Search

We aimed to establish the prevalence of atypical masturbation in the general population and explore the association between atypical masturbation and male sexual dysfunction in heterosexual males. Atypical masturbation refers to stimulation significantly distinct from that encountered during partnered sexual activity. We posted questionnaires that contained the abridged International Index of Erectile Function (IIEF-6) and the premature ejaculation diagnostic tool on social media in China. We collected 2743 valid questionnaires from December 9, 2020, to April 18, 2021. We found that the prevalence of atypical masturbation in the general population was 10.97%. Men with atypical masturbation had lower IIEF-6 scores and higher rates of erectile dysfunction (ED) than men with typical masturbation. The prevalence of premature ejaculation and estimated intravaginal ejaculatory latency time were not significantly different among men with different patterns of masturbation. Our study demonstrated that atypical masturbation is associated with ED, and a clinician dealing with sexual issues should inquire more fully about masturbation patterns than has been done to date., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Although sexual life and its knowledge are still taboo in many cultures, especially for women, it can negatively affect women's sexual health., Aim: The aim of this study was to examine the relationship between the frequency and duration of masturbation and the sexual health literacy among young Muslim women of reproductive age between 18 and 25 years living in western Turkey., Methods: The cross-sectional descriptive study was conducted with 921 young women in western Turkey between March and December 2023. Participants were included in the study per the snowball method. The data consisted of attitudes, beliefs, and behaviors regarding masturbation, sexual life, and sexual health literacy. Data were obtained on an online platform and analyzed with SPSS (version 24; IBM). Difference, correlation, and regression analyses were performed. The significance level for statistical analyses was accepted as P < .05., Outcomes: The outcomes of the study are the attitudes, beliefs, and behaviors regarding masturbation, orgasm, sexual health literacy, and sexual function in women., Results: The participants were young Muslim women aged 21.00 ± 1.89 years (mean ± SD). The frequency of masturbation was 5.06 ± 2.03 times per month, and the duration was 3.47 ± 1.77 minutes per day. Masturbation frequency and duration were significantly associated with sexual health literacy and sexual function (P < .001). According to regression analysis, sexual function increased and sexual health literacy increased as masturbation frequency and duration increased (P < .001)., Clinical Implications: This study presents results on the current situation regarding the sexual health literacy and sexual lives in women from different geographies and cultures, and it serves as a source for future studies on areas that need to be improved., Strengths and Limitations: The limitation of the study is that it was conducted only with Muslim and Turkish women who use smartphones and are sexually active, so it cannot be generalized to all women. The strengths of the study are that it was conducted with a sample of 921 women, it was based on self-report and addressed many dimensions related to masturbation and female sexuality, and the results were reached through exploratory analysis., Conclusion: The study found that the higher the duration and frequency of masturbation in young women, the better their sexual function and higher their sexual literacy., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The relationship between factors related to masturbation, sexual function, and genital self-image among women has not been fully explored in the literature., Aim: The study sought to investigate the association between masturbation frequency, feelings, and behaviors with sexual function and genital self-image in young women., Methods: A cross-sectional survey among 110 undergraduate female students was conducted. Online self-administered questionnaires to assess sociodemographic characteristics, masturbatory frequency, feelings, and behavior were completed. Participants also answered the Brazilian version of the Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS)., Outcomes: The outcome includes masturbation frequency and behaviors associated, as well as scores on the FSFI and FGSIS., Results: Women showed higher scores in FSFI subdomains when masturbation was considered important for them, along with reported feelings of empowerment and satisfaction during this activity. However, those who experienced negative emotions during masturbation, such as shame or guilt, demonstrated a significant association with lower scores in both FSFI and FGSIS. Masturbation frequency was found to correlate with better sexual function specifically in the desire domain among women who engaged in daily masturbation. Additionally, an association was observed between higher scores in the FGSIS and increased scores in the domains of satisfaction, arousal, and orgasm within the FSFI. There was an association in the domain's satisfaction, arousal, and orgasm of the FSFI with greater scores in FGSIS., Clinical Implications: The clinical implications encompass the augmentation of understanding pertaining to female sexual function., Strengths and Limitations: The study provides valuable insights into the sexual behavior of undergraduate female students, and its methodology improves openness in responses, as it provides anonymity given the sensitive nature of the topic studied. Study limitations include the unsuitability of the FSFI questionnaire for sexually inactive women in the past 4 weeks; the participation bias and reporting bias in sexuality searches; and the unknown validity of the investigator-derived questionnaire about masturbation, as it has not been previously validated., Conclusion: Masturbation frequency has minimal to no impact on female sexual function, whereas harboring positive feelings toward it and maintaining a positive genital self-image may exert a positive influence on sexual function., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Solo masturbation is prevalent across adulthood. However, there are conflicting findings regarding how masturbation is associated with well-being. Understanding individuals' motives for masturbating might help disentangle these conflicting findings; yet, existing measures are suboptimal for assessing motives for solo masturbation. In this study, 2960 adults (18-84 years old, M age = 32.62, SD age = 11.36, 60.2% men, 36.8% women) who had engaged in solo masturbation within the past year responded to items, written based on existing literature, reflecting a wide range of motives for masturbating. Exploratory factor analysis revealed eight factors that warranted retention (Fantasy, Pleasure/Arousal, Compulsion, Improvement, Sexual Dissatisfaction, Coping, Efficiency, and Avoidance of Risky Sex), and this structure was confirmed using confirmatory factor analysis. Measurement invariance was established across men and women, and individuals in and not in a sexually active romantic relationship. The resultant measure comprises 24 items assessing eight distinct motives. Fit indices and scale reliabilities suggest this new measure of masturbation motives is psychometrically sound. Correlations with related constructs (e.g., sex drive, dissatisfaction with partnered sex, religiosity, depression, anxiety, and attitudes toward masturbation) provide preliminary evidence of validity. Suggestions for future investigations and further development of this new measure are discussed.

The current study investigated the correlates of post-coital dysphoria (PCD) in men and women. Moreover, the study explored the PCD prevalence in the sexual contexts of a relationship, casual sex, and masturbation. An online survey was completed by 156 participants, 51 males and 105 females. All participants were over 18 and have had sex in and out of relationships, as well as having engaged in masturbation. Results showed that PCD was prevalent in each of the three sexual contexts, for both males and females. Furthermore, some previously identified correlates were replicated and found to be statistically significant predictors of PCD. A previously unexplored variable that was also found to significantly predict PCD were negative attitudes toward masturbation. The current research established that PCD occurs in multiple sexual contexts - something previously unknown. Prevalence rates of PCD after sex within a relationship, casual sex, and masturbation, for males were 21.6, 49 and 72.5, respectively. For females, prevalence rates were 11.4, 77.1 and 51.4%, respectively. Additionally, it identified which factors predict the experience of PCD for each of the different sexual contexts for each gender. This has potentially huge implications in formulating a focus for the treatment of PCD, dependent upon the gender and sexual context it is experienced in.

Gender differences in appraisals of first intercourse are among the largest in sexuality research, with women indicating less satisfying "sexual debuts" than men. Dispositional or "actor-level" explanations for this gender gap are pervasive, yet research has largely examined heterosexual debuts in which actor gender and partner gender are confounded. We assessed whether women's less satisfying sexual debuts are better explained by actor gender or partner gender, comparing experiences of women who debuted with men (WDM) with those of men and women who debuted with women (MDW, WDW). Retrospective accounts of sexual debut were collected from 3033 adults. At first intercourse, we found that WDW had equal physical and emotional satisfaction to MDW, and more satisfaction than WDM, suggesting satisfaction gaps owing to partner gender, not actor gender. This pattern did not extend to a comparison event (first masturbation), where WDW and WDM had similar satisfaction, but less satisfaction than MDW, suggesting an actor gender gap. To identify sources of satisfaction gaps, we probed for corresponding differences in the circumstances of sexual debut. Sexual circumstances were more strongly implicated than nonsexual ones, with relative deprivation of glans stimulation explaining relative dissatisfaction at first intercourse, but not first masturbation, and orgasm explaining it at both. Findings challenge the view that the satisfaction gap at first intercourse reflects an inherent difference between genders. Indeed, they demonstrate similarities when partner gender does not differ and suggest strategies for ensuring equal sexual satisfaction-and equal sexual rights realization-at (hetero) sexual debut., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The subjective orgasm experience (SOE) is the psychological perception of orgasm sensations and closely related to sexual health. Here, SOE was studied through the context in which it is experienced (sexual relationships and solitary masturbation), gender, and sexual orientation. For this purpose, data were collected from 4255 people (1927 men and 2328 women) of different sexual orientations (heterosexual = 1545; bisexual = 1202; and gay = 1508) who completed two versions of the Orgasm Rating Scale (ORS) for both contexts (i.e., sexual relationships and solitary masturbation) along with a socio-demographic questionnaire. Results showed that the ORS in the context of solitary masturbation is an instrument invariant by gender and sexual orientation. Significant differences in SOE were found by context: it was more intense in the context of sexual relationships (vs. solitary masturbation); by gender: women (vs. men) reported greater intensity; and by sexual orientation, with heterosexual people (vs. gay and bisexual people) having a more intense experience., (© 2022. The Author(s).)

The relation of masturbation to orgasmic facility and orgasm satisfaction in the sexual relationships context was examined in elderly population. This cross-sectional study included 546 Spanish heterosexual adults aged 50-83 years. They completed a Socio-Demographic Questionnaire, and scales to assess negative attitude towards masturbation, solitary sexual desire, subjective orgasm experience in the solitary masturbation context and orgasmic facility and orgasm satisfaction in sexual relationships. Significant differences were observed on all the masturbation-related indicators between men and women. For men, a regression model was obtained in which age (β = 0.15), current masturbation frequency (β = 0.18) and negative attitude towards masturbation (β = 0.17) explained 8% of the difficulty in orgasmic facility, and another in which age (β = 0.14) and negative attitude towards masturbation (β = 0.13) explained 8% of orgasm satisfaction. For women, two regression models were obtained, in which the Affective dimension of the subjective orgasm experience in masturbation explained 11% of orgasmic facility (β = -0.22) and 15% of orgasm satisfaction (β = -0.33) in sexual relationships. Significant differences in the intensity of the subjective orgasmic masturbation experience were observed between elderly people with and without difficulties in orgasmic facility and orgasm satisfaction in sexual relationships., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Sexuality is a complex social and psychological phenomenon even more complicated in the setting of Assisted Reproductive Technology (ART)., Subjects and Methods: In total 192 participants entered the study (96 couples) in the process of ART. Participants filled up anonymous questionnaire while waiting routine procedure. At the time of questionnaire males and females were in separate rooms without knowledge about partners answers., Results: The frequency of sexual intercourse was not related to the sociodemographic variables in women but was related to education level and work status. More educated men who were employed had more frequent sexual intercourses. Moreover, the frequency of the sexual intercourse was not related to the duration of the relationship nor the infertility treatment. The correlational analyses showed that the frequency of sexual masturbation was not related to the sociodemographic variables, except for place of living. Both women and men from more urban areas reported to engage in masturbation more often. The frequency of specific sexual activities did not differ between reports by women and men for vaginal, oral, anal, and foreplay activities. However, men reported engaging in masturbation more often than women., Conclusion: The frequency of sexual activities is similar in women and men for vaginal, oral, anal, and foreplay activities. However, men reported engaging in masturbation more often than women. ART could only slightly affect quality of sexual life. Both partners should be informed.

Background: Spina bifida (SB) may differentially impact adults' participation in solo and partnered sexual behaviors, but little research investigates this topic., Aim: Describe solo and partnered sexual behaviors among an international sample of adult men and women with SB., Main Outcome Measures: Ever participated (no/yes) and recent participation (>1 year ago/within last year) in solo masturbation, cuddled with a partner, held hands with a partner, kissed a partner, touched a partner's genital, had genitals touched by a partner, gave a partner oral sex, received oral sex from a partner, vaginal sex, anal sex, and sex toy use., Methods: Data were drawn from a larger cross-sectional, internet-based survey assessing the sexual behaviors of an international sample of men and women with SB. We used logistic regression to examine the impact of background (gender, age, independent living, and relationship status) and health (shunt status, ambulation, and genital sensation) factors on each outcome., Results: The sample consisted of 345 respondents aged 18-73 years from 26 nations. Very few (<3%) had no lifetime experience with any solo or partnered behaviors; 25.0% reported participating in all behaviors at some point in their lives. The median number of past year sexual behaviors (of 16 total) was 7. Lifetime and recent participation were associated with demographic and health factors., Clinical Implications: Despite impairment, adults with spina bifida do participate in solo and partnered sexual behaviors. Medical personnel who work with this population should include discussions about sexuality as part of routine care., Strengths & Limitations: Although this research measured solo and partnered sexual behavior in large international sample of adults with spina bifida, it is limited by its cross-sectional retrospective design and non-clinical convenience sample., Conclusion: Despite disability, many adults with SB participate in solo and partnered sexual behavior. Medical and psychosocial supports are needed to help adults in this population enjoy sexuality in a healthy and safe manner. Hensel DJ, Misseri R, Wiener JS, et al. Solo and Partnered Sexual Behavior Among an International Sample of Adults With Spina Bifida. J Sex Med 2022;19:1766-1777., (Copyright © 2022 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Despite many benefits related to masturbation, we know surprisingly little about how solo sex is associated with sexual satisfaction. Using questionnaire data from a probability-based sample of 4,160 Norwegians aged 18-89 years, we explored subgroups of women and men that differed in their masturbation-sexual satisfaction typology and examined whether sociodemographic, psychological, and sexual behavioral characteristics were associated with distinct masturbation-satisfaction patterns. A cluster analysis revealed four similar groupings for women and men, reflecting sex lives characterized by high masturbation/sexual satisfaction, low masturbation/sexual satisfaction, high masturbation/sexual dissatisfaction, or low masturbation/sexual dissatisfaction. While being younger, higher pornography consumption, and sexual variety were primarily associated with increased masturbation frequency, sexual distress and a negative body and genital self-image were more clearly associated with sexual dissatisfaction. Predicting different masturbation-satisfaction groupings also revealed some gender-specific findings in the use of pornography, and in the association between masturbation and intercourse frequency, which suggested a complementary pattern for women and a compensatory pattern for men. Our findings emphasize that the linkage between masturbation and sexual satisfaction warrants closer focus., (© 2022. The Author(s).)

Background: Premature ejaculation (PE) is a highly prevalent male sexual dysfunction. Its current definition, together with the most used diagnostic tools, does not include nonvaginal sexual intercourse such as anal sex, self-masturbation and/or partnered-masturbation, and other forms of sexual stimulation. However, diagnostic psychometry currently available is exclusively evaluating PE in the vaginal coitus., Objectives: To validate a new tool, the masturbatory premature ejaculation diagnostic tool (MPEDT), by assessing the control over ejaculation and its psychological effects during self-masturbation, rather than heterosexual vaginal intercourse., Materials and Methods: We studied 135 male patients aging from 18 to 40 years seeking medical care for PE in the Infertility and Sexual Medicine Department from June to September 2020. All the participants were asked to fill the premature ejaculation diagnostic tool PEDT and MPEDT questionnaires to estimate the PE symptoms during, respectively, intercourse and self-masturbation. The reliability/validity, the factor analysis of the tool, and the diagnostic sensitivity/specificity of MPEDT were calculated., Results: The overall Cronbach alpha was 0.884. In our adjusted model, both root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) were lower than 0.08, while goodness of fit index, adjusted goodness of fit index, non-normed fit index (NNFI), and comparative fit index (CFI) were higher than 0.9. The area under the ROC curve (AUC) is 0.943 ± 0.015. The results suggest MPEDT points being ≤5 as "normal," ≥7 as "PE during self-masturbation," and 6 as "suspected PE," with the sensitivity of 91.9% and specificity of 88.1%., Discussion: An efficient diagnostic psychometric tool is needed for the individuals who, based on the impaired control over ejaculation during self-masturbation, may also suffer from PE during partnered intercourse. MPEDT is able to evaluate the existence of PE symptoms not necessarily during heterosexual intercourse but rather during self-masturbation, possibly aiding to the diagnosis, as well as planning and follow-up of a prompt therapeutical strategy., Conclusion: MPEDT could be considered a new, objective, and reliable diagnostic tool for the evaluation of the existence of PE symptoms., (© 2021 American Society of Andrology and European Academy of Andrology.)

This article argues that that there are two important reasons why many potential donors refrain from donating and why many donors value not being outed as a sperm donor. The first reason is the stigma attached to sperm donation. The second is the attribution of fatherhood to the donor. Attributional fatherhood is based on the rejection of the basic rule underlying the practice of sperm donation, i.e. the donor is not the father of the offspring. Attributional fatherhood ascribes the status of father exclusively on the basis of the genetic connection between the donor and the offspring. The violation of the 'responsible father' rule generates moral blame and may result in conflicts, disapproval and rejection. The presence of this view in different groups is demonstrated. Possible solutions for this issue are briefly presented. Given the geneticization of relationships in society in general, this phenomenon may increase in the future, thus putting pressure on the practice of sperm donation., (Copyright © 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Background and Objective: The subjective orgasm experience refers to the evaluation of sensations caused by orgasm from a psychological approach. The objective of this study was to examine the subjective orgasm experience in the context of solitary masturbation taking into account sex and age, as well as to compare this experience with perceived experience in the context of a sexual relations., Material and Methods: The sample was composed of 874 heterosexual adults from the general Spanish population (441 men [50.5%], 433 women [49.5%]). It was distributed into two age ranges: 18-34 and 50-93years. Participants completed a survey composed of a Background questionnaire and the Spanish version of the Orgasm Rating Scale., Results: It was shown that sex (p<.001) and age (p<.001) influence subjective orgasm experience in the context of solitary masturbation. Women and young people showed greater intensity. Furthermore, significant differences in the subjective orgasm experience between the context of solitary masturbation and the context of a sexual relations were found. It was estimated as more intense in a sex-with-partner context., Conclusions: The subjective orgasm experience in the context of solitary masturbation is different to the one experienced in the context of a sexual relationship, being more intense in women and in young people., (Copyright © 2019 Asociación Española de Andrología, Medicina Sexual y Reproductiva. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: The aim of the study is to evaluate how individual and couple's sexuality had changed during the COVID-19 pandemic-related quarantine., Methods: A quantitative correlational research study was conducted, using a web-based survey., Results: About 1576 participants were involved: 1018 women (64.6%) and 558 men (35.4%). A significant decline in the mean well-being scores during the quarantine, compared to before, was reported. A positive correlation between the well-being scores and the number of sexual intercourse (SI) before and during the quarantine was found. The mean number of SI decreased significantly during the quarantine. The main reasons were: poor privacy (43.2%) and lack of psychological stimuli (40.9%). About 1124 respondents (71.3%) did not report sexual desire (SD) reduction. A positive association between SD and SI during the quarantine was found. About 61.2% did not report autoerotism reduction. In those who reported decreased masturbation activity, the main causes were poor privacy (46.4%) and lack of desire (34.7%). We found that men presented lower SD during the quarantine, than women (P < 0.01)., Conclusion: Potentially, the more time available might lead couples to reconnect at an intimate level and to improve their sexuality. However, the majority of quarantined participants experienced reduced number of SI per week, with poor household privacy and lack of psychological stimuli as cited causes, even as a majority did not report reduced autoeroticism., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Coinciding with declining rates of marriage and coupled sex in the U.S., some scholars have proposed that the growing availability of "low-cost sexual gratification" or "cheap sex"-sexual activities such as hookups, pornography use, and masturbation that demand little effort or investment-will lead men to find marital commitment less appealing. Using data from two nationally representative surveys of American adults (2012 New Family Structures Study, N = 349; 2014 Relationships in America Survey, N = 1402), the current study tested the thesis that unmarried men's pornography use, masturbation habits, or frequency of recent hookup sex would be associated with a lower likelihood of them finding marriage desirable. This thesis was unsupported. In both surveys, masturbation and hookup sex were not associated with unmarried men wishing to be married, while pornography use was robustly and linearly associated with a higher likelihood of wanting to be married. This association was apparent at both the bivariate level and after taking into account sexual satisfaction, relationship status, beliefs about marriage, and a host of other potential confounds. Findings suggest that, rather than making marriage less desirable, some forms of "low-cost sexual gratification" such as pornography use to predict a comparatively higher desire for marriage. The implications of these findings are considered in light of sex-exchange theories of marital commitment and the large body of previous research connecting pornography use to more liberal, non-monogamous sexual attitudes.

Despite the lack of evidence for negative health effects of masturbation, abstinence from masturbation is frequently recommended as a strategy to improve one's sexual self-regulation. We adopted a framework of perceived problems with pornography to collect first hints about whether abstinence from masturbation stems from a psychological and behavioral "addiction" or conflicting attitudes. In an online questionnaire survey recruited via a non-thematic Reddit thread (n = 1063), most participants reported that they had tried to be abstinent from masturbation. As visible from zero-order correlations and multiple linear regression, motivation for abstinence was mostly associated with attitudinal correlates, specifically the perception of masturbation as unhealthy. While there were associations with hypersexuality, no significant correlation with behavioral markers such as maximum number of orgasms was found. Higher abstinence motivation was related to a higher perceived impact of masturbation, conservatism, and religiosity and to lower trust in science. We argue that research on abstinence from masturbation can enrich the understanding of whether and how average frequencies of healthy behavior are pathologized.

Introduction: Postcoital dysphoria (PCD) is a condition characterized by inexplicable feelings of tearfulness, sadness, and/or irritability. Previous research has mostly focused on these 3 symptoms, failing to explore other symptoms that can occur after sexual activity., Aim: The aim of the present study was to get a more in-depth understanding of postcoital symptom variety, to compare the type and frequency of these symptoms in men and women, and to explore the context in which they manifest., Methods: A convenience sample of 223 women and 76 men filled in an online survey consisting of a list of 21 symptoms and a set of additional questions., Main Outcome Measure: The study outcomes were obtained using a study-specific questionnaire to assess postcoital symptoms, consisting of a list of 21 symptoms that form 4 domains and 2 additional questions that assess personal and interpersonal distress., Results: Of all participants, 91.9% reported any postcoital symptom over the past 4 weeks and 94.3% ever since they had been sexually active. The most common symptoms in women were mood swings and sadness, whereas in men, it was unhappiness and low energy. Men and women differed in the frequency of postcoital symptoms experienced ever since being sexually active, with women reporting more sadness, mood swings, frustration, and worthlessness. For 73.5% of individuals, the postcoital symptoms were present after consensual sexual intercourse, for 41.9%, after general sexual activity, and for 46.6% also, after masturbation. Of all participants, 33.9% said that they only experienced the symptoms after orgasm., Clinical Implications: Postcoital symptoms are clearly more varied than previously suggested and are not related to classic "dysphoria" only. Hence, we propose to cease calling the phenomenon "postcoital dysphoria" and suggest to simply use the term "postcoital symptoms.", Strength & Limitations: This is the first study ever to provide a more in-depth exploration of postcoital symptom variety. The sample was relatively small, and the representativeness and, therefore, generalizability of the results was limited, given that a convenience sample was used., Conclusion: Our results indicate that postcoital symptoms are a multifaceted phenomenon which shows similar expression in men and women. The symptoms are clearly more varied not related to classic "dysphoria" only. Burri A, Hilpert P. Postcoital Symptoms in a Convenience Sample of Men and Women. J Sex Med 2020;17:556-559., (Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Masturbation, as a significant sexual activity within its own right, has garnered substantial interest as a research topic only within the past 10-20 years. In this in-depth analysis of masturbation in women, we examined relationships among frequencies of, reasons for, and activities during masturbation, and investigated how such parameters predict orgasmic pleasure, latency, and difficulty. Participants were 2215 women at least 18 years of age participating in a 42-item opt-in online survey that collected detailed information about women's orgasmic response during masturbation and partnered sex. Higher frequency of masturbation was related to lower satisfaction with partner, greater importance of sex, and higher levels of general anxiety/depression. Frequency of, reasons for, and activities during masturbation predicted both orgasmic pleasure and orgasmic difficulty during masturbation. The pattern of results enabled the development of three typologies of women who differ systematically with respect to their masturbation and partnered sex behaviors.

Numerous studies have observed a persistent and most often negative association between pornography use and romantic relationship quality. While various theories have been suggested to explain this association, studies have yet to empirically examine whether the observed link between pornography consumption and relationship outcomes has more to do with solo masturbation than actually watching pornography. The current study drew on two nationally representative data sets with nearly identical measures to test whether taking masturbation practice into account reduces or nullifies the association between pornography use and relational happiness. Controls are included for sex frequency and satisfaction, depressive symptoms, and other relevant correlates. Results from both the 2012 New Family Structures Study (NFSS; N = 1,977) and the 2014 Relationships in America survey (RIA; N g = 10,106) show that masturbation is negatively associated with relational happiness for men and women, while pornography use is either unassociated or becomes unassociated with relational happiness once masturbation is included. Indeed, evidence points to a slight positive association between pornography use and relational happiness once masturbation and gender differences are accounted for. Findings suggest that future studies on this topic should include measures of masturbation practice along with pornography use and that modifications to theories connecting pornography use to relationship outcomes should be considered.

This systematic review provides an overview of what qualitative research has revealed about partner-related factors around women's masturbation and explores how these factors relate to women's behavior, perceptions, and motives toward masturbation. Eleven studies were identified and secondary thematic analysis was used for synthesis. Women's perceptions often focus on the (potential) negative influences of masturbation on current or future relationships. Motivations some women reported for masturbating due to partner-related factors were diverse. Findings suggested that some women modify their masturbation behavior when in a relationship. The implications of these findings for sexual health educators and clinicians are discussed.

Background: Human masturbation is and has been a very heatedly and controversially discussed topic in human sexuality. Studies investigating aspects of human masturbatory behavior and female sexual pleasure remain scarce. This lack of knowledge opens the door to further controversies and misconceptions., Aim: To conduct an explorative study on female masturbatory behavior to gain more insight into this nonreproductive sexual behavior and provide an empiric basis for future research., Methods: A total of 425 German women (mean age 26.6 years), 61.4% of whom were in a committed relationship, completed a comprehensive 76-item online survey consisting of study-specific, self-constructed questions and validated and standardized questionnaires., Main Outcome Measure: Correlation and comparative analyses were performed. Results are presented numerically as means and percentages., Results: The majority (94.5%) of women indicated having masturbated at least once in their life, with a mean age at first masturbation of 14 years. 85.9% of women described masturbation as "genital self-stimulation until reaching orgasm." The majority of women reported masturbating 2 or 3 times a week (26.8%) or once a week (26.3%). Factors independently associated with masturbation frequency were relationship status, orgasm frequency, openness to new experience, and body acceptance. Almost all women (91.5%) reported masturbating also when in a relationship. For the 5.5% of women who had never engaged in autoerotic stimulation, the 2 main reasons were "I hardly every feel sexual desire" and "sex is a partner-only thing." 7.6% reported never experiencing an orgasm during masturbation, whereas 50.3% indicated that they always reached orgasm during autostimulation. The reasons cited for engaging in masturbation were manifold, ranging from sexual desire to relaxation and stress reduction. The most common fantasy included the partner; however, 20.7% fantasized about being "defenseless," and 8.7% thought about a "disturbing" scenario that they chose not to elaborate further., Clinical Implications: For many women, masturbation does not represent "a partner substitute" to seek sexual pleasure, but rather is a stress coping and relaxation strategy., Strengths & Limitations: This is one of the very first studies to provide more in-depth insight into a variety of aspects related to female masturbation. The representativeness of the data is limited to this particular sample of German women., Conclusion: Our findings highlight the huge diversity in terms of masturbation frequency, motivations, styles, and preferences that can be observed in this particular population sample of German women. Burri A, Carvalheira A. Masturbatory Behavior in a Population Sample of German Women. J Sex Med 2019;16:963-974., (Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: Specific sexual activities during partnered sex are likely to affect orgasmic parameters, such as latency, pleasure, and difficulty, but such relationships have not been examined in detail., Aim: To ascertain whether specific kinds of sexual activities account for variation in orgasmic latency, pleasure, and difficulty during partnered sex., Method: Participants were 2,068 women drawn from community-based samples in the United States and Hungary who completed an investigator-derived questionnaire regarding their sexual history and response, including items related to frequency of masturbation and partnered sex, sexual desire, sexual arousal, orgasmic response, orgasmic latency, distress, partner distress, and sexual satisfaction., Main Outcome Measures: Self-reported orgasmic latency, pleasure, and difficulty during partnered sex were assessed., Results: Orgasmic pleasure and orgasmic difficulty were related to the types of sexual activities incorporated into partnered sex. Nevertheless, relationship satisfaction played as large a role in both orgasmic parameters. Orgasmic latency, on the other hand, was less affected by the type of sexual activity during partnered sex, but it was also affected by relationship satisfaction and orgasmic difficulty., Clinical Implication: Addressing relationship satisfaction and expanding the behavioral repertoire of activities during partnered sex may increase sexual satisfaction and mitigate orgasmic difficulty., Strength & Limitations: The study, well powered and drawing from a multinational population, is 1 of the few to analyze specific types of sexual activity and stimulation during partnered sex. Major limitations were the younger age and self-selection of the sample., Conclusion: Type and conventionality of sexual activities during partnered sex affect orgasmic pleasure and difficulty. Rowland DL, Kolba TN. Relationship of Specific Sexual Activities to Orgasmic Latency, Pleasure, and Difficulty during Partnered Sex. J Sex Med 2019;16:559-568., (Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Little is known about sexual behaviour, attitudes, and associated factors among adolescents in Saudi Arabia. A cross-sectional study using a multistage sampling technique was conducted among 453 male adolescents selected from high schools in Riyadh, Saudi Arabia. About 54.1% of the adolescents practiced masturbation daily and 38% had experienced sexual contact, while 67% had friends who had experienced sexual contact. The majority of adolescents (72.2%) believed men engage in sexual experience before marriage, and only 11.5% discussed sexual health issues with their parents. Most adolescents believed in the effectiveness of sex education (92.3%) and the need for school-based sex education (85.6%). The logistic regression analyses showed adolescent sexual activity was independently associated with age [adjusted odds ratio (AOR) = 1.5, 95% confidence interval (CI): 1.3-1.8, p < 0.001), daily masturbation (AOR = 2.1, 95% CI: 1.3-3.2, p < 0.004), friends who engaged in sexual activity (AOR = 2.8, 95% CI: 1.4-4.6, p < 0.001), and belief that men experience sexual contact before marriage (AOR = 5.1, 95% CI: 2.8-9.3, p < 0.001). The findings indicated that male adolescents had negative attitudes toward sexual activity and were involved in risky sexual behaviour. To mitigate these issues, schools and community networks should be involved in the delivery of a culturally sensitive sexual health-promoting programme., Competing Interests: The author declares no conflict of interest., (© Atlantis Press International B.V.)

Objectives: To validate a psychometric instrument, the Masturbation Erection Index (MEI) able to evaluate erectile function (EF) during masturbation. In fact, although the evaluation of EF during masturbation is pivotal in evaluating erectile dysfunction (ED), to date no specific psychometric tools have been developed to measure it both in the routine clinical practice and in the experimental setting., Patients and Methods: Of 560 men attending our andrological outpatient clinic for the first time, 99 (17.7%) had ED. As a control group, we enrolled 102 sexually healthy men. All the men were requested to complete both the six-item version of the International Index of Erectile Function (IIEF-6) and the MEI. The MEI was used together with a standardised tool, the Erection Hardness Score (EHS). The MEI was validated in terms of content validity. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC). Internal consistency was evaluated by Cronbach's α. The comparability between the MEI and IIEF-6 in measuring EF was tested by Bland-Altman analysis. The concordance correlation coefficient (CCC) between the two questionnaires was also determined., Results: Internal consistency of the MEI was >0.93. Test-retest reliability was 0.982 (95% confidence interval [CI] 0.975-0.987). Bland-Altman analysis showed a good level of agreement between the IIEF-6 and MEI in the whole ED population, with stronger agreement in the organic-ED subpopulation. The estimated area under the curve of the MEI was 0.983 (P < 0.001; 95% CI 0.954-0.996), with a score of ≤27 as the optimal threshold to discriminate between the presence and absence of ED during self-induced masturbation. The CCC, Pearson ρ and bias correction factor (Cb) were 0.951 (95% CI 0.936-0.962), 0.968, and 0.982, respectively., Conclusion: The MEI showed good internal consistency and a good level of agreement with the IIEF-6. Hence, the MEI fulfills the major psychometric requirements for measuring EF during masturbation., (© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.)

Pleasure is critically important to the experience of sexual behavior, yet few studies have examined factors that influence it. We explored orgasmic pleasure during masturbation and partnered sex in women with and without orgasmic difficulty, as well as the mutual influence of each type of activity on the other. Data were collected from 2059 women through online surveys and paper-and-pencil tests in both the USA and Hungary. Among women who both masturbated and had partnered sex, orgasmic pleasure was higher during partnered sex. Although women with orgasmic difficulty exhibited a similar pattern of greater pleasure during partnered sex, they reported lower pleasure during partnered sex than women without orgasmic difficulty. Women struggling most to reach orgasm were likely to view masturbation as equally or more satisfying than partnered sex. Several covariates were relevant to pleasure during partnered sex, including the importance of sex, the frequency of partnered sex, and the relationship quality, affirming the idea that relational factors play a critical role in orgasmic pleasure in women. Pleasure during masturbation was associated with higher age, frequency of masturbation, and shorter latencies to orgasm, suggesting that pleasure during masturbation was related to greater experience with masturbation and greater efficiency in reaching orgasm.

Background and aims Compulsive sexual behaviors (CSBs) are an important clinical and social issue. Despite the increasing number of studies, some of CSB's aspects remain under-investigated. Here, we explore the nature of CSB, such as binge pornography use and masturbation (PuM), and verify the correspondence between self-perceived factors leading to such behavior with its measures obtained in a diary assessment. Methods Semi-structuralized interviews with nine treatment-seeking males aged 22-37 years (M = 31.7, SD = 4.85) were followed by a questionnaire and a 10-week-long diary assessment, allowing us to acquire real-life daily patterns of CSB. Results Six out of nine subjects experienced binge (multiple hours or times a day) PuM. All subjects presented a high level of anxiety and perceived PuM as a way to regulate mood and stress. Data collected in the diary assessment uncovered a high diversity in the patterns of sexual behaviors (such as frequency of regular and binge PuM) and its correlates. Binge PuM was related to decreased mood and/or increased stress or anxiety. The causal relation between these correlates remains undetermined. Discussion and conclusions Binge PuM seems to be one of the most characteristic behavior among males who are seeking treatment for CSB and is related to the feeling of losing control over one's sexual activity. CSB individuals indicate a variety of binge triggers. Also, diary assessment data indicate that specific correlates of binge PuM (decreased mood, increased stress, and anxiety) differ between subjects. It suggests the existence of significant individual differences in binge PuM behaviors, and a need to study these differences, as it may help guide personalized treatment.

This paper investigates how masturbation, as one form of non-coital sexual practice, is interpreted and experienced by young married women in contemporary Vietnam. Data were collected through semi-structured interviews with 20 professional women aged 25-40 living in Hanoi. Thematic analysis suggests that by embracing the pursuit of pleasure and aspiring to achieve this goal, many women stake a claim for modernity by promoting the idea that they are no longer traditional in this particular domain of social life. However, wider social forces associated with traditional Vietnamese gender ideology and sexual values remain firmly rooted, impacting on their everyday lives as working wives and mothers, and stalling their pursuit of pleasure and thus 'wellbeing' in its fullest sense. Indeed, among participants in this study, sex was interpreted as being almost exclusively organised around penile-vaginal intercourse. Even when sex was conceptualised as involving more than penetration, penile-vaginal intercourse was still viewed as its most essential component, without which a sexual transaction could not be seen as complete. The normality of penetrative sex was sometimes coupled with the stigma and discrimination associated with other non-coital sexual practices, positioning women firmly within conventional discourses of naturalness and health in regard to sex.

Most women report reliably experiencing orgasm from masturbation, but a smaller proportion of women report regularly experiencing orgasm from intercourse. Research suggests that concurrent clitoral stimulation during intercourse increases the likelihood of orgasm, yet most surveys of orgasm during intercourse leave unspecified whether vaginal intercourse does or does not include concurrent clitoral stimulation (assisted intercourse or unassisted intercourse, respectively). Using an online sample of 1569 men and 1478 women, we tested whether phrasing of questions about the occurrence of orgasm in intercourse modulates women's reported frequency and men's estimates of women's frequency of orgasm in intercourse. Participants provided estimates of orgasm when asked explicitly about intercourse with stimulation unspecified, assisted intercourse, and unassisted intercourse. Women's reports of orgasm occurrence were highest in response to assisted intercourse (51-60%), second highest in response to intercourse with clitoral stimulation unspecified (31-40%), and lowest in response to unassisted intercourse (21-30%). Men's estimates of women's orgasms were highest in response to assisted intercourse (61-70%), and lowest in response to unassisted intercourse (41-50%); in both conditions, men's estimates were significantly higher than women's reports. When clitoral stimulation was unspecified, women interpreted "orgasm in intercourse" in three ways: as from intercourse alone, as including concurrent clitoral stimulation though it was unspecified, or as an average of assisted and unassisted intercourse. Taken together, these results demonstrate that the phrasing of questions about women's orgasm produces markedly different orgasm estimates, and suggest that concurrent clitoral stimulation increases the likelihood of women experiencing orgasm in intercourse.

Background: In spite of a growing interest in research on hypersexuality, consensus about its etiology and best treatment strategy has not been achieved., Aim: To further the empirical and clinical understanding of hypersexuality by exploring the structure of its symptoms using a network analytic approach., Methods: In 2014, an online survey advertised as focusing on Internet pornography, sexual health, and relationships was carried out among Croatian men and women aged 18-60 years (M age  = 31.1 years, SD = 9.67). In a sample of 3,028 participants, we applied a network analytic approach to explore the structure of hypersexuality symptoms. In the network, nodes represented hypersexuality symptoms and associated sexual behaviors, while their connections were operationalized as partial correlations. 4 Research questions were addressed: (1) does the hypersexuality network differ between genders; (2) which symptoms are centrally positioned; (3) what is the topological location of pornography use; and (4) are there distinct clusters ("communities") of symptoms in the network?, Outcomes: We estimated and plotted hypersexuality networks by gender using items from the Hypersexual Disorder Screening Inventory and the Hypersexual Behavioral Consequences Scale, as well as indicators of sexual desire, pornography use, sexual intercourse, and masturbation frequency., Results: The structure of the hypersexuality network was surprisingly similar in women and men, both in terms of symptom centrality and the clustering of symptoms. Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors, together with a loss of control over sexual feelings, occupied central positions in the networks. Pornography use was located peripherally in both the men's and women's hypersexuality networks., Clinical Translation: Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors constituted the core of the hypersexuality network, which makes them potential prime targets for clinical intervention and calls for normalization of (presumably self-stigmatized) sexual expression through affirmative therapy and interventions that enhance self-care, self-compassion, and adaptive coping mechanisms., Strengths & Limitations: This is the first network analytic approach to hypersexuality. Apart from its novel insights about the structure of hypersexuality, the study employed several methods to assure reliability and robustness of findings. Considering that networks were estimated in a convenience-based community sample, the findings might not generalize to clinically distressed individuals., Conclusion: Our results demonstrate the usefulness of network analytics to hypersexuality in a non-clinical sample and we encourage future clinical and longitudinal explorations of hypersexuality using this novel approach. Werner M, Štulhofer A, Waldorp L, et al. A Network Approach to Hypersexuality: Insights and Clinical Implications. J Sex Med 2018;15:373-386., (Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

The current study examined the relationship between traditional masculine traits and attitudes toward vibrator use, actual vibrator use, and frequency of vibrator use in China. In all, 235 Chinese females aged between 16 and 58 years completed a questionnaire regarding attitudes toward, and personal use of, vibrators. The results showed a positive association between masculine traits and attitudes toward women's vibrator use, attitudes toward vibrator use and actual vibrator use, as well as frequency of vibrator use. The findings revealed an indirect path in which masculinity influences actual and frequency of vibrator use through attitudes toward women's vibrator use. Limitations and implications of the study are discussed.

Masturbation is the stimulation of sexual organs usually to the point of orgasm with an essential autoerotic component. Due to the high prevalence of this sexual behavior, it was and still is a matter of debate if masturbation is a normal action without any side effects and even if it is advantageous or it is associated with side effects necessitating public education how to avoid it. In addition, it is a common question if masturbation is religiously lawful or not. In this study, I assess the results of scientific studies about this sexual behavior and also shed some light on the Islam's view about it.

Drawing upon a large, recent probability sample of American adults ages 18-60 (7648 men and 8090 women), we explored the association between sexual frequency and masturbation, evaluating the evidence for whether masturbation compensates for unavailable sex, complements (or augments) existing paired sexual activity, or bears little association with it. We found evidence supporting a compensatory relationship between masturbation and sexual frequency for men, and a complementary one among women, but each association was both modest and contingent on how content participants were with their self-reported frequency of sex. Among men and women, both partnered status and their sexual contentment were more obvious predictors of masturbation than was recent frequency of sex. We conclude that both hypotheses as commonly evaluated suffer from failing to account for the pivotal role of subjective sexual contentment in predicting masturbation.

The present paper addresses the psychological impact of body modifications (e.g. tattoos, body piercing and esthetic genital plastic surgery) on the sexual health of individuals and refers to past and present research insights. Body modifications are understood as invasive interventions on the human body, especially interventions on the human skin which result in (semi-)permanent changes. Tattoos and body piercing (in particular genital piercing) positively affect the sexual satisfaction and the sexual appeal of men and women but there is a controversial association with high risk sexual behavior. Moreover, this article focuses on esthetic genital plastic surgery based on the increasing interest and insights of the impact on female genital self-perception and sexual behavior.

This study examines behaviors associated with sex frequency and sexual satisfaction in a national sample of partnered older adults, age 50 to 85 (N = 9,164), together for over one year. The results indicate that older adults with active and satisfying sex lives engage more frequently in open sexual communication and setting the mood for sexual activity. Additionally, synchronicity in sexual desire and activities is related to a high-frequency and highly satisfying sex life in older adulthood. An expansive sexual repertoire, as measured by the number of sexual activities used during the last sexual encounter and the incorporation of sexual variety, is also associated with greater sex frequency and sexual satisfaction.

Human asexuality is generally defined as a lack of sexual attraction. We used online questionnaires to investigate reasons for masturbation, and explored and compared the contents of sexual fantasies of asexual individuals (identified using the Asexual Identification Scale) with those of sexual individuals. A total of 351 asexual participants (292 women, 59 men) and 388 sexual participants (221 women, 167 men) participated. Asexual women were significantly less likely to masturbate than sexual women, sexual men, and asexual men. Asexual women were less likely to report masturbating for sexual pleasure or fun than their sexual counterparts, and asexual men were less likely to report masturbating for sexual pleasure than sexual men. Both asexual women and men were significantly more likely than sexual women and men to report that they had never had a sexual fantasy. Of those who have had a sexual fantasy, asexual women and men were significantly more likely to endorse the response "my fantasies do not involve other people" compared to sexual participants, and consistently scored each sexual fantasy on a questionnaire as being less sexually exciting than did sexual participants. When using an open-ended format, asexual participants were more likely to report having fantasies about sexual activities that did not involve themselves, and were less likely to fantasize about topics such as group sex, public sex, and having an affair. Interestingly, there was a large amount of overlap between sexual fantasies of asexual and sexual participants. Notably, both asexual and sexual participants (both men and women) were equally likely to fantasize about topics such as fetishes and BDSM.

Solitary and partnered sexuality are typically depicted as fundamentally similar, but empirical evidence suggests they differ in important ways. We investigated how women's definitions of sexual pleasure overlapped and diverged when considering solitary versus partnered sexuality. Based on an interdisciplinary literature, we explored whether solitary pleasure would be characterized by eroticism (e.g., genital pleasure, orgasm) and partnered pleasure by nurturance (e.g., closeness). Via focus groups with a sexually diverse sample of women aged 18-64 (N = 73), we found that women defined solitary and partnered pleasure in both convergent and divergent ways that supported expectations. Autonomy was central to definitions of solitary pleasure, whereas trust, giving pleasure, and closeness were important elements of partnered pleasure. Both solitary and partnered pleasure involved exploration for self-discovery or for growing a partnered relationship. Definitions of pleasure were largely similar across age and sexual identity; however, relative to queer women, heterosexual women (especially younger heterosexual women) expressed greater ambivalence toward solitary masturbation and partnered orgasm. Results have implications for women's sexual well-being across multiple sexual identities and ages, and for understanding solitary and partnered sexuality as overlapping but distinct constructs.

Rind and Welter (2014) examined first postpubertal coitus using the Kinsey sample, finding that reactions were just as positive, and no more negative, among minors with adults compared to minors with peers and adults with adults. In the present study, we examined first postpubertal male same-sex sexual experiences in the Kinsey same-sex sample (i.e., participants mostly with extensive postpubertal same-sex behavior), comparing reactions across the same age categories. These data were collected between 1938 and 1961 (M year: 1946). Minors under age 18 years with adults (M ages: 14.0 and 30.5, respectively) reacted positively (i.e., enjoyed the experience "much") often (70 %) and emotionally negatively (e.g., fear, disgust, shame, regret) infrequently (16 %). These rates were the same as adults with adults (M ages: 21.2 and 25.9, respectively): 68 and 16 %, respectively. Minors with peers (M ages: 13.3 and 13.8, respectively) reacted positively significantly more often (82 %) and negatively nominally less often (9 %). Minors with adults reacted positively to intercourse (oral, anal) just as often (69 %) as to outercourse (body contact, masturbation, femoral) (72 %) and reacted emotionally negatively significantly less often (9 vs. 25 %, respectively). For younger minors (≤14) with adults aged 5-19 years older, reactions were just as positive (83 %) as for minors with peers within 1 year of age (84 %) and no more emotionally negative (11 vs. 7 %, respectively). Results are discussed in relation to findings regarding first coitus in the Kinsey sample and to the cultural context particular to Kinsey's time.

Male attitude about masturbation may influence early diagnosis and treatment of infertility and may be of particular burden in developing countries. We sought to explore attitude about masturbating and examine comfort/discomfort with masturbating and sexual history, pregnancy history and sperm quality in men investigating fertility potential. The study consisted of 83 male volunteers, 23-61 years, attending a fertility management unit in Kingston, Jamaica. Comfort with masturbation was assessed by a self-administered questionnaire. Participants also completed the unit's standard intake form for infertility investigations and produced a semen sample. T-tests, Mann-Whitney U-test and chi-square were used to compare differences in comfort level with outcome variables. We found 59% were comfortable masturbating although requiring external stimulation to produce a sample (48%); 6% (n = 5) failed to produce a sample after repeated attempts. A higher percentage of men uncomfortable with masturbating reported sexual problems (P < 0.05) and spending a longer time trying to have a baby (P < 0.05). Semen quality was not associated with masturbating comfort. Producing a sample by masturbation is standard for many assisted conception treatments. As comfort with masturbating may influence delay in infertility investigations and fertility outcome, efforts to improve men's comfort level with semen production should be considered in pre-treatment fertility counselling., (© 2015 Blackwell Verlag GmbH.)

Aims and Objectives: To explore staff attitudes and reactions towards masturbation in long-term care facilities., Background: Staff attitudes and reactions towards the expression of sexuality in long-term care facilities may be influenced by the nature of the sexual behaviour being expressed. Staff attitudes towards masturbation, a common sexual behaviour in such settings, have gone largely unexplored so far., Design: An exploratory, descriptive, qualitative research design., Methods: Fifty-three staff members working in five different long-term care facilities participated in the study. They were asked about what they would think, how they would react, and what possible reactions they might expect from workmates if they entered a room and found a resident masturbating., Results: The majority of participants considered that masturbation was acceptable and avoiding interference was by far the most common reaction, although other reactions also arose. When asked about reactions attributed to workmates, mentions to reprimanding the resident and gossiping/joking about the issue were more frequent than acceptance., Conclusions: The discrepancy between professionals' own reported attitudes and those attributed to workmates suggests the existence of widespread negative reactions towards sexual activity in later life., Relevance to Clinical Practice: In the light of these results, we underline the necessity of developing explicit policies regarding sexual issues. Formal training offered to staff would also help to recognise and preserve resident's sexual rights and needs., (© 2016 John Wiley & Sons Ltd.)

This paper explores a subjective experience-and identification-that a cohort of Indian women identifies as "home." This experience of "home" provides an attachment to a collective melancholia that keeps in place a prohibited female sexual subjectivity. The paper provides a brief historical overview of the prohibition of female sexual subjectivity and erotic agency in India. Following this, it discusses women's masturbation fantasies that illustrate the toggle between women's permitted and prohibited identifications. A clinical case example is presented to illustrate the hopelessness and mourning inherent in the psychoanalytic journey into subjectivity, a journey involving a departure from a shared cultural history.

Introduction: Research indicated that (i) vaginal orgasm consistency is associated with indices of psychological, intimate relationship, and physiological functioning, and (ii) masturbation is adversely associated with some such measures., Aim: The aim of this study was to examine the association of various dyadic and masturbation behavior frequencies and percentage of female orgasms during these activities with: (i) measures of dyadic adjustment; (ii) sexual satisfaction; and (iii) compatibility perceived by both partners., Methods: In a sample of 85 Czech long-term couples (aged 20-40; mean relationship length 5.4 years), both partners provided details of recent sexual behaviors and completed sexual satisfaction, Spanier dyadic adjustment, and Hurlbert sexual compatibility measures. Multiple regression analyses were used., Main Outcome Measure: The association of sexual behaviors with dyadic adjustment, sexual compatibility, and satisfaction was analyzed., Results: In multivariate analyses, women's dyadic adjustment is independently predicted by greater vaginal orgasm consistency and lower frequency of women's masturbation. For both sexes, sexual compatibility was independently predicted by higher frequency of penile-vaginal intercourse and greater vaginal orgasm consistency. Women's sexual satisfaction score was significantly predicted by greater vaginal orgasm consistency, frequency of partner genital stimulation, and negatively with masturbation. Men's sexual satisfaction score was significantly predicted by greater intercourse frequency and any vaginal orgasm of their female partners. Concordance of partner vaginal orgasm consistency estimates was associated with greater dyadic adjustment., Conclusions: The findings suggest that specifically penile-vaginal intercourse frequency and vaginal orgasm consistency are associated with indices of greater intimate relationship adjustment, satisfaction, and compatibility of both partners, and that women's masturbation is independently inversely associated with measures of dyadic and personal function. Results are discussed in light of previous research and an evolutionary theory of vaginal orgasm., (© 2014 International Society for Sexual Medicine.)

The relation between masturbation and sexual desire has not been systematically studied. The present study assessed the association between masturbation and pornography use and the predictors and correlates of frequent masturbation (several times a week or more often) among coupled heterosexual men who reported decreased sexual desire. Analyses were carried out on a subset of 596 men with decreased sexual desire (mean age = 40.2 years) who were recruited as part of a large online study on male sexual health in 3 European countries. A majority of the participants (67%) reported masturbating at least once a week. Among men who masturbated frequently, 70% used pornography at least once a week. A multivariate assessment showed that sexual boredom, frequent pornography use, and low relationship intimacy significantly increased the odds of reporting frequent masturbation among coupled men with decreased sexual desire. These findings point to a pattern of pornography-related masturbation that can be dissociated from partnered sexual desire and can fulfill diverse purposes. Clinical implications include the importance of exploring specific patterns of masturbation and pornography use in the evaluation of coupled men with decreased sexual desire.

Introduction: Hypersexual behavior has been a controversial and much disputed issue in the field of sexual medicine. However, only little attention has been paid to hypersexual behavior in women. Therefore, to date there is limited knowledge on the behavioral patterns of hypersexuality in women., Aims: The purpose of the present study was to examine which sexual behavioral patterns are associated with self-reported indicators of hypersexuality in a female online sample. The second aim was to evaluate the association between hypersexuality and sexual risk behavior in women., Methods: In total, 988 women participated in an online survey. Logistic regression analysis was conducted to examine the association between sexual behavioral patterns and hypersexuality. Furthermore, correlation analyses were calculated in order to identify the relationship between sexual risk behavior and hypersexuality., Main Outcome Measures: Indicators of hypersexual behavior were measured by the Hypersexual Behavior Inventory (HBI). In addition, current and present impersonal sexual activities were investigated. Sexual risk behavior was assessed using the Sexual Sensation Seeking Scale (SSSS)., Results: High masturbation frequency, number of sexual partners, and pornography use were associated with a higher degree of hypersexual behavior in women. Furthermore, the HBI total score was positively correlated to sexual risk behavior., Conclusion: The results of the current study do not support the idea of previous research that hypersexual women are typically engaged in more passive forms of sexual behavior. Rather female hypersexuality seems to be more characterized by impersonal sexual activity. An association between hypersexual behavior and sexual risk behavior was identified. The implications of these findings for potential prevention strategies and therapeutic interventions are discussed., (© 2014 International Society for Sexual Medicine.)

In spite of his contribution to psychiatry in 19th century Britain, Henry Maudsley remains a mysterious figure, a man mostly known for his donation to the London County Council for the building of the Maudsley Hospital and for The Maudsley Annual Lecture created in honour of his benevolence. Besides Sir Aubrey Lewis' article in 1951 and Michael Collie's attempt in 1988 to construct a biographical study on Maudsley, there does not seem to be any current endeavour to tell the story of his life, whereas Trevor Turner's contribution to the 2004 Oxford Dictionary of National Biography gives a somewhat scathing but unattributed account of Maudsley's personality. This essay attempts to explore his contributions to the Medico-Psychological Association (MPA), the current Royal College of Psychiatrists, his editorship of the Journal of Mental Health (currently named the British Journal of Psychiatry), his literary contributions and his vision for a psychiatric hospital. This essay is an attempt to demystify his figure and to explore some of the rumours and criticisms surrounding his name and the reasons why so little has been written about him. It is also a venture to unravel his complex personality and his intricate philosophy., (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Introduction: Masturbation is a common sexual activity among people of all ages throughout life. It has been traditionally prohibited and judged as immoral and sinful by several religions. Although it is no longer perceived as a negative behavior, masturbation is often omitted in the diagnostic inquiry of patients with sexual problems., Aims: The aims of this study are to increase the awareness of clinicians to the importance of including questions regarding masturbatory habits in the process of sexual history taking, to analyze cases of male sexual dysfunction (SD) associated with unusual masturbatory practices, and to propose a practical tool for clinicians to diagnose and manage such problems., Methods: A clinical study of four cases that include a range of unusual masturbatory practices by young males who applied for sex therapy is described. An intervention plan involving specific questions in case history taking was devised. It was based on detailed understanding of each patient's masturbatory practice and its manifestation in his SD., Main Outcome Measures: Effects of identifying and altering masturbatory practices on sexual function., Results: The four men described unusual and awkward masturbatory practices, each of which was associated with different kinds of SD. The unlearning of the masturbatory practices contributed notably to improvement of their sexual function., Conclusions: The four cases in this study indicate that the detailed questioning of masturbatory habits is crucial for a thorough assessment and adequate treatment of sexual problems in men. We propose specific questions on masturbatory behavior as well as a diagnostic and therapeutic flowchart for physicians and sex therapists to address those problems., (© 2014 International Society for Sexual Medicine.)

Introduction: Sexual assistance may have some aspects that resemble prostitution and others that might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability (devotees). In this study, we investigate whether a rigorous selection and training process on the part of specialised organisations may reduce the risk of training subjects with an atypical sexual interest and behaviours resembling prostitution., Materials and Methods: The study population consisted of 152 subjects defining themselves as sexual assistants. Subjects were initially contacted on websites specifically dedicated to sexual assistants and prostitutes. One hundred and twenty subjects were selected, by propensity score analysis, and studied by means of a modified version of a semi-structured questionnaire previously developed to investigate a population of subjects attracted by disability., Results: The study group was composed of 80 trained and 40 untrained sexual assistants, with mean ages of 41.5 (SD +/-12.58) and 44.5 (SD +/-11.62), respectively. A significant number of untrained subjects affirmed that their motivation in carrying out sexual assistance was of a remunerative nature, while this number was lower among the trained assistants (p = 0.001). Nearly all untrained subjects claimed to do one or more of the following activities during sexual assistance: sexual intercourse, oral sex, and masturbation. Among the trained subjects, however, only 47.5% claimed to do one or more of these activities, which means that there is a significant gap between trained and untrained assistants (p<0.0001). The existence of an atypical sexual interest was more evident between untrained rather than between trained subjects (p<0.0001)., Conclusions: Sexual assistance represents a way through which people affected by disabilities may attain the right to explore their sexuality in a safe setting. This can be guaranteed only if sexual assistants are trained and carefully selected by specialised organisations.