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Pornography and sexual function in the post-pandemic period: a narrative review from psychological, psychiatric, and sexological perspectives

International Journal of Impotence Research (2024)Cite this article

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Abstract

The COVID-19 pandemic and lockdowns had significant impacts on sexual functioning and behavior. Partnered sexual activity decreased overall, while solo sex activities such as masturbation and pornography consumption increased exponentially. Given the ongoing debate about the effects of pornography on sexual function, it was prudent to consider how the increase in porn consumption during the pandemic might have impacted sexual function in the post-pandemic period. Results indicated that despite the increased rates of use during lockdowns, there remains no evidence supporting the relationship between sexual dysfunction and porn use during and following the pandemic period. On the contrary, pornography consumption and solo sex activities offered an alternative to conventional sexual behavior during a highly stressful period and were found to have positive effects of relieving psychosocial stress otherwise induced by the pandemic. Specifically, those who maintained an active sexual life experienced less anxiety and depression, and greater relational health than those who were not sexually active. It is important to consider factors including frequency, context, and type of consumption when analyzing the impact of pornography on sexual function. While excessive use can have negative effects, moderate use can be a natural and healthy part of life.

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Fig. 1: The impact of dysregulated cortisol and epinephrine on sexual functioning.
Fig. 2: The bidirectional association between erectile dysfunction and COVID-19.
Fig. 3: The role of inflammation on overall health and sexual dysfunction.
Fig. 4: The multifaceted relationship between mental illness and sexual dysfunction.
Fig. 5: The costs and benefits of pornography use on sexual function.

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Acknowledgements

AS and EAJ were partially supported by the PRIN grant 2017S9KTNE_002. Moreover, EAJ was also partially supported by #NEXTGENERATIONEU (NGEU) project funded by the National Recovery and Resilience Plan (NRRP), project MNESYS (PE0000006)—a multiscale integrated approach to the study of the nervous system in health and disease (DN. 1553 11.10.2022).

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Authors and Affiliations

  1. Course of Clinical Psychosexology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy

    Kathryn Fotinos & Erika Limoncin

  2. Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy

    Kathryn Fotinos, Andrea Sansone & Emmanuele A. Jannini

  3. Stress Trauma Anxiety Rehabilitation Treatment (S.T.A.R.T.) Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada

    Kathryn Fotinos, Alexandria Greifenberger & Martin A. Katzman

  4. Adler Graduate Professional School, Toronto, ON, Canada

    Martin A. Katzman

  5. Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada

    Martin A. Katzman

  6. School of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy

    Tommaso B. Jannini

  7. Flare Health, Amstelveen, The Netherlands

    Yacov Reisman

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KF, AS, and EAJ conceived and designed the work that led to the submission. KF and AS managed the literature searches and data acquisition. KF drafted and revised the manuscript. AG formatted the manuscript for publication. AS, TBJ, YR, EL, MAK, and EAJ edited the manuscript. AS and EAJ supervised the manuscript. All authors contributed to and have approached the final manuscript.

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There are no specific conflicts of interest to declare with regards to the preparation or submission of this manuscript. However, EAJ is or has been paid consultant and/or paid speaker for Bayer, Ibsa, Menarini, Otsuka, Pfizer, Shionogi, and Viatris. MAK has participated on advisory boards and/or similar committees for GlaxoSmithKline Inc., Wyeth Pharmaceuticals, Lundbeck Canada Inc., Eli Lilly, Organon, AstraZeneca, Janssen-Ortho Inc., Shire, Bristol-Myers Squibb, Pfizer, Biovail, Genuine Health, Boehringer Ingelheim, and Solvay; has received research funding from CIHR, Sick Kids Foundation, Centre for Addiction and Mental Health Foundation, Canadian Psychiatric Research Foundation, Canadian Foundation for Innovation, GlaxoSmithKline Inc., Wyeth Pharmaceuticals, Lundbeck Canada Inc., Eli Lilly, Organon, AstraZeneca, Janssen-Ortho Inc., Solvay, Genuine Health, Shire, Bristol-Myers Squibb, Takeda, Pfizer, and Roche.

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Fotinos, K., Sansone, A., Greifenberger, A. et al. Pornography and sexual function in the post-pandemic period: a narrative review from psychological, psychiatric, and sexological perspectives. Int J Impot Res (2024). https://doi.org/10.1038/s41443-023-00812-3

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