Very good question, indeed. You can enlarge this to the entire spectrum of addictions, being it P, alcohol, eating disorders etc. While there is not a single factor influencing it, two things come to my mind: 1) A natural self confidence. I don‘t mean the kind of overly extrovert „here I come mentality“, but rather the confidence that comes from the fundamental acceptance of oneself, which will digress in some points from the social norms widely proclaimed or used. So you may not make it into the football team and are considered less cool, but you are confident in your abilities in other fields. Or you may not be 1.8m in height as a girl, but you are bright, have charisma and are fun to be with. Self confidence in the sense I mean it results in you being able to accept yourself and to go along with what you got at hand. 2) A social network you can turn to and the ability to use those close contacts in case of need. Being able to show the weakness to the close ones, accepting their comfort, eventually being able to draw strength from that network of friends or family. I see and accept your point on the effect P has on women and the false role model it is propagating, clearly out of reach for any woman. I don’t want to defend it, nor say it is okay. I took a more general view taking it as one of the many role models our society is still clinging to and we all too often use, too: the female model with the BMI of less than 16, the family father who has to provide for his family, the strong and hung hero being able to satisfy every woman, the spouse who has no difficulties to manage both her career and the four kids while looking like one of those women in the magazines at all times and, yes, the demure wife who is managing the family life who is able to act like a porn star at night with her husband. I did pile it on to make it blatantly obvious that we will never be able to meet those expectations. While some may say that today nobody is expected to be like that, ask yourself whether there is not a grain of truth in those believes. Let me know whether you believe I got it all wrong.