Problematic pornography use (PPU) is a type of compulsive sexual behavior disorder (CSBD). It can affect a person’s mental health and sexual relationships. It can also lead to sexual violence.
CSBDs make it difficult for the individual to control or manage intense sexual impulses or urges. Medical professionals sometimes refer to these behaviors as out-of-control sexual behavior (OCSB).
However, it is important to note that there is much disagreement about whether CSBDs, including PPU, can be a type of porn addiction. Some medical professionals do not recognize porn addiction as a diagnosable condition, and similarly, there is controversy about whether PPU has an addiction component.
If a person believes that they are experiencing PPU, they may wish to contact a certified sex therapist for advice. Other strategies may also help.
Read on to learn more about PPU, including how it can affect an individual and what treatments may help.
What are the signs or symptoms of problematic pornography use?
A person may be experiencing PPU if they persistently have an uncontrollable or intense urge to use pornography even when it impairs functioning or relationships.
PPU can affect each person differently but may causeTrusted Source:
- feelings of distress or guilt about pornography use
- a decrease in the quality of sexual intimacy with a partner
- reduced sexual drive when not using pornography
- reduced genital sensitivity
- delayed or reduced ability to orgasm
- pornography-induced erectile dysfunction
- delayed ejaculation
- cognitive deficits, or brain fog
- feeling physically or mentally exhausted
- difficulty becoming motivated for everyday tasks
- new or worsening mental health problems, such as anxiety or depression
- problems with functioning or performance at work
- sexual violence toward other people, such as a partner
A person may also find that they focus on different stimuli when consuming pornography. For example, they may have multiple tabs open on the computer that they move between in one sitting.
Sessions viewing pornography may also last hoursTrusted Source at a time.
It is important to note that these symptoms may have numerous possible causes. A person can discuss these with a medical professional to help determine the underlying cause.
What causes problematic pornography use?
The cause of PPU is unclear.
However, a 2024 article suggestsTrusted Source that factors such as loneliness and difficulties regulating emotions may worsen or prolong PPU.
More research into what causes PPU and CSBD is necessary. An individual can work with their doctor to help identify any factors that may be worsening their symptoms.
Their doctor can then advise on ways to manage those factors. For example, if an individual finds that PPU worsens during periods when they have difficulty regulating emotions, a doctor may recommendTrusted Source medications that can help.
How do doctors diagnose problematic pornography use?
Diagnosing PPU can be difficult, as there are no official diagnostic criteria.
A 2024 studyTrusted Source suggests that there are two approaches to assessing the severity of PPU: the Problematic Pornography Consumption Scale (PPCS and PPCS-6) and the Brief Pornography Screen (BPS).
The PPCS contains 18 items for assessing PPU. The PPCS-6 is a shorter scale that derives from the PPCS. It contains six of the most appropriate items from each of the factors in PPCS-18, allowing for a short but reliable assessment of PPU.
BPS contains five items. The individual answers each question according to their experiences over the previous 6 months. Answering “never” is worth 0 points, “occasionally” is worth 1 point, and “very often” is worth 2 points. Scoring equal to or greater than 4 points may indicate a risk of PPU.
What are the treatments for problematic pornography use?
There is limited research into the benefits of treatments for PPU.
If a person is experiencing symptoms of PPU, or if a doctor suspects the disorder, they may wish to seek support from a certified sex therapist.
A 2022 studyTrusted Source found that various types of therapy may help improve symptoms of PPU. Types of therapy may include:
- cognitive behavioral therapy (CBT), which can help the individual learn coping methods for their symptoms
- psychotherapy, which can help improve overall well-being
- psychopharmacological therapy, which can involve working with a psychologist to find suitable medications to improve mental health
Medications that may help with PPU include opioid antagonists, such as naltrexone, while antidepressants may also help.
A 2022 article also suggests that seeking social support may be beneficial in managing PPU. This could include talking with a partner or family member. Group therapy or support groups may also help.
Working with a certified therapist can help an individual monitor any changes in their symptoms, help them identify coping strategies, and assess whether their treatment approaches are working.
When should a person contact a doctor?
A person needs to contact a doctor as soon as they have concerns about PPU or CSBD. They can help them assess their symptoms and help them receive an accurate diagnosis.
The doctor may refer them to a specialist or certified sex therapist for evaluation and support with treatments.
Where possible, a person needs to try to work with a therapist who has experience with PPU or CSBD.
Summary
Problematic pornography use (PPU), a type of compulsive sexual behavior disorder (CSBD), can cause anxiety, depression, distress, and other mental health changes. It can also cause reduced sexual abilities or intimacy with a partner.
If a person believes they are experiencing PPU, they can contact a medical professional for advice. They may find it beneficial to talk with a certified sex therapist or psychotherapist. They may recommend cognitive behavioral therapy (CBT), psychotherapy, or medications.
Talking with a family member or other loved one may also help manage the effects of PPU. Some people may also find group therapy or support groups beneficial.