Women in Relationships and Their Pornography Use: A Systematic Review and Thematic Synthesis

Figures & data

Table 1. Search strategy for databases.

Search terms for: PsychINFO, Medline and ProQuest Dissertations and Theses Global
porn* OR “sexually explicit material*” OR “visual sexual stimul*”	AND	wom?n* OR female*	AND	pleasur* OR sex* OR desire* OR arousal OR satisf* OR orgasm* OR excite* OR motivat* OR function* OR impact*	AND	relationship* OR commit* OR exclusive* OR partner* OR husband* OR wi?e* OR spouse*
Search terms for Web of Science
porn* OR “sexually explicit material*” OR “visual sexual stimul*”	AND	wom?n OR female*	AND	pleasur* OR sex* OR desire* OR arousal OR satisf* OR orgasm* OR excite* OR motivat* OR function* OR impact*	AND	relationship* OR commit* OR exclusive* OR partner* OR husband* OR wife* OR wive*OR spouse*

Figure 1. PRISMA flowchart.

Table 2. Characteristics of included papers.

Authors, year & location	Aims	Women participants & sample sizes	Methods	Key findings
Ashton et al. (2019) Australia	To increase knowledge of how women themselves understand sexual pleasure in the context of pornography.	27 women who had sex with men aged 18–30; about half in intimate relationships.	In-depth interviews & thematic analysis supported by narrative theory – Bruner's narrative mode of thought	Pornography was constructed as interfering with pleasure through its misrepresentation (of bodies, sexual acts, and expression of pleasure), women’s concern for actors’ wellbeing, and its disruption of intimacy. Accounts were consistent with women’s place in a culture that subordinates female pleasure to male pleasure. Pornography plays complex, dynamic roles in the production of pleasure, acting in the domains of physiology, psychology, relationships, ethics, society, and culture.
Ashton et al. (2020) Australia	To investigate how young women themselves understand what pornography means for and in relationships.	27 women, aged 18–30, half in relationships	In-depth interviews, discursive analysis	Young women are perplexed by the interaction of pornography with relationships and attempt to make sense of what it means through discourses of intimacy, fidelity, and sexual freedom. Pornography mediates intimacy; men are the gatekeepers of intimacy; for intimacy, women need to objectify themselves to compete with pornography; religions equate pornography with infidelity; using pornography is relaxation and therefore not infidelity; men have an inherent right to sexual fulfillment; and sexual freedom is paramount.
Benjamin and Tlusten (2010) Israel	To better define how women make sense of the radical conceptualizations of pornography as reinforcing the hierarchical nature of heterosexuality, the relationship between consuming sexually explicit material and the stability of intimate relationships.	20 women aged 22–53, all in intimate relationships, length 1–33 years	Semi-structured interviews, analysis according to Giorgi’s (1985) four stages of phenomenological analysis	A process was identified in women who expect to have passionate and sexually active relationships. Three main dimensions of couples’ relationships emerged: (a) the individual space, (b) cooperation and (c) relationship work ethics. Embracing pornography and using it as a guiding resource for developing couples’ sexuality is characteristic of women for whom togetherness implies the need to nurture mutual passion.
Bridges (2007) Online survey, not specified but probably participants from USA as they had to access specific USA websites devoted to psychological studies	Three hypotheses were examined: negative interpretations of a partner's SEM use would be related to lower dyadic satisfaction; interactive SEM use would result in more negative partner interpretations of that use; and distressed couples would be less reliable reporters of each other's SEM use. The study also explored how feminist values, depression, and sexual functioning correlated with interpretations of a partner’s SEM use.	124 women aged 19–76, all in exclusive heterosexual relationships, average duration 9.16 years	Online survey. Reliability and validity analyses were conducted, and measurement model evaluated. Tools used: Dyadic Adjustment Scale or DAS-7, Index of Sexual Satisfaction or ISS, the Feminist Perspectives Scale or FPS, the Patient Health Questionnaire, a mix from Triangular Love Scale - Passionate Love Scale -Miller Social Scale	The first research hypothesis was partially supported: both direct and mediated effects were present. For women, her SEM use was directly and positively related to sexual and dyadic satisfaction, but the effects of her male partner’s SEM use were fully mediated by her interpretations of that use. Higher female partner use of SEM resulted in more positive interpretations of her use and more positive relationship outcomes. The second hypothesis was unsupported. There was no evidence that participants whose partners used interactive SEM were more distressed than participants whose partners used more conventional materials. The third hypothesis was unsupported. Couples exhibited high reliability in reporting one another’s use of SEM, but distressed couples were just as reliable reporters as well-functioning couples. Results from exploratory analyses revealed that sexual functioning and feminist values were not related to SEM use or distress over partner SEM use. In women, higher levels of depression were related to higher levels of distress over a partner’s SEM use.
Bridges and Morokoff (2011) Online survey, not specified but probably participants from USA as they had to access specific USA websites devoted to psychological studies	To assess how the sexual media use by one or both members of a romantic dyad related to relationship and sexual satisfaction.	217 heterosexual couples (mean age 34 years; couples were together for an average of 9.16 years	Online survey. Correlations of age, depression, and sexual functioning with relationship and sexual satisfaction by gender. Two structural models were analyzed. Structural equation modeling to test the associations between men’s and women’s sexual media use and men’s general dyadic satisfaction was. Tools used: Dyadic Adjustment Scale or DAS-7 and Index of Sexual Satisfaction.	A higher frequency of men’s sexual media use related to negative satisfaction in men, while a higher frequency of women’s sexual media use related to positive satisfaction in male partners. Reasons for sexual media use differed by gender: Men reported primarily using sexual media for masturbation, while women reported primarily using sexual media as part of lovemaking with their partners. Shared sexual media use was associated with higher relational satisfaction compared to solitary sexual media use.
Brown et al. (2017) USA	Three hypotheses were proposed for how pornography use, and acceptance relates to heterosexual couple relationships, particularly the level of sexual satisfaction.	335 heterosexual married couples (mean age 36 years)	Survey in person. Structural equation modeling within Mplus software. Tool used: the Relationship Evaluation Questionnaire (RELATE).	The shared variance of pornography acceptance was positively associated with both spouses’ pornography use and that spouses’ pornography use was negatively associated with their own sexual satisfaction. Wives’ pornography use was found to be positively associated with the couple’s shared variance of sexual satisfaction, but pornography use did not significantly mediate the relationship between pornography acceptance and sexual satisfaction.
Carroll et al. (2017) Online survey, not specified but probably participants from USA because they completed a specific questionnaire used in USA	Research questions: What are men and women’s pornography patterns (i.e., frequency of use, used together or alone patterns, acceptance, etc.) at different stages of relationship commitment? How aware are partners at different stages of relationship commitment of their partner’s pornography use (i.e., perception of use versus partner’s reported use)? Are there differences in men and women’s pornography use (i.e., frequency of use, used together or alone, etc.), pornography attitudes (i.e., acceptance, boundaries, etc.), and levels of pornography conflict at different stages of relationship commitment?	21,555 participants (mean age 31 years) who reported they were in a casually dating (n = 655), serious dating (n = 6,167), engaged (n = 8,720), or married (n = 6,013) heterosexual relationship. 53% of the sample was female.	Online survey. Frequencies, Multivariate analysis of covariance (MANCOVA). Tool used: the Relationship Evaluation Questionnaire (RELATE).	There is a notable “pornography gap” between many partners and for some opposite-sex couples there is significant conflict related to pornography. Many of the couples who experience congruence or a similar pattern of use between partners are those in which both abstain from using pornography.
Daspe et al. (2018) Online survey, locally advertised, probably participants from Canada	To explore whether low relationship quality and sexual dissatisfaction strengthen or weaken the association between frequency of Internet pornography use and perceived lack of control over this behavior.	565 women, aged 18–55	Online survey. Descriptive and correlational analyses were conducted using SPSS version 20. Regression analyses were conducted in Mplus, version 6.12. Tools used: a four-item version of the Dyadic Adjustment Scale and other Likert scale items created by the authors.	Frequency of pornography use was positively associated with perceived lack of control for both men and women. Frequency of pornography use was negatively associated with sexual satisfaction in men. Perceived lack of control was negatively correlated with relationship satisfaction and sexual satisfaction in men. Length of the relationship was negatively associated with frequency of pornography use in women and with relationship and sexual satisfaction in both men and women.
Dellner (2008) USA	To examine how pornography use is related to aspects of relationship functioning in committed relationships.	266 women, average age 28; all in a committed relationship 6 months or longer.	Online survey. G*Power was used to perform post-hoc analyses on statistical power for each of the main research hypotheses. One-way ANOVA, non-experimental correlational design, multiple regression for mediation analyses. Tools used: Relationship Assessment Scale, Crucible Differentiation Scale, Crucible Sexual Inventory.	Findings support the strength of the differentiation construct as the relationships between pornography use and relationship and sexual satisfaction disappeared after controlling for differentiation. Exploratory analyses on motivation revealed two factors—using pornography to "Cope” and using pornography to "Augment". The "Augment" motivation factor was found to have neutral or slightly positive relationships with study variables, whereas the "Cope" motivation factor was found to have strong negative relationships with differentiation, relationship satisfaction and sexual satisfaction.
Leonhardt and Willoughby (2019) Online survey, not specified but probably participants from USA	To evaluate how two components of sexual content (pornography use and provocative sexual media use) were associated with several components of sexual satisfaction (time spent on foreplay, variety, overall satisfaction, frequency, love and affection, and time spent on intercourse) for both men and women.	858 participants, 46.5% female, aged 18–77, in committed romantic relationships	Online survey, structural equation model, bivariate associations, multivariate analysis of variance (MANOVA). Tools used: Golombok-Rust Inventory of Sexual Satisfaction and other Likert scale items created by the authors.	Higher pornography use was significantly associated with lower satisfaction with sexual variety and time spent on intercourse for men, yet not associated with any sexual satisfaction outcomes for women. Greater use of provocative sexual media for men and women was significantly associated with lower satisfaction with the love and affection in the sexual relationship. Provocative sexual media use for women was also associated with lower satisfaction with sexual variety, overall sexual satisfaction, and time spent on intercourse.
McKeown et al. (2018) Canada	To explore the possibilities of women’s consumption enabled through digital technologies. Research questions explored: How do women use digital technologies to consume pornography online? In what ways do digital technologies enable women’s consumption of online pornography?	11 women aged 23–47	In-depth interviews, thematic analysis	Findings illustrate the ways women can use digital technologies to consume pornography online in ways that help them to fulfill their sexual needs, embrace and explore their sexual selves, connect in sexual relationships, and normalize their sexual desires.
Perry (2017) USA	To test whether more frequent pornography use influences marital quality later on and whether this effect is moderated by gender.	Number of participants not clearly stated but 45% were women, aged 18–80, married participants	Online survey. Descriptive statistics correlations, regression models. Dataset from Portraits of American Life Study (a national representative panel survey).	Married persons who more frequently viewed pornography in 2006 reported significantly lower levels of marital quality in 2012. Pornography’s effect was not simply a proxy for dissatisfaction with sex life or marital decision-making in 2006. Frequency of pornography use in 2006 was the second strongest predictor of marital quality in 2012. The negative effect of porn use on marital quality applied to husbands, but not wives. Wives who viewed pornography more frequently, reported higher marital quality than those who viewed it less frequently or not at all.
Perry (2020) USA	To establish a dominant pattern in the association between pornography use and relationship quality in a way that mitigated these issues.	Number of women participants not clearly stated, age 18–80, participants were married	Datasets from 30 nationally representative surveys (not stated whether online or in person), bivariate association, full regression models	Pornography use was either not associated or negatively associated with nearly all relationship outcomes. Significant associations were mostly small in magnitude. Except for one unclear exception, pornography use was never positively associated with relationship quality. Associations were only occasionally moderated by gender, but in inconsistent directions.
Perry and Davis (2017) USA	To examine whether Americans who use pornography, either at all or more frequently, are more prone to report experiencing a romantic breakup over time.	Number of participants not clearly stated but 53% were women, aged 19–80; 57% were married, 6% were cohabitating	Surveys online and in person, Longitudinal data, descriptive statistics, zero-order correlations, binary logistic regression analyses. Dataset from Portraits of American Life Study (a national representative panel survey).	Americans who viewed pornography at all in 2006 were nearly twice as likely as those who never viewed pornography to report experiencing a romantic breakup by 2012, even after controlling for relevant factors such as 2006 relationship status and other sociodemographic correlates. This association was considerably stronger for men than for women and for unmarried Americans than for married Americans. Analyses showed a linear relationship between how frequently Americans viewed pornography in 2006 and their odds of experiencing a breakup by 2012.
Perry and Schleifer (2018) USA	To examine the relationship between pornography use and marriage. It aimed to determine whether married Americans’ pornography use predicted their likelihood of divorce over time and under what social conditions.	2,120 married couples, aged 20–80	Survey in person, longitudinal data, logistic regression models, associations. Dataset from the GSS (a nationally representative face-to face survey of noninstitutionalized English or Spanish speaking American adults).	The probability of divorce roughly doubled for married Americans who began pornography use between survey waves and this relationship held for both women and men. Discontinuing pornography use between survey waves was associated with a lower probability of divorce, but only for women. The association between beginning pornography use and the probability of divorce was particularly strong among younger Americans, those who were less religious, and those who reported greater initial marital happiness.
Poulsen et al. (2013) USA	To explore how the use of pornography in a committed relationship is related to the sexual quality and relationship satisfaction reported by each partner.	617 married or cohabitating couples (17–58 years) at the time of the study	Survey in person, descriptive statistics, discriminant analysis, paired-sample t-test. Tool used: the Relationship Evaluation Questionnaire (RELATE).	Male pornography use was negatively associated with both male and female sexual quality, whereas female pornography use was positively associated with female sexual quality.
Resch and Alderson (2014) Canada	To investigate honesty regarding pornography use and mutual consumption between partners, along with honesty and mutual use as predictors of satisfaction.	340 heterosexual women (18–41 years), in committed relationships of at least 6 months	Online survey, one-way analysis of variance (ANOVA), simple linear regression. Tools used: Pornography Distress Scale and Couples Satisfaction Index.	Participants reporting more honesty showed higher satisfaction and lower levels of distress, and participants disclosing mutual use showed lower levels of distress, although no differences were reported in satisfaction. Honesty regarding pornography use significantly predicted relationship dissatisfaction.
Willoughby et al. (2016) USA	To examine how different patterns of pornography use between romantic partners may be associated with relationship outcomes.	1755 heterosexual couples; average age of women 27 years	Online survey. Cross-sectional, mediation analyses. Descriptive statistics, hierarchical regression models, structural equation models. Tool used: the Relationship Evaluation Questionnaire (RELATE).	Greater discrepancies between partners in pornography use were related to less relationship satisfaction, less stability, less positive communication, and more relational aggression. Mediation analyses suggested that greater pornography use discrepancies were primarily associated with elevated levels of male relational aggression, lower female sexual desire, and less positive communication for both partners which then predicted lower relational satisfaction and stability for both partners. Discrepancies in pornography use at the couple level were related to negative couple outcomes. Pornography differences may alter specific couple interaction processes which, in turn, may influence relationship satisfaction and stability.
Willoughby and Leonhardt (2020) USA	To explore actor and partner associations between pornography use, sexual dynamics, and relational well-being.	240 committed heterosexual couples, women aged 18–60	Online survey. Preliminary bivariate correlations. Tools used: Golombok-Rust Inventory of Sexual Satisfaction, parts from the Relationship Evaluation Questionnaire (RELATE) and other Likert scale items created by the authors	Female pornography use was associated with higher female sexual desire but no other dependent variables. Male pornography use was associated with a wide array of negative well-being indicators, including less male and female relationship satisfaction, lower female sexual desire, and lower male positive communication. Couple pornography use was associated with higher reported sexual satisfaction for both partners but no other well-being indicators. Partner knowledge of use had little direct association with well-being, but some evidence suggested that unknown individual use may be associated with less sexual satisfaction but more relationship satisfaction.

Table 3. Quality evaluation of included studies using the mixed methods appraisal tool by Hong, Q., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M.-C., & Vedel, I. (2018).

Studies	Qualitative studies					Quantitative non-randomized					Quantitative descriptive
	1.1	1.2	1.3	1.4	1.5	3.1	3.2	3.3	3.4	3.5	4.1	4.2	4.3	4.4	4.5
Ashton et al. (2019)	Y	Y	Y	Y	Y
Ashton et al. (2020)	Y	Y	Y	Y	Y
Benjamin and Tlusten (2010)	Y	Y	Y	Y	Y
Bridges (2007)											Y	Y	Y	C	Y
Bridges and Morokoff (2011)											Y	Y	Y	C	Y
Brown et al. (2017)											Y	Y	Y	Y	Y
Carroll et al. (2017)											Y	Y	Y	Y	Y
Daspe et al. (2018)											Y	Y	Y	C	Y
Dellner (2008)											Y	Y	Y	C	Y
Leonhardt and Willoughby (2019)											Y	Y	Y	C	Y
McKeown et al. (2018)	Y	Y	Y	Y	Y
Perry (2017)						Y	Y	Y	Y	Y
Perry (2020)											Y	Y	Y	C	Y
Perry and Davis (2017)						Y	Y	Y	Y	Y
Perry and Schleifer (2018)						Y	Y	Y	C	Y
Poulsen et al. (2013)											Y	Y	Y	C	Y
Resch and Alderson (2014)											Y	Y	Y	C	Y
Willoughby et al. (2016)											Y	Y	Y	C	Y
Willoughby and Leonhardt (2020)											Y	Y	Y	C	Y

Y = Yes; C = Can’t tell.

1.1. Is the qualitative approach appropriate to answer the research question?

1.2. Are the qualitative data collection methods adequate to address the research question?

1.3. Are the findings adequately derived from the data?

1.4. Is the interpretation of results sufficiently substantiated by data?

1.5. Is there coherence between qualitative data sources, collection, analysis and interpretation?

3.1. Are the participants representative of the target population?

3.2. Are measurements appropriate regarding both the outcome and intervention (or exposure)?

3.3. Are there complete outcome data?

3.4. Are the confounders accounted for in the design and analysis?

3.5. During the study period, is the intervention administered (or exposure occurred) as intended?

4.1. Is the sampling strategy relevant to address the research question?

4.2. Is the sample representative of the target population?

4.3. Are the measurements appropriate?

4.4. Is the risk of nonresponse bias low?

4.5. Is the statistical analysis appropriate to answer the research question?

Table 4. Sources of Themes .

Themes		Analytical themes				Sub themes
	Methodology	Porn use enhances – plays a positive role	Porn use disrupts – plays a negative role	Shared use	Reasons for porn use	Sexual satisfaction	Relations hip satisfaction	Sexual desire	Marital quality	Sexual quality	Porn use and separation	Porn disrupting pleasure in relationships	Intimacy	Pornogra phy acceptan ce/porn as infidelity	Lack of control	Unrealistic expectatio ns
Ashton et al. (2019)	Qualitative		+	+								+	+			+
Ashton et al. (2020)	Qualitative			+
Benjamin and Tlusten (2010)	Qualitati ve			+
Bridges (2007)	Quan titati ve	+	+		+	+	+	+					+
Bridges and Morokoff (2011)	Quantit ative	+	+		+	+	+
Brown et al. (2017)	Quan titati ve	+	+			+								+
Carroll et al. (2017)	Quantitative		+											+
Daspe et al. (2018)	Quantitative	+	+			+	+								+
Dellner (2008)	Quan titati ve	+	+			+	+
Leonhardt and Willoughby (2019)	Quantitativ e	+	+			+
McKeown et al. (2018)	Qualitative			+	+
Perry (2017)	Quan titati ve	+							+
Perry (2020)	Quan titati ve		+								+
Perry and Davis (2017)	Quantit ative		+								+
Perry and Schleifer (2018)	Quantit ative		+								+
Poulsen et al. (2013)	Quantitativ e	+					+			+
Resch and Alderson (2014)	Quantit ative	+					+
Willoughby et al. (2016)	Quantitative
Willoughby and Leonhardt (2020)	Quantitative	+				+		+

Ashton, S., McDonald, K., & Kirkman, M. (2019). Pornography and women's sexual pleasure: Accounts from young women in Australia. Feminism & Psychology, 29(3), 409–432. doi:https://doi.org/10.1177/0959353519833410

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Ashton, S., McDonald, K., & Kirkman, M. (2020). Pornography and sexual relationships: Discursive challenges for young women. Feminism & Psychology, 30 (4), 489-507,. doi:https://doi.org/10.1177/0959353520918164

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Benjamin, O., & Tlusten, D. (2010). Intimacy and/or degradation: Heterosexual images of togetherness and women's embracement of pornography. Sexualities, 13(5), 599–623. doi:https://doi.org/10.1177/1363460710376492

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Bridges, A. J., & Morokoff, P. J. (2011). Sexual media use and relational satisfaction in heterosexual couples. Personal Relationships, 18(4), 562–585. doi:https://doi.org/10.1111/j.1475-6811.2010.01328.x

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Brown, C., Carroll, J., Yorgason, J., Busby, D., Willoughby, B., & Larson, J. (2017). A common-fate analysis of pornography acceptance, use, and sexual satisfaction among heterosexual married couples. Archives of Sexual Behavior, 46(2), 575–584. doi:https://doi.org/10.1007/s10508-016-0732-4

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Daspe, M.-È., Vaillancourt-Morel, M.-P., Lussier, Y., Sabourin, S., & Ferron, A. (2018). When pornography use feels out of control: The moderation effect of relationship and sexual satisfaction. Journal of Sex & Marital Therapy, 44(4), 343–353. doi:https://doi.org/10.1080/0092623X.2017.1405301

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Leonhardt, N. D., & Willoughby, B. J. (2019). Pornography, provocative sexual media, and their differing associations with multiple aspects of sexual satisfaction. Journal of Social and Personal Relationships, 36(2), 618–641. doi:https://doi.org/10.1177/0265407517739162

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Perry, S. L., & Davis, J. T. (2017). Are pornography users more likely to experience a romantic breakup? Evidence from longitudinal data. Sexuality & Culture: An Interdisciplinary Quarterly, 21(4), 1157–1176. doi:https://doi.org/10.1007/s12119-017-9444-8

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Perry, S. L., & Schleifer, C. (2018). Till porn do us part? A longitudinal examination of pornography use and divorce. Journal of sex research, 55(3), 284–296. doi:https://doi.org/10.1080/00224499.2017.1317709

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Poulsen, F., Busby, D., & Galovan, A. (2013). Pornography use: Who uses it and how it is associated with couple outcomes. Journal of Sex Research, 50(1), 72–83. doi:https://doi.org/10.1080/00224499.2011.648027

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Resch, M. N., & Alderson, K. G. (2014). Female partners of men who use pornography: Are honesty and mutual use associated with relationship satisfaction? Journal of Sex & Marital Therapy, 40(5), 410–424. doi:https://doi.org/10.1080/0092623X.2012.751077

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Willoughby, B. J., Carroll, J. S., Busby, D. M., & Brown, C. C. (2016). Differences in pornography use among couples: Associations with satisfaction, stability, and relationship processes. Archives of Sexual Behavior, 45(1), 145–158. doi:https://doi.org/10.1007/s10508-015-0562-9

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Willoughby, B. J., & Leonhardt, N. D. (2020). Behind closed doors: Individual and joint pornography use among romantic couples. Journal of Sex Research, 57(1), 77–91. doi:https://doi.org/10.1080/00224499.2018.1541440

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Carroll, J. S., Busby, D. M., Willoughby, B. J., & Brown, C. C. (2017). The porn gap: Differences in men's and women's pornography patterns in couple relationships. Journal of Couple & Relationship Therapy, 16(2), 146–163. doi:https://doi.org/10.1080/15332691.2016.1238796

 Web of Science ®Google Scholar

McKeown, J., Parry, D. C., & Light, T. P. (2018). 'My iphone changed my life': How Digital technologies can enable women’s consumption of online sexually explicit materials. Sexuality & Culture, 22(2), 340–354. doi:https://doi.org/10.1007/s12119-017-9476-0

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