The neurological repercussions of porn consumption

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Pornography has existed throughout recorded history, transforming with the introduction of each new medium.

Hundreds of sexually explicit frescoes and sculptures were found in the Mount Vesuvius ruins of Pompeii.

Since the advent of the internet, porn use has skyrocketed to dizzying heights. Pornhub, the world’s largest free porn site, received over 33.5 billion site visits during 2018 alone.

Science is only just beginning to reveal the neurological repercussions of porn consumption. But it is already clear that the mental health and sex lives of its widespread audience are suffering catastrophic effects. From depression to erectile dysfunction, porn appears to be hijacking our neural wiring with dire consequences.

In my own lab, we study the neural wiring that underlies learning and memory processes. The properties of video porn make it a particularly powerful trigger for plasticity, the brain’s ability to change and adapt as a result of experience. Combined with the accessibility and anonymity of online porn consumption, we are more vulnerable than ever to its hyper-stimulating effects.

Impacts of porn consumption

In the long term, pornography seems to create sexual dysfunctions, especially the inability to achieve erection or orgasm with a real life partner. 

Marital quality and commitment to one’s romantic partner also appear to be compromised.

To try to explain these effects, some scientists have drawn parallels between porn consumption and substance abuse. Through evolutionary design, the brain is wired to respond to sexual stimulation with surges of dopamine.

This neurotransmitter, most often associated with reward anticipation, also acts to program memories and information into the brain. This adaption means that when the body requires something, like food or sex, the brain remembers where to return to experience the same pleasure.

Instead of turning to a romantic partner for sexual gratification or fulfillment, habituated porn users instinctively reach for their phones and laptops when desire comes calling. Furthermore, unnaturally strong explosions of reward and pleasure evoke unnaturally strong degrees of habituation in the brain. Psychiatrist Norman Doidge explains:

“Pornography satisfies every one of the prerequisites for neuroplastic change. When pornographers boast that they are pushing the envelope by introducing new, harder themes, what they don’t say is that they must, because their customers are building up a tolerance to the content.”

Porn scenes, like addictive substances, are hyper-stimulating triggers that lead to unnaturally high levels of dopamine secretion. 

This can damage the dopamine reward system and leave it unresponsive to natural sources of pleasure. This is why users begin to experience difficulty in achieving arousal with a physical partner.

Beyond dysfunction

The desensitization of our reward circuitry sets the stage for sexual dysfunctions to develop, but the repercussions don’t end there.

Studies show that changes in the transmission of dopamine can facilitate depression and anxiety.

In agreement with this observation, porn consumers report greater depressive symptoms, lower quality of life and poorer mental health compared to those who don’t watch porn.

The other compelling finding in this study is that compulsive porn consumers find themselves wanting and needing more porn, even though they don’t necessarily like it. This disconnect between wanting and liking is a hallmark feature of reward circuitry dysregulation.

Following a similar line of inquiry, researchers at the Max Planck Institute in Berlin, Germany, found that higher porn use correlated with less brain activation in response to conventional pornographic imagery.

This explains why users tend to graduate to more extreme and unconventional forms of porn.

Pornhub analytics reveal that conventional sex is decreasingly interesting to users and is being replaced by themes like incest and violence.

The perpetuation of sexual violence online is particularly troubling, as rates of real-life incidences may escalate as a result.

Some scientists attribute this relationship to the action of mirror neurons. These brain cells are aptly named because they fire when the individual performs an action but also while observing the same action performed by someone else.

Credit: BBC Three.

The regions of the brain that are active when someone is viewing porn are the same regions of the brain that are active while the person is actually having sex. Marco Iacoboni, a professor of psychiatry at University of California Los Angeles, speculates that these systems have the potential to spread violent behavior: “the mirror mechanism in the brain also suggests that we are automatically influenced by what we perceive, thus proposing a plausible neurobiological mechanism for contagion of violent behavior.”

Though speculative, this suggested association between porn, mirror neurons and increased rates of sexual violence serves as an ominous warning. While high porn consumption may not drive viewers to harrowing extremes, it is likely to change behaviour in other ways.

Moral development

Porn use has been correlated with erosion of the prefrontal cortex — the region of the brain that houses executive functions like morality, willpower and impulse control.

Pornography viewers are increasingly choosing more violent forms of pornography; this may be attributed to the desensitizing effect of regular consumption.

To better understand the role of this structure in behaviour, it’s important to know that it remains underdeveloped during childhood. This is why children struggle to regulate their emotions and impulses. Damage to the prefrontal cortex in adulthood is termed hypofrontality, which predisposes an individual to behave compulsively and make poor decisions.

It’s somewhat paradoxical that adult entertainment may revert our brain wiring to a more juvenile state. The much greater irony is that while porn promises to satisfy and provide sexual gratification, it delivers the opposite.


The online pornography industry has been developing at a fast pace due to a global increase of Internet accessibility and technological progress, particularly in streaming media that allow users to continuously watch content, usually a video, without the need to download it [1]. It is, thus, no surprise that explicit material is now ubiquitously and readily available on the Internet while intended and unintended exposure to it may sometimes be difficult to avoid [2,3].

According to statistics shared by Pornhub, a major online website with explicit content, the group of pornography consumers is steadily increasing and it is mostly represented by men (over 70% of all users) and young adults, below 34 years old [4].

In line with this data, over 70% of adult US citizens, aged 18–30 years old, admit to watching online pornography at least once a month while nearly 60% of college students admitted to its consumption once a week [5]. Adolescents also constitute an important group of intentional online viewers of pornography with user rates in countries such as Taiwan and Sweden estimated at level up to 59% and 96%, respectively [6,7].

Although pornography has a long history, the new technologies have undoubtedly led it to new heights. It is now offered in almost unlimited sexual diversity via free-of-charge online websites accessible through any device with Internet access, mostly in the form of video pornography, which was reported to be the most sexually arousing of all forms of explicit material [8,9]. The ease, diversity, and arousal strength with which online pornography can reach its consumers indicates that it may operate as a supernormal stimulus [10,11,12].

There are, however, controversies over the exact effects that it may potentially exert on its consumers. Some studies reported that long-term use correlates with erectile dysfunction, decreased libido [12,13,14,15], higher interest in pornography than sexual contacts with real partners [13,16], and lower sexual and relationship satisfaction [15,17,18,19,20]. One should, however, note that the majority of these investigations cannot assess the causality and, furthermore, that there are some other research that clearly produced the contrary observations.

For example, some cross-sectional studies and experimental investigations failed to find an association between erectile dysfunction and pornography use [21,22,23,24], some research also suggest that men with sexual dysfunctions, such as erectile dysfunction, may tend to use more pornography, including patterns they self-perceive as problematic [24].

There are also investigations reporting a positive correlation between pornography use in men and their sexual arousal, desire for solo and partnered sexual behaviors [23], as well as studies suggesting that pornography use may reduce risky sexual behaviors [25], indicating that women involved in long-term relationships that use pornography more frequently may reveal increased sexual desire towards their partners and report higher desire for sexual variety [26], and highlighting that shared viewing of pornography in heterosexual couples correlates with increase of sexual satisfaction [27].

All in all, there is a need to further explore pornography use among different groups and by using various research approaches encompassing cross-sectional, case-control, and prospective cohort studies.

The pornography addiction is not a formally recognized disorder in the ICD-10 or DSM-5 classifications, therefore, some investigators have referred to it as “self-perceived pornography addiction” [28,29,30].

The evidence from neurobiological studies indicates that it may fit into the general addiction framework, and share similar mechanisms with those observed in addictions to chemical substances [31,32,33,34,35] although controversies in this regard exist [35,36] and some alternative models based on compulsivity, impulsivity or moral incongruence were suggested to describe high and problematic consumption of pornography [24,36].

Some preliminary case reports suggest that naltrexone, predominantly used in the treatment of alcohol and opioid dependence, can be successfully applied in patients with compulsive pornography use [37,38].

It is known that most individuals actively explore sexual behaviors and gain sexual experience until their mid-20s [39,40]. It can, therefore, be hypothesized that for young adults the consumption of pornography may represent some sort of substitute for these activities or be a part of them. This, in turn, creates a need to understand how these individuals may perceive pornography. For this reason, some studies have addressed this issue by investigating groups of college students but sample size was often not high or limited to only one gender [41,42,43,44,45,46].

This is, therefore, of interest to conduct further studies that would survey large groups and assess to which extent individual characteristics may affect differentiate the patterns of pornography use. For example, it would be interesting whether particular personality traits can be associated with pornography use as some previous studies have reported that they may influence sexual activities, such as novelty seeking [47].

The sexual activities might also be influenced by physical characteristics such as Body Mass Index [48], yet not much is known whether it may be associated in any way with pornography use. Moreover, patterns of pornography consumption may depend on whether studied individuals are single or in a relationship; it was reported recently that the latter group tend to use it less often [49].

The aim of the present cross-sectional online survey study was to assess the prevalence of pornography use, age of first exposure, patterns of pornography consumption, attempts to cease its use and self-reported effects of such cessation, self-perceived effects of pornography use, and prevalence of self-perceived addiction to pornography among Polish female and male university students aged 18–26 years old.

The associations of these parameters with body mass index (BMI), status of romantic relationship, and eighteen self-reported personality traits were evaluated. Moreover, students opinions on the effects associated with pornography use and its legal status were also assessed. The study provides a broad insight into various aspects of pornography use in young adults.

 Discussion

There has been a continuous interest in the study of various aspects of pornography consumption. The present study explores these issues in university students aged 18–26 years old—a group which can be expected to be sexually active. As shown, in the United States the average age of first sexual intercourse is 17–18 years [57].

The results of the present study offer an insight into the prevalence and patterns of pornography use, and the way it is perceived in the group of university students in Poland. It demonstrates that the majority of students use pornography and that unsurprisingly, online streaming videos are the most popular form of use, as they can currently be easily reached with any device with Internet access.

The rate of exposure as reported here falls within ranges observed for young adults in previous studies [58,59]. According to statistical data provided annually by the largest online pornography service Pornhub and observations from various epidemiological studies, the prevalence of use, particularly on a regular basis, is higher among males [4,45,60,61].

Similar conclusions were formulated in previous research employing a smaller sample size of Polish (n = 1135) and German (n = 1303) students [59]. Contrary to this, the present investigation found no significant difference between sex subsets, not only in the prevalence of pornography consumption, but also its frequency.

However, recent analysis has shown that the incidence of women using pornography in various world regions is increasing [62] and, subsequently, more of them may be willing to admit it. It is also possible that the high prevalence of pornography use in females as observed in the present study is, to some extent, a result of volunteer bias—an anonymous online survey may attract consumers of pornography more than individuals not associated with explicit materials.

A number of previous studies have focused on potential negative outcomes of pornography [63]. The present research demonstrated that nearly 25% and 15% of surveyed students perceived that pornography use adversely affects their sexual and relationship satisfaction, respectively. However, it is worth noting that majority of the surveyed individuals did not report any negative effect on their sexual satisfaction, and did not note any changes to sexual performance that would occur over the course of pornography consumption.

Moreover, majority of those in relationship did not perceive that pornography had some negative effect on the quality of relationship, and over one-quarter actually indicated that pornography had beneficial effect on it.

Interestingly, despite that majority of students did not note any negative effects on their own sexual function, sexual and relationship satisfaction, they mostly expressed an opinion that pornography use may adversely affect human health.

This, in turn, may potentially indicate that how the pornography is perceived by young adults may not be driven by their own experience but by cultural factors, and opinions formulated by authorities and media.

However, a design of the present study cannot conclude on causality, the discrepancies in self-perceived effects of pornography use (negative, positive, or none) suggest its outcomes may potentially be associated with individual characteristics.

Apart from BMI and age of first exposure, which are discussed later, the variables, such as baseline sexual satisfaction, history of sexual activities (number of partners, age of first sexual intercourse etc.), compulsivity, and impulsivity may also be important to consider. Further studies are required to explore these issues although they may be difficult to establish on basis of cross-sectional studies.

Given the fact the high frequency of pornography consumption among young adults, it can be hypothesized that the context of its use may be crucial in understanding the potentially associated effects. For example, a number of studies have shown that individual pornography use may be negatively correlated with partner’s sexual satisfaction [64] while a recent investigation indicated that shared use may actually be positively associated with promotion of sexual interaction between partners and their sexual satisfaction [65].

It is also plausible that individuals with some sexual dysfunction may tend to use more pornography, highlighting a need for longitudinal studies in which baseline sexual characteristics of enrolled subjects are established.

As demonstrated in the present study, women using pornography more often reported disgust, guilt, and embarrassment [27], and this may also limit their willingness to report or discuss any association with explicit material [66].

This advocates the use of anonymous online surveys in epidemiological studies on pornography exposure although they also introduce number of limitations as discussed later. The present study highlights that over half of female students using pornography, a significantly higher number than in the case of their male counterparts, report to be embarrassed by this activity.

This difference may arise from cultural influences and much lower acceptance of pornography consumption among women compared to men, and that some women may more often associate it with an act of infidelity, although contradictory findings were reported in this respect [67,68,69]. It could be hypothesized that such embarrassment could induce distress associated with pornography use.

The present study also found that women who are embarrassed about their pornography activity more often perceive that its consumption negatively impact a romantic relationship quality. However, one should also note that such an association was even more frequent in male students. Feeling ashamed of pornography consumption may impede discussing it with a partner, and potentially undermine trust in a relationship. Altogether, it supports the notion that partners should openly discuss the pornography use with each other.

With some exceptions, none of personality traits, which were self-reported in this study, differentiated the studied parameters of pornography. These findings support the notion that access and exposure to pornography are presently issues too broad to specify any particular psychosocial characteristics of its users. However, an interesting observation was made regarding consumers who reported a need to view increasingly extreme pornographic content. As shown, frequent use of explicit material may potentially be associated with desensitization leading to a need to view more extreme content to reach similar sexual arousal [32].

Nevertheless, it was recently evidenced that the pornography industry does not produce increasingly more material presenting violent and degrading acts, and that streaming videos presenting such acts receive less views and lower rankings from online viewers [70].

As indicated by Italian research surveying high school students, a minority of them (18.8%) were exposed to violent/degrading material with a lower rate observed for females [71]. The present study found that a need to use more extreme pornography material was more frequently reported by males describing themselves as aggressive.

A link between pornography and aggression has been studied previously: intentional exposure to violent material over time predicted an almost six-fold increase in the odds of self-reported sexually aggressive behavior [72]. One should, however, note the present findings cannot exclude the possibility of reverse causation (aggressive males more frequently preferring violent pornographic material). This would require case-controlled or cohort studies.

Interestingly, in the present study females reporting a gradual need to explore more violent explicit materials more frequently perceived themselves as curious. It could, therefore, be hypothesized that violent pornography may attract females with a specific interest in sexual exploration, although this would also require further investigation.

An interesting observation of this research is that overweight/obese (≥25 kg/m2) female and male students perceived that pornography has negative effect on relationship quality more often than those with BMI <25 kg/m2. For young adults, pornography may model their sexual perception and expectations, and has been reported to serve as a source of sexual information [3]).

This may not unambiguously lead to adverse effects if pornography is not regarded as a primary source of such information and, as a fantasy, it is not mistaken for sexual reality [73]. Pornographic materials often present unnatural or even extreme acts by actresses and actors who, in order to adapt to the promoted type of physical appearance, often undergo plastic surgeries or use pharmaceuticals to sustain the state of erection [74].

Altogether, this may lead to the generation of sexual demands which are often impossible to meet, and discrepancies between physical attractiveness as presented in pornography and that of the exposed subjects, particularly those who are overweight or obese.

It can be hypothesized that pornography may further magnify the effect, already observed in previous studies, in which heavier women were judged by their male partners as lower in attractiveness/vitality and as poorer matches to their partners’ ideals of attractiveness [75].

Moreover, high BMI has been shown to be a significant predictor of erectile dysfunction [76], an association which could also lead to a potential discrepancy between male sexual skills and those presented by pornography actors.

Age of first exposure to explicit material was associated with increased likelihood of negative effects of pornography in young adults—the highest odds were found for females and males exposed at 12 years or below. Although a cross-sectional study does not allow an assessment of causation, this finding may indeed indicate that childhood association with pornographic content may have long-term outcomes. It has been previously suggested that early exposures support adherence to unhealthy notions of sexual relations [77].

The present study shows that individuals exposed earlier were more likely to report neglecting basic needs and duties at least once in their lifetime due to pornography use, and had perceived its negative effects on relationships quality more frequently.

Whether these effects result from hypofrontal syndromes manifested by compulsivity, emotional lability, and impaired judgment is unknown, although such effects have already been reported among pornography consumers [32,34].

The present study also suggests that earlier exposure may be associated with potential desensitization to sexual stimuli as indicated by a need for longer stimulation and more sexual stimuli required to reach orgasm when consuming explicit material, and overall decrease in sexual satisfaction. As shown in neuroimaging study, exposure to pornography may lead to down-regulation of the reward system in adults via a decreased volume of caudate gray matter and its altered functional connectivity with prefrontal cortex [32].

Finally, earlier exposed female and male students had higher odds for self-perceived addiction to pornography – a phenomenon observed at a rather higher rate of 12.2% in the surveyed group. One should note, however, that this rate does not reflect whether the studied subjects were addicted to pornography in a neurobiological sense. As recently indicated, self-perceived addiction may not always be an accurate indicator of problematic pornography use [29].

Nevertheless, previous investigations have already shown that if such a perception is present it is more often associated with increased psychological distress [78].

Overall, as exposure to online pornographic content is almost unavoidable for young generations, the findings of the present study support the notion that protection of children from too early exposure should be prioritized.

Restriction to pornography access has become a subject of political discussion. The majority of countries, including Poland, allow unrestricted access to adult pornography by adult individuals. Recently, in response to an increase in the rate of documented rapes, the government of Nepal banned pornography distribution.

In the present study, the surveyed students often indicated that pornography exposure may have an adverse outcome on social relationships, mental health, sexual performance, and may affect psychosocial development in childhood and adolescence. Despite this, the majority of them did not support any need for restrictions to pornography access.

In the long-term, a law that limits access to pornography, bans specific pornography websites, or implements age-verification systems may be difficult or expensive to fully enforce. However, countries such as the United Kingdom are considering restrictions based on age-verification systems for online pornography to protect children from exposure, and ensure that only adults (≥18 years old) will have access to explicit content.

Although the present research reveals some valuable information regarding pornography consumption within a relatively large and homogeneous group of university students, there are a number of limitations which need to be outlined for cautious data interpretation. Firstly, the multiple comparisons performed when analyzing data without correction increase the probability of type 1 errors. However, a simple Bonferroni correction could potentially be overly conservative, and increase the risk of type II errors [79].

Nevertheless, the lack of such correction must be taken into account in the interpretation of the findings of the study. Moreover, the anonymous and online character of the survey excluded the possibility of verifying the data.

Additionally, the reported effects of pornography use were self-perceived by surveyed individuals, and were not confirmed on clinical level. Importantly, a cross-sectional study design does not allow any identification of causation. This also relates to classical ORs calculated for associations between age of first exposure to pornography and self-perceived effects of pornography use.

The age of first exposure reported by surveyed students should be also treated with caution rather as a rough estimate. As already outlined, volunteer bias could not be fully excluded under the anonymous study design and must be taken into account when interpreting the high prevalence of pornography use, particularly in females, or the high rate of self-perceived addiction.

Moreover, it is unknown to what extent pornography use in the studied group varied with sexual orientation as the surveyed individuals were not asked to determine it. Some previous studies have, however, shown that homo- and bisexual subjects may be disproportionately high consumers of pornography [80].

Finally, the associations between the religiousness of the surveyed individuals and pornography use was not evaluated. As shown, religion may be an additional factor causing distress to pornography users [81].


Source:
The Conversation

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