Q: I just read your Q and A in www.thestar.com.my and I have some questions. I’m a 27 year-old guy. Is the frequency of “self-pleasure” between four and five times considered normal?
Despite having a girlfriend, I am still “doing it myself” frequently. Maybe this is because we are not living together.
Am I very active? In the long-term, will such masturbation affect my marriage? Will I encounter an impairment to my fertility in the future?
A: Thank you for your email. I have been wondering when I'm going to receive a query about “self-pleasure”.
“Self-pleasure” also known as onanism, is the act of sexual stimulation of one’s genitals to the point of climax. Despite the act being depicted since the prehistoric wall paintings, it is viewed as “hideous” and “deplorable” by many religions and cultures.
Although the taboos are generally declining in the modern 21st century, onanism may still be considered as a spiritually detrimental practice surrounded by myths and fears. The fine line between “self-pleasure” and “self-abuse” is often the subject of uncertainty.
The frequency of “self-pleasure” is determined by one’s hormonal levels, sexual tensions, influence of peers, attitude and culture, and therefore is very difficult to determine the “norm”.
In the Kinsey’s 1950s estimate, 95% of men have practised onanism in their lifespan. Despite “self-pleasure” being considered “normal”, compulsive masturbation or hyper sexuality can often be viewed as a symptom of an emotional problem, rather than a cause.
It is also a popular belief that individuals who are not in active relationships tend to masturbate more frequently. On the contrary, several studies had actually highlighted positive correlations frequency of masturbation and sexual intercourse.
In the 18th century Europe, “self-pleasure” is considered an act of “self-pollution”, which may lead to impotency, gonorrhea, and epilepsy. Men and boys who continued to “indulge” were branded “ill” and “weak minded”.
In the modern era, the medical consensus is that masturbation is medically healthy and psychologically a normal habit, relying on evidence-based research. An Australian research also supported daily ejaculation to be an important factor in sperm quality and enhances chances of pregnancy.It is believed that masturbation flushes out older sperms with lower motility. The Cancer Council Australia even demonstrated in a study that men who masturbated frequently had a lower probability in developing prostate cancer. Men who average ejaculate five or more times weekly in the 20s had significant lower risk of such cancer.
In mental health, masturbation is related to relieving depression, blood pressure and leads to a higher sense of self-esteem. And a study published in 1997 also found an inverse association between death from coronary disease and frequency of sexual climax.
The taboo and myths surrounding “self-pleasure” has been scrutinised under the microscope of scientific research in recent years. This has assured many men that their “practices” in early years had not caused detrimental adversity to their current and future health. However, it will probably take more than science to change many generations of tales and beliefs.
Q: Just wanted to say first and foremost, I am a big fan of yours both on radio and The Star.
My son, 10, has a significant difference in size in his testicles. I know you have said in your Aug 4 column that it is normal, but I'm still very concerned, and would like to take him to see a doctor.
Shall I take him to see a GP, or to a urologist like yourself?
A: It is absolutely wonderful for having received an email from a “hands-on” dad. Most 10-year-olds would have approached mummies about issues like this. I feel that many daddies are left out in dealing with the “growing pains” of the kids. Such involvement is crucial for the father-son bonding.
The discrepancy in size of testicles for a 10-year-old boy is not uncommon. This could be physiological, as most of us are born with slight differences in the contents of our scrotal sacks. However, several conditions can result in “lopsided” scrotum, namely hernia, epididymal cysts or hydrocele. As your boy is only 10, the chance of testicular cancer is miniscule, but not impossible.
One of the common causes of lumps in the groin boys have before puberty is hernia. Believe it or not, our testicles started the journey in-utero inside the abdomen. At seven months gestation as fetus, with the aid of testosterone, the testicles will migrate down to the scrotal sacks to find a permanent cooler dwelling for optimal spermatogenesis.
In some boys, such migration is impeded and results in undescended testicles. In others, the migration is successful but the track in the groin is left wide open resulting in inguinal hernia (also known as patent processes vaginalis).
As this is a trail of a natural defect, it is unlikely to self-rectify and in most instances, will require a corrective operative intervention. Occasionally, the contents of the abdomen such as fluid can drain into the scrotum, which is known as hydrocele. This is simple a collection of fluid in the scrotum.
The other common lump in the scrotum is epididymal cyst. The epididymis plays a role of sperm storage and maturation. Occasionally, the drainage system may be occluded and result in a collection of fluid. This is common but symptomless.
Of course seeing a GP or a specialist would be the way forward. Most of the above-mentioned scrotal conditions can be diagnosed by general practitioners. The urologists can also be more specific in their investigations.
The simple way parents can also get involved in the scrotal examination is to shine a small torchlight (Yes, torchlight and I am not joking) in contact with the enlarged scrotum. If the scrotum lights in a dark room, there is likely to be fluid content due to hydrocele or epididymal cysts.
One can also check whether there is a cough impulse (the lump protruding when coughing), which is likely to be related to hernia. If the actual testicle itself is hard and irregular in surface, cancer needs to be excluded urgently!
Q: I am a 58-year-old man. In the last three months, I begin to have erection problem. I have also noticed significant decrease in my libido.
In the event that I achieve some degree of rigidity, it is at best suboptimal, and hardly sustaining the hardness.
Please recommend any treatment.
My wife is 51 and we are still engaging in active sexual relationship.
A: Thanks for your email. I am sorry your last three months has not been the best months of your love life. It is not normal, but it is definitely not uncommon. You and your wife are ‘still” active in engaging sexual relationship - this is healthy ageing!
You do suffer from erectile dysfunction (ED) as you experience suboptimal erectile rigidity and difficulties in sustaining an erection during intercourse. Most of such dysfunction are gradual in onset and the deficiencies will have an impact on your libido.
Therefore, I think the decrease in the sex drive is an effect rather than the cause of your problems. Of course, it is reasonable to check your serum testosterone. I do not believe you are experiencing male menopause (after all, men-no-pause!)
ED can affect up to half of the men above the age of 50, and most of this is mild in nature, resulting in suboptimal rigidity that barely makes it possible for penetration. Contrary to common belief, the vast majority of such sexual dysfunction are not psychological in nature.
Recent studies had outlined the common causes of ED are diabetes, dyslipidemia, hypertension and heart condition. As your ED is treated and investigated in early stage, it is likely that your associated commodities are less serious. With appropriate treatment, most men can avoid the deterioration of both the cardiac and sexual dysfunction.
I think it is important for you to get your fasting glucose and lipids investigated. It is also reasonable to put you through a stress test, in order to assess your cardiovascular status. For most men, with the healthier lifestyle and the correction of risk factors, your love life will naturally resume in no time.
For others, the ED may not resolve despite a corrective lifestyle. Under such circumstances, the use of medications such as the blue pills may be necessary.
So, Dr G’s advice is to get checked out before getting burnt out!
> The views expressed are entirely the writer’s own.