THE BLOG
09/20/2013 10:31 pm ET Updated Nov 20, 2013

Youthful ED: More to the Story?

Researchers are alarmed by the upswing in young men seeking clinical treatment for persistent ED according to new research now making the rounds. When the severity of their ED was measured, 48 percent of the young Italians had severe ED as compared with only 40 percent of those over 40. The younger guys were healthier, thinner and had higher testosterone.

With these data in mind consider these findings from the famous Kinsey study, which was the first to report rates of impotence (severe ED):

Results from this study, based on the detailed interview of 12,000 males, stratified for age, education and occupation, indicated an increasing rate of impotence with age. Its prevalence was cited as less than 1 percent in men under 19 years of age, 3 percent of men under 45 years, 7 percent less than 55 years and 25 percent by the age of 75 years.

So, in 1948, 19-year-olds were nearly invincible, and men under 45 had severe ED rates of up to 3 percent.

Of course, the new research doesn't tell us what percentage of young men are now seeking treatment for severe ED. (Most guys experience repeated failures before seeking help.) Alarmingly, in 2012 a Swiss study found that 30 percent of young men (mean age 19.58) were experiencing some degree of ED.

What has changed?
There has been a radical shift in the environment of young men: easy access to ever-novel, streaming Internet porn. Both early Internet porn use and daily use are free and effortless for the first time in history. Could this new reality be contributing to low libido and weak erections?

Here in the states, urologists and psychiatrists have begun to raise the alarm about Internet porn's effects on sexual performance. For example, watch this "Dr Oz" segment on porn-induced ED. Italian urologists are equally concerned.

On forums around the globe anecdotal evidence of porn-related sexual dysfunction has been piling up for several years: complaints of porn-induced ED, DE (delayed ejaculation) and PE. Young men are reporting the need to fake orgasm and growing reliance on sexual-enhancement drugs. The latter article reports that:

Harley Street psychosexual counsellor Raymond Francis says he sees about 15 men a month who feel dependent on Viagra. The average age is about 32 -- his youngest client is just 27.

Such drugs only work below the belt, and guys suffering from porn-related problems often report feeling little genuine pleasure even if the pills produce an erection. Moreover, as their porn use continues, they sometimes report the pills cease to work. Their issue seems to be a dampened pleasure response in the brain's reward circuitry.

The good news is that when men give up Internet porn use, their sexual dysfunctions generally reverse themselves. Some need months, however, and young men require longer to achieve normal sexual functioning than older men (who tended to wire their brains to partnered sex before they began overconsuming streaming porn). In short, the young guys appear to be conditioning their brains (to voyeurism? POV? constant novelty?) in ways that earlier generations did not.

Since young men do not have the vascular deterioration or other diseases that tend to cause ED in older men, most researchers studying ED in young men continue to look to the remaining traditional causes for explanation: smoking and drug and alcohol abuse. However, such habits cause cumulative problems over many years. Moreover, smoking in young men is at an all time low, and drug use and binge drinking have also dropped in young adults.

Mental health problems are also a potential cause. Interestingly, addiction can cause symptoms that mimic other mental health disorders: concentration trouble, mood swings, anxiety, sleep disorders, depression, decreased pleasure response, etc. Yet so far, most doctors are not considering addiction-related brain changes as a possible cause because they haven't been asking patients about Internet porn consumption levels.

However, urologist Lawrence A. Smiley, M.D., who has been specializing in men's sexual dysfunction for 18 years, reports that he sees men almost every day who:

... have developed over time, the inability to easily get a good solid erection with their partner and sometimes find it difficult to ejaculate with their partner. I advise these men to dramatically cut out the pornography they watch and after a few months their erections and ability to ejaculate with their partners almost always returns to normal for them.

Bottom line
Young men who are heavy Internet porn users and have ED should, of course, see a doctor to rule out organic causes. If everything checks out, they may want to consider whether chronic or early porn use is the culprit. Here's a tip: If someone can get erections with porn, but cannot while masturbating without it, then his issue could well be porn-related.

Meanwhile, one young psychiatrist (himself recovered from porn-induced ED) warned that it could be decades before the medical profession fully catches up with the effects of streaming porn on young users' sexuality and brains. He points out that there's a lot of money to be made on sexual enhancement drugs, and that drug companies have no incentive to fund research that would reveal that there is a behavioral (i.e., free) solution for some youthful sufferers of this demoralizing health problem.

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