I'll be honest - reading the description of my "hypothesis", and the non-answer by the neurologist left me feeling cold.
(Warning - all the article posted have multiple links to citations. If the links go to our articles - those articles contain citations.)
First, my TED talk is not really about porn-induced ED, and my hypothesis for porn-induced ED is addiction, not dopamine. Porn-induced ED is far more than desensitization, as it involves multiple addiction-related brain changes, and alterations in the hypothalamic erection centers which run on dopamine D2 receptors.
I also have written articles about the neurobiology of porn addiction and social anxiety. Please see -
Porn, Masturbation and Mojo: A Neuroscience Perspective - Ex-porn users usually get their mojo back. Why?
http://www.yourbrainonporn.com/porn-masturbation-and-mojo-neuroscience-perspective
Here's what you should have given the neurologist. Really get that unless your specialty is addiction, you may have no clue about addiction neurobiology - whether you are a neurologist or not.
This is a new phenomenon, which he has never heard of, so he equates it with MASTURBATION. That's all he knows. His answer had nothing to do with "my hypothesis", since his doesn't include, high speed internet porn, neuroplasticity, addiction mechanisms, adolescent brain plasticity, or the neurobiology of erections.
A) the basics of behavioral addictions, and how Internet porn is unique1) Start here for an overview of key conceptshttp://www.yourbrainonporn.com/doing-what-you-evolved-to-do2) Porn Then and Now: Welcome to Brain Traininghttp://www.yourbrainonporn.com/porn-then-and-now-welcome-to-brain-training3) Porn, Pseudoscience and ΔFosBhttp://www.yourbrainonporn.com/node/9854) Porn, Novelty and the Coolidge Effecthttp://www.yourbrainonporn.com/porn-novelty-and-the-coolidge-effect
B) How the adolescent brain is unique, plasticity and sexual conditioning1) Sexual brain training matters—especially during adolescencehttp://yourbrainonporn.com/why-shouldnt-johnny-watch-porn-if-he-likes
2) Is Internet porn making male sexuality more plastic?http://www.yourbrainonporn.com/can-you-trust-your-johnsonC) Then all the neuroscience confirming these brain changes in Internet addictions (25 brain studies)1) Recent Internet Addiction Brain Studies Include Pornhttp://www.yourbrainonporn.com/node/858D) The experts stating that sexual behavior addictions exist:1) Toss Your Textbooks: Docs Redefine Sexual Behavior Addictionshttp://yourbrainonporn.com/toss-your-textbooks-docs-redefine-sexual-behavior-addictions
Only after reading the above can we start the discussion. Let's talk about ED
This is our most important article about porn induced-ED and its focus is sensitization, NOT desensitization. We had Eric Nestler read this article, and he gave his OK to it. He is one of the top five addiction neuroscientists in the world. See -
http://en.wikipedia.org/wiki/Eric_J._Nestler1) Why Do I Find Porn More Exciting Than A Partner?http://www.yourbrainonporn.com/why-do-i-find-porn-more-exciting-partnerThis is our very popular PT post, which has almost 900,000 reads even though it was buried by Psychology today.
1) Porn-Induced Sexual Dysfunction Is A Growing Problemhttp://yourbrainonporn.com/porn-induced-sexual-dysfunction-is-growing-problemPlease note that the
Italian Society of Andrology and Sexual Medicine agrees with us.
Here's what I say to doubters:
First, the Italian Society of Andrology and Sexual Medicine (SIAMS) states that porn-induced ED exists. The largest urology organization in Italy is the one and ONLY group of medical doctors to study this emerging phenomenon. More importantly they cured it by having guys stop porn use for 2-3 months. However, we haven't relied on SIAMS as we were writing articles on porn-induced ED long before their statements went public.
http://yourbrainonporn.com/too-much-internet-porn-may-cause-impotenceSecond, naysayers suggest that we need "peer-reviewed studies" to confirm the existence, before we can make any claims. That's nonsense, as the only experiment possible is well under way - with thousands of results reported.
It's painfully obvious that no researcher can conduct a study where one group of young healthy men use Internet porn for 10 years, and a comparable control group does not, with erectile function assessed through masturbation to sensation only (no porn).
However, there an ongoing experiment on porn-induced ED that is valid, reproducible, and empirical.
THE EXPERIMENT - UNEXPLAINED CHRONIC ED IN YOUNG MEN AND ALTERATION OF A SINGLE VARIABLEThe Subjects:- Thousands of other-wise healthy young men, with only one variable in common: Years of masturbation to Internet porn.
- The subjects differ in backgrounds, ethnicity, diets, exercise regimens, religious beliefs, moral beliefs, country or origin, education, economic status, on & on.
- These young men cannot achieve an erection without porn use, and many can no longer achieve an erections with porn use.
- Most have seen multiple health care practitioners and all have tried a number of approaches with no results.
- Most state that they cannot believe that porn use could have caused ED. Some are very skeptical prior to starting their reboot.
The regimen:All eliminate porn use.
Most (but not all) eliminate or drastically reduce the frequency of orgasms.
The results: Nearly every subject reports a similar constellation of physical & psychological symptoms when the stop porn use/masturbation, a similar time-frame for the appearance of symptoms, and 2-5 months to regain erectile function. This indicates a very specific set of physical changes, and not a psychological "issue". The usual pattern of recovery is as follows:
1) Subjects experience varying withdrawal symptoms that parallel drug/alcohol withdrawal, such as cravings, anxiety, lethargy, depression, sleeping abnormalities, restlessness, agitation, aches, pains, etc.
2) Within 1-2 weeks, most subjects experience what is called "the flatline": low libido, perceived changes in genital sensation or size.
3) The flatline slowly abates and men experience a gradual increase in libido, return morning erections, spontaneous erections, attraction to real partners, etc.
4) If the men stick to the regimen, nearly all regain erectile health.
5) Lengths of full recovery vary from a few weeks to a few months. Most are in the 2-4 months range for chronic, long standing ED.
Summary:Young healthy men with unexplained ED and
only one variable in common (Internet porn use) attempt multiple regimens and treatments with no success. The subjects
remove the one variable they have in common and almost all experience the same results - remission of their medical condition.That's an experiment with unequivocal results. This is empirical evidence at its best.
Bottom line: Naysayers (the neurologist) are unwilling to address the ACTUAL FACTS as described. In debating the existence of porn-induced ED, doubters go no further than this single fact:
1) Some healthy young guys who watch Internet porn develop ED - so "correlation does not equal causation".
They refuse to venture into the rest of the facts, such as:
2) All subjects had been using porn for years with no problems.
3) Few report any moral or religious misgivings, or guilt, surrounding their porn use.
4) Subjects experienced a gradual decline is sexual function - often over the course of years.
5) Most subjects had seen medical professionals, and had tried various therapies or regimens - with no success.
6) When they abstain, nearly all experience similar symptoms - which mimic withdrawal from an addiction.
7) The clincher: All had only one variable in common. When that single variable was removed (masturbation to porn) - nearly all regained erectile health. (If they did not regain erectile health & libido, the cause of their ED was unlikely to be porn use.)
8 - Men who regain erectile health, then return to regular porn use, experience a return of ED