It's really hard to get erections when I'm trying to [have intercourse]. Takes about 20 minutes or so to get it up. Really embarrassing. But if I'm sitting and watching my pornz, it's almost instant.—Porn user in his 20s
Are you a heavy porn user who, during lovemaking, cannot consistently produce/sustain an erection or penetrate a real partner, feel much sensation, or climax (without difficulty)? If your doctor has ruled out organic causes for your woes, he/she is likely to hand you a trial pack of Viagra and refer you to counseling for your "sexual issues." The medical assumption is that your issue is psychological (performance anxiety) rather than physiological. After all, if you can get it up for porn, your penile health is fine.
Growing evidence suggests that the problem is indeed in your head, not your penis, but that it is primarily physical. Specifically, overstimulation has produced plastic changes in your brain, which make you less responsive to pleasure—and yet hyper-responsive to Internet porn. These addiction-related changes are called desensitization and sensitization, respectively. Together, they explain why porn does the job and your hot babe doesn't.
Before you panic, know that these brain changes appear to be reversible—most easily in guys who wired to real sex before highspeed Internet arrived. Guys who stop masturbating to porn generally regain their responsiveness during sex within a few months (often after a nasty withdrawal and a disconcerting, temporary absence of libido):
(Age 30, 4 months) From the reboot standpoint, I'm doing spectacular! Any time my girlfriend and I make out, caress etc., I get rock hard and it lasts. I really just don't worry about penile function anymore.
If performance problems are plaguing you, take this simple test. Do your problems appear to be porn-related? Keep reading to learn more about the changes going on in your brain. Otherwise, you may erroneously conclude that if you can climax to porn, you don't have a problem, and that the problem lies in your alcohol use or your partner's behavior or looks, or solely in your anxious feelings. You may spend thousands of dollars on counseling, or resort to costly, and increasingly ineffective, sexual enhancement drugs—and still be left with your problem:
I never had a problem getting hard for porn, but when it came to the real thing, I started taking Cialis. Over time, I took more, and even then there were times when it would only partly work. WTH? Yet I could still get hard to porn.
Why is Mr. Happy ignoring hotties?
With Internet porn it's easy to overstimulate your brain. Each search, each novel image, each surprising visual, each new genre, and sexual arousal itself all release dopamine in your reward circuitry. Dopamine is the gas that powers the reward circuitry and it equates with desire, anticipation, cravings, and wanting something in particular.
Unfortunately, too much stimulation causes some brains to protect themselves by decreasing their sensitivity to dopamine, and thus to pleasure, for a while. Obviously, if your brain does this and you are using porn frequently and heavily, your brain doesn't ever have a chance to return to normal sensitivity. You may find yourself clicking to more extreme material to arouse your reward circuitry's numbed pleasure center.
Over time, your brain adapts to this situation with measurable decreases in dopamine signaling. You want more, but experience decreasing satisfaction. This is an addiction process called desensitization. (See Intoxicating Behaviors: 300 Vaginas = A Lot of Dopamine.) Recent research confirms it occurs in behavioral addictions such as gambling, food, video gaming, and Internet addiction (which includes cyber erotica addiction). When desensitized, you experience a numbed response to all so called "natural rewards"—including sex with hotties.
Your reward circuitry is the barometer for "How exciting is this?" so if dopamine signaling (desire) is low, erections are sluggish. Erections only arise when dopamine signals flow from the reward circuitry to the hypothalamus.
