From the Guidelines
Masturbation and erectile dysfunction are not directly linked in most cases, and masturbation is a normal sexual activity that doesn't cause physical weakness or erectile dysfunction when done in moderation. According to the American Urological Association (AUA) guideline on erectile dysfunction 1, a comprehensive evaluation and targeted physical exam should be performed to assess the underlying cause of ED. The guideline recommends that men with ED should undergo a thorough medical, sexual, and psychosocial history, a physical examination, and selective laboratory testing.
Key factors to consider when evaluating ED include age, comorbid medical and psychological conditions, prior surgeries, medications, family history of vascular disease, and substance use 1. The presence of nocturnal and/or morning erections, as well as masturbatory erections, can provide valuable information about the underlying cause of ED. However, the AUA guideline does not suggest a direct link between masturbation and ED.
In fact, the guideline emphasizes the importance of addressing psychological factors, such as depression, anxiety, and relationship conflict, which can contribute to ED 1. Referral to a mental health professional may be necessary to promote treatment adherence, reduce performance anxiety, and integrate treatments into a sexual relationship.
Lifestyle modifications, such as smoking cessation, weight loss, and increasing physical activity, can also improve sexual function in men 1. Additionally, treatment of psychosocial problems, with referral to sex and couples therapy as appropriate, can often alleviate symptoms of male sexual dysfunction.
In summary, masturbation is not a direct cause of erectile dysfunction, and a comprehensive evaluation and targeted treatment approach are necessary to address the underlying cause of ED. Treatment options may include lifestyle changes, medication, counseling, or a combination of approaches, and should be guided by a healthcare provider.
From the Research
Relationship Between Masturbation and Erectile Dysfunction (ED)
- There is evidence to suggest a relationship between masturbation and ED, particularly in terms of cardiovascular risk factors 2.
- A study found that impaired masturbation-induced erections were associated with a higher risk of major adverse cardiovascular events (MACE) in men with sexual dysfunction 2.
- The study also found that subjects with impaired erection during masturbation had more often a positive personal or family history of cardiovascular disease, and a higher risk of reduced intercourse- and sleep-related erections 2.
- Another study highlighted the importance of considering psychological aspects of ED, including the valuation of sexual disturbances, in the management of erectile dysfunction 3.
- However, there is no direct evidence to suggest that masturbation causes ED, and the relationship between the two is likely to be complex and multifaceted 4, 5, 6.
Risk Factors for ED
- Common risk factors for ED include age, heart disease, diabetes, dyslipidemia, hypertension, and depression 4, 5, 6.
- Modifiable lifestyle factors, such as physical activity, smoking, alcohol consumption, and obesity, have also been associated with ED 5.
- Weight loss, increased exercise, and stopping smoking may help to improve or restore erectile function, particularly in men without established comorbidities 5.
Diagnosis and Treatment of ED
- Diagnosis of ED is based on medical and sexual history, including validated questionnaires, physical examination, and laboratory testing 4, 6.
- Treatment options for ED include phosphodiesterase type 5 inhibitors (PDE5-Is), intracavernous injections, intraurethral alprostadil, vacuum constriction devices, and implantation of a penile prosthesis 4, 6.
- Sexual therapy may also be an effective treatment for ED, particularly in cases where psychological factors are involved 3.