Masturbation is sexual self-stimulation, most commonly by touching, stroking or massaging the penis or clitoris until this triggers an orgasm. Some women also masturbate by stimulating the vagina. In America today, private masturbation is a very common sexual behavior during adolescence and throughout adult life, even among people who also have sexual relations with a partner.
In young children, masturbation is a normal part of the growing child's exploration of his or her own body. This exploration is different from adult erotic behavior. It is done simply because the child is curious about how various body parts work and because the genital sensations feel good. Of all age groups, children aged 15 to 19 months are most likely to masturbate in public; however, in 85% of cases, this behavior stops spontaneously after age 2.
In older children and adults, masturbation often continues throughout life in private.
Recent surveys suggest that in the United States about, about 55% of all 13-year-olds (both boys and girls) masturbate. This figure increases to more than 80% in 15-year-olds.
Among American adults, about 90% of men and 65% of women practice masturbation. Despite the fact that this is an exceptionally common practice, about half the teen-agers and adults who masturbate feel guilty or anxious about their behavior.
Masturbation also can be used as a safe way of relieving sexual tension in adolescents who want to avoid pregnancy and the dangers of sexually transmitted diseases.
Although there is nothing abnormal or unhealthy about masturbation from a medical point of view, some people have strong religious, cultural or moral objections to the practice. For those who hold these values, choosing not to masturbate is normal, too. There is nothing weird, odd, or unhealthy about this choice.
In addition to being a form of sexual activity, masturbation becomes necessary when a man must give a semen sample for infertility testing. After not ejaculating for 48 hours, the man masturbates, ejaculates and collects his seminal fluid for laboratory analysis. In the lab, the sample is checked for sperm count, shape and sperm movement.
In general, the medical community considers masturbation to be a normal part of human sexuality, as long as it is not practiced excessively or under inappropriate circumstances. If you are an adult, your doctor probably will not ask you about masturbation unless you bring up the subject. This is because masturbation is a form of normal sexual behavior, and it is not usually a symptom of illness. In adult patients, doctors usually see masturbation as a healthy, acceptable way to relieve sexual tension, especially when a patient's sexual partner is ill, absent, or otherwise uninterested in regular sexual contact. The National Institute on Aging emphasizes that masturbation actually "can help unmarried, widowed or divorced people and those whose partners are ill or away."
When counseling teen-agers, for example, pediatricians typically reinforce the fact that masturbation is one of many normal adolescent sexual behaviors.
Doctors who treat teens and preteens may discuss masturbation during the one-on-one portion of an office visit with an older child, beginning at age 10 to12. During this part of the office visit — when parents are not in the examining room — the doctor may ask the child whether he or she wishes to talk about masturbation and other matters of sexual health, including prevention of sexually transmitted diseases.
In most cases, masturbation is a normal, harmless sexual activity. However, it may become a symptom of illness if an older child or adult masturbates in public or masturbates compulsively. Although there is no simple rule about how much masturbation is too much, it is generally considered to be compulsive if masturbation:
Compulsive masturbation in an older child can sometimes appear if the child is being sexually abused. When this is the case, the child may show other forms of inappropriate sexual behavior, such as repeatedly talking about sexual acts (especially if the child seems to have more sexual knowledge than expected for their age), imitating the motions of sexual intercourse, inserting objects into the vagina, trying to undress other people and imitating the sexually seductive behavior of adults.
Compulsive or public masturbation may also occur in people who suffer from severe psychiatric illness, severe mental retardation or dementia (a brain illness that affects higher mental functions, including judgment). This behavior can be a special problem among male patients with chronic brain illnesses who require nursing-home care.
Adults who masturbate publicly also may be diagnosed with the psychiatric disorder called exhibitionism. This obsessive masturbation may be just one of several different compulsive sexual behaviors, including sexual promiscuity and a compulsive fascination with pornography. In adults and adolescents, compulsive masturbation can also be a symptom of addiction to cocaine or methamphetamine.
When a child masturbates compulsively or shows other persistent behaviors that may point to sexual abuse, the doctor may begin an official process to determine if sexual abuse has occurred. This process usually includes specialized interviews with the child, and interviews with family members and other adults who have had contact with the child. In addition, the child is usually examined to check for signs of genital injury and sexually transmitted diseases.
Sometimes an adult with dementia or another form of brain illness will begin to masturbate compulsively or publicly, either at home or in a long-term care facility. Often this is triggered by a change in medications, a worsening of the underlying condition, or a new medical problem that has developed. Much less commonly, compulsive or public masturbation develops in adults who were previously healthy. Under these circumstances, a thorough medical evaluation should be perfumed to look for new neurological or psychiatric illness.
When compulsive masturbation develops in a child who has been sexually abused, the child will usually require professional help to deal with the medical and emotional consequences of the abuse. The compulsive masturbation should disappear as the child begins to recover.
When a patient with a severe brain illness begins to masturbate compulsively or publicly, a medical evaluation or adjustment of medications is often required. If no clear trigger for the behavior is found, some doctors will treat the patient with psychiatric medications called selective serotonin reuptake inhibitors (SSRIs). This family of drugs includes fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil). If these drugs do not correct the problem in male patients, the next step may be to give drugs that decrease the levels of male sex hormones.
Only a small percent of normal boys and girls continue public masturbation during their preschool or early school-age years (ages 2 to 6). If you discover that your child is masturbating in public, many pediatricians suggest that you simply ignore the behavior without worrying.
This is because most children usually stop on their own. Any overreaction on your part may trigger unwarranted guilt feelings in your child. Your overreaction also may give your child the impression that his or her genitals are bad parts of the body.
Other doctors suggest that you deal with the situation by simply telling the child that masturbation is something that some people do in private when they are alone. Then gradually, as your toddler approaches school age, you can introduce more complex issues such as which sexual behaviors are acceptable in public.
Some parents begin by teaching their child the correct anatomic names for the genitals, then moving on (at the child's pace) to discussions about sexual behavior and values. If your family holds special religious or cultural beliefs regarding masturbation or other aspects of sexuality, the best time to share these beliefs with your child is usually after age 5. The challenge for parents is to teach the child about sexuality gently and accurately, without triggering feelings of guilt or shame.
Make an appointment with your doctor whenever you have any questions concerning masturbation or other aspects of sexuality.
If you suspect that you have a sexual problem, discuss the situation with your doctor openly and honestly. In some cases, your doctor will simply reassure you that you have nothing to worry about.
However, if there is a real problem, your doctor can either treat it directly or refer you to professionals who specialize in sexual disorders.
If you are concerned that your child has been sexually abused, call your pediatrician or family doctor immediately.
American Academy of Pediatrics (AAP)
141 Northwest Point Blvd.
Elk Grove Village, IL 60007-1098
For more information about sexual abuse in children, you can contact:
National Clearinghouse on Child Abuse and Neglect Information
330 C St., SW
Washington, DC 20447
For more information about general adult sexual issues, you can contact:
American College of Obstetricians and Gynecologists
409 12th St., SW
P.O. Box 96920
Washington, DC 20090-6920
National Women's Health Information Center (NWHIC)
200 Independence Avenue, S.W.
Washington, DC 20201
Urology Care Foundation
1000 Corporate Boulevard
Linthicum, MD 21090
For more information about masturbation and other sexual issues in older Americans, you can contact:
National Institute on Aging
31 Center Dr.
Bethesda, MD 20892