What are the risks and recommendations for masturbation in terms of sexually transmitted infections (STIs) and pregnancy?

Risks and Recommendations for Masturbation Regarding STIs and Pregnancy

Masturbation is generally a safe sexual activity with minimal risk for sexually transmitted infections (STIs) or pregnancy when performed alone, though certain precautions should be taken when sharing sex toys or engaging in mutual masturbation.

STI Risk Assessment

Solo Masturbation

• Solo masturbation (self-stimulation) carries virtually no risk of STI transmission or pregnancy when performed alone without sharing sex toys 1
• This makes it one of the safest sexual activities from an infection prevention perspective 1

Mutual Masturbation

• Mutual masturbation (with a partner) carries a lower risk of STI transmission compared to penetrative intercourse, but is not entirely risk-free 1
• Risk-reduction counseling should be provided for individuals participating in noncoital activities including mutual masturbation 1
• The U.S. Preventive Services Task Force recommends behavioral counseling for all sexually active individuals, including those engaging in noncoital sexual activities 1

Sex Toy Use

• When sex toys are shared between partners, there is potential for STI transmission 1
• All patients should be encouraged to use safe sex practices when sharing sex toys, including:
  • Using condoms on sex toys 1
  • Using gloves and dental dams as appropriate 1
  • Avoiding sharing sex paraphernalia without proper cleaning 1

Pregnancy Risk

• Solo masturbation poses no risk of pregnancy as there is no exchange of bodily fluids between partners 1
• Mutual masturbation that involves genital-to-genital contact without barrier protection could potentially lead to pregnancy if ejaculate comes into contact with the vagina 1
• Emergency contraception should be offered to females who think ejaculate has come into contact with their genitalia within 120 hours of the incident 1

Recommendations for Safe Masturbation Practices

For Solo Masturbation

• Maintain good hand hygiene before and after masturbation 1
• Clean sex toys thoroughly before and after use according to manufacturer recommendations 1
• Do not share personal sex toys without proper cleaning and barrier protection 1

For Mutual Masturbation

• Use barrier methods (condoms, gloves, dental dams) when sharing sex toys or touching a partner's genitals 1
• Avoid contact with a partner's bodily fluids if there are open cuts or sores on hands 1
• Consider getting tested for STIs with partners before engaging in any sexual activity, including mutual masturbation 1

For Adolescents

• The American Academy of Pediatrics recognizes that masturbation is part of normal sexual development 1
• Age-appropriate education about masturbation should be provided as part of comprehensive sexual health education 1, 2
• Adolescents should receive information about safe masturbation practices as part of STI prevention counseling 1

Common Pitfalls and Misconceptions

• Many individuals receive mixed or inadequate information about masturbation, often learning through media and peers rather than from healthcare providers or educators 2
• There is often a social stigma and taboo surrounding masturbation that can lead to guilt, shame, or anxiety 2
• Gender-based double standards exist regarding masturbation, with different social expectations for males and females 2
• Healthcare providers should address these misconceptions by providing accurate, non-judgmental information about masturbation as a normal sexual behavior 1, 2

Healthcare Provider Approach

• Use open-ended questions and non-judgmental language when discussing masturbation with patients 1
• Include questions about all sexual activities, including masturbation, when taking a sexual history 1
• Provide tailored risk-reduction counseling that includes information about masturbation as a lower-risk alternative to penetrative intercourse 1
• Apply principles of motivational interviewing when discussing sexual health practices 1