A 25-year-old man visited the Men's Health Male Health Center because he experienced desire during self-stimulation but encountered erectile difficulties when with his girlfriend. However, when watching pornography, his erectile function almost returned to normal.
Doctor Tra Anh Duy, a specialist doctor level 2 at Men's Health, has observed many similar cases while counseling young men on sexual health. However, he could not solely rely on this symptom to conclude that pornography caused erectile dysfunction, as various other factors also influence erectile difficulties.
Online pornography offers a continuous diversity that real-life sexual experiences can rarely match. With just a few clicks, viewers can easily switch between different images and scenarios, generating novel stimulating signals.
Dopamine, a neurotransmitter, plays a role in motivation, attention, and reward-related learning. Therefore, many people believe that excessive viewing of pornography leads to "dopamine spikes," eventually causing the brain to become "desensitized."
According to Doctor Duy, this statement is not entirely accurate. "Science has not proven that pornography 'burns out' or damages dopamine receptors," he explained. In some individuals who engage in problematic pornography use, the brain's reward system may react more strongly to cues that precede sexual content.
A study by Gola published in Neuropsychopharmacology showed that men seeking treatment for problematic pornography use exhibited stronger reactions in brain regions associated with motivation and reward when exposed to cues preceding sexual images. Simply put, the brain may gradually become accustomed to the sensation of "wanting to watch more."
Why the lack of sensation in real life?
Real-life intimacy differs from screen-based stimulation. Arousal typically builds gradually through eye contact, hugs, kisses, caresses, body odor, emotions, and connection.
If one develops a prolonged masturbation habit accompanied by intense, constantly changing videos, they may become accustomed to a very specific type of stimulation. During actual intercourse, when the level of stimulation is not as intense as on screen, it can lead to difficulties achieving arousal, maintaining an erection, or requiring the individual to re-imagine previously viewed scenes to continue.
A study by Banca and colleagues in the Journal of Psychiatric Research also noted that individuals with compulsive sexual behavior tend to seek out novel sexual images more frequently and adapt more quickly to repeated images.
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Don't blame everything on pornography
Erectile dysfunction in young men is also linked to stress, performance anxiety, depression, lack of sleep, relationship conflicts, alcohol, tobacco, obesity, metabolic diseases, endocrine issues, or medication side effects.
A common vicious cycle occurs after one instance of "malfunction": the man worries about repeating the failure. During intercourse, he constantly monitors his performance. The more anxious he becomes, the harder it is to maintain an erection. Therefore, achieving an erection while watching pornography but struggling with a partner does not definitively mean one suffers from "pornography-induced erectile dysfunction."
Current research has not generally proven that pornography viewing directly causes erectile dysfunction. A more notable correlation exists among individuals whose use is uncontrolled, consumes significant time, or negatively impacts their real life. The important factor is not just the frequency of viewing, but whether the individual can control this habit.
Is a 90-day "brain reboot" necessary?
On social media, many advise "quitting pornography" for 30 days or a "reboot" of 60 or 90 days to "restore dopamine." According to Doctor Duy, there is no strong evidence for a fixed timeframe to "reset" the brain and automatically restore sexual ability.
If pornography becomes almost the sole source of stimulation, reducing or temporarily stopping consumption can help adjust habits. The goal is not "dopamine detox," but to lessen dependence on overly intense stimulation and return to real-life sexual experiences.
Men should avoid excessive masturbation or consistently using one type of intense stimulation. They should get sufficient sleep, exercise, limit alcohol consumption, and increase interaction with their partner. During intercourse, instead of aiming to "achieve a strong erection," one can begin with hugs, kisses, and caresses, focusing on bodily sensations.
When should one seek medical attention?
If erectile difficulties are prolonged, occur repeatedly, or affect self-confidence and relationships, men should consult a urology specialist rather than self-diagnosing. Medical attention is necessary if there is reduced morning erections, decreased libido, difficulty achieving an erection even during self-stimulation, penile pain or curvature, or if underlying conditions such as hypertension, diabetes, or dyslipidemia are present.
When pornography viewing becomes difficult to control, with repeated attempts to stop failing, and it impacts work or relationships, the individual may require psychological or mental health support. A simple self-assessment question is: when the screen is turned off, can one still experience desire, feel, and connect with a real person?
Le Phuong
