← Back to all notesJUL 10 · 2026

Your body is not broken

There is a specific fear that men carry quietly.

It works alone.
It doesn't work with her.

And somewhere in the gap between those two facts, a story arrives — usually at two in the morning, usually from a forum. The story says: you broke something. Too much, for too long, and now the wiring is wrong.

It is a compelling story. It explains everything. It has a villain, a mechanism, and a cure.

It is also, as far as the research goes, not what the evidence shows.

What the evidence actually says

The claim has a name online: porn-induced erectile dysfunction. PIED. It is not a formal diagnosis, and the science behind it is genuinely contested — not settled in the way the forums suggest.

In 2019, Grubbs and Gola examined this across three separate samples of sexually active men, including one followed for a full year. They found little or no evidence of a link between simply using pornography and erectile difficulty. They found no evidence of any causal link at all.

But they found something else. Something worth sitting with.

They found a consistent association between erectile difficulty and self-reported problematic use — that is, between erectile difficulty and how much distress a man felt about his own use.

Read that slowly.
Not how much he watched.
How much it troubled him.

A separate review of the observational literature reached the same conclusion from another direction: there is little if any evidence that pornography use induces erectile dysfunction, and the existing data — mostly cross-sectional, mostly case reports — cannot establish cause at all.

A larger systematic review of forty-four studies found the picture messier still. Pornography use was associated with better sexual functioning in some contexts and worse in others. The one thing that consistently predicted lower functioning was problematic use. The distress. Not the frequency.

We should be careful here, and we will be. These are associations. Association is not cause, and it points in both directions at once: distress may worsen function, or difficulty may generate distress, or something underneath drives both. Nobody has shown which. That honesty cuts against the story you have been told, but it also cuts against any story we might prefer to tell you.

Before anything else: see a doctor

This is the part almost nobody in this corner of the internet will say, so we will say it first and say it plainly.

New or persistent erectile difficulty can be the earliest visible sign of vascular disease.

The Princeton IV consensus recommends that clinicians treat erectile dysfunction as a warning sign for cardiovascular disease — with particular attention to younger men. The reason is mechanical, not moral: the arteries in the penis are narrower than the coronary arteries. The same degree of endothelial dysfunction restricts flow there first. Erectile difficulty can precede a cardiovascular event by years.

It can also be a first sign of diabetes, or low testosterone, or a side effect of medication you are already taking.

So here is the sentence that matters most in this essay:

A man who decides his problem is pornography may not go to a doctor.

He has an explanation. Explanations are comfortable. And the explanation costs him the appointment that might have caught something serious while it was still quiet.

Go. Get the blood work. Rule out the dangerous things. Then, and only then, is it reasonable to think about the rest.

The pattern that everyone misreads

Now — the split itself. Works alone, fails with a partner.

In younger men without vascular risk factors, psychogenic causes are generally considered the main source of erectile difficulty, and performance anxiety is the most common one.

And the hallmark of psychogenic difficulty is precisely that it is situational. It shows up in certain circumstances and not others. It appears with a new partner, or with a partner who matters, and vanishes when nothing is at stake. Organic causes tend to be more consistent — they do not care who is in the room. Regular morning erections suggest the physical machinery is intact.

Which means: the exact pattern that convinced you something is permanently damaged is the pattern clinicians recognise as anxiety.

Not damage. Not a burned-out brain. A body doing what bodies do when they are being watched, and graded, and afraid of failing.

Arousal is contextual. It attaches to circumstances — to privacy, to the absence of another person's judgement, to having no one to disappoint. A partner is a different context, carrying different stakes. That is not a malfunction. It is what it sounds like: an old context is familiar and a new one is not yet.

The loop

Here is the cruelty of it.

The belief that you have broken yourself is itself an anxiety.
Anxiety is the most common driver of the very thing you are afraid of.
And the fear that it will happen again is the most reliable way to make it happen again.

The forums hand a frightened man a diagnosis, and the diagnosis produces the symptom, and the symptom confirms the diagnosis.

This is the same machinery we wrote about in Shame doesn't make you disciplined. Shame does not correct behaviour. It narrows a person until there is nothing left to work with. Applied to the body, it does the same thing — only faster, and more visibly.

You cannot frighten a body into working.

What is actually left to do

Almost everything, as it turns out. Just none of it dramatic.

See a doctor. That is first and it is not optional.

Then look at the honest questions. Whether you are anxious. Whether your use has become a way of handling pressure rather than a thing you chose. Whether it is the volume that troubles you, or the loss of choosing.

That last one is the only question that has ever mattered here. Not what you watch. Not how often. Whether you are still choosing — or whether something else is choosing, and you are arriving afterwards to feel bad about it.

That question has answers. They are slow, and unglamorous, and they have nothing to do with your wiring.

Your body is not broken.

You may simply have been afraid, for a long time, in a way nobody told you was ordinary.