Erectile dysfunction (ED) is the inability to get or maintain a full erection during sexual activity. It can occur sporadically, or it may be long-term or even permanent.

ED can affect those with a penis for many reasons, including physical and psychological causes, such as performance anxiety, depression, or physical health. But what about watching pornography? Here’s what the research shows.

While ED mostly affects older adults, a survey conducted in Italy found that an increase in internet pornography viewing among teenage boys may cause “sexual anorexia,” or a pathological loss of appetite for romantic-sexual interactions.

The notion that watching too much porn causes ED has since spread like wildfire. But not all experts think so.

“Our study, and now two others, have found there is no relationship between the number of sex films men view and erectile functioning with their partner,” says Nicole Prause, PhD, a sexual psychophysiologist and licensed psychologist at the Sexual Psychophysiology and Affective Neuroscience Laboratory at UCLA.

Her research with Jim Pfaus, PhD, was published in Sexual Medicine and was the first peer-reviewed study of this topic.

“In one case, the study found stronger sexual arousal in men who reported viewing more sex films at home,” Prause adds.

Only those men considered “conservative” and in relationships had any relationship between sex film viewing and erectile functioning.

“Taken together, this means that sex films do not contribute to erectile dysfunction,” Prause notes.

“However, those whose personal values contradict with viewing sex films may be experiencing general shame around sex that also influences their erectile functioning.”

Experts do say, however, that watching pornography can influence sexual appetite. This may make it difficult to achieve an erection and have an orgasm with a sexual partner.

Nikki Martinez, PsyD, LCPC, says modern access to a wide array of adult material can make it difficult to become aroused with a partner or to participate in sexual activities as someone always has.

“They have unleashed their true desires and proclivities, and now they struggle to become aroused when this is not involved,” she says. “The other partner feels rejected, and as if they are not attractive, and the first partner is most often too embarrassed to tell them what is really going on.”

Natalie Finegood Goldberg, LMFT, CST, says that pornography can create unrealistic expectations of what sex should look like and what your partner should look like and be able to do.

For lots of people, she says, pornography can engender shame if they feel they are not living up to the standards of the actor.

“Also, not to mention the piece where people can get any fantasy delivered to them through channels of pornography, rather than having to open up to their partner about what turns them on.”

Alexis Conason, PsyD, who practices in New York City, says she doesn’t think porn causes erectile dysfunction, but it’s important to look at how someone views pornography.

“For example, compulsive porn viewing, or watching several scenes at once, or quickly switching from one scene to another, creates a lot of stimulation not typically experienced in real-life sexual encounters. This may create ED issues,” she says.

“In addition, watching men in porn can create feelings of insecurity if men compare themselves to the actors, and this can lead to ED.”

If you think any of these aspects of pornography might be affecting your sexual functioning, Goldberg recommends avoiding pornography for at least 90 days.

This can help soften visual cues that can become overdeveloped through regular pornography viewing. She encourages people to explore their sexuality and sensuality through their other senses during this break.

“This [exploration] can also include arousal through visual cues, but the visual cues must be 3-dimensional,” she says. “Formal partner exercises like sensate focus are very helpful in restoring a person’s connection to a more robust sensuality.”

For self-pleasuring purposes, Goldberg encourages masturbating to sensations rather than recalled pornographic images.

“I encourage people to dig deep and explore their sexuality by also making an inventory of their turn-ons outside of the porn and visual realm,” she says.