How to Talk to Your Doctor About Porn Addiction (Without Awkward Silence)

Most people never raise this with a doctor, and the reason is almost always the imagined reaction rather than anything that has actually happened.

Worth knowing before you go: they have heard it. Compulsive sexual behaviour disorder is in the World Health Organization's ICD-11, which means it is a recognised clinical category and not something you are inventing to describe yourself.

What a doctor can actually do

Useful to know, because expecting the wrong thing is how people leave disappointed.

They can:

• Refer you to therapy, which is the main treatment.
• Screen for depression and anxiety, which very often sit underneath this and are frequently the more treatable target.
• Review your medication, since several common drugs affect sexual function and mood.
• Investigate physical symptoms such as erectile difficulty, which needs assessment in its own right.
• Treat sleep problems, which drive more of this than most people realise.

They generally will not: prescribe a medication for porn use itself, because there is no established drug treatment for it. Medication may be offered for depression or anxiety if those are present.

A ten-minute appointment is also not therapy. The realistic outcome of the first visit is a referral, a blood test, or a follow-up booked. That is a good outcome.

Prepare four things

Doctors work far better with specifics, and you will not recall them accurately in the room.

1. How long, and how often. Roughly is fine. "Most days for about three years, and it has got worse in the last six months."
2. What it is affecting. Sleep, work, relationship, mood. This is what makes it a clinical matter rather than a private worry, so do not leave it out.
3. What you have already tried. Blocks, breaks, how long they lasted, what happened.
4. Any physical symptoms. Erectile difficulty, absent morning erections, low libido, poor sleep. Say these plainly, because they may need investigating for reasons unrelated to porn.

Write it on a card and hand it over if saying it aloud is hard. That is entirely acceptable and doctors are used to it.

How to open

The first sentence is the whole barrier. Any of these work:

"I want to talk about compulsive porn use. It is affecting my sleep and my relationship and I have not been able to stop on my own."

"I think I have a behavioural addiction and I do not know what help exists."

"This is embarrassing to bring up, so I have written it down."

Lead with the impact rather than the behaviour. "It is affecting my sleep and my work" moves an appointment forward faster than a description of the habit, because impact is what clinicians triage on.

Ask these questions

• "Can you refer me for therapy, and what is the wait?"
• "Could depression or anxiety be underneath this?"
• "Could any of my current medication be contributing?"
• "Should we check anything with a blood test?"
• "Can we book a follow-up so this does not stop here?"

That last one matters more than it looks. A booked follow-up is the difference between a conversation and a course of action.

On confidentiality

The usual worry. Medical confidentiality applies here as it does to anything else, and the exceptions are narrow and serious, principally a risk of harm to you or to someone else.

Raising compulsive porn use is not one of them. If you want to know exactly how it will be recorded in your notes, ask directly at the start. That is a reasonable question and asking it is not suspicious.

If it goes badly

Occasionally it does. A dismissive response, or being told to just stop.

That is a bad consultation, not a verdict on you or on whether help exists. See a different doctor at the same practice, or ask directly for a referral rather than for an opinion. You are allowed to do both.

You can also self-refer to talking therapies in many places without going through a GP at all. It is worth checking what is available where you live before assuming the door is closed.

Go sooner if

Do not wait for it to get worse if there is low mood lasting more than two weeks, any thoughts of harming yourself, erectile difficulty that has come on suddenly, or use that is putting your job or your safety at risk.

If you are having thoughts of suicide, get help now. In the US, call or text 988. In the UK and Ireland, call Samaritans on 116 123. Elsewhere, contact your local emergency number.

Going to a doctor and using a block are not alternatives; most people do both. See how a block you cannot bypass works, or check where you stand with the porn addiction test and take the result with you.