Every man suffers from psychological impotence at some point in his life. Problems arise when 'stage fright' occurs so often as to negatively impact a man's lifestyle. This form of erectile dysfunction (ED) can be more troublesome than biological impotence because there's no magic pill like Viagra to counteract it. While searching for the best methods for dealing with psychological impotence, I corresponded via email with Dr. Muhammad Mirza, M.D., the Medical Director at Doctor Available and the founder of ErectileDoctor.com. He believes there is a link between porn consumption and psychological ED.
[jump]What do you think about the practice of watching porn without masturbating to completion as a way of boosting a man’s libido?
There’s no scientific study that has been conducted that can answer this question. This question may very well be a part of the sexual myths surrounding ED. To the best of our research, we have not found any evidence supporting this.
Ron Jeremy once told me the secret to always staying hard at his age was to never climax, or at least to only climax when you can’t hold back anymore. What do you think of this advice?
No scientific evidence is suggestive of this. Extensive scientific studies conducted by Masters and Johnson has not brought any evidence about this particular type of sexual behavior.
What do you say to those who accuse porn of turning men into insatiable, sex maniacs?
Scientific studies have suggested that chronic and frequent porn consumption can change the brain at a neurotransmitter level and cause an imbalance within the brain. Not only does this level of porn consumption have a psychological impact, but it also has a molecular impact on the brain. Such molecular change within the brain can manifest itself in the form of psychological misbehavior, and psychological maladjustment. It can also manifest with pathological behavior.
Have you noticed similar personality traits in the types of men who are susceptible to psychological impotence: obsessive, hypertension, nervous…?
Psychological impotence can effect men across all personalities. There’s no specific personality that is associated with psychological impotence. There is a multitude of factors that can play a role in psychological impotence.
Other than eliminating porn consumption, what are some strategies you suggest for coping with psychological impotence? Would you recommend these men quit masturbating all together?
I would recommend that these men see a professional sex therapist and/or psychologist to treat the psychological impotence. This needs to be a multidisciplinary effort, not only psychological, but also potentially involving general physician, endocrinologist, or urologist, to approach this particular issue. There’s no direct correlation between masturbation and impotence.
Are mornings the best time to have sex for those with psychological impotence, as stress levels are often at their lowest and the worries of the day have yet to accumulate?
One of the ways to differentiate between psychological and organic ED is early morning erections. If someone does not have early morning erections, then they most likely have organic impotence, and if they do have early morning erections, then it’s more likely that they have psychological impotence.
It’s well known that excessive alcohol use can cause impotence. However, for those with psychological impotence, does a little bit of red wine or alcohol help suppress the fear of impotence?
Chronic alcohol use is associated with impotence. Any stimulus that can impair consciousness can remove the phobia of impotence but in the long run is not the right treatment approach for this condition and can be more harmful than helpful.
Does quitting caffeine and other stimulants that boost the stress hormone, cortisol, help prevent psychological impotence?
There’s no direct correlation between caffeine consumption and impotence. Over the counter stimulants, like vitamin shop, and other non-prescription stimulants, can at times be associated with impotence because they’re not FDA regulated and the consumer doesn’t know what kinds of chemicals are within the products they’re consuming.
Which do you think will be discovered first, an effective drug for psychological impotence or a drug that stimulates female arousal?
We should not expect a silver bullet, single magic pill cures, whether it’s for male impotence or female arousal. There’s a complex interplay between multiple physiologies involved in these conditions and a multidisciplinary approach is required to treat such kinds of sexual issues. Our magic pill approach is not going to resolve these clinical sexual issues.
Being depressed can negatively impact one’s libido. Why then are so many anti-depressant drugs also linked to low libido and impotence?
Depression can effect libido in a negative way, but ironically, the antidepressant drugs deregulate the body’s autonomic system and effect the neurotransmitters within the brain, thus effecting the libido and sometimes causing impotence.
Who do you think suffers more from psychological impotence: men in long-term relationships or men who pursue sexual encounters with a steady stream of new partners?
There is not enough data available that compares men in monogamous relationships with those who are not. The risk of psychological impotence would be higher for men not in relationships due to the more frequent changes in partners. It would be natural to see less anxiety from a man who is only sexually engaged with one partner.
Do you recommend men with psychological impotence avoid planning sex for specific times, and instead focus on having spontaneous sex when the mood strikes as a way to reduce the anxiety associated with being expected to perform on command?
This is something that needs to be assessed in a supervised setting after a thorough medical and psychological evaluation. This is not a cut and paste approach that can be applied to all patients with this particular condition. Each patient has a unique history and subset of medical conditions so each patient requires a tailored treatment.
What research has found links between porn consumption and psychological impotence?
a. Research published in March of 2012 in the International Journal of Impotence Research, derived from the Journal of Sexual Medicine, discusses some potential causes of psychological impotence, including masturbation correlated with porn consumption.
b. The article, "Psychological Interventions for Delayed Ejaculation/Orgasm," describes 4 potential theories behind why men experience delayed ejaculation/orgasm due to masturbation or other stimulation that does not involve an actual partner with or without porn consumption.
c. The 4 psychological theories that do not currently have empirical support are as follows:
1. Insufficient Stimulation: failure to achieve sufficient mental or physical stimulation --> some men experience a great disparity between their sexual fantasies that are fulfilled through porn and their experiences with an actual partner. Because there is a higher excitement threshold established by excessive porn use, it can be difficult for these men to become as excited when engaging sexually with an actual partner.
2. Masturbation: high frequency of masturbation, idiosyncratic masturbatory style, disparity between fantasy and reality --> looks at the amount and type of pressure a man uses while masturbating and whether or not this mimics the types of pleasure that can be experienced inter-vaginally. If the pressure from masturbation is very different from that experienced through sex with a partner, this could create issues for a man attempting to orgasm when with a partner due to a lack of physical sensation required to reach climax for that individual.
3. Outgrowth of Psychic Conflict: less to do with porn and more to do with psychological ED stemming from anxiety and fear related to loss of semen, being physically hurt from having sex with a woman, fear of impregnating a woman, negative feelings toward the partner, performance anxiety, guilt from religious upbringing, etc.
4. Disguised Subtle Desire Disorder: experiencing an erection automatically without experiencing genuine arousal, auto sexual orientation (liking pleasure one receives from masturbation more so than from a partner), feeling inhibited by partner’s touch, lacking sensation to the penis, and feelings of compulsion to satisfy one’s partner --> concerns a form of performance anxiety caused by feelings of inadequacy or uncertainty in the bedroom which could be exacerbated by a man becoming accustomed to being able to orgasm by himself with the use of porn and masturbation. In this theory, one prefers sex with oneself over sex with another person. Difficult to achieve orgasm with intercourse due to more pleasure gained from masturbation, along with worrying that one will not be able to satisfy his partner due to his inability to remain excited or to ejaculate.