Patient's question:
I now ejaculate in just a few minutes during masturbation. Is this considered premature ejaculation?Doctor's answer:
Hello! First of all, I wish you good health! I want to talk to you about the topic of "masturbation."Boys in their adolescence are becoming more handsome and maturing into men, while girls are growing taller and more attractive, all thanks to the gonads. The active function of the gonads triggers the theme of puberty— the development of secondary sexual characteristics. The gonads are innate. Before puberty, they remain dormant. During puberty, the gonads awaken, and the hormones they secrete—sex hormones—determine the development of primary sexual characteristics (reproductive organs) and the appearance of secondary sexual characteristics in adolescents.
So, what are secondary sexual characteristics? Secondary sexual characteristics refer to the external manifestations of sexual development. Besides the distinct reproductive organs of males and females, boys and girls differ significantly in body shape, posture, appearance, voice, and other aspects. During the development of secondary sexual characteristics, adolescents also experience psychological and physiological changes. Generally, their temperament may become more anxious or irritable, they may easily get angry over things they dislike, but they are filled with interest in the opposite sex and develop curiosity about "sex." These psychological, emotional, and behavioral changes are greatly influenced by cultural media and social factors, which are referred to as tertiary sexual characteristics. There is no clear physiological basis for this; instead, it is formed through the acquisition of gender roles in society.
1) Masturbation and nocturnal emissions. Masturbation, also known as self-pleasure, is, in a narrow sense, the act of stroking one's external genitalia with the hands to achieve psychological satisfaction and self-pleasure. Broadly speaking, any form of self- or mutual touching to seek self-pleasure and satisfaction is considered masturbation, and people of all ages and genders engage in it. However, masturbation is a common phenomenon among adolescents. According to some domestic data, 86% of people have a history of masturbation, with the age of onset typically ranging from 12 to 16 years old, with an average age of 14, which aligns with the age when nocturnal emissions begin. In China, masturbation is considered a "private matter," and most people do not openly admit to or discuss this sexual behavior. For years, there has been debate over whether masturbation is harmful, harmless, or beneficial, especially in recent decades when masturbation has become a widely discussed issue among men. Authors in publications have offered inconsistent evaluations of masturbation. Some argue, "Masturbation is harmless and is a normal phenomenon during sexual maturation, a normal and common form of self-pleasure." Others believe, "Masturbation can occur without ejaculation and can be used as a treatment for conditions like impotence and chronic prostatitis, essentially strengthening genital exercise." Opinions are divided.
2) How should masturbation be evaluated? This cannot be generalized. For a mentally and physically healthy person with a correct understanding, moderate masturbation is harmless. This is especially true in cases where couples are separated for a long time, the female partner is ill, pregnancy requires abstinence, or there are differences in sexual needs after marriage, making it impossible for one partner to fully satisfy the other. In such situations, masturbation may be a more practical solution. Unmarried individuals who masturbate 1–2 times a month to relieve psychological or physiological urges do not harm their health. Under a doctor's guidance, masturbation can also be a method for treating certain sexual dysfunctions. Clinically, masturbation is often used to collect semen samples for examination. Masturbation itself does not cause any harm or adverse consequences. However, if masturbation becomes frequent, habitual, or even seen as a substitute for sexual activity, it may lead to mental burdens that are difficult to shake off. Some people who masturbate may experience guilt and self-blame, often wanting to change but struggling to resist physiological impulses, leading to frustration and mental damage. Excessive masturbation can also cause some urogenital diseases and sexual neurosis, primarily:
1. Central nervous system and systemic symptoms such as depression, memory loss, poor concentration, reduced comprehension, insomnia, frequent dreams, dizziness, palpitations, etc.
2. Urogenital diseases such as chronic prostatitis, which can cause frequent urination, white discharge at the end of urination, discomfort in the lower abdomen and perineum, lower back pain and weakness, reduced libido, impotence, premature ejaculation, and anejaculation.
3) What impact does masturbation have on fertility? Masturbation refers to the act of satisfying sexual urges by oneself during moments of arousal. If masturbation occurs occasionally, it has little impact on physical and mental health. However, frequent masturbation can have adverse effects on various aspects of physical and mental health. In reality, the harm of masturbation to the body does not lie in the loss of semen but in the abnormal psychological state and repeated sexual stimulation caused by frequent masturbation, which affect sexual function. After masturbation, adolescents often experience complex psychological states such as regret, shame, and anxiety, as well as symptoms of sexual dysfunction such as fatigue, lower back and leg weakness, mental fatigue, reduced libido, premature ejaculation, nocturnal emissions, and anejaculation. In severe cases, it can lead to neurosis and chronic prostatitis due to repeated congestion of the genital organs. Long-term and frequent masturbation can also cause severe mental burdens. Frequent ejaculation may lead to a decline in semen quality and reduced libido. Some individuals may experience an increased threshold for ejaculation stimulation, making it difficult to achieve ejaculation during normal sexual activity, which may affect fertility. As for whether masturbation can cause impotence, current data cannot establish a clear relationship between the two. Therefore, those who believe their impotence is caused by masturbation during their youth should eliminate psychological guilt and anxiety and seek other causes and appropriate treatments.
4) How to prevent and treat masturbation? Excessive masturbation requires prevention and treatment. The key to prevention and treatment lies in the following points:
- Treat masturbation correctly, prioritizing prevention. Use mental therapy and psychological guidance to strengthen spiritual civilization construction and sex education, guiding attention toward all-round development in morality, intelligence, and physique, and overcoming excessive focus.
- Maintain a regular lifestyle and adjust daily routines. Avoid wearing tight clothing, sleep on time, do not overeat at dinner, keep bedding warm and light, avoid sleeping on your back or stomach, and avoid foods like tobacco, alcohol, coffee, and spicy dishes.
- Develop good hygiene habits, maintain cleanliness of the external genitalia, and frequently clean to remove accumulated dirt and.
- Encourage men and women to participate in social activities to reduce sensitivity to the opposite sex and avoid early romantic relationships.
- For adolescents who have a habit of masturbation, do not scold them harshly but help them build confidence and determination to quit. Avoid exaggeration or intimidation, as this will only increase their mental burden.
- If there are urogenital infections, take symptomatic treatment with anti-inflammatory drugs to alleviate the patient's discomfort.
- Some young people experience nocturnal emissions too frequently—1–2 times a day or even during naps—leading to symptoms such as dizziness, fatigue, lower back pain, tinnitus, palpitations, shortness of breath, pale complexion, and mental lethargy. In severe cases, insomnia, memory loss, and difficulty concentrating in class may occur. This should be taken seriously. First, practice self-regulation, balance your mindset, learn healthy sex knowledge, relax mentally, divert attention to reduce sexual arousal, consciously avoid books and films, establish a regular sleep schedule, and actively participate in various cultural and sports activities. Second, moderate masturbation. Excessive masturbation in young people can also lead to frequent nocturnal emissions. Although masturbation is harmless, there is a "degree" to it. Excessive masturbation, especially when it becomes a "habit," is very harmful to health. It makes classmates disinterested in studying, makes them solitary, lacking interest in class activities, indifferent to interactions with peers, and feel extremely empty inside. Therefore, it is important to treat nocturnal emissions and masturbation correctly and scientifically. For middle school students, I hope you follow what the renowned urologist Professor Wu Jieping of China said: "Do not start out of curiosity, do not regret if it happens, if it has become a habit, have the determination to overcome it, and once you overcome it, you will no longer worry." Channel your youthful energy into the golden time of acquiring knowledge!
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