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Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction

Authors:
  • Liberos LLC
  • Charles University in Prague and Czech National Institute of Mental Health

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IntroductionTime spent viewing visual sexual stimuli (VSS) has the potential to habituate the sexual response and generalize to the partner context.AimThe aim of this study was to examine whether the time spent viewing VSS is related to sexual responsiveness felt in the laboratory or with a sexual partner.Methods Nontreatment-seeking men (N = 280) reported their weekly average VSS viewing in hours. VSS hours were examined in relation to the sexual arousal experienced while viewing a standardized sexual film in the laboratory and erectile problems experienced with a sexual partner.Main Outcome MeasuresSelf-reported sexual arousal in response to sexual films and erectile problems on the International Index of Erectile Function were the main outcome measures.ResultsMore hours viewing VSS was related to stronger experienced sexual responses to VSS in the laboratory, was unrelated to erectile functioning with a partner, and was related to stronger desire for sex with a partner.ConclusionsVSS use within the range of hours tested is unlikely to negatively impact sexual functioning, given that responses actually were stronger in those who viewed more VSS. Prause N and Pfaus J. Viewing sexual stimuli associated with greater sexual responsiveness, not erectile dysfunction. Sex Med **;**:**–**.
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... Such studies, however, have typically been fraught with methodological issues, including ones related to small sample sizes or to simple bivariate correlational analyses that do not concomitantly control for possible confounding variables [26][27][28][29][30][31]. In fact, a number of other studies have suggested no role-or even an opposite and beneficial role-for pornography use on sexual arousal and erectile response [32][33][34]. In a recent comprehensive review, Dwulit and Rzymski [35] concluded that a causal link between pornography use and erectile problems has yet to be demonstrated, noting methodological issues such as unreliable self-reported erectile dysfunction (ED) (i.e., not using standardized instruments), and interpretation issues regarding a possible opposite directional effect such that men experiencing problems with erection turn to pornography use during masturbation as a means of increasing arousability and sexual satisfaction, rather than vice versa. ...
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The role of masturbation frequency and pornography use on sexual response during partnered sex has been controversial, the result of mixed and inconsistent findings. However, studies investigating this relationship have often suffered from methodological shortcomings. We investigated the role of masturbation frequency and pornography use on both the occurrence and severity of delayed/inhibited ejaculation (DE), an increasingly common sexual problem among men. We did so in a large (nonclinical) multinational sample of cisgender men (N = 2332; mean age = 40.3, SE = 0.31) within a multivariate context that relied on multiple (and, when possible, standardized) assessments of sexual dysfunctions while controlling for possible confounding variables. Results indicated a weak, inconsistent, and sometimes absent association between the frequency of pornography use and DE symptomology and/or severity. In contrast, both poorer erectile functioning and anxiety/depression represented consistent and strong predictors of DE and, to a lesser extent, DE severity. Other factors, including relationship satisfaction, sexual interest, and masturbation frequency, were significantly though moderately to weakly associated with DE. In conclusion, associations (or sometimes lack thereof) between masturbation frequency, pornography use, and delayed ejaculation are more clearly understood when analyzed in a multivariate context that controls for possible confounding effects.
... Mixed results have been reported among women, but in general, women's pornography use frequency is unrelated to their sexual satisfaction (Bridges & Morokoff, 2011;Muusses, Kerkhof, & Finkenauer, 2015;Yucel & Gassanov, 2010). Concerning sexual functioning, multiple studies have reported no significant associations between pornography use frequency and sexual functioning in men (Dwulit & Rzymski, 2019;Grubbs & Gola, 2019;Landripet & Štulhofer, 2015;Prause & Pfaus, 2015), while in women, pornography use frequency has been associated with better sexual functioning (Blais-Lecours, Vaillancourt-Morel, Sabourin, & Godbout, 2016;Bőthe, Tóth-Király, Griffiths, et al., 2021). Less is known about the associations between problematic pornography use and sexual outcomes. ...
Chapter
The present chapter addresses the many faces of cybersex and describes the mental health challenges of various sexual activities using new technologies. This includes a range of sexual behaviors, from Internet use to sex with robots. In many cases, cybersex use is not problematic and not associated with personal distress or functional impairment. However, in those cases where people lose control over their cybersexual behavior or harm others we discuss diagnostic criteria as well as differential diagnoses and ways to evaluate the given behavior. The chapter also addresses the current state of research regarding the psychobiology as well as pharmacological and psychotherapeutic treatment options of cybersexual behaviors that are associated with mental health issues.
... Data on country of birth, region of residence, educational level and income were obtained from the national Longitudinal Integration Database for Health Insurance and Labour Market Studies. 37 15,186 individuals returned the questionnaire (response rate 30.5%); nonresponders were more likely to be men, young, born outside of Sweden and having lower educational levels. ...
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Background Little is known about pornography use and its relationship with sexual health outcomes in the general population. Aim To assess frequency of pornography use and the association of sexual health outcomes with frequent pornography use in Sweden. Methods Cross-sectional analysis of 14,135 participants (6,169 men and 7,966 women) aged 16–84 years in a Swedish nationally representative survey from 2017. We used logistic regression to assess the association of sexual health outcomes with use of pornography ≥3 times/wk. Outcomes Frequency of pornography use (never; less than once/mo to 3 times/mo; 1–2 times/wk; 3–5 times/wk; and daily or almost daily) and sexual health outcomes (eg, sexual satisfaction and sexual health problems). Results In total, 68.7% of men and 27.0% of women used pornography. Among men aged 16–24 years, 17.2% used pornography daily or almost daily, 24.7% used pornography 3–5 d/wk and 23.7% used pornography 1–2 d/wk. Among women aged 16–24 years, the proportions were 1.2% for daily or almost daily, 3.1% for 3–5 times/wk, and 8.6% for 1–2 times/wk. Frequency of pornography use decreased with age among both men and women. While 22.6% of all men and 15.4% of all women reported that their or a sex partner's pornography use predominantly had positive effects on their sex life, 4.7% of men and 4.0% of women reported that the effects were predominantly negative. Variables indicating sexual dissatisfaction and sexual health problems were associated with use of pornography ≥3 times/wk: for example, dissatisfaction with sex life (age-adjusted odds ratio [aOR]: men 2.90 [95% CI 2.40–3.51]; women 1.85 [95% CI 1.09–3.16]), not having sex in the preferred way (aOR: men 2.48 [95% CI 1.92–3.20]; women 3.59 [95% CI 2.00–6.42]) and erection problems (aOR: men 2.18 [95% CI 1.73–2.76]). Clinical Implications While frequent pornography use is common, potential effects on sexual health outcomes are likely to differ between individuals. Strength & Limitations We used a large and recent nationally representative survey with detailed information regarding frequency of pornography use. The temporality of associations of sexual health variables with frequency of pornography use could not be assessed. Conclusion In this analysis of a nationally representative survey in Sweden, we found that frequent pornography use was common among young men; that reporting predominantly positive effects of pornography use on the sex life was more common than reporting predominantly negative effects; and that sexual dissatisfaction and sexual health problems were associated with using pornography ≥3 times/wk. Malki K, Rahm C, Öberg KG, et al. Frequency of Pornography Use and Sexual Health Outcomes in Sweden: Analysis of a National Probability Survey. J Sex Med 2021;XX:XXX–XXX.
... 23 Similarly, in a smaller study, researchers found no association between hours of IP use and erectile problems/ED and in fact found increased sexual arousal to pornography videos, increased desire for sex with their partner, and increased masturbation in men who watched IP more frequently. 46 Further, evidence of different user profiles was demonstrated by different sexual outcomes: researchers found highly distressed non-compulsive IP users reported more sexual problems and dissatisfaction than both compulsive and recreational users; compulsive users had less sexual problems than recreational users, but were more sexually dissatisfied. The researchers concluded that distress about IP addiction had greater impact on sexual function and satisfaction than frequency of IP use alone, whilst compulsive IP use may have protective benefits by way of practice effects. ...
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... That the majority of pornography consumers experience pornographic arousal as rewarding is indicated by self-reports on how pornography is experienced and the research on the positive self-perceived effects of pornography cited previously (Grubbs et al., 2019;Hald & Malamuth, 2008;Mulya & Hald, 2014). That frequent pornography consumption is associated with higher levels of arousal to subsequent pornography exposure is indicated by Prause and Pfaus (2015). In this study, participants who reported consuming pornography in varying degrees were subsequently presented with pornographic stimuli in a laboratory setting. ...
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... Using pornography to learn about new sexual practices may result in more extensive knowledge about sexual activities, and lower levels of anxiety, shame, and guilt around sexual behaviors, resulting in lower sexual distress Staley & Prause, 2013;Wincze & Caird, 1976). Moreover, learning about new sexual practices may promote sexual responsiveness and normalize different sexual behaviors (e.g., oral sexual activities), thus providing a wider sexual repertoire, resulting in higher levels of sexual arousal, and desire (i.e., greater sexual function; Kohut et al., 2017;Prause & Pfaus, 2015). ...
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