Shutterstock, Willequet Manuel

As a therapist specializing in sexual issues for nearly 30 years, I have witnessed firsthand the changing nature of the pornographic universe. As it moved from print and VHS to the internet, I've seen the ongoing impacts of its use on both individuals and relationships.

As the internet has expanded, pornography has become more available, affordable, and anonymous. And with that, I have seen a corresponding increase in the number and variety of people who qualify as heavy porn users, a category of people I define as follows:

1. They are inordinately preoccupied with pornography. Often, they are either thinking about porn or using porn for an hour or more every day.
2. They have repeatedly tried and failed to quit or cut back on their use of porn. They tell themselves they will not use porn today, but then they do. They tell themselves they will go online only for ten minutes today, but then they’re online for several hours.
3. They are experiencing negative consequences related to their usage of pornography.

For starters, heavy porn users find themselves leading stressful, highly compartmentalized lives. Typically, because they feel so much personal, cultural, religious, and/or moral shame about their porn use, they hide their behavior from family, friends, and everyone else who matters to them.

Of course, stress and shame are not the only consequences heavy porn users experience. One relatively large-scale study of heavy porn users identified the following consequences:

• Shame, 70.5% of users
• Low self-esteem, 65.0%
• Mental health issues (depression, anxiety, etc.), 49.8%
• Loss of a relationship, 46.5%
• Sexual dysfunction, 26.7%
• Serious suicidality, 19.4%
• Sexually transmitted disease, 19.4%
• Other (non-STD) physical health problems, 15.7%
• Debt, 14.7%
• Impaired parenting, 14.7%
• Legal actions against, 6.0%
• Loss of employment, 4.1%
• Press exposure, 0.9%

I find it interesting though not surprising that shame and low self-esteem are listed as the top consequences of heavy porn use, even more than relationship trouble. If porn-using individuals were raised in a home or a religion or a culture that frowns upon porn use, they can’t help but feel defective and “less than” for using it. And even if they were not externally shamed for using pornography, they may feel internal shame about it, especially if pornography is their primary or only sexual outlet. In such cases, they may feel lonely and embarrassed about their “failure” to engage sexually in the real world, and, over time, this can eat away at them, diminishing their self-esteem in all areas of life.

That said, it is usually relationship woes that drive heavy porn users into my office. I actually think that this issue may be underreported in the study referenced above because, in addition to upsetting a person’s primary partner, which is what is reported on in the study, pornography may also prevent the formation of a relationship in the first place. It is this “lack of relationships” that is not sufficiently addressed in the study.

Other research also finds strong links between heavy use of porn and diminished relationship satisfaction. For the most part, what happens with heavy porn use is that porn becomes progressively more important in the user’s life, with other aspects of healthy living and healthy relationships pushed to the side.

Basically, with heavy porn use, long-term relationships (and other important aspects of life) take a back seat to pornography. And with that, a relationship cannot help but suffer on multiple levels. At the very least, there is a loss of trust wrought by the secrets and lies surrounding the use of pornography. This alone is more than enough to create emotional and even physical distance between partners. Thus, marital satisfaction takes a nosedive. In fact, in the research cited above, using porn almost doubles the likelihood of getting divorced in the next four-year period.

Another issue for relationships is what I refer to as porn-induced male sexual dysfunction. In my experience, such struggles are not physical in nature. Nor are they related to the frequency of masturbation and orgasm (i.e., the need for a sexual refractory period in which males reload, so to speak). Instead, problems with erectile dysfunction, delayed ejaculation, and anorgasmia (the inability to reach orgasm) are tied to the fact that when a male spends most of his sexual energy viewing and masturbating to pornography—with its never-ending variety and intensity—he is, over time, likely to find a lone real-world partner less enticing.

The most common signs of porn-induced male sexual dysfunction include:

• A man can achieve erections with pornography but struggles when he’s with a real-world partner.
• A man can maintain an erection with real-world partners, but he can achieve orgasm only by replaying porn clips in his mind.
• A man increasingly prefers pornography to real-world sex, finding it more intense and more engaging.

Sadly, porn-induced male sexual dysfunction affects not just heavy porn users but their romantic partners. If a man can’t get it up, keep it up, or reach orgasm, then his partner’s sexual pleasure and self-esteem are likely to be diminished. Some heavy porn users find themselves ending an existing relationship with someone they genuinely care about because of the shame they feel when they can’t perform sexually, or their partners end it for them because they don't feel a healthy sexual and romantic connection with their partner and don't know why.