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A brief summary of articles about prone masturbation

Prone masturbation has been known as a variant form of masturbation from ancient times, documented by the Romans. Alfred C. Kinsey (Sexual Behavior in the Human Male, Saunders, 1948, p. 509), called masturbating prone a rare technique, limited to "an incidental experience or two." Kinsey's landmark study of male sexuality found that as many as 13 percent of males masturbate prone "much of the time." (Gebhard & Johnson, The Kinsey Data, Saunders, 1979, Table 161, p. 210). Kinsey's close associate Wardell Pomeroy noted that prone masturbation was the preferred method of no more than 5-10 percent of boys. (Boys and Sex, Random House, 1991). Shere Hite in her non-scientific bestseller puts the figure as high as 15 percent. (The Hite Report, Bookthrift, 1983, p. 1106).

Bernie Zilbergeld, in his groundbreaking book Male Sexuality, described masturbating by stroking up and down the shaft with one hand as "the usual way" and other ways as "atypical." He presented the case of a man in his 20s who masturbated prone and had problems with erectile dysfunction and inability to reach orgasm with a partner. He advised men in this situation to expand their sexual horizons by learning to masturbate in the usual way. (Bernie Zilbergeld, Male Sexuality, Boston: Little Brown, 1978, p. 141).

William Hartmann & Marilyn Fithian present the case of a man who had a history of prone masturbation and was unable to complete sexual intercourse. He had to "learn a new pattern of sexual response" before he was able to function in sexual intercourse. Hartmann & Fithian contend that the way a boy learns to masturbate can affect how he will perform sexually as a man. (William Hartman & Marilyn Fithian, Any Man Can, New York: St. Martin's, 1984, p. 35).

Eva Margolies cites prone masturbation as a typical pitfall of sexual inexperience in her 1994 book Undressing the American Male: Men with Sexual Problems and What You Can Do to Help Them (Dutton). In a section, "Sexual Habits of the Older Virgin," she specifically cites masturbating in the prone position as an example of atypical masturbatory styles and habits that can prevent men from enjoying normal sexual relations.

Also in 1994, Michael Perelman advises physicians treating patients with sexual dysfunctions to inquire as to their masturbatory technique and frequency, noting, "atypical masturbatory techniques are among the most frequent causes of retarded ejaculation." (Masturbation Revisited, Contemporary Urology, November 1994, Vol. 6, No. 11)

In 1998, Lawrence Sank coins the term Traumatic Masturbatory Syndrome to describe prone masturbation. (This term is no longer used on His journal article is summarized below.

Barbara Bartlik & Marion Zucker Goldstein mention "atypical masturbatory styles, such as the face-down position," as frequent causes of male orgasmic disorder (delayed ejaculation). (Men's Sexual Health After Midlife, Practical Geriatics, March 2001, Vol. 52, p. 291-294)

Josie Lipsith, Damian McCann, & David Goldmeier explore the links between masturbation and male psychogenic sexual dysfunction. They cite Sank not only for his describing prone masturbation as atypical masturbatory behavior, but also for his conception of the psychotherapy process as needing to involve more specific communication about masturbation between the therapist and the patient. ("Male Psychogenic Sexual Dysfunction: The Role of Masturbation," Sexual and Relationship Therapy, Vol. 18, Nov. 2003, pp. 447-471)

Michael Perelman characterizes sexual troubles resulting from prone masturbation as "the counterproductive consequence of high-frequency masturbation in the prone position." ("Retarded Ejaculation," Current Sexual Health Reports, 2004, pp. 95-101)

Daniel Richardson & David Goldmeier cite Sank's article as an example of how atypical masturbatory practices have been shown to cause a "disabling" of a man's ability in penetrative sex. ("Recommendations for the Management of Retarded Ejaculation," International Journal of STD & AIDS, Vol. 17, Jan. 2006, pp. 7-13)

Richardson & Goldmeier follow up in another article citing Sank's article relative to an idiosyncratic style of masturbation being a cause of orgasmic disorder in penetrative sex. ("Retarded Ejaculation -- A Review," International Journal of STD & AIDS, Vol. 17, Mar. 2006, pp. 143-150)

David L. Rowland discusses prone masturbation as a cause of sexual dysfunction in his 2012 book Sexual Dysfunction in Men, Cambridge, Massachusetts: Hogrefe Publishing, 2012,, ISBN 978-1-61676-402-9.

Gila Bronner & Itzhak Ben-Zion authored a set of instructions for primary care physicians dealing with cases of sexual dysfunction resulting from prone masturbation. ("Unusual Masturbatory Practice as an Etiological Factor in the Diagnosis and Treatment of Sexual Dysfunction in Young Men," The Journal of Sexual Medicine, Vol. 11, July 2014, pp. 1798-1806)

Articles about prone masturbation

Alfred C. Kinsey had this to say about prone masturbation in his landmark 1948 study Sexual Behavior in the Human Male (Philadelphia: Saunders), p. 509:

There are some boys who attempt to masturbate by moving the penis against a bed or against some other object; but for most males this technique is rare and confined to an incidental experience or two. *** Many of the persons who depend on this mode of masturbation think of the act as a substitute for heterosexual coitus, and there are some clinicians who specifically recommend such a technique, in conjunction with fantasy, on the ground that it may have some carry-over into later heterosexual activity. But however good the theory may appear to be, it finds no substantiation in the specific record, for the great majority of boys use simpler manual techniques in masturbation, and make perfectly satisfactory heterosexual adjustments anyway. It is also to be noted that males have been known to masturbate against a bed while fantasying frictation or anal relations in the homosexual.

Kinsey recorded the prevalance of prone masturbation as follows, although his breakpoints "much," "some," and "rare" do not correspond well to the more specific breakpoints this site uses: "almost always," "most of the time," "sometimes," "rarely or never."

Q. How often do you masturbate by pelvic thrusts while prone?
College Ed.
Non-College Ed.
None 58.2% 72.4% 68.9%
Have tried 1.4% 0.4% 0.8%
Rarely 1.9% 1.8% 0%
Little 21.6% 12.9% 18.2%
Some 4.0% 1.2% 5.3%
Much 12.9% 11.2% 6.8%
Number of cases 3819 490 132

Source: Paul H. Gebhard and Alan B. Johnson, ed., The Kinsey Data: Marginal Tabulations of the 1938-1963 Interviews Conducted by the Institute for Sex Research. Philadelphia: Saunders, 1979, Table 161, p. 210.

The survey gives "much" as the maximum, but it would be useful to know how much "much" is. Obviously most of these men did not masturbate prone exclusively, because in answer to Kinsey's question about the frequency of masturbating by hand on the penis, the percentage of the three groups answering "much" were respectively 90.9, 95.5, and 95.1 percent. (Gebhard & Johnson, Table 160, p. 209.)

Wardell Pomeroy says this about prone masturbation in the third edition (Random House, 1991) of his book Boys and Sex:

A minority of boys, probably no more than 5 to 10 percent, lie on their bellies and use a pushing motion to rub the penis against the bed or a pillow, in a movement like intercourse itself. Younger boys use this method more often.

Thanks to reader J. for bringing that quote to my attention

Shere Hite tabulates in her unscientific best-seller The Hite Report on Male Sexuality (Bookthrift, 1983, p. 1106) that 82 percent of males masturbate using manual stimulation of the penis, while 15 percent masturbate prone. (Two percent masturbate using other methods and one percent of men claim to not masturbate.) She notes (p. 507) that many more had masturbated prone when they were younger, and she points out (p. 502) that regular masturbation almost never involves thrusting.

Dr. William Hartman & Marilyn Fithian, in their book Any Man Can: The Multiple Orgasmic Technique for Every Loving Man, (New York: St. Martin's, 1984, p. 57), present this as a case illustration:

Saul is another man who didn't learn to masturbate by conventional means. He masturbated by lying face down and moving his body so his penis moved against the sheet. He, too, had to learn a new pattern of response before he was capable of "normal" sexual intercourse with a partner. His problem? He could get an erection without any difficulty. But coitus did not put enough pressure on his penis, so he couldn't reach a climax.

So you can see that the way a boy learns to masturbate can affect his ability to have intercourse when he becomes a man.

Eva Margolies alluded to prone masturbation in her 1994 book Undressing the American Male: Men with Sexual Problems and What You Can Do to Help Them (Dutton). On p. 115, in a section headed "Sexual Habits of the Older Virgin," she says this:

An addiction to a particular and often idiosyncratic way of masturbating: The result is that a man becomes overly sensitized to the sensations he receives from his own hand, as well as to the perfect adjustments -- faster, slower, harder, softer -- that a person can only get through masturbation. He may also develop very particular types of motion, such as shaking his penis or tickling just the tip, to which he becomes responsive. He may also become used to masturbating by rubbing against a pillow or mattress. This is a sign of regressed sexuality as well as a problem in translating arousal to a partner. (emphasis added)

Michael Perelman of Weill Cornell Medical College and New York Presbyterian Hospital authored a 1994 article in the journal Contemporary Urology urging physicians to investigate the masturbatory frequency and technique of their patients presenting with sexual dysfunctions. Perelman noted, "idiosyncratic masturbatory techniques are among the most frequent causes of retarded ejaculation."

Traumatic Masturbatory Syndrome by Dr. Lawrence Sank

In a 1998 article, Dr. Lawrence I. Sank of the Center for Cognitive Therapy in Bethesda, Md. characterized prone masturbation as Traumatic Masturbatory Syndrome. What follows is the abstract of his article and a summary of it prepared for this site.

Source: Journal of Sex & Marital Therapy. 24(1):37-42, 1998 (Jan.-Mar.)

Abstract: This article describes a previously unreported pattern of atypical masturbatory behavior, which presents as either an erectile or orgasmic disorder in men. Four case histories are described of men who masturbated in an idiosyncratic manner. The distinguishing features of the masturbatory style include a prone position and daily masturbation over a period of years. It is suggested that the primary care physician or specialist (urologist or neurologist) screen for this problematic style when presented with male sexual dysfunction. Further, and more controversially, it is suggested that a primary prevention model would argue for masturbatory instruction in the home, classroom, or pediatric clinical setting.

Sank notes that much attention over the past 30 years in sexual therapy practice, self-help books, and the media has been paid to the sexual problems of women and how masturbation can help them. He notes that there is a lack of comparable help for men and states that the problem in men, unlike women, is not that they don't masturbate, but that they might not masturbate correctly, leading to "a long history of sexual failure." (p. 42)

Sank describes four men he treated in his practice with a problem he defines as Traumatic Masturbatory Syndrome (TMS).

Sank notes that finding out a patient practices prone masturbation is problematic because it is difficult for a health care practitioner to bring up the subject of masturbation at all, to say nothing of discussing how the patient masturbates. He urges practitioners to do so in spite of this, because of the existence of the four cases he presents.

Sank declines to suggest in the article that prone masturbation is the sole cause of the mens' problems and calls for more inquiry into the condition. He notes that in each case, the referring physicians ruled out physical problems. He suggests that prone masturbation does not cause permanent physical trauma, although he states that this too needs further study by doctors of medicine. He notes that "errant forms of masturbation" may have been created as the result of psychological disorders.

Sank declines to outline his treatment strategy for prone masturbation, but notes it involves resensitizing the penis through "individualized behavioral exercises and psychotherapy when appropriate." (p. 41)

Sank recommends teaching of proper masturbatory technique to "emerging pubescent youngsters" in the family, school, or pediatric medical practice. He also recommends that health care professionals be made aware of the existence of prone masturbation and its implication when male sexual dysfunction is presented in their practices.

Sank revisited the topic in a new article in 2020. Traumatic Masturbatory Syndrome: A Proposed Treatment Protocol, Journal of Sexual Medicine 4(6): 1049 (2020).

A new set of cases by Dr. Georgina Whelan

In a 2008 presentation to the Australian Society of Sex Educators, Researchers & Therapists (New South Wales), Dr. Georgina Whelan outlined her work with four patients from her Australian practice:

Dr. Whelan includes these strategies variously for the four men:

Dr. R. Murray Thomas (2009) notes that prone masturbation is one of the ways pre-pubescent boys learn to experience their sexuality, but leaves such experimentation out of his conception of grown-up masturbation. "For the postpubescent male, masturbating consists of stimulating the penis by pumping it rapidly until the pleasurable sensation of orgasm is reached and semen is ejaculated." (book)

Jelto Drenth (2012) notes prone masturbation as one possible factor and something to be considered influencing genital pain in patients having difficulty with that condition. "They learn to masturbate by lying on their stomachs on the sheet or sliding [across] a pillow," translated from the Dutch by Google. (article, in Dutch)

Gila Bronner & Dr. Itzhak Z. Ben-Zion (2014) devise a treatment plans for males with sexual dysfunctions stemming from unusual masturbatory practices and also a series of screening questions that primary care physicians should use to detect sexual dysfunctions and unusual masturbatory practices in their clients. Among these is "Do you masturbate on your back, or stomach, or another position?" They describe "normal masturbation" as essential to sexual functioning and note, "Changing the patientís masturbatory practice to be more compatible with sex with a partner led to a beneficial impact on his sexual function and enabled him to engage in normal intimate relationships." "Masturbatory practices may ... sometimes lead to [sexual dysfunctions], and we propose several detailed questions to elicit the nature of problematic habits." (Journal of Sexual Medicine 11:1798Ė1806 (2014). article)

Michael J. Butcher, DO (Park Nicollet Health Partners, Minneapolis) & Robert E. Brannigan, MD (Northwestern Memorial Hospital, Chicago) (2016) report, "Idiosyncratic masturbation style refers to an individualís technique that involves the combination of pressure, speed, duration, and intensity needed to achieve an ejaculation and orgasm which is not reproducible with a partner using hands, mouth, and/or vagina. Men who practice this type of masturbation have a higher rate of sexual dysfunction. ("Ejaculatory Disorders," in Contemporary Treatment of Erectile Dysfunction, Tobias S. Kohler & Kevin T. McVary, eds., New York: Humana Press, 2016. chapter)

Videocast about prone masturbation

View this brief video by Dr. Karthik Gunasekaran of Metromale Clinic in Chinnai, India explaining why prone masturbation is a cause of sexual dysfunction in men

Other articles about masturbation

A study published in the British Journal of Urology International in August 2003 found that males who masturbated daily in their 20s had the least chance of getting prostate cancer when they're older. More here:

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