Health and Wellness

DR PHILIPPA KAYE: My deep concerns about the rise in young women addicted to porn… and how doctors like me can help them quit

Dr Philippa Kaye, GP with a particular interest in women’s and sexual health

Pornography is everywhere. Thanks to the internet, and the advent of smartphones, porn is constantly at our fingertips and almost inescapable.

It’s a far cry from just a few decades ago when porn was banished to the top shelf magazines at newsagents, hastily shoved under the bed, or limited to a copy of The Joy of Sex or a nondescript video tape.

But its new ubiquitous nature is having a real impact on our lives, with people of both genders being exposed to porn at an ever early ages.

By the age of 18, about 93 per cent of boys and 63 per cent of girls have seen porn, according to the Institute for Family Studies.

But the average age of first viewing porn was found to be even younger, just 12-years-old.

While there are differences between genders with regards to watching porn, it is clear that both men and women are being frequently exposed to explicit content.

By the end of 2019, approximately a third (33 per cent) of uses of PornHub, the UK’s most commonly used adult content website, were female.

While many people report pleasure from viewing adult content, for some it can become an issue.

Aa US study in 2019 found that 11 per cent of men and 3 per cent of women reported porn addiction.

There is still, unfortunately, many taboos and stigmas in society and in health and sex is definitely still one of them, in particular female sexual pleasure.

And there are still lots of feelings of shame and embarrassment around masturbation and porn use, particularly in females.

By the end of 2019, approximately a third (33 per cent) of uses of PornHub, the UK¿s most commonly used adult content website, were female

By the end of 2019, approximately a third (33 per cent) of uses of PornHub, the UK’s most commonly used adult content website, were female

Take Elise*, 19, who muttered under her breath that there was ‘something wrong down there’ and didn’t want to make eye contact.

She was extremely anxious about the appearance of her vulva, the external genitals, and was asking for a referral to see a plastic surgeon to get her labia adjusted surgically so they were equal in length and didn’t stick out.

Her partner had mentioned it and she had accessed porn because she thought she would be able to see a variety of bodies.

In fact, what she saw was a consistent body type, completely hairless and all looking a certain way, without the natural variation which occurs. She thought she was abnormal, and this worry had become an intrusive obsession.

The more she worried, the more she searched, which made her more worried.

Or Rachel*, 27, who came with skin damage from trying to lighten the appearance of her vulva and anus after watching more and more porn.

Body image issues aside there is also a risk of addiction to porn itself, which can have an impact on your mental health.

Caryn* had started to watch porn as a partner said she was ‘vanilla’ if she didn’t, and the more she watched with her partner the more she was made to feel that she had to try increasingly extreme sexual acts. 

She didn’t want to, she didn’t get pleasure from them and yet she found herself unable to refuse initially for fear of what her partner might say.

Porn is now considered mainstream, but the content may not be, with aggressive, violent, or degrading acts being portrayed as the norm.

The women I see in my surgery seem to feel, or perhaps are made to feel, that if they don’t enjoy these acts then the fault lies within themselves, that something is wrong with them.

Patience, 31, told me that she wanted to feel confident and empowered, that as a sexually liberated woman she could enjoy porn, but actually it made her feel low and anxious about her body and sexual preferences.

Instead of empowering her, it actually made her so anxious about sex she mostly stopped having it, and when she did, she didn’t enjoy it, didn’t become aroused and it was even painful.

Research conducted in 2021 suggests 58 per cent of women say they have been choked during sex, an increase from 21 per cent recorded in a 2020 survey.

Violent acts such as choking, or strangulation have become normalised despite the very real health risks they involve.

Choking quite literally cuts the flow of blood, and therefore oxygen to the brain, leading to light-headedness with the aim of intensifying pleasure, but it has inherent risks. There is no safe way to perform this act.

Could you be one of the one-in-20 Brits caught in the grips of a porn addiction?

Could you be one of the one-in-20 Brits caught in the grips of a porn addiction?

Physical risks aside there is a power dynamic to choking, and it has become so normalised that people may not realise that specific consent should be asked for.

Even if it is asked for, how many women are consenting because they think they should, or because they think their partner will get pleasure from it, as opposed to themselves getting pleasure from it. Is it even true consent at all?

Much of the porn available is made for the male gaze and focuses on the pleasure of men.

Anecdotally, I have seen that many heterosexual women prefer to watch female pornography, perhaps because it focuses on the pleasure of the women involved.

PornHub has a category entitled ‘popular with women’, which states it includes ‘everything from story driven, passionate soft-core porn to hardcore gangbangs’.

Data from 2015 from PornHub showed that female viewers are more likely to search ‘hardcore’, or ‘rough’ content than men, 100 times more, which seems counterintuitive.

But porn addiction is the same as many other addictions, in terms of the response in the brain.

Watching porn affects the reward and pleasure centres in the brain, releasing feel good chemicals such as dopamine.

Over time, more and more explicit videos need to be watched to create the same effect, just like someone with a drug addiction needing ever increasing doses to get high.

This means that viewers may then struggle to become aroused and reach orgasm with a real partner, who responds differently to the image on a screen, after all porn is not real life. But it can impact real life relationships.

I have a patient who feels such shame about her relationship with pornography she feels she cannot enter a relationship.

Other signs that you may have a porn addiction include watching ever increasing amounts of porn, neglecting other activities such as work, eating or sleeping to watch porn, being unable to enjoy sex without porn and feeling unable to stop even though you may be aware of the harm it is causing.

We cannot know the true numbers of women suffering with porn addiction, due to stigma and cultural pressures they may simply not be coming forward or may present with other mental health issues.

Porn addiction is a very real, and likely increasing problem, which can impact on mental health leading to depression, anxiety and body image issues as well as affecting relationships and even impacting work, perhaps due to difficulties with concentration or mental health issues.

Simply replace the word porn in that sentence with ‘alcohol’, ‘drug’ or ‘sex’ and it is clear that it is an addiction like any other.

Addiction needs treatment, and it is often not as simple as simply stopping looking at porn, which in itself is not simple.

The underlying reasons why the addiction developed may need to be addressed such as anxiety, and it is incredibly difficult to stop being exposed to explicit videos when they are easily accessible anywhere and everywhere.

A US study in 2019 finding that 11 per cent of men and 3 per cent of women reported porn addiction

A US study in 2019 finding that 11 per cent of men and 3 per cent of women reported porn addiction

In the same way that someone suffering with alcohol addiction may remove all sources of alcohol in their home, getting rid of hard copies of porn, deleting saved tabs or subscriptions to websites may be helpful, as may installing anti-pornography software on your devices (ask someone else to have the password).

Talking therapies can be helpful, as can medication for example if there is an underlying mental health condition. Psychosexual counselling can also be used to help treat porn addiction, though access to this can be difficult and waits can be long.

Society and the internet have normalised the use of pornography. Now we need to normalise talking about the problems it can cause and encouraging people to come forward for help so that they can have a healthy sex life, after all, sex and orgasms are good for your health!

*Patient names have been changed. 

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