Introduction

Sexual function is typically assessed within the context of partnered sexual activity for both men and women. Nevertheless, masturbation is a very common sexual activity that could provide valuable information about an individual’s sexual response/function. For example, determining if/how a person’s sexual response differs during partnered sex versus masturbation could have big implications regarding the potential causes of and possible treatments for any sexual dysfunctions. To this end, the authors of a recent Journal of Sexual Medicine study explored the differences in sexual response during masturbation and partnered sex for a large, multinational sample of men with and without sexual dysfunction.

Methods

The participants of this study were recruited via online forums and social media platforms to take an anonymous 55-item sexual health survey. To be included in the analysis, the respondents needed to be men of at least 18 years and have had at least one sexual partner in their lifetime. After excluding surveys with conflicting answers and men who had never had a sexual partner, the researchers were left with a sample of 4,209 men from the United States and Hungary.

There were two sections of the sexual health questionnaire. The first addressed the participants’ demographics, lifestyle behaviors, medical history, sexual history, frequency of partnered sex and masturbation, and sexual interest. The second part of the survey was dedicated to the participants’ erectile and ejaculatory function during partnered sex and masturbation. Three sexual dysfunctions were examined in this study: erectile dysfunction (ED), premature ejaculation (PE), and delayed ejaculation (DE).

ED was assessed with 4 items from the International Index of Erectile Function-5 (IIEF-5), PE was assessed with 3 items from the Premature Ejaculation Diagnostic Tool (PEDT), and DE was assessed with a question regarding the “difficulty reaching orgasm/ejaculation” during masturbation and partnered sex on a scale of 1 to 5 (with 1 indicating no difficulty and 5 indicating severe difficulty).

For the purposes of this study, the researchers created three categories to indicate the severity of each sexual dysfunction: no/low, moderate/probable, and severe/definite dysfunction. Participants with IIEF scores between 4-9 were considered to have moderate to severe ED, 10-13 showed moderate ED, and 14-20 showed no/mild ED. PEDT scores between 13-15 represented definite PE, 9-12 showed probable PE, and less than or equal to 8 showed no PE. Finally, those who selected 1 or 2 in response to the DE question were considered to have no/mild DE, 3 represented moderate DE, and a 4 or 5 represented severe DE.   

Results

The men with mild sexual dysfunction or no sexual dysfunction demonstrated similar sexual responses during partnered sex and masturbation. However, the men with moderate to severe sexual dysfunction, whether ED, PE, or DE, consistently reported better sexual response during masturbation than partnered sexual activity.

Men with moderate ED during partnered sex showed IIEF-5 scores in the normal range during masturbation, and men with severe ED during partnered sex had moderate ED scores during masturbation. Similarly, men with probable PE during partnered sex had close to normal PEDT scores during masturbation, and men with definite PE during partnered sex showed probable PE levels during masturbation. Finally, the men who reported moderate to severe DE during partnered sex had little to no difficulty ejaculating during masturbation.

Discussion & Conclusion

Upon seeing consistently better sexual responses during masturbation than partnered sexual activity in men experiencing moderate to severe sexual dysfunction, the authors discussed the possible rationale. They stated, “We entertain 3 possible, though non-exclusive, explanations for this disparity: (i) partnered sex may intensify or exacerbate a sexual problem; (ii) masturbation may lessen the sexual problem; or (iii) the criteria men use to rate impairment differs for different types of sexual activity (masturbation vs. partnered sex).”

According to the authors, partnered sex may introduce elements such as expectations, evaluation, and attraction into the sexual activity, which may in turn heighten a man’s sexual performance anxiety and impair his sexual function. On the other hand, he may have more control during masturbation, enabling him to create conditions that better support his sexual function. Lastly, an individual may evaluate the experience of sexual dysfunction during masturbation differently than sexual dysfunction during partnered sexual activity. That is, a person may find sexual dysfunction less bothersome or distressing when they are alone versus when they are with a partner.

Further research is necessary to determine why sexual response may differ during masturbation and partnered sexual activity, but this information highlights the importance of understanding a person’s potential during masturbation when evaluating sexual function.

“Regardless of whether the disparity in dysfunctional symptomology between masturbation and partnered sex results from variables arising from the partner or from greater stimulus control during masturbation, the implications for the management of the problem are significant. Identifying factors responsible for these differences could offer ways to help men achieve a level of sexual functionality during partnered sex that equals their best functionality during masturbation,” concluded the authors.

Resources:

• Rowland, D.L., Hamilton, B.D., Bacys, K.R., & Hevesi, K. (2021). Sexual response differs during partnered sex and masturbation in men with and without sexual dysfunction: implications for treatment. The Journal of Sexual Medicine, 18(11), 1835-1842. DOI: https://doi.org/10.1016/j.jsxm.2021.09.005