A growing number of young, healthy Internet pornography users are complaining of delayed ejaculation, inability to be turned on by real partners, and sluggish erections.

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Is anxiety really the cause? Here's a simple test: Try to masturbate (alone) using no porn and no fantasy—only sensual touch. Use the same speed and pressure as you would during intercourse. How erect is your penis without porn? If your penis is not fully erect, or it takes effort to become erect, then the chances are that anxiety is not the source of your problems. Persistent performance problems can certainly lead to anxiety, however. As one man said after he recovered following three months without masturbation or porn,

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Erections start with dopamine and end with cGMP. Sexual enhancement drugs work by inhibiting the breakdown of cGMP, thus allowing it to accumulate in the penis. Yet if the patient's brain isn't producing enough signals in the first place, ED drugs will not increase libido or pleasure even if they (sometimes) produce an erection.