Do Pornography Use and Masturbation Frequency Play a Role in Delayed/Inhibited Ejaculation during Partnered Sex? A Comprehensive and Detailed Analysis

Abstract

The role of masturbation frequency and pornography use on sexual response during partnered sex has been controversial, the result of mixed and inconsistent findings. However, studies investigating this relationship have often suffered from methodological shortcomings. We investigated the role of masturbation frequency and pornography use on both the occurrence and severity of delayed/inhibited ejaculation (DE), an increasingly common sexual problem among men. We did so in a large (nonclinical) multinational sample of cisgender men (N = 2332; mean age = 40.3, SE = 0.31) within a multivariate context that relied on multiple (and, when possible, standardized) assessments of sexual dysfunctions while controlling for possible confounding variables. Results indicated a weak, inconsistent, and sometimes absent association between the frequency of pornography use and DE symptomology and/or severity. In contrast, both poorer erectile functioning and anxiety/depression represented consistent and strong predictors of DE and, to a lesser extent, DE severity. Other factors, including relationship satisfaction, sexual interest, and masturbation frequency, were significantly though moderately to weakly associated with DE. In conclusion, associations (or sometimes lack thereof) between masturbation frequency, pornography use, and delayed ejaculation are more clearly understood when analyzed in a multivariate context that controls for possible confounding effects.

Self-reported reasons for having difficulty reaching orgasm in men with diverse etiologies

“…Specifically, anxiety and negative emotions—whether sex-specific or more general distress—received the strongest endorsements from respondents, a pattern consistent across both DE + ED and pure DE groups. The association between anxiety and sexual performance problems has long been known, 10 , 18 , 20 , 27 , 43 but we were surprised that it occupied such primacy in the list of reasons for DE symptomology: as noted in Table 5 , 4 of every 10 participants uniquely identified it as the most important typal reason for their problem. Whether or not anxiety/distress is an actual cause for the sexual difficulty is not known; however, whether cause or consequence, it was the reason most associated with difficulty reaching orgasm by the men in our sample and, as such, reiterates the importance of the management of stress/anxiety in any protocol designed to address this sexual problem.…”

“…These reasons might also include a strong autoerotic orientation that—for whatever reason—lead some men to prefer the physical and psychological (eg, sexual fantasy) stimulation associated with masturbation over that of partnered sex. 18 , 20 On a positive note, both inadequate stimulation and low arousal are processes that could be addressed within the sexual dyad, particularly under the guidance of a knowledgeable therapist. 1 , 3 , 49 Specifically, relative to partnered sex, DE symptomology is greatly attenuated during masturbation 49 and, consistent with this general idea, the current study found that nearly 3 out of every 4 men who indicated difficult or absent ejaculation during partnered sex reported no or only mild difficulty during masturbation.…”

“… 3 , 4 , 15 But for men having a lifelong condition of DE, etiological pathways remain largely hypothetical. Based on recent theoretical and empirical reports, several differentiating etiological risk factors have been proposed to explain men’s difficulty reaching orgasm/ejaculation, including ones related to genetic/biological predispositions, 18 , 19 levels of distress/anxiety, 16 , 20-22 relationship issues, 13 , 23 and insufficient arousal to reach ejaculation. 24 , 25 Each hypothesized factor has garnered some support.…”

“…As of yet, however, no specific data support this assumption, and one twin study concluded that genetic factors did not reliably predict DE status. 26 Regarding a role for distress/anxiety, men with DE consistently report greater levels of distress/anxiety than men without DE, 16 , 18 , 20 but whether these negative emotional states are a cause or consequence of DE has not been clarified. Insufficient sexual arousal—which might well be linked to poorer relationship quality/satisfaction 16 —has also been identified as a putative factor for DE.…”