The researchers noted that over time rates of sexual problems declined for females, but not for males [ 11 ]. Medically, he had no history of major illness, surgery, or mental health diagnoses. Put simply, it was sensitization that best predicted symptoms of Internet pornography addiction. This finding aligns with studies reporting increased amygdala activation when substance abusers are exposed to cues related to drug use [ ]. Our review also included two papers claiming that Internet pornography use is unrelated to rising sexual difficulties in young men. He was masturbating for about an hour without an orgasm, and his penis went flaccid. The first group, in —, were aged 40— He could achieve an erection but could not orgasm, and after 10—15 min he would lose his erection, which was not the case prior to his having ED issues. Second Clinical Report A year old African American enlisted serviceman with 17 years of continuous active duty presented with difficulty achieving erections for the previous three months. She was starting to think that he was no longer attracted to her. For example, it provides no statistical results for the erectile function outcome measure in relation to Internet pornography use. The first study claimed to be the first nationally-representative study on married couples to assess the effects of pornography use with longitudinal data. Not only is the relationship between depression and ED likely bidirectional and co-occurring, it may also be the consequence of sexual dysfunction, particularly in young men [ 26 ]. However, this publication has come under criticism for various discrepancies, omissions and methodological flaws.