Does Porn Cause Erectile Dysfunction? What Research Shows

I’ll start with the part most guys leave out. I’ve been there.

Sometimes you’re with someone you’re into, and your body just doesn’t cooperate. Nothing happens. Or it starts strong and fades. That’s erectile dysfunction (ED), and almost nobody talks about it, even though plenty of us have lived it.

I did, for a long time. And like a lot of guys, my first suspect was porn.

Search does porn cause ED? and the first page is a wall of reboot forums and anti-porn sites telling you your brain is “desensitized,” your wiring is fried, and the fix is a 90-day challenge. It’s easy to see how a guy ends up writing off his sex life.

Here’s what the research says, what actually turned out to be going on in my case, and the stuff that helped. It’s less dramatic than the forums. It’s also more useful.

My story

For years I had generalized anxiety disorder (GAD) and didn’t know it. Nobody had diagnosed it, and I’d just assumed that humming, tense, always-braced feeling was what being an adult felt like.

It turns out anxiety doesn’t stay in your head. It showed up in my erections, and I had no idea the two were connected. Like a lot of men, I blamed myself, or my porn habit, or something I was supposedly doing wrong. The real culprit was a nervous system stuck on high alert, and it had been that way for years.

Once I got serious about it, I ended up trying more therapies than I can easily list, all under the care of a urologist and physical therapists. Some did a lot. Some did a little. A few changed things in a way I wasn’t expecting. I’ll get to them below.

First, the science, because the myth is worth taking apart.

The claim, and why it sounds so believable

The pitch goes like this: porn gives you so much novelty that real sex starts to feel bland, so your body stops responding to a real partner. It sounds logical. It also sounds like something a scientist might have found.

The trouble is that when researchers went looking for it, they mostly didn’t find it.

What the studies found

• A 2019 literature review in the Journal of Clinical Medicine went through the available observational studies on porn use and sexual dysfunction and found essentially no evidence that pornography causes erectile dysfunction.
• A multi-sample study led by Joshua Grubbs used both cross-sectional and longitudinal (over time) data and found no consistent link between porn use and erectile functioning.
• A 2024 review by Rowland and Cooper pulled together more than fifty studies and concluded that the widespread claim, that porn use impairs a man’s response with a partner, isn’t supported by the research as a whole.
• A 2022 lab study measured actual physiological arousal instead of relying on what people said about themselves. People who watched more porn in daily life showed higher arousal with a real partner, not lower. If porn were numbing men to real partners, you’d expect the opposite.

Here’s the nuance, because it matters. When a link did show up in some studies, it was between feeling that your porn use is out of control and having erection problems. It wasn’t about how much porn a man watched. That points somewhere very different than “porn breaks your body.”

Why “it’s the porn” feels so true anyway

Anxiety is brutal. It’s one of the best-documented erection killers there is. Men with anxiety disorders appear to be at higher risk of erectile problems, and their problems may be more severe. A partner in the room adds pressure that doesn’t exist when you’re alone with a screen, so “it works fine by myself but not with her (or him)” is extremely common. That was me.

Technique can train you. If you’ve spent years using a very tight grip and a very specific rhythm, your body can get used to stimulation that a real partner isn’t going to match. People call it “death grip.” It’s a technique issue, not a porn issue. It’s also worth knowing that many studies blaming “porn” don’t separate porn from masturbation itself, so a finding pinned on porn can really be about habits and technique.

The belief can become the problem. If you decide porn broke you, the worry you carry into every sexual encounter can make things harder, which seems to confirm the theory, which adds more worry. Researchers who study reboot and abstinence communities have a word for harm caused by the “cure” itself: iatrogenic. One off night, one forum thread, and a loop starts.

What else causes it

Most of these are far more common culprits than porn:

• Anxiety and stress, including plain old nerves with someone new
• Tension or distance in the relationship
• Blood vessel and heart health, since erections depend on blood flow
• Low testosterone
• Tight or weak pelvic floor muscles
• Medication side effects, including some antidepressants
• Alcohol, bad sleep, and general exhaustion
• Low mood or depression
• A perfectly normal night where your body didn’t feel like it

None of those require a reboot. Several of them, though, are things you can test for and treat.

What helped me

Everything here is my own experience, not a prescription. I’m not a doctor, your body is not mine, and I’ll flag where the research is thinner than my enthusiasm.

1. Treating the anxiety

This was the foundation. Nothing else worked as well until the anxiety had a name and a plan.

Here’s what makes it sneaky. A lot of guys have run on anxiety as their default setting for so long that they don’t know it’s there. For some of us it’s been that way our whole lives. For others it was picked up from family, from parents or relatives who lived on high alert, so it just felt like normal. That was me. When something has always been part of you, you don’t question it. You think everyone’s body feels this tense.

If that sounds familiar, talk to a qualified professional who can help you figure out whether anxiety is at play for you. Don’t just tell a forum, and don’t try to diagnose yourself at 1am.

One warning if you’re a guy who loves sex. A commonly prescribed treatment for anxiety is a selective serotonin reuptake inhibitor (SSRI). One of the most common side effects of SSRIs in men is sexual dysfunction, especially delayed orgasm or not being able to orgasm at all. For a sex-loving man, that can be debilitating. A 2025 study of outpatients on antidepressants found sexual problems in about 85 percent of the men. It was a small study that can’t prove cause, and anxiety and depression can affect sex on their own. But the authors also noted these side effects are probably underreported unless a doctor asks directly.

So tell your doctor how much sex matters in your life, up front, and ask for something with a lower sexual side effect profile. I personally recommend asking about a serotonin-norepinephrine reuptake inhibitor (SNRI) like duloxetine (generic Cymbalta), which is typically thought to have a lower sexual side effect profile. Check with your doctor, though, because SNRIs can cause sexual side effects too (the duloxetine label lists erectile problems, delayed ejaculation and lower sex drive in a small share of men), and research hasn’t settled how much better they are than SSRIs. Whatever you do, don’t stop or switch a medication on your own. Quitting suddenly can cause its own problems.

2. Pelvic floor physical therapy

I did months of pelvic floor therapy, and I recommend it very highly. It’s also where I’d tell every guy to start. Insurance can cover it (check your plan), and you may see enough improvement here that the bigger-ticket option further down the list turns out to be unnecessary.

Most guys have never heard of it. That’s partly because it’s a newer kind of physical therapy that was mostly marketed to women, though in recent years more men have been showing up. My pelvic floor therapist is the reason I now keep a little stool under my feet when I’m on the toilet. There are a surprising number of things nobody ever taught us that can affect how this part of the body works.

So, the basics. Your pelvic floor is the group of muscles at the base of your pelvis. They help control urination, support erections and play a role in ejaculation. They can be weak, and they can also be too tight. Both cause trouble. A pelvic floor physical therapist can sort out which one you’ve got, and treatment differs for each: strengthening work for weak muscles, and release and relaxation work for tight ones.

The problems it gets used for go well beyond erections:

• Erectile dysfunction
• Premature ejaculation
• Delayed ejaculation (anxiety can be behind it, and so can a death grip during masturbation, which may mean your technique needs adjusting)
• Pain with ejaculation or during sex
• Chronic pelvic pain
• Urinary trouble, including pee shyness (it may be anxiety-related, or tied to a past trauma, and a certified sex therapist can help you figure out which)

What does the research say? A systematic review of ten trials found that pelvic floor muscle training appears to help both erectile dysfunction and premature ejaculation. The authors also said the studies were low to moderate in quality and nobody has pinned down the best protocol. In one often-cited trial of 55 men, 22 regained normal erectile function and another 19 improved after up to six months of pelvic floor exercises with biofeedback.

So: promising, not proven beyond doubt.

One more thing, and my pelvic floor therapist drilled this into me. Kegels are great for a weak pelvic floor, and I do them and recommend them. But most people overdo them, and overdoing them can work against your treatment. If your muscles are the tight kind, more squeezing can make things worse.

My own routine is small: no more than 15 to 20 reps in a set, and one or two sets a day at most. That’s what works for me, and yours may look different. Have a pelvic floor physical therapist or your doctor tell you the right amount for your body before you start, and don’t just YouTube a routine.

3. Get your testosterone checked (both numbers)

I had very low testosterone. My total came back at 245 ng/dL. I didn’t know until I was tested, and it was part of the picture. My advice: if you’re 30 or older and having erection or sex drive trouble, get both total and free testosterone checked. Early morning is best, when levels peak.

Here’s the part that matters most: insist on both. Well-meaning doctors sometimes order only one of the two, and one number alone can give you an incomplete or misleading picture. If the lab work comes back missing one, you may have to go back for another blood draw. Urologists and other men’s health specialists usually know the drill. Some primary care doctors might not, so take charge of the conversation. Say it out loud (“I want total and free testosterone”), ask them to confirm both are on the order, and check that your results show both numbers. Be polite about it. Be firm about it too.

For what it’s worth, the American Urological Association guideline diagnoses low testosterone only when two separate early-morning total testosterone tests come in low (it uses under 300 ng/dL as a reasonable cutoff) and you have symptoms, like low sex drive or ED. So ask a doctor to interpret the numbers. A single reading or a supplement ad doesn’t make a diagnosis.

One more thing. A lot of guys with low T assume their sex drive must be fine because they’re still watching porn and masturbating all the time. But ask yourself why. Is it desire? Or are you doing it to soothe anxiety or a low mood? From the outside those can look identical. A confirmed test result gives you real peace of mind, which matters in a world where far too many men, even young ones, seem to be turning up with low testosterone.

4. Low-intensity shockwave therapy (LiST)

This was the biggest single improvement for me, bigger than anything else on this list. Low-intensity shockwave therapy (LiST) sends low-energy acoustic waves to the penis and is thought to encourage new blood vessel growth. For me it helped bring back a firmness and responsiveness I thought was gone for good. It wasn’t painful.

Here’s how I got there, though. I was stubborn. I didn’t want to cough up the money for it, so I made myself try everything else first and see what worked. Only then did I do LiST. I get it if you take the same path, since it’s expensive. For me it was worth every penny.

A urologist explains how the procedure works in this video.

The catches, and they’re real:

• Cost. In the United States it often runs $2,000 to $3,000, and insurance generally doesn’t cover it.
• It isn’t a one-and-done. Many patients go back for another round several years later.
• The evidence is good but not settled. A meta-analysis of sham-controlled trials found better erection scores than placebo, mostly in men with mild to moderate ED. The American Urological Association still calls LiST investigational, and the European Association of Urology gives it only a weak recommendation for mild cases or men who don’t respond well to pills. Results vary, and no honest clinic can guarantee them.

5. Daily tadalafil

My urologist also put me on 5 mg of tadalafil (the generic form of Cialis) once a day to support blood flow. This is the same medicine many men take as needed, just at a low daily dose.

Here’s why I take blood flow seriously. In a large meta-analysis, men with ED had roughly a 44 percent higher risk of cardiovascular events than men without it. That’s an association, not proof that ED causes heart trouble. But it fits what doctors keep saying: the small blood vessels in the penis can show trouble first, so an erection problem can be the early warning for something bigger.

My personal take: every man over 40 who cares about his health and his sex life should at least ask his doctor about this, especially if your morning erections have mostly disappeared. If you’re down to fewer than a few a week, mention it.

It’s a prescription for a reason. It lowers blood pressure, and it can cause headaches, back pain and indigestion. Your doctor needs to look at your heart, your blood pressure and everything else you take first.

This next part could save your life. Tadalafil, sildenafil (generic Viagra) and similar drugs must never be combined with nitrates. That includes the nitrate medications prescribed for chest pain, and it also includes amyl nitrite and its relatives, the “poppers” a lot of guys use during sex. Poppers are popular with bisexual and gay men especially, so this one is aimed at a lot of us. Together, they can drop your blood pressure sharply and suddenly, which can mean fainting, a heart attack or a stroke, and it can be fatal. Tadalafil also stays in your system for a couple of days, so ask your doctor how long to wait. The product label says at least 48 hours after a dose before any nitrate. If you’re on one of these drugs, skip the poppers. Full stop.

If it’s happening to you

1. Don’t panic over one night. One off night is human. Bodies aren’t machines.
2. Check the obvious stuff first. Drinking, sleep, stress, new meds.
3. Be honest with yourself about anxiety. If it’s a constant companion, that’s information.
4. See a doctor, preferably a urologist, if it keeps happening. Insist on testosterone testing for both total and free, and ask about blood pressure, blood sugar and your heart. If you’re taking an erection medication, never use poppers. Don’t skip this because the internet handed you a more comfortable explanation.
5. Ask about pelvic floor physical therapy. It’s one of the best-kept secrets in men’s health, and it helps with more than erections.
6. If anxiety is driving the bus, a certified sex therapist can help. Look for credentials from the American Association of Sexuality Educators, Counselors and Therapists (AASECT) at aasect.org, and ask what they believe about porn before you book.
7. Skip the 90-day reboot as your first move. The research suggests it tends to increase shame and distress, not relieve it.

This is one of the myths Chapter 4 of No More Porn Shame takes apart, along with the dopamine story, the “brain shrinkage” headlines, and the testosterone claims.

You’re probably not broken. You may just have been handed a scary story with no good evidence behind it, and an undiagnosed problem nobody told you to look for.

This post is general education and my personal experience, not medical advice. If you’re having erection problems, talk to a doctor.

Sources

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