Erectile dysfunction
There is an increase in men (and sometimes women) who recognise that their sexualised internet use is out of control, says NHS sexual and relationship psychotherapist Angela GregoryiStock

For the past 16 years I have worked full-time as an NHS sexual and relationship psychotherapist, treating men and women with a range of sexual difficulties. Sexual problems can have a medical or psychological ethology or a mixture of both.

In our clinic we see adults from 18 years onwards.

Erectile dysfunction is commonly associated with cardio vascular disease, diabetes, prostate surgery, spinal cord injury and multiple sclerosis. However over the past five years there has been an increase in young men being referred to our NHS clinic with erectile dysfunction and delayed/inhibited ejaculation, and I soon realised that their masturbatory habit alongside their online porn use was a significant maintaining factor for their sexual difficulties.

It is also of concern that there is an increase in men (and sometimes women) who recognise that their sexualised internet use was "out of control", damaging their relationships and, in essence, taking over their lives.

The past 10 years has seen a digital revolution that has facilitated accelerated communication; Western culture is being shaped more and more by the internet, smart phones and social media. Via the internet sexual contact and pornography is accessible and anonymous; it has created a cultural context that is educating young people about what is "normal". Gone are the days when our exposure to something explicit was the underwear section of your grandmother's Littlewoods catalogue or a centre page spread of adult magazines like Playboy and Penthouse.

What happens when the adolescent brain meets high-speed hard-core pornography? Well we can only begin to guess at the long term consequences, but what we do know is that as human beings we can all experience feelings of inadequacy, that on some level we don't measure up when compared to others. But young people are particularly vulnerable and online they can view a kaleidoscope of sexualised images and Olympic-style performances to compare themselves with, just one click away.

Porn sex is based on performance, on the penetration of any orifice with a guaranteed orgasm every time. What it is not about is love, teasing, sensuality, eroticism or emotion. The message is very clear, hard, fast penetration equals great sex and any personal "failure" to measure up can be immediately posted on social networking sites.

Some will experience erection problems and ejaculation difficulties due to performance anxiety or from psychological and physical desensitisation due to high-frequency masturbation. According to the website www.yourbrainonporn.org the younger a boy is when he starts watching porn the longer it can take to reverse the conditioning effect of highly arousing stimulation. To put it bluntly, they will have to learn to find their girlfriend or boyfriend sexy or real life sex, arousing.

In the field of sexology/sexual medicine there is much debate about the existence and use of the term "sexual addiction". Many years ago there was a newspaper report about a Hollywood A-list actor who was seeking help for "sexual addiction", and I remember thinking that it sounded like an excuse for his infidelities. However, over the past few years I have witnessed first-hand the personal devastation that online sexual activity/porn can have on young people and on their ability to form and maintain regular intimate and loving sexual relationships. And make no mistake, older people are equally vulnerable to explicit imagery and online sex.

Below is an example of a 19-year-old man who feels his life totally revolves around viewing pornography and sex chat rooms:

  • He feels his problems started when at the age of 13 he was introduced to explicit images online by his school friend.
  • Using his smart phone he currently he masturbates five times per day, in his bedroom, at work and sometimes in public places.
  • He has had one sexual relationship but this ended when she found out he also had numerous casual sexual encounters with partners he met online.
  • He has also started to see escorts.
  • He rarely socialises with friends and feels isolated from "normal"' life.
  • He has smashed up two smart phones in his efforts to stop but this hasn't worked.
  • He feels his life isn't worth living and he doesn't know what to do.

Sadly for many people in this situation there is very little NHS help available so many will turn to online forums for help such as www.yourbrainonporncom and www.nofap.com. Private therapists can be accessed via College of Sexual & Relationship Therapists (COSRT) and organisations such as Relate. Also useful is Understanding and Treating Sex Addiction by Paula Hall.

For parents, blocking porn sites is an option but sadly online pornography is only the tip of the iceberg. Twitter, Snapchat, and chat rooms also expose young people to sexual images, explicit chat and videos. Equally worrying is that children and young people are willingly putting indecent images of themselves online.

In 2012 the Child Exploitation & Online Protection Centre (CEOP) found that the vast majority of sexually generated indecent images of children are uploaded onto the internet by the children and young people themselves without any external coercion.

Social networking sites and peer pressure are powerful and persuasive weapons and rarely will they be challenged by an embarrassed teacher responsible for their sex education. As adults, the first step in the fight to challenge the power of the internet and social media is to be aware of what's accessible online and to create an open and frank dialogue with each other.


Angela Gregory is the Lead for Psychosexual Therapy at the Chandos Clinic, a sexual dysfunction service for men and women based at Nottingham University Hospital Trust. She is currently the secretary of the British Society of Sexual Medicine.