Third Clinical Report A year old junior Enlisted Sailor was admitted to the inpatient mental health unit after a suicide attempt by overdose. The hypothalamic nuclei that facilitate erections receive pro-erectile input from the mesolimbic dopamine pathway, which comprises the ventral tegmental area VTA and the nucleus accumbens NAc [ 62 ]. Erections are dependent upon activation of dopaminergic neurons in VTA and dopamine receptors in the NAc [ 65 , 66 ]. In another study, cocaine addicts had nearly identical brain activation patterns when viewing pornography and cues related to their addiction, but brain activation patterns when viewing nature scenes were completely different [ ]. The researchers noted that over time rates of sexual problems declined for females, but not for males [ 11 ]. Clinical Reports While correlation studies are easier to conduct, the difficulty in isolating the precise variables at work in the unprecedented rise of sexual dysfunction in men under 40 suggests that intervention studies in which subjects removed the variable of Internet pornography use would better establish whether there is a connection between its use and sexual difficulties. Incidentally, in a related paper on problematic low sexual desire involving many of the same survey participants from Portugal, Croatia and Norway, the men were asked which of numerous factors they believed contributed to their problematic lack of sexual interest.
The mean time typically spent watching sexually explicit material weekly was min for the CSB group and 29 min for the control group. Hypothalamic nuclei play an important role in regulating sexual behavior and erections by acting as an integration center for brain and peripheral input [ 62 ]. Thus, dopamine signaling in the reward system and hypothalamus plays a central role in sexual arousal, sexual motivation and penile erections [ 65 , 66 , 69 ]. In —, it was administered to 13, sexually active men in 29 countries [ 5 ]. Addiction studies have reported that cues explicitly paired with the absence of drug reward can have marked inhibitory effects on dopamine release [ 72 ]. However, as was the case with Internet pornography, with increased use, he needed longer and longer to ejaculate, and eventually he was unable to orgasm at all. He formerly masturbated every other week on average, but that increased to two to three times per week. In , Bronner and Ben-Zion reported that a compulsive Internet pornography user whose tastes had escalated to extreme hardcore pornography sought help for low sexual desire during partnered sex. For example, it provides no statistical results for the erectile function outcome measure in relation to Internet pornography use. A cross-sectional study of active duty, relatively healthy, male military personnel aged 21—40 employing the five-item IIEF-5 found an overall ED rate of At the conclusion of the visit, it was explained to him that use of a sex toy had potentially desensitized his penile nerves and watching hardcore Internet pornography had altered his threshold for sexual stimulation. A EEG study by Steele et al. He wanted to try to work on his behavior on his own. The first mentioned variables 1 , 6 and 7 , listed in the preceding paragraph. Current theory suggests glutamatergic synapses associated with seeking and obtaining a particular reward undergo modifications, which enhance the response of the mesolimbic dopamine system to that same reward [ , ]. The first paper contains useful insights about the potential role of sexual conditioning in youthful ED [ 50 ]. In fact, symptoms of Internet pornography addiction as assessed by the s-IATsex were the only significant predictor of ventral striatum response to preferred versus non-preferred pornographic pictures. ED is usually classified as either psychogenic or organic. Incidentally, in a related paper on problematic low sexual desire involving many of the same survey participants from Portugal, Croatia and Norway, the men were asked which of numerous factors they believed contributed to their problematic lack of sexual interest. The hypothalamic nuclei that facilitate erections receive pro-erectile input from the mesolimbic dopamine pathway, which comprises the ventral tegmental area VTA and the nucleus accumbens NAc [ 62 ]. The second mentioned 6 and 7. Consistent with a negative prediction error, Banca et al. In contrast, recent studies on ED and low sexual desire document a sharp increase in prevalence of such dysfunctions in men under Similar to our servicemen, the majority of Voon et al. Below we report on three active duty servicemen. While Voon et al [ 31 ] examined cue-induced activity in the dACC-ventral striatal-amygdala functional network, Seok and Sohn assessed activity in the dorsolateral prefrontal cortex DLPFC , caudate nucleus, inferior parietal lobe, dorsal anterior cingulate gyrus, and the thalamus.
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