Is pornography really causing erectile dysfunction to young men—or is that oversimplified?

This large study analyzed 3,419 men aged 18-35 using detailed surveys on sexual health, porn use, and behavior to explore a growing concern: the link between online pornography use and erectile dysfunction (ED). Among those who were sexually active, about 1 in 5 (21%) reported some level of ED.

The key finding wasn’t just how often men watched porn—but how problematic the use became. Men with higher scores on a validated “problematic use” scale were significantly more likely to have ED. In fact, each increase in score raised ED risk by about 6%, even after adjusting for factors like libido, relationship status, and anxiety.

Interestingly, masturbation frequency had no meaningful link to ED. Instead, the strongest pattern appeared in men who reported needing more intense or extreme content to feel aroused, suggesting a possible “tolerance” effect.

In real-world terms, this points to a shift: it’s not porn itself, but escalating, compulsive patterns of use that may affect sexual response. Still, the study cannot prove cause-and-effect, and results rely on self-reported data.

The takeaway? For some young men, compulsive porn use can be associated with erectile dysfunction. Compulsive use is often seen when men begin to use pornography to avoid negative feelings or escape boredom rather than for pleasure. Also, people tend to have more negative experiences with pornography use when they have a moral incongruence - meaning they feel bad about using it. Porn itself is not inherently bad or dangerous in men using it for pleasure without it impacting relationships or daily life in a negative way.

Can simple pelvic exercises really improve both sexual function and bladder control?

This randomized controlled study followed women with overactive bladder (OAB) over 6 weeks, comparing a structured daily pelvic floor muscle training (PFMT) program to no treatment.

Women who performed PFMT showed significant improvements in sexual desire, arousal, orgasm, satisfaction, and pain. Even more surprisingly, their partners’ sexual satisfaction also increased notably.

At the same time, urinary symptoms dropped sharply, and pelvic muscle strength improved with large effect sizes across most outcomes. About 33% of women in the exercise group moved out of the “sexual dysfunction” range, compared to just 9% in the control group.

The most meaningful takeaway: a 6-week, progressive daily PFMT program (increasing contraction sets weekly) appears to deliver broad benefits—improving both bladder symptoms and sexual health without medication.

This suggests a low-risk, at-home intervention can meaningfully impact quality of life for both patients and partners. However, the short duration means we still don’t know if these benefits last long-term.

This week, someone asked me, “Is there a relationship between aging and the subjective intensity of orgasm. I am 65. It still feels nice, but sure isn't the fireworks it was when I was 20 (or 12!). Yes—what you’re noticing is very common and usually a normal part of aging. As we get older, testosterone levels, nerve sensitivity, and blood flow can gradually change, and that can make orgasm feel less intense than in our teens or 20s. Medications, stress, and overall health can also play a role. Pleasure doesn’t disappear; it often just feels different. Staying active, optimizing cardiovascular health, and addressing any medical issues can help preserve sexual function and enjoyment.

I love hearing from you, so if there’s a question you’ve been wanting to ask, just let me know. Who knows? Your question might be the one I dive into next!

This week I’ve been putting the finishing touches on my upcoming book, The Hard Truth. I really can’t wait for it to be out in the world for you to read! We’re working on finalizing a cover now, and it will be out September 1, 2026.

I wrote this book for each and every one of you - this is the book every man and woman who loves a man needs to have on their bookshelf. It covers everything you need to know to build and maintain your sexual health for life.

If you think you might be interested in making a bulk order for your company, association, or even friends/family, please let me know. Pre-orders really help authors like me get on important lists like the New York Times Bestseller and let publishers and bookstores know what to expect when the book goes to market.

In this video, I broke down the 8 foods you should rethink if you want a healthy prostate. It’s not about one “bad” food, but how your daily habits add up over time. "Not any one single food is going to give you prostate cancer. And cutting a single food out doesn't guarantee that you're protected from it. Again, we're talking about how your foods contribute to your overall metabolic environment."

Here are some quick takeaways:

Remember, every little step you take toward healthier eating helps protect your prostate!

I had an eye-opening conversation with Dr. Trisha Pasricha all about gut health, poop habits, and why what we do in the bathroom really matters! Dr. Pasricha dropped some wisdom bombs, like: “If you're spending more than five minutes in there, straining, struggling to have a bowel movement, that's abnormal to me.”

She explains why we should rethink our toilet habits:

Seriously, this episode made me rethink my bathroom routine! Listen in to learn the gut-health habits Dr. Pasricha recommends—and why she’s Team Bidet!

So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Very helpful! I also gained some valuable lessons on how to improve my own health and that of my family. Thank you very much!”.

Thinking about a vasectomy—but feeling unsure? Check out my new Substack: Demystifying the Vasectomy: A Urologist’s Real Talk on Men’s Health, Masculinity, and Contraception.

In this article, I break down what actually happens during a vasectomy, what it does (and doesn’t) change about your body and sex life, and why it’s one of the safest, most effective options for long-term birth control.