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 special interest in women’s health and sexual health
Pornography is everywhere. Thanks to the internet and the advent of smartphones, porn is constantly within reach and almost inescapable.
It’s a far cry from a few decades ago, when porn was relegated 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 videotape.
But its new ubiquitous nature is having a real impact on our lives, with people of both genders being exposed to porn from an early age.
According to the Institute for Family Studies, by age 18, about 93 percent of boys and 63 percent of girls have seen porn.
But the average age of first viewing porn turned out to be even younger: just 12 years old.
Although there are differences between the genders when it comes to watching porn, it is clear that both men and women are often exposed to explicit content.
At the end of 2019, around a third (33 percent) of users on PornHub, the most used adult website in Britain, were female.
While many people report that they enjoy watching adult content, this can become a problem for some.
A 2019 US survey found that 11 percent of men and 3 percent of women reported porn addiction.
There are unfortunately still many taboos and stigmas in society and in health, and sex is certainly still one of them, especially female sexual pleasure.
And there are still many feelings of shame and embarrassment surrounding masturbation and porn use, especially among women.
At the end of 2019, around a third (33 percent) of users on PornHub, Britain’s most used adult website, were female
Take Elise*, 19, who muttered under her breath that “something was wrong down there” and wouldn’t make eye contact.
She was very concerned about the appearance of her vulva and external genitalia, and requested a referral to a plastic surgeon to surgically adjust her labia so that they were of equal length and did not protrude.
Her partner had mentioned it and she had started accessing porn because she thought she would be able to see different bodies.
In fact what she saw was a consistent body type, completely hairless and all looking a certain way, without the natural variation that occurs. She thought she was abnormal, and these worries had become an intrusive obsession.
The more she worried, the more she searched, which made her worry even more.
Or Rachel*, 27, who suffered skin damage when she tried to lighten the appearance of her vulva and anus after watching more and more porn.
In addition to body image issues, there is also a risk of addiction to porn itself, which can impact your mental health.
Caryn* had started watching porn because a partner said she was “vanilla” if she didn’t, and the more she watched with her partner, the more she felt like she had to try more and more extreme sex acts.
She didn’t want it, she didn’t enjoy it, and yet she found herself initially unable to refuse for fear of what her partner would say.
Porn is now considered mainstream, but the content may not be, with aggressive, violent or degrading acts portrayed as the norm.
The women I see in my practice seem to feel, or perhaps come to feel, that if they don’t like these actions, the fault is their own, that there is something wrong with them.
Patience, 31, told me that she wanted to feel confident and powerful, that she could enjoy porn as a sexually liberated woman, but that it left her feeling depressed and anxious about her body and sexual preferences.
In fact, instead of empowering her, it made her so anxious about sex that she usually stopped having it, and when she did, she didn’t enjoy it, didn’t get aroused, and it was even painful.
A 2021 survey shows that 58 percent of women say they have been choked during sex, up from 21 percent in a 2020 survey.
Violent acts such as choking or strangulation have become normalized, despite the very real health risks they pose.
Choking literally cuts off blood flow, and therefore oxygen, to the brain, leading to light-headedness with the aim of intensifying pleasure, but it carries inherent risks. There is no safe way to perform this operation.
Could you be one of the one in twenty Britons trapped in the grip of a porn addiction?
Beyond the physical risks, there are power dynamics involved in choking, and they have become so normalized that people may not realize that specific consent needs to be sought.
Even if asked, how many women agree because they think they should, or because they think their partner will enjoy it, rather than them enjoying it. Is there any real consent at all?
Much of the porn available is made for the male gaze and focuses on men’s pleasure.
Anecdotally, I have seen that many heterosexual women prefer to watch women’s porn, perhaps because it focuses on the pleasure of the women involved.
PornHub has a category titled “popular with women,” which states that it “includes everything from story-driven, passionate softcore porn to hardcore gangbangs.”
2015 data from PornHub showed that female viewers search for “hardcore” or “rough” content 100 times more often than men, 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 centers in the brain, releasing feel-good chemicals like dopamine.
Over time, more and more explicit videos need to be watched to achieve the same effect, just as someone with a drug addiction needs higher and higher doses to get high.
This means that viewers may then struggle to become aroused and achieve orgasm with a real partner, who reacts differently to the image on a screen – after all, porn is not real life. But it can affect relationships in real life.
I have a patient who is so ashamed of her relationship with pornography that she feels like she can’t be in a relationship.
Other signs that you may have a porn addiction include watching increasing amounts of porn, neglecting other activities such as working, eating, or sleeping to watch porn, not being able to enjoy sex without porn, and feeling not being able to stop it, even though you are aware of the damage it causes.
We cannot know the true number of women suffering from porn addiction, due to stigma and cultural pressures they may simply not come forward or they may develop other mental health issues.
Porn addiction is a very real and likely increasing problem, which can impact mental health, leading to depression, anxiety and body image issues, as well as affecting relationships and even impacting work, perhaps as a result of concentration problems or mental health problems.
Simply replace the word porn in that sentence with “alcohol,” “drug,” or “sex” and it’s clear that it’s an addiction like any other.
Addiction needs treatment, and it’s often not as easy as simply stopping watching porn, which in itself isn’t easy.
The underlying reasons why the addiction developed may need to be addressed, such as anxiety, and it is incredibly difficult to avoid being exposed to explicit videos when they are easily accessible anywhere, anytime.
A 2019 US survey found that 11 percent of men and 3 percent of women reported porn addiction
In the same way that someone suffering from alcohol addiction might eliminate all sources of alcohol in their home, it can be helpful to get rid of hard copies of porn, delete saved tabs or website subscriptions, as well as installing anti-porn software on your devices (ask someone else for the password).
Talking therapies can be helpful, as can medication if there is an underlying mental health condition, for example. Psychosexual counseling can also be used to treat porn addiction, although access can be difficult and the wait can be long.
Society and the Internet have normalized the use of pornography. Now we need to normalize talking about the problems it can cause and encourage people to seek help so they can have a healthy sex life. After all, sex and orgasms are good for your health!
*Patient names have been changed.
