various thoughts presented here. Moreover, being an introvert, this is the first time I have actually reached out to someone who is completely unaware to me. I happened upon this topic today and I really wanted your help on some of the things I am facing right now.

What is PIED?

Pornography-induced erectile dysfunction (PIED), is a specific type of ED, that is thought to be caused by over-exposure to porn. If you can get an erection when watching porn, but not with a partner, it is likely that you are suffering from PIED.

The Brain on Porn

Over time, high exposure to porn can reduce your sexual responsiveness. This means that you may need to watch more extreme porn to become aroused, to get an erection or to orgasm. Dopamine is a chemical in the brain required for sexual arousal and getting an erection. When you watch porn – and masturbate – you get a huge influx of dopamine. Being exposed to such a high level of dopamine can dull the dopamine receptors in your brain. This means that the receptors need more and more dopamine to be stimulated enough to make you feel aroused. This desensitisation can cause erectile dysfunction, as you may not get enough dopamine stimulation in a real-life situation. You may have conditioned yourself to be sexually responsive to extreme porn, but not real-life sex. This can lead to erectile dysfunction.

Unrealistic Porn

Everyone knows that porn is not realistic. Pornstars are professional actors who often have greater flexibility and stamina than most people. Porn also often features extreme sex acts, which can be carefully staged to exaggerate certain aspects. The situations portrayed in extreme porn are unlikely to occur in real-life. Being exposed to this sort of material can make real-sex feel comparatively disappointing, resulting in a decrease of dopamine.

How does age affect PIED?

The younger you are, when you first begin to watch porn regularly, the more likely you are to suffer from PIED. You are also more likely to get less enjoyment in real-life sex situations than you get from porn. People who had early exposure to online porn may also be more likely to suffer from ED related to porn, as the internet provides greater access to more extreme porn, compared to other mediums.

A Negative Cycle

When a man experiences ED with a partner, he may often feel embarrassed, worried or depressed. The next time he is going to have sex, he may feel more worried about the possibility of ED occurring again. This anxiety can actually make him more likely to experience ED again. If a man is not able to get fulfilment from sex, he may turn to porn more, which can lead to further issues with ED in real-life situations. This negative cycle can be difficult to break, but it is possible.

How to overcome PIED

Currently, little is known about how to best overcome PIED, but there are several methods to try:
Abstinence

There is some evidence to suggest that abstaining from watching porn for 90 days, gives the body time to readjust to real-life sexual cues. You can still masturbate during this time, but you should not do so after watching porn. Another method is to stop masturbating and watching porn for 1 month. After 1 month you can start masturbating again, but you should continue to avoid watching porn.

If you can’t stop yourself from watching porn, you should try to avoid extreme porn and only watch porn that is more similar to real-life situations. You could also invest in some tools to stop you from accessing porn websites. Web-filters can be used to block porn sites, or if it would help you, you can use websites such as Ever Accountable, which will alert a friend when you watch porn, holding you accountable.
Counselling

If you think you may be addicted to porn, or if you just want a little extra help, counselling may be a good option to help you overcome PIED. A counsellor can help you to:

Identify what leads you to watch porn
Manage what causes you to watch porn i.e. stress etc.
Manage your impulse to watch porn
Find other ways to achieve pleasure without porn
Explore any past relationships and your previous history of porn use
Build and develop your current sexual relationships

Medication

ED medication such as Viagra, Cialis or Levitra, may be an option to consider to treat your PIED. However, as PIED has psychological and behavioural elements to it, you may find that medication is not the right option for you. It is important that you let your prescribing doctor know if you believe your ED may be linked to your porn habits. This will help them to make the best decision about which treatment would be most suitable for your individual situation.