Pornography and problematic pornography use: occurrence, patterns, and associated factors in a national gender-based controlled cross-sectional study.

This article presents a nationwide, gender-based study conducted in Iran in 2021 that estimates the prevalence, patterns, and associated factors of pornography use (PU) and problematic pornography use (PPU) among married adults. The study found that 30.1% of participants reported PU in the past year (27.5% of women and 35.9% of men), with 3.9% classified as PPUs based on the Problematic Pornography Consumption Scale (PPCS-6). Key factors associated with PU included male gender, shorter marriage duration, earlier sexual debut, lower religiosity, masturbation, substance abuse, and depression, while PPU was linked to male gender, longer marriage duration, masturbation, sexual distress, and higher pornography consumption; having more children was protective. The study highlights cultural and religious influences on PU in Iran, notes that a significant portion of self-identified PPUs were infrequent users suggesting moral incongruence, and recommends objective measures alongside subjective assessments for accurate evaluation. Limitations include a high dropout rate, focus on married heterosexual individuals, and imbalanced gender participation, but strengths involve standardized tools and anonymous sampling in a conservative context.