Porn-Induced Erectile Dysfunction: A New Differential to Consider in Response to Increasing Rates of
AAPA ePoster library. Curtin M. 05/17/17; 180537; 198
Martha Curtin
Martha Curtin
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Abstract
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A growing trend of healthy young men complaining of erectile dysfunction is prompting new research. Erectile dysfunction is the consistent or recurrent inability to acquire or sustain an erection of sufficient rigidity and duration for sexual intercourse. A 2013 study from The Journal of Sexual Medicine reveals that one in four newly diagnosed cases of erectile dysfunction involves a man under 40 years old, and severe erectile dysfunction has now become more common in this demographic than in older men. Historically, the differentials for erectile dysfunction have included diabetes, cardiovascular disease, anxiety, and other chronic illnesses. More recently, young men are engaging in excessive amounts of pornography, which can cause a condition called Porn-Induced Erectile Dysfunction (PIED), a differential that should now be considered. In this case, a healthy 23-year-old male presented to the urology office with a chief complaint of erectile dysfunction that had been worsening over the past year. His history revealed decreased libido, difficulty in obtaining and sustaining erections, and premature ejaculation. He was sexually active with one female partner and denied any use of tobacco or drugs. The patient was otherwise healthy and had not been diagnosed with any other medical conditions. He did not take any daily medications and denied a history of anxiety or depression. He reported using pornography for a number of years. Vital signs and physical exam were unremarkable. Fasting lipids, glucose, thyroid stimulating hormone, and total testosterone levels were all within normal limits. This differential is gaining importance because this is the first generation of men to grow up with high speed Internet and easy access to pornography. Studies show that 42% of adolescent males ages 10-17 have been exposed to pornography, and that pornography accounts for 25% of all Google searches. Pornography may become addictive, and masturbation compulsive; thus, it is important that clinicians consider PIED when young men present with erectile dysfunction. Addictions cause complex chemical, anatomical, and pathologic alterations in the brain. Collectively these changes, in response to addiction, are labeled hypofrontal syndromes. Atrophy of the frontal lobe can be seen in serial MRI scans over time. The transformation of the brain in response to addiction causes a numbed pleasure response, formation of addiction pathways, inhibition of executive control, a...
A growing trend of healthy young men complaining of erectile dysfunction is prompting new research. Erectile dysfunction is the consistent or recurrent inability to acquire or sustain an erection of sufficient rigidity and duration for sexual intercourse. A 2013 study from The Journal of Sexual Medicine reveals that one in four newly diagnosed cases of erectile dysfunction involves a man under 40 years old, and severe erectile dysfunction has now become more common in this demographic than in older men. Historically, the differentials for erectile dysfunction have included diabetes, cardiovascular disease, anxiety, and other chronic illnesses. More recently, young men are engaging in excessive amounts of pornography, which can cause a condition called Porn-Induced Erectile Dysfunction (PIED), a differential that should now be considered. In this case, a healthy 23-year-old male presented to the urology office with a chief complaint of erectile dysfunction that had been worsening over the past year. His history revealed decreased libido, difficulty in obtaining and sustaining erections, and premature ejaculation. He was sexually active with one female partner and denied any use of tobacco or drugs. The patient was otherwise healthy and had not been diagnosed with any other medical conditions. He did not take any daily medications and denied a history of anxiety or depression. He reported using pornography for a number of years. Vital signs and physical exam were unremarkable. Fasting lipids, glucose, thyroid stimulating hormone, and total testosterone levels were all within normal limits. This differential is gaining importance because this is the first generation of men to grow up with high speed Internet and easy access to pornography. Studies show that 42% of adolescent males ages 10-17 have been exposed to pornography, and that pornography accounts for 25% of all Google searches. Pornography may become addictive, and masturbation compulsive; thus, it is important that clinicians consider PIED when young men present with erectile dysfunction. Addictions cause complex chemical, anatomical, and pathologic alterations in the brain. Collectively these changes, in response to addiction, are labeled hypofrontal syndromes. Atrophy of the frontal lobe can be seen in serial MRI scans over time. The transformation of the brain in response to addiction causes a numbed pleasure response, formation of addiction pathways, inhibition of executive control, a...
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