For men, there is a dark side to pornography. 

Story: Dr. Richard T. Bosshardt

On any given evening, everywhere in the United States, millions of men of all ages sit down in front of their computers and with a few clicks can view any type of pornography they wish, for free, in the privacy and comfort of their home. It wasn’t always this way. 

Men of my generation grew up with porn only through men’s magazines, of which Playboy was the most widely known. The only other practical access was through X-rated movies in theaters and “peep shows” in video arcades. In other words, you had to travel to get porn, either to buy magazines or see movies or videos. With the advent of online porn around 1997, this paradigm shifted in ways we could not have imagined. Now, porn of every type is available in unlimited quantities, for free, and without ever leaving your room. Always a solitary, private affair, it is now this to the nth degree. 

The popularity of porn is undisputed. Only one porn site, Pornhub, has released its statistics, and they are mind-numbing. In 2018, there were 33.5 billion visits to the site, a 15 percent increase over 2017. Every minute there are 64,000 new visitors to the site. Over the year, 4.79 million videos were uploaded to the site. The United States has the highest daily traffic. Thirty-five percent of all internet downloads are for porn. 

Porn definitely has gone mainstream, with porn sites receiving more regular traffic than Netflix, Amazon, and Twitter combined. It is not discussed in hushed tones anymore. Popular television shows regularly make references to porn viewing. Porn stars are the new celebrities. Jenna Jameson, a former hardcore porn star, is now an entrepreneur with multiple business interests, an author, and actress with a net worth estimated at $10 million.

Porn even influences my profession. Young women desiring breast and other cosmetic procedures sometimes cite porn stars as their model or inspiration. Genital enhancement, including such things as labiaplasty and anal bleaching (Yes, that’s correct. You can’t make this stuff up), was unheard of just a few years ago but has become increasingly requested.

Porn is primarily the domain of men, by far the most frequent users. Regardless of age range or demographic, the majority—about 75-90 percent—of regular porn users are male. One-fourth of teenage boys view porn at least weekly. Ninety percent of boys are exposed to porn by age 12. 

So, in all of these statistics, is there a problem here? What’s wrong with porn? Sex is natural, after all, and promoters of porn describe it as a means of sex education, of enhancing one’s sex life, even of bringing couples together. Unfortunately, the reality is a bit darker. Let’s put aside moral judgements for a moment and focus on porn medically and psychologically. 

A few years ago, Dr. Valerie Voon, a neuropsychiatrist at Cambridge University, published a study of men who were addicted to porn. She performed brain scans on them that documented, for the first time, an objective change in the brain due to porn. There was increased activity in the reward center that regulates motivation, reward, and pleasure. We are naturally programmed to seek out things that stimulate our pleasure center. In this case, the finding was the same change seen in alcoholics and drug addicts.

This finding raises some disturbing concerns about exposure to porn in teenagers and young men, when the brain is still very plastic and immature. Does porn viewing lead to porn addiction? While we still don’t know how frequent this is, the answer is clearly yes. 

Porn addiction shares two characteristics with alcohol and drug addiction: lack of control and tolerance. It is interesting that many regular porn users express ambivalence about porn, with some actually saying they don’t like it but continue to view it nonetheless. Regular users may risk their jobs to view it at work or to the exclusion of personal relationships. Tolerance means that, over time, regular viewers may need to seek more explicit material, more variety, or more extreme, frankly, even deviant, behaviors. Porn can make men feel less, not more, attracted to their sexual partner. I have personally seen several marriages destroyed by porn addiction. Not all will go down this path, of course, just as not all marijuana users will eventually become hardcore drug addicts. The risk is there, however, and people often do not know their susceptibility until it is too late. 

The widespread availability of internet porn is relatively new, and one concern for social scientists is that we literally are engaging in a massive social experiment as to the long-term effects of widespread, early exposure to porn on relationships and our society, the results of which may not be known for decades. It is more than a little bit worrisome that for many teenagers, their idea of “normal” sex is what they see on porn sites on the internet, the content of which is largely devoid of such anachronistic concepts as love, devotion, faithfulness, and commitment. Combine this with the disintegration of many norms in society and the fragmentation of the traditional nuclear family and the future of human relationships is nothing if not uncertain. 

Men need to reconsider whether porn is just a pleasant, harmless distraction or a potential source of serious problems. Fathers need to know just what their teenage, and younger, sons are seeing online and have candid discussions of the dangers of viewing porn. 

In closing, I read an interesting story that is telling. For many men of my generation, when we were young, the late Hugh Hefner, founder of the Playboy empire, was the epitome of the suave man of the world who, sexually speaking, had it all: unlimited access to beautiful, sexually available women. His supposed sexual exploits were the stuff of legend. In her book, “Bunny Tales: Behind Closed Doors at the Playboy Mansion,” Izabella St. James, one of Hefner’s former “official” girlfriends, reported that, in his 70s, Hefner would have sex twice a week with as many as four women at once. He would always finish, however, by masturbating while watching porn.

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About the writer → Dr. Richard T. Bosshardt graduated from the University of Miami School of Medicine in 1978. He founded Bosshardt & Marzek Plastic Surgery Associates, Lake County’s first practice to provide full-time cosmetic and reconstructive plastic surgery services, in 1989.