Can Masturbation Cause ED (Erectile Dysfunction)?

What is masturbation?

Betty Dodson, an American sex educator and a sexology icon, defined masturbation as “the primary sexual activity of humankind. It is self-stimulation of the genitals for the purpose of erotic pleasure or orgasm.” She also described it as, “the foundation of sexual health. It’s the natural practice that allows us to explore our bodies, learn what feels good, and better understand our desires and needs.”

Masturbation, also referred to as autoeroticism, is a common sexual behavior that people of all genders and ages engage in during their journey of exploring their sexual lives.

It is an act that has been conducted since before recorded history, experts even stated that they found depictions of male and female masturbation in prehistoric rock paintings dating back thousands of years.

Although, throughout history, masturbation was perceived as an unnatural, unhealthy or even mad habit, it was considered to be associated with mental diseases and beliefs such as homosexuality that were deemed demonic and unacceptable at the time.

This idea only began to evolve in the 20th century, when Alfred Kinsey, an American sexologist, presented his statistical findings showing that masturbation was rather frequent among the general population, and hence the public opinion about it gradually shifted in favor of it.

Physiology of penile erection:

Normal penile erection is a complex physiological process that involves the coordinated involvement of various pathways within the body. The main trigger is sexual stimulation which sets off a cascade of neurovascular responses regulated by psychological and hormonal factors.

Sexual stimulation of erogenous parts activates the bulbocavernosus reflex by initiating a nerve impulse that leads to the secretion of neurotransmitters, mainly nitric oxide (NO) along with others, from cavernous nerve terminals and endothelial cells in the penis.

The NO then results in the relaxation of smooth muscles within the penis and subsequent dilation of penile arteries that supply the erectile tissue, leading to a sharp increase in blood flow and engorgement of the penis.

What is erectile dysfunction (ED)?

ED is a common public health problem in men. It affects 1-10% of males under the age of 40, and its frequency rises with age.

Some people refer to it as sexual impotence as it is defined as the inability of an individual to attain or maintain a penile erection sufficient for efficacious sexual intercourse, which has a substantial negative impact on one’s sexual, emotional, and psychological well-being.

However, it could be a symptom of an underlying medical problem such as diabetes or cardiovascular diseases which is why people should consult a medical professional in order to properly identify and treat ED and its causes.

What are the causes of erectile dysfunction?

ED can arise due to a number of causes, including:

• Organic causes such as diabetes, hypertension, hyperlipidemia, metabolic syndrome, hypogonadism and lower urinary tract symptoms…
• Psychiatric disorders, mainly depression
• Traumatic causes that can affect the male genital area such as a penile fracture or attain the nervous system such as spinal cord injury.
• Local penile or cavernous issues including cavernous fibrosis after priapism or due to other reasons, and Peyronie’s disease…
• Iatrogenic causes (medications): some antihypertensives, antidepressants, antiandrogens, and major tranquilizers…
• Illicit drugs and recreational substances namely cocaine, marijuana, alcohol and nicotine…

Additionally, some common lifestyle factors can be linked to ED such as:

• Age (Sexual function progressively declines with age)
• Sedentary state or lack of physical activity
• Obesity

It is noteworthy to highlight that there are several risk factors for the occurrence of psychogenic ED, such as traumatic past experiences, a rigid upbringing, improper sex education, physical and mental health problems, and social issues.

How to prevent erectile dysfunction?

Some preventative measures need to be taken in order to minimize the risk of developing an ED, especially in men that are predisposed to this condition:

• Keeping a healthy lifestyle through frequent exercise, weight loss (for obese males), and maintaining a well-balanced diet.
• Avoiding or limiting the use of alcohol and tobacco, and abstaining from illicit drugs.
• Treating and controlling any pre-existing medical disorders that may contribute to ED, such as diabetes or hypertension (as well as other factors mentioned above in the ‘Causes of ED’ section)
• Using testosterone supplementation for people with hypogonadism but it is crucial to consult a doctor before taking any medications or supplementations.

Finally, is it true that masturbation can cause ED?

A lot of experts addressed this question over the years, and, while there have been concerns that excessive masturbation may lead to ED, research has proven that regular and moderate masturbation does not cause ED, but rather enhances sexual function.

Dr. Lawrence Sank, a psychologist, sex therapist, and author, on the other hand, had a different take on the matter. While investigating the association between masturbation and sexual dysfunction, he coined the term traumatic masturbation syndrome, or TMS, to describe the unusual habit that entails finding sexual pleasure over a period of years by repeatedly and aggressively stimulating the penis during masturbation. These people, according to him, are more likely to suffer from ED.

It is important to note that ​​this syndrome is not a medically recognized diagnosis and its occurrence remains controversial, with only anecdotal evidence suggesting its validity.

Moreover, Sank believes that these kinds of abnormal habits may be the consequence of the lack of male-orientated literature on sexual themes; in his perspective, the real issue is that men who have little or no sexual understanding or guidance are unable to masturbate properly and are therefore more likely to engage in aggressive sexual behaviors, which can lead to problems with ED and sexual health in general.

Aside from that, some believe that ED results from guilt and associated fear of failure arising from masturbatory practices. This may be the case for some individuals with certain religious or cultural backgrounds that are uncomfortable or anxious about engaging in sexual practices. Yet once more, there is no proof of the accuracy of this theory.

To conclude, proper masturbation doesn’t lead to erectile dysfunction. Although irregular/aggressive sexual actions or psychological disorders may cause it, this shouldn’t be used as a justification to forgo masturbation, but rather to encourage individuals to learn more about their sexual health and its good and harmful behaviors.