Traumatic masturbatory syndrome (TMS)?

Dear Alice,

What's the deal with Traumatic Masturbatory Syndrome? Is it real or some sort of hoax?

Worried about TMS

Dear Worried about TMS, 

Although it may be a bit of a touchy subject, rest assured that traumatic masturbatory syndrome isn't a hoax but is definitely not as scary as it sounds. In 1998, Doctor Lawrence Sank, a psychologist in the United States (US), proposed a theory of sexual dysfunction called traumatic masturbatory syndrome (TMS)—sometimes referred to as prone masturbation. Sank theorizes that people who consistently masturbate by laying on their stomach and rubbing their penis against their hand, the surface of the floor, bed, pillow, or whatever they were laying on, are desensitizing their penis to other types of sexual activity. In his paper, Sank shared clinical notes from four case studies of men who engaged in prone masturbation and experienced issues like erectile dysfunction and delayed orgasms (anorgasmia). These things were experienced when they were engaging in other sexual behaviors like sex with a partner or masturbating while laying on their back. He noted that potential treatments to mitigate the effects of TMS include masturbation while lying face up and to stop engaging in prone masturbation entirely. 

It’s worth noting that this theory isn’t widely recognized in the medical community, and there are only a few more recent studies that may have found some validity to Sank's claim. More research is needed in order to determine if the theory is true, but if you still have some musings about masturbation and sexual function, read on! 

The penis has a high concentration of nerve endings, which is what creates the strong feelings of pleasure while engaging in sexual activities. In the same vein, masturbating in a prone position can cause an unnecessary amount of pressure to be placed on vital nerves in the base of the penis. This can contribute to physical symptoms such as delayed erectile dysfunction or delayed ejaculation. According to Sank's claim, the stimulation from prone masturbation, as well as other actions like masturbating with a tight grip or using objects, can create a desensitization that causes other sexual activity to lack the same type of pleasure. Other factors that could also contribute to this include the type of bed sheet, towels, or texture in general of the surfaces prone masturbation is happening on. That said, there are some objects and techniques that are more preferable to use in order to reduce the likelihood of desensitization such as a pillow or using lubricant or a toy if you don’t already. The idea is to switch things and break any repetitive habits that may be contributing to the urge to masturbate in a prone position. 

While masturbating is healthy and common, it can be important to recognize when it may be negatively impacting you physically or emotionally or interfering with other aspects of your daily life. If you're having problems enjoying the ride or you start to notice that masturbation is consuming your life, it may help to implement different techniques or frequency. If that doesn’t seem to help, you might consider meeting with a health care provider about your concerns. There are a number of educators and counselors that may be available to explore sexual health topics and concerns with you. To learn more about difficulties with delayed ejaculation or erectile dysfunction, consider checking out Can't ejaculate in the Go Ask Alice! archives. 

Last updated Nov 03, 2023
Originally published Nov 17, 2006