EAU 2020: More Porn, Worse Erectile Function

San Francisco, California (UroToday.com) – A study has shown that the amount of porn a man watches is linked to worse erectile function. Watching porn is also associated with greater dissatisfaction with “normal” sex, with only 65% of respondents rating sex with a partner to be more stimulating than porn. This work is presented at the EAU Virtual Congress. 

Pornography has been increasingly available via the internet since around 2007. This has led to a rapid uptake in use, but there is little information on how increasing porn use might affect erectile function. Researchers from Belgium, Denmark and the UK established an online questionnaire www.malesexualhealth.be, which was advertised mainly to men in Belgium and Denmark through social media, posters and flyers. 3267 men replied to the 118 questions, answering questions about masturbation, frequency of porn watching, and sexual activity with partners. The questionnaire concentrated on men who had had sex within the previous 4 weeks, which allowed the team to relate the effect of porn watching on sexual activity. The questionnaire incorporated questions from standard erectile function and sexual health surveys (see notes).

Head researcher, Professor Gunter de Win (University of Antwerp and University Hospital Antwerp) said:

 “We found that there was a big range of responses. In our sample, men watch quite a lot of porn, on average around 70 minutes per week, normally for between 5 and 15 minutes per time, with obviously some watching very little and some watching much, much more”.

They also found that around 23% of men under-35 who responded to the survey had some level of erectile dysfunction when having sex with a partner.

Professor de Win commented:

“This figure was higher than we expected. We found that there was a highly significant relationship between time spent watching porn and increasing difficulty with erectile function with a partner, as indicated by the erectile function and sexual health scores. People who watch more porn also scored high on porn addiction scales.

We need to keep understand what this work means and doesn’t mean. It is a questionnaire rather than a clinical trial, and it could be that the people who have responded are not completely representative of the whole male population. However, the work was designed to unpick any relationship between porn and erectile dysfunction, and given the large sample size, we can be pretty confident about the findings. 

We found that 90% of men fast-forward to watch the most arousing pornographic scenes. There’s no doubt that porn conditions the way we view sex; in our survey, only 65% of men felt that sex with a partner was more exciting than watching porn. In addition, 20% felt that they needed to watch more extreme porn to get the same level of arousal as previously. We believe that the erectile dysfunction problems associated with porn stem from this lack of arousal. 

Our next step in this research to identify which factors lead to erectile dysfunction, and to conduct a similar study on the effects of porn on women. In the meantime, we believe that doctors dealing with erectile dysfunction should also be asking about watching pornography”.

Commenting, Professor Maarten Albersen (University of Leuven, Belgium) said:

“This is an interesting study by Prof. De Win and colleagues. The sample consisted mainly of younger men recruited via (social) media and posters, which may result in a sample biased towards higher online porn consumption rates. All-in-all, the study raises interesting insights in the fact that porn consumption by men may lead to impaired erectile function and/or sexual satisfaction or confidence during partner-sex. As Professor De Win says, the running hypothesis is that the type of porn watched may come more explicit over time and partner-sex may not lead to the same level of arousal as the pornographic material does. The study contributes to an ongoing debate on the topic; experts have highlighted that porn may have both positive and negative effects, and could, for example, be used as an aid in the treatment of sexual dysfunctions, so this is a controversial area and the last words have not been said on this topic”.

Professor Albersen was not involved in this work, this is an independent comment.

The 35th European Association of Urology conference takes place online from 17-19 July 2020. This replaces the physical conference which was scheduled to take place in Amsterdam. The EAU Congress is the largest and most important urology congress in Europe, with up to 14,000 attendees. Conference website https://eaucongress.uroweb.org/.

Abstract 730
The effect of porn watching on Erectile Function

Introduction & Objectives
More and more young men present with erectile dysfunction (ED)(1). This study was undertaken to see if the amount of porn watching has an effect on erectile function in men.

Materials & Methods
A 118-item questionnaire about male sexual health was created on Qualtrics® and published online (www.malesexualhealth.be). The link to the anonymous questionnaire was spread through (social) media, posters and flyers. Apart from standard demographic questions, participants were asked about their frequency of sexual intercourse and masturbation, frequency and duration of porn watching. IIEF-5 score(2) was also included. Because IIEF can be falsely low in men who don’t have penetrative sex(3), we also used MSHQ-ED(4) (including ED bother item) alongside IIEF.

Hours of porn watching per week of each participant were calculated and a scatter plot correlating hours of porn watching with IIEF and MSHQ-ED was created. Assumptions for linear trendline analyses were checked.

Results
3267 men responded to the necessary questions. Age distribution was as follows: 38.1% between 16 and 25, 29% between 26 and 35, 22.5% between 36 and 45, 10.4% above 45 years of age. 28.4% of our participants was single, 5.7% was in a new relationship (<6 months), 35,4% was in a longstanding relationship (>6 months), 29.2% engaged or married and 1.3% was divorced or widowed. Frequency of porn watching was on average 70 minutes per week with a minimum of 0 and a maximum of 1575 minutes (SD 119). 2.2% watched more than 7 hours per week. A porn watching session lasted on average below 5 min in 7.5% of participants, between 5 to 10 minutes in 28.0%, between 10 to 15 minutes in 27.7%, between 15 and 30 minutes in 22.8%, 30 min to 1 hour in 10.7% and more then 1 hour in 3.1%. Assumptions for a linear trend line were confirmed. A clear negative trendline was observed showing lower IIEF-5 and MSHQ-ED scores with more porn watching with R2=0.009 for the correlation with IIEF-5 and R2=0.005 for MSHQ-ED.

Note
The abstract contains graphs which are not reproduced here.

Conclusions
This analysis indicates an inverse correlation between amount of porn watching and Erectile Function. The R2 values indicate that ED is not only explained by porn watching but is of course multifactorial. More analyses are necessary to find out from which threshold porn watchers are at risk.

Authors
Jacobs T.1, Fog-Poulsen K.2, Vermandel A.1, Wood D.3, De Wachter S.1, De Win G.1

1. Universiteit Antwerpen, Dept. of Urology, Edegem, Belgium, 2. Hospital of Holstebro, Dept. of Urology, Holstebro, Denmark, 3. University College London Hospitals, Dept. of Adolescent Urology, London, United Kingdom


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