Masturbation

masturbation-imgMasturbation means the stimulation of the sex organs to obtain pleasure. Boys as well as girls indulge in it. Popular belief is that masturbation is common only during teenage and among the unmarried singles. But, is not true. Many people even after marriage do indulge in masturbation, at a less frequent rate than when they didn’t had a stable partner.

Perhaps no other act of sex has been associated with as many myths and misconceptions as masturbation. The act of masturbation creates an inferiority complex, a feeling of guilt and sin. Many religions condemn masturbation saying that it is a sinful act; perfect abstinence from any sort of sexual act, including masturbation before marriage is suggested by many religions. But for many individuals it is practically not possible to control the sexual desire and arousal, especially during puberty. Masturbation is proven to be medically perfectly normal act . Masturbation does not cause any damage to the nervous system.

Even small babies handle their own genitals. This is simply a part of the normal process by which they explore and learn about their own bodies. Although the sensation is pleasurable, it cannot be called sexual at this stage.

Masturbation may be regarded as a sort of imitation of real intercourse. The big and real difference is that it is entirely self-centred, while real love-making is very much a shared experience, a means of expressing mutual love and a giving as well as taking of pleasure and emotional satisfaction.

Masturbation can be considered as a useful method to relieve the sexual arousal when an individual is not in a committed relationship.It is always better and harmless to masturbate and relieve the sexual arousal than to indulge in high risk behavior of visiting a prostitute or having casual one night stand with a stranger. High risk behavior (especially without proper use of a condom) will lead to increased incidence of HV/ AIDS and other sexually transmitted diseases (Syphilis, Gonnorrhoea, Herpes etc)

Some Myths about Masturbation.

The following are some wrong opinions people have about masturbation:

  • Only the young, the immature and the unmarried practice masturbation
  • Only men practice it.
  • It leads to weakness, insanity, impotence, homosexuality and dark circles around the eyes.
  • Masturbation leads to acne on face.
  • People who masturbate are not sexually normal.
  • Frequent masturbation can lead to sexual inadequacy.
  • Regular masturbation will lead to shrinkage of the penis.
  • Every male is born with certain amount of semen and if you masturbate regularly, the quota gets exhausted and after marriage you will not able to father a child.

In spite all the education, many young adult men come to the sexual medicine specialists with many questions that they are embarrassed to ask or discuss elsewhere. These people often come with one or more of the following complaints:

  • Weakness following excessive masturbation
  • Loss of interest in sex following masturbation
  • Premature Ejaculation developed due to masturbation
  • Impotence/Erectile Dysfunction developed due to masturbation
  • Penis has become small due to masturbation
  • Testis have become smaller or disproportionate following masturbation
  • Afraid that one cannot father a child, due to loss of entire semen and sperms, attributing to masturbation.
  • Penis has developed a bent or curvature due to masturbation
  • Pain after masturbation

Just dismissing the patient by saying “Masturbation is not harmful, all your problems are just psychological….” would harm the patient. He will not be convinced. Moreover, weakness following masturbation may be an early warning signal of any other general metabolic disorder like diabetes. This needs to be ruled out through investigations.

Curvature of penis following excessive and aggressive masturbation might not always be physiological, it might be a case of ‘Fracture Penis’ or Peyronies Disease. (even though the chances are less)The sexual physician will ask for ‘what is the technique of masturbation’ to rule out the possibilities of any physical injury to the penile tissue. Based on the history and physical examination, if required, an injection test may be performed on the patient to rule out any fracture penis/ peyroines disease. These diseases, if present, would require immediate intervention, to prevent further damage.

Loss of interest in sex after masturbating for 5 years. This might be an indication of depression or decreased testosterone levels (secondary hypogonadism). Both these conditions require thorough evaluation and proper treatment.

Pain in the penis after masturbation requires further evaluation of prostatitis. It may also result from phymoisis or paraphymosis. All these are completely treatable causes.

A proper history taking (including the technique of masturbation), physical examination followed by investigations (if required) will give a proper insight regarding the patient’s concerns. Based on which, it can be decided what is the most appropriate way to help the patient. The treatment modalities may include one or more of the following:

  • Sex education and counseling to allay the fears and concerns,
  • simple anxiolytics to alleviate the anxiety disorder
  • Treatment of any other coexisting diseases (by concerned specialist doctor) like diabetes, hyperlipidemias etc.
  • Testosterone replacement therapy if secondary hypogonadism is found
  • Treatment of fracture penis/ peyroines disase, which had been developed due to physical/ mechanical injury to the penile tissue.