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

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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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... Because of this process, it is possible that sensitized sexual arousal to Internet pornography may cause that sexual experience with a real partner may no longer trigger the sufficient dopamine release to produce and sustain sexual arousal and erection (Melis and Argiolas, 2011;Prause and Pfaus, 2015;Schultz, 1998). Prause and Pfaus suggested that "erectile problems may occur when real-life sexual stimulation does not match the broad content [accessible online]" (Prause and Pfaus, 2015). ...
... Because of this process, it is possible that sensitized sexual arousal to Internet pornography may cause that sexual experience with a real partner may no longer trigger the sufficient dopamine release to produce and sustain sexual arousal and erection (Melis and Argiolas, 2011;Prause and Pfaus, 2015;Schultz, 1998). Prause and Pfaus suggested that "erectile problems may occur when real-life sexual stimulation does not match the broad content [accessible online]" (Prause and Pfaus, 2015). Human and animal studies also indicate that when expectations are not met (due to a negative prediction error), then such a "disappointing event" may cause that as a response certain activities in the mesolimbic dopaminergic system are inhibited (Bayer and Glimcher, 2005;Hart et al., 2014;Mauer-Vakil and Bahji, 2020;McClure et al., 2003;Sunsay and Rebec, 2014). ...
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According to recent studies, the growing consumption of Internet pornography mainly in male population becomes an increasing problem, which is closely linked to compulsive sexual behavior. Some findings also suggest that Internet pornography consumption might represent a defense mechanism against excessive stress, which enables to cope with stressful events, helps in mood regulation, and decreases depression and anxiety. Users of online pornography involved in these activities also reported that their self-exposition to pornographic material may create guilty feelings and internal conflict in themselves with respect to their own "involuntary" sexual behavior, which suggest that psychosocial stress and possibly traumatic experiences may play a significant role in Internet pornography addiction. Taken together, these findings show that stressful experiences, anxiety, and depression are strongly related to pornography consumption. In addition, conflicting emotional experiences as well as identity problems significantly increase vulnerability to addictive sexual behavior and pornography consumption.
... However, no clear relationship between FPU and sexual dysfunction was found in either male or female participants. 22 On the other hand, Prause and Pfaus 23 reported that time spent viewing visual sexual stimuli led to a stronger desire for sexual intercourse with a partner and did not predict changes in erectile functioning. Also, conclusions from the literature review indicate no clear evidence of time spent on pornography use altering erectile functioning or ejaculation. ...
... As sexual dysfunctions are associated with age, gender, and sexual orientation, 42,43 we also included these demographic characteristics as additional variables in the analyses. Sexual functioning can also depend on the frequency of sexual activities, 23,25 and thus we additionally controlled analyses for relationship status as well as frequency of pornography use, masturbation, and sexual intercourse. Also, instead of only controlling for gender in the analyses, we performed the same steps of the analyses separately for males and females, to clearly present possible differences between genders. ...
Article
Background Previous studies linking compulsive sexual behavior disorder (CSBD) and sexual health have shown mixed results, which could be due to the fact that different CSBD facets may have differential relationships with sexual functioning. Aim As CSBD is a multidimensional disorder, we wanted to investigate whether distinct CSBD domains are differentially related to sexual health. Methods Two online studies were conducted—the first on a convenience sample (812 Polish participants; mean [SD] age, 22.07 [5.91] years) and a replication study on a representative sample of Polish adults (n = 1526; 43.02 [14.37]). Hierarchical regression was employed with sexual functioning as a predicted variable and CSBD symptoms as predictors. Outcomes The Compulsive Sexual Behavior Disorder Scale was used to assess CSBD symptoms, and the Arizona Sexual Experience Scale was used to measure sexual dysfunction. Results In study 1, CSBD salience (β = −.20, P < .001) predicted hyperfunction (ie, stronger sex drive, easier sexual arousal, easier vaginal lubrication/penile erection, easier ability to reach an orgasm, and more satisfying orgasms). Yet, CSBD negative consequences (β = .15, P = .001) and dissatisfaction (β = .22, P < .001) predicted hypofunction (ie, weaker sex drive, more difficulties in sexual arousal, greater difficulties in vaginal lubrication/penile erection, less ability to reach an orgasm, and less satisfying orgasms). Similar results were found in study 2: salience (β = −.26, P < .001) and relapse (β = −.11, P = .004) predicted hyperfunction, while negative consequences (β = .12, P < .001) and dissatisfaction (β = .12, P < .001) predicted hypofunction. Clinical Implications Our results stress the importance of assessing the severity of each group of symptoms in patients with CSBD to better understand possible difficulties in their sexual functioning. Strengths and Limitations Our studies are the first to evaluate the effects of each CSBD domain on sexual health. We also replicated results obtained from a convenience sample on a representative sample. The cross-sectional design of the current studies does not allow causal relations to be tested, so future longitudinal research should be carried out. We also gathered data from a general population—thus, it is important to replicate these results on patients diagnosed with CSBD. Conclusion Our research points out the differential impact of CSBD domains on sexual health: salience and relapse are related to sexual hyperfunction, while negative consequences and dissatisfaction to hypofunction.
... [40,41,[53][54][55][56]. 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 [46,57,58]. In a recent comprehensive review, Dwulit and Rzymski [45] concluded that a causal link between pornography use and erectile problems has yet to be demonstrated, noting methodological issues such as unreliable self-reported ED (i.e., not using standardized instruments) and interpretation issues regarding direction of effect (e.g., it may be that men experiencing erectile problems increase their use of pornography during masturbation as a means of increasing arousability and sexual satisfaction, rather than pornography use being the cause of impaired erectile response). ...
... At the same time, over-dependence on strong pornographic content to achieve adequate sexual arousal could place some men at risk for diminished sexual and overall relationship satisfaction-probable characteristics of men who seek out treatment for problematic pornography use and thus come to the attention of the clinical/ health community. Men distressed by their pornography use are also more likely to be depressed or anxious, or to have low selfesteem, factors also known to affect sexual and relationships satisfaction [3,54,57]. ...
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Both masturbation frequency and pornography use during masturbation have been hypothesized to interfere with sexual response during partnered sex as well as overall relationship satisfaction. However, results from prior studies have been inconsistent and frequently based on case studies, clinical reports, and simple binary analyses. The current study investigated the relationships among masturbation frequency, pornography use, and erectile functioning and dysfunction in 3586 men (mean age = 40.8 yrs, SE = 0.22) within a multivariate context that assessed sexual dysfunctions using standardized instruments and that included other covariates known to affect erectile functioning. Results indicated that frequency of pornography use was unrelated to either erectile functioning or erectile dysfunction (ED) severity in samples that included ED men with and without various sexual comorbidities or in a subset of men 30 years or younger (p = 0.28–0.79). Masturbation frequency was also only weakly and inconsistently related to erectile functioning or ED severity in the multivariate analyses (p = 0.11–0.39). In contrast, variables long known to affect erectile response emerged as the most consistent and salient predictors of erectile functioning and/or ED severity, including age (p < 0.001), having anxiety/depression (p < 0.001 except for a subset of men ≤ 30 years), having a chronic medical condition known to affect erectile functioning (p < 0.001 except for a subset of men ≤ 30 years), low sexual interest (p < 0.001), and low relationship satisfaction (p ≤ 0.04). Regarding sexual and relationship satisfaction, poorer erectile functioning (p < 0.001), lower sexual interest (p < 0.001), anxiety/depression (p < 0.001), and higher frequency of masturbation (p < 0.001) were associated with lower sexual and lower overall relationship satisfaction. In contrast, frequency of pornography use did not predict either sexual or relationship satisfaction (p ≥ 0.748). Findings of this study reiterate the relevance of long-known risk factors for understanding diminished erectile functioning while concomitantly indicating that masturbation frequency and pornography use show weak or no association with erectile functioning, ED severity, and relationship satisfaction. At the same time, although verification is needed, we do not dismiss the idea that heavy reliance on pornography use coupled with a high frequency of masturbation may represent a risk factor for diminished sexual performance during partnered sex and/or relationship satisfaction in subsets of particularly vulnerable men (e.g., younger, less experienced).
... One neglected characteristic of the hypersexual patient is the loss of the pleasure principle. Some data account, in fact, for the absence of sexual pleasure and satisfaction after the adoption of compulsive sexual behavior [65,66]. Furthermore, in a significant percentage of hypersexual patients, available data show the presence of associated sexual disorders, such as erectile dysfunction (16%), premature ejaculation (12%), or a paraphilic disorder (60%), [67], among which the most prevalent are the voyeuristic disorder (36%), the fetishistic disorder and the sexual coercive behavior (males: 21%; females: 4%), and of the adoption of sexually risky behaviors (32%) [68,69]. ...
... Partly different is, instead, the relationship between viewing visual sexual stimuli (VSS), an aspect which, in some cases, is put in relation to hypersexuality, and the presence of sexual dysfunctions. Recently, a study has evidenced that the VSS induces a stronger sexual response, but is not related to erectile functioning during partnered sexual intercourse [65]. Rather, VSS may induce a stronger sexual desire for sexual intercourse with the partner. ...
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In the last years, hypersexual behavior has been broadly scientifically studied. The interest in this topic, belonging to psycho-sexology and sexual medicine, has been due to its still unclear aetiology, nature, and its manifestation in relationship with several organic and psychopathological conditions. So, the specialist (the psychologist, psychiatrist, endocrinologist, neurologist) may encounter some difficulties in diagnosing and managing this symptom. The first main objective of this position statement, which has been developed in collaboration between the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Psychopathology (SOPSI) is to give to the reader evidence about the necessity to consider hypersexuality as a symptom related to another underlying condition. Following this consideration, the second main objective is to give specific statements, for the biopsychosocial assessment and the diagnosis of hypersexual behavior, developed on the basis of the most recent literature evidence. To develop a psycho-pharmacological treatment tailored on patients' needs, our suggestion is to assess the presence of specific comorbid psychopathological and organic conditions, and the impact of pharmacological treatments on the presence of an excess of sexual behavior. Finally, a suggestion of a standardized psychometric evaluation of hypersexuality will be given.
... Sex is generally assumed to be an inherent primary reward that elicits approach behaviors and positive emotions, such as pleasure, happiness, and trust [113]. Sex is further incentivized by conditioned and unconditioned pleasurable and aversive aspects of sexual responding [114]. While contextual factors contribute to variation in sexual pleasure and reward, E2 and P4 play significant roles in regulating sexual motivation [15,109]. ...
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Purpose of Review Hormones undeniably play a role in women’s sexual function, but there is much controversy regarding when and how—potentially because psychological effects of hormones depend on social and developmental context. Existing literature documents various health outcomes of sexual trauma and hormonal changes, however, specific mechanisms linking trauma experiences and hormones to sexual wellbeing remain unclear. This review aims to bridge two disparate lines of research, illustrating how sexual trauma may moderate the role of hormones in supporting women’s sexual function. Recent Findings Testosterone, estradiol, progesterone, and cortisol orchestrate an array of physiological, behavioral, psychological, and social effects, each of which may be impacted by sexual trauma experiences. In particular, the adaptive role of steroid hormones in regulating approach and avoidance of sexual behavior may be disrupted by sexual trauma experiences, especially childhood sexual abuse. Mirroring hormonal effects on anxious, depressed, and anhedonic mood, hormones show wide individual variation in effects on sexual function, and sexual trauma may amplify these effects, leading to more extreme sexual outcomes. Summary Research synthesized here supports the notion that effects of sexual trauma on sexual physiology and psychology have been inconsistently considered in basic and applied research—often neglected as a factor altogether or grouped with non-sexual trauma types. Yet, many processes by which hormones regulate women’s sexual motivation and pleasure, such as attention to sexual cues and reward processing, are impacted by sexual trauma. Poor consideration of factors related to sexual trauma has likely contributed to variable reported effects of hormones on women’s sexual wellbeing. As such, we propose that clinical research examining the role of hormonal treatments in sexual wellbeing should account for women’s sexual trauma histories.
... Men that have a greater frequency of pornography consumption per week are actually better able to achieve erection to visual sexual stimuli in laboratory situations relative to men with a lower frequency of pornography consumption [22]. However, men with frequent but problematic pornography consumption who also have high sexual desire show a blunted processing of visual sexual cues [23], suggesting some attempt at active inhibition. ...
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... The link between pornography viewing and erectile difficulties presents what might appear to be a confusing picture. Prause and Pfaus (2015) found that longer hours of watching pornography were not associated with erectile difficulties. However, their participants were described as "non-treatment seeking men" so it cannot be concluded that even the high end met criteria of addiction. ...
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