Does Porn Cause Erectile Dysfunction? What the Research Really Says, From a Man Who Makes It

In this guide

• Why I am the wrong person to defend porn, and the right person to be honest about it
• What “porn-induced ED” means, and why it is not an official diagnosis
• The studies that found a link, and the ones that did not
• Porn addiction, ICD-11 and the “moral incongruence” finding
• NoFap and “rebooting”: what is claimed and what is proven
• What I would actually do if my erections stopped cooperating
• When to see a doctor

Every week someone asks me a version of the same question: does porn ruin your erections? Sometimes it comes as an accusation, sometimes as a confession from a young man who is scared. And I understand why people ask me. I have been an adult performer for 14 years. My job depends on getting an erection on demand, in front of a crew, under lights, on a schedule. If porn destroyed erections, I would have noticed.

But that is exactly why I want to be careful. I have an obvious conflict of interest here, and “it never happened to me” is not evidence of anything. So instead of my opinion, I am going to walk you through what researchers have actually found, where they disagree, and what a sensible man should do with all of it.

This is not medical advice. I am a performer, not a doctor, and if you have a real problem you should talk to one.

What people mean by “porn-induced ED”

“Porn-induced erectile dysfunction” (you will also see PIED) is a term that grew up mostly online, in forums and on YouTube. The idea goes like this: internet porn offers endless novelty, one click away, at an intensity real life cannot match. Over time, the theory says, the brain gets conditioned to that kind of stimulation, so a real partner, in a dim room, without tabs to switch, no longer “registers” and the erection fades.

It is an intuitive story. It is also not an official medical diagnosis. You will not find “porn-induced ED” as a category in the World Health Organization’s ICD-11 or in the American psychiatric manual, the DSM-5-TR. Doctors diagnose erectile dysfunction, and then look for its causes.

And erectile dysfunction has a lot of causes. The NHS says most men occasionally fail to get or keep an erection, usually because of stress, tiredness or too much alcohol, and that when it happens often it may be caused by conditions such as high blood pressure, high cholesterol, diabetes, hormone problems, depression or anxiety, or by the side effects of some medicines (NHS: Erection problems). Mayo Clinic adds heart disease, obesity, smoking and relationship problems to the list (Mayo Clinic: Erectile dysfunction). Porn might sit somewhere in that picture for some men. The question is how big a piece it is.

The case for a link

The most-cited paper arguing that porn can cause sexual problems is a 2016 review in Behavioral Sciences by Park and colleagues, several of them doctors with the US Navy (Park et al., 2016). They argued that traditional risk factors do not seem to explain reports of rising erectile problems, delayed ejaculation and low desire with partners in men under 40. They proposed that internet porn’s “limitless novelty” and easy escalation might condition arousal to things that do not transfer to a real partner.

The paper also presented clinical reports of men whose problems improved after they stopped using porn.

That is worth taking seriously. But read what the authors themselves say: they present it as a possible direction for future research, and they call for studies in which men actually remove porn so the effect can be tested. Clinical case reports are interesting. They are not proof, because the men who come to a clinic convinced porn is the problem are not a random sample, and many things change in a man’s life when he decides to quit something.

The case against a link

Now the larger datasets.

In 2015, Croatian researchers Ivan Landripet and Aleksandar Stulhofer analysed online surveys of nearly 4,000 younger heterosexual men in Croatia, Norway and Portugal (Landripet & Stulhofer, 2015). They found only a small, inconsistent association between porn use and erectile problems in one of the samples, and no significant association in the second study, which used a standard erectile-function questionnaire. Their conclusion was that porn “does not seem to be a significant risk factor” for younger men’s desire, erectile or orgasm difficulties.

The same year, Nicole Prause and James Pfaus looked at 280 men who were not seeking treatment and asked how many hours a week they viewed sexual material (Prause & Pfaus, 2015). More viewing was linked to stronger arousal to a sexual film in the lab, was unrelated to erectile function with a partner, and was linked to more desire for sex with a partner.

Neither of those studies proves porn is harmless for everyone. Survey studies have their own weaknesses: they rely on self-report, they show associations rather than causes, and they average across thousands of men, so a minority with a real problem can disappear in the numbers. But if porn were the main driver of erectile problems in young men, you would expect it to show up clearly in data this size. It does not.

The honest summary is boring: some clinicians see men they believe were harmed by their porn habits; large population studies mostly do not find that porn use predicts ED. Nobody has proven cause and effect in either direction.

Porn “addiction” and what ICD-11 actually says

The word “addiction” gets thrown around constantly. Here is what the medical classification says.

In ICD-11, the World Health Organization included compulsive sexual behaviour disorder (code 6C72) as an impulse-control disorder, not as an addiction alongside drugs or gambling (Kraus et al., 2018, World Psychiatry). It describes a persistent pattern of failing to control intense, repetitive sexual impulses, leading to repetitive behaviour that becomes a central focus of life, unsuccessful efforts to cut down, and continuing despite negative consequences or little satisfaction, over an extended period (around six months or more), causing marked distress or impairment.

One sentence in the ICD-11 description matters a lot: distress that is entirely related to moral judgements and disapproval about sexual impulses or behaviour is not enough, on its own, to meet the requirement.

Mayo Clinic describes compulsive sexual behaviour in similar practical terms: urges and behaviours that take up a lot of time, feel beyond your control, are used to escape loneliness, depression or stress, and continue despite serious problems in your relationships, work or health (Mayo Clinic: Compulsive sexual behavior).

So yes, a man can have a genuine problem with porn. It is real, it can wreck relationships and careers, and it deserves proper treatment. But “I watch porn and feel bad about it” is not the same thing as a disorder.

The “moral incongruence” finding

This is the part of the research I find most interesting, and it is the one most men have never heard of.

Psychologist Joshua Grubbs and colleagues developed a short questionnaire on perceived addiction to internet pornography. They found that feeling addicted was strongly linked to psychological distress, even after accounting for how much porn people actually watched (Grubbs et al., 2015).

They then went further. In a systematic review and meta-analysis in Archives of Sexual Behavior, Grubbs, Perry, Wilt and Reid proposed a model in which many porn “problems”, especially feeling addicted, are better understood as moral incongruence: the gap between what you believe about porn and what you actually do (Grubbs et al., 2019). A related review in the Journal of Sex Research made the same case (Grubbs et al., 2019).

In plain words: two men can watch exactly the same amount of porn. The one who believes it is shameful is much more likely to feel addicted, distressed and out of control. That does not mean his suffering is fake. It means the solution may be different. For some men it is a therapist who helps them decide what they actually want, rather than another round of white-knuckle abstinence followed by guilt.

And guilt is terrible for erections. Anxiety is one of the most common causes of erection problems, which I explain in my piece on sexual performance anxiety. A man who goes into sex already convinced he is “broken by porn” is putting pressure on the exact system that needs him to relax.

NoFap and “rebooting”: what is claimed, what is proven

Online abstinence communities promise a lot: stronger erections, more confidence, more energy, even more success with women. Some men report real benefits, and I do not doubt their experiences.

But personal reports in a community built around one idea are not trials. As far as I know, there are no good randomised controlled trials showing that quitting porn cures erectile dysfunction. Park and colleagues themselves said this kind of study still needed to be done (Park et al., 2016).

There is also research on why men try to abstain. A 2020 study of more than 1,000 men recruited online found that the strongest predictor of wanting to quit masturbation was believing that masturbation is unhealthy, with weaker links to actual hypersexuality or loss of control (Zimmer & Imhoff, 2020). Again: beliefs matter as much as behaviour.

My view: taking a break from porn is a perfectly reasonable experiment if you want to. It costs nothing and may teach you something about your habits. What worries me is men who decide porn is the whole explanation and never get checked for things that can actually hurt them.

What I would actually do

If my erections started letting me down, here is the order I would follow. Not because I am a doctor, but because this is what the sources support and it is how I protect my own body for work.

1. Do not panic over one bad night. The NHS says most men occasionally fail to get or keep an erection and that this is usually nothing to worry about. Panic is how one night turns into a pattern.
2. Notice the pattern. Do you still get morning erections? Do erections work when you masturbate? If yes, doctors often look first at psychological and situational causes. I wrote about this in my guide to morning erections.
3. Look at the boring stuff. Sleep, alcohol, smoking, weight, exercise and stress. These are on every medical list for a reason.
4. Change how you masturbate, not only whether. If your routine is fast, intense and always to a screen, slow it down. Pay attention to your body instead of switching clips. Practise with less stimulation. That habit is much closer to sex with a partner.
5. Take a porn break if you want to, as an experiment, without turning it into a moral test you can fail.
6. Talk to your partner. Expectations are part of this. Sex that is not one long performance takes pressure off.
7. See a doctor if it keeps happening. Especially if you are also losing morning erections.

In my professional life the main thing that protects my erections is not avoiding porn, which would be difficult in my line of work. It is sleep, training, not drinking before a shoot and managing nerves. I have written about the physical side in erectile dysfunction in young men.

When to see a doctor

The NHS advises seeing a GP or a sexual health clinic if erection problems keep happening, because it might be a sign of a health condition that can be treated (NHS). Mayo Clinic lists heart disease, high blood pressure and diabetes among the physical causes, and finding those early matters far more than any argument about porn.

Ask for help with your porn use itself if you have tried to cut down and cannot, if it is damaging your work or relationships, or if you use it to escape feelings you cannot otherwise handle. Mayo Clinic recommends looking for a mental health professional experienced in compulsive sexual behaviour. There is no shame in that.

What I want you to take away

Porn is not a magic poison, and it is not harmless for every single man either. The best large studies do not show that watching porn predicts erectile dysfunction. Some clinicians see men who improve when they stop. And a lot of the suffering men attribute to porn seems to come from the conflict between what they believe and what they do.

So: get your health checked, look at your habits honestly, take a break if you want to, and do not let shame do the damage that porn is getting blamed for.

If you want to know who I am and what I do, everything official is on maximogarciaworld.com, and the explicit side of my work lives on fuckingpornstars.net (18+ only). For the human stories behind the industry, read the latest columns on House of Maximo, and if you want to see how scenes are really made, read is porn real? What happens behind the scenes.

Sources

1. NHS. Erection problems (erectile dysfunction).
2. Mayo Clinic. Erectile dysfunction: symptoms and causes.
3. Mayo Clinic. Compulsive sexual behavior: symptoms and causes.
4. Park BY et al. Is Internet pornography causing sexual dysfunctions? A review with clinical reports. Behav Sci (Basel), 2016.
5. Landripet I, Stulhofer A. Is pornography use associated with sexual difficulties and dysfunctions among younger heterosexual men? J Sex Med, 2015.
6. Prause N, Pfaus J. Viewing sexual stimuli associated with greater sexual responsiveness, not erectile dysfunction. Sex Med, 2015.
7. Kraus SW et al. Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry, 2018.
8. Grubbs JB et al. Internet pornography use: perceived addiction, psychological distress, and the validation of a brief measure. J Sex Marital Ther, 2015.
9. Grubbs JB, Perry SL, Wilt JA, Reid RC. Pornography problems due to moral incongruence: an integrative model with a systematic review and meta-analysis. Arch Sex Behav, 2019.
10. Grubbs JB et al. Moral incongruence and pornography use: a critical review and integration. J Sex Res, 2019.
11. Zimmer F, Imhoff R. Abstinence from masturbation and hypersexuality. Arch Sex Behav, 2020.