Masturbation, sexual function, and genital self-image of undergraduate women: a cross-sectional study.

BACKGROUND: The relationship between factors related to masturbation, sexual function, and genital self-image among women has not been fully explored in the literature. AIM: The study sought to investigate the association between masturbation frequency, feelings, and behaviors with sexual function and genital self-image in young women. METHODS: A cross-sectional survey among 110 undergraduate female students was conducted. Online self-administered questionnaires to assess sociodemographic characteristics, masturbatory frequency, feelings, and behavior were completed. Participants also answered the Brazilian version of the Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS). OUTCOMES: The outcome includes masturbation frequency and behaviors associated, as well as scores on the FSFI and FGSIS. RESULTS: Women showed higher scores in FSFI subdomains when masturbation was considered important for them, along with reported feelings of empowerment and satisfaction during this activity. However, those who experienced negative emotions during masturbation, such as shame or guilt, demonstrated a significant association with lower scores in both FSFI and FGSIS. Masturbation frequency was found to correlate with better sexual function specifically in the desire domain among women who engaged in daily masturbation. Additionally, an association was observed between higher scores in the FGSIS and increased scores in the domains of satisfaction, arousal, and orgasm within the FSFI. There was an association in the domain's satisfaction, arousal, and orgasm of the FSFI with greater scores in FGSIS. CLINICAL IMPLICATIONS: The clinical implications encompass the augmentation of understanding pertaining to female sexual function. STRENGTHS AND LIMITATIONS: The study provides valuable insights into the sexual behavior of undergraduate female students, and its methodology improves openness in responses, as it provides anonymity given the sensitive nature of the topic studied. Study limitations include the unsuitability of the FSFI questionnaire for sexually inactive women in the past 4 weeks; the participation bias and reporting bias in sexuality searches; and the unknown validity of the investigator-derived questionnaire about masturbation, as it has not been previously validated. CONCLUSION: Masturbation frequency has minimal to no impact on female sexual function, whereas harboring positive feelings toward it and maintaining a positive genital self-image may exert a positive influence on sexual function.

Not Who You Are, But Who You Are With: Re-examining Women's Less Satisfying Sexual Debuts.

Gender differences in appraisals of first intercourse are among the largest in sexuality research, with women indicating less satisfying "sexual debuts" than men. Dispositional or "actor-level" explanations for this gender gap are pervasive, yet research has largely examined heterosexual debuts in which actor gender and partner gender are confounded. We assessed whether women's less satisfying sexual debuts are better explained by actor gender or partner gender, comparing experiences of women who debuted with men (WDM) with those of men and women who debuted with women (MDW, WDW). Retrospective accounts of sexual debut were collected from 3033 adults. At first intercourse, we found that WDW had equal physical and emotional satisfaction to MDW, and more satisfaction than WDM, suggesting satisfaction gaps owing to partner gender, not actor gender. This pattern did not extend to a comparison event (first masturbation), where WDW and WDM had similar satisfaction, but less satisfaction than MDW, suggesting an actor gender gap. To identify sources of satisfaction gaps, we probed for corresponding differences in the circumstances of sexual debut. Sexual circumstances were more strongly implicated than nonsexual ones, with relative deprivation of glans stimulation explaining relative dissatisfaction at first intercourse, but not first masturbation, and orgasm explaining it at both. Findings challenge the view that the satisfaction gap at first intercourse reflects an inherent difference between genders. Indeed, they demonstrate similarities when partner gender does not differ and suggest strategies for ensuring equal sexual satisfaction-and equal sexual rights realization-at (hetero) sexual debut.

Masturbation in middle and late adulthood: its relationship to orgasm.

The relation of masturbation to orgasmic facility and orgasm satisfaction in the sexual relationships context was examined in elderly population. This cross-sectional study included 546 Spanish heterosexual adults aged 50-83 years. They completed a Socio-Demographic Questionnaire, and scales to assess negative attitude towards masturbation, solitary sexual desire, subjective orgasm experience in the solitary masturbation context and orgasmic facility and orgasm satisfaction in sexual relationships. Significant differences were observed on all the masturbation-related indicators between men and women. For men, a regression model was obtained in which age (ß = 0.15), current masturbation frequency (ß = 0.18) and negative attitude towards masturbation (ß = 0.17) explained 8% of the difficulty in orgasmic facility, and another in which age (ß = 0.14) and negative attitude towards masturbation (ß = 0.13) explained 8% of orgasm satisfaction. For women, two regression models were obtained, in which the Affective dimension of the subjective orgasm experience in masturbation explained 11% of orgasmic facility (ß = -0.22) and 15% of orgasm satisfaction (ß = -0.33) in sexual relationships. Significant differences in the intensity of the subjective orgasmic masturbation experience were observed between elderly people with and without difficulties in orgasmic facility and orgasm satisfaction in sexual relationships.

Evaluating the Subjective Orgasm Experience Through Sexual Context, Gender, and Sexual Orientation.

The subjective orgasm experience (SOE) is the psychological perception of orgasm sensations and closely related to sexual health. Here, SOE was studied through the context in which it is experienced (sexual relationships and solitary masturbation), gender, and sexual orientation. For this purpose, data were collected from 4255 people (1927 men and 2328 women) of different sexual orientations (heterosexual = 1545; bisexual = 1202; and gay = 1508) who completed two versions of the Orgasm Rating Scale (ORS) for both contexts (i.e., sexual relationships and solitary masturbation) along with a socio-demographic questionnaire. Results showed that the ORS in the context of solitary masturbation is an instrument invariant by gender and sexual orientation. Significant differences in SOE were found by context: it was more intense in the context of sexual relationships (vs. solitary masturbation); by gender: women (vs. men) reported greater intensity; and by sexual orientation, with heterosexual people (vs. gay and bisexual people) having a more intense experience.

Solo and Partnered Sexual Behavior Among an International Sample of Adults With Spina Bifida.

BACKGROUND: Spina bifida (SB) may differentially impact adults' participation in solo and partnered sexual behaviors, but little research investigates this topic. AIM: Describe solo and partnered sexual behaviors among an international sample of adult men and women with SB. MAIN OUTCOME MEASURES: Ever participated (no/yes) and recent participation (>1 year ago/within last year) in solo masturbation, cuddled with a partner, held hands with a partner, kissed a partner, touched a partner's genital, had genitals touched by a partner, gave a partner oral sex, received oral sex from a partner, vaginal sex, anal sex, and sex toy use. METHODS: Data were drawn from a larger cross-sectional, internet-based survey assessing the sexual behaviors of an international sample of men and women with SB. We used logistic regression to examine the impact of background (gender, age, independent living, and relationship status) and health (shunt status, ambulation, and genital sensation) factors on each outcome. RESULTS: The sample consisted of 345 respondents aged 18-73 years from 26 nations. Very few (<3%) had no lifetime experience with any solo or partnered behaviors; 25.0% reported participating in all behaviors at some point in their lives. The median number of past year sexual behaviors (of 16 total) was 7. Lifetime and recent participation were associated with demographic and health factors. CLINICAL IMPLICATIONS: Despite impairment, adults with spina bifida do participate in solo and partnered sexual behaviors. Medical personnel who work with this population should include discussions about sexuality as part of routine care. STRENGTHS & LIMITATIONS: Although this research measured solo and partnered sexual behavior in large international sample of adults with spina bifida, it is limited by its cross-sectional retrospective design and non-clinical convenience sample. CONCLUSION: Despite disability, many adults with SB participate in solo and partnered sexual behavior. Medical and psychosocial supports are needed to help adults in this population enjoy sexuality in a healthy and safe manner. Hensel DJ, Misseri R, Wiener JS, et al. Solo and Partnered Sexual Behavior Among an International Sample of Adults With Spina Bifida. J Sex Med 2022;19:1766-1777.

A Seemingly Paradoxical Relationship Between Masturbation Frequency and Sexual Satisfaction.

Despite many benefits related to masturbation, we know surprisingly little about how solo sex is associated with sexual satisfaction. Using questionnaire data from a probability-based sample of 4,160 Norwegians aged 18-89 years, we explored subgroups of women and men that differed in their masturbation-sexual satisfaction typology and examined whether sociodemographic, psychological, and sexual behavioral characteristics were associated with distinct masturbation-satisfaction patterns. A cluster analysis revealed four similar groupings for women and men, reflecting sex lives characterized by high masturbation/sexual satisfaction, low masturbation/sexual satisfaction, high masturbation/sexual dissatisfaction, or low masturbation/sexual dissatisfaction. While being younger, higher pornography consumption, and sexual variety were primarily associated with increased masturbation frequency, sexual distress and a negative body and genital self-image were more clearly associated with sexual dissatisfaction. Predicting different masturbation-satisfaction groupings also revealed some gender-specific findings in the use of pornography, and in the association between masturbation and intercourse frequency, which suggested a complementary pattern for women and a compensatory pattern for men. Our findings emphasize that the linkage between masturbation and sexual satisfaction warrants closer focus.

Sexuality in Assisted Reproductive Technology Couples.

BACKGROUND: Sexuality is a complex social and psychological phenomenon even more complicated in the setting of Assisted Reproductive Technology (ART). SUBJECTS AND METHODS: In total 192 participants entered the study (96 couples) in the process of ART. Participants filled up anonymous questionnaire while waiting routine procedure. At the time of questionnaire males and females were in separate rooms without knowledge about partners answers. RESULTS: The frequency of sexual intercourse was not related to the sociodemographic variables in women but was related to education level and work status. More educated men who were employed had more frequent sexual intercourses. Moreover, the frequency of the sexual intercourse was not related to the duration of the relationship nor the infertility treatment. The correlational analyses showed that the frequency of sexual masturbation was not related to the sociodemographic variables, except for place of living. Both women and men from more urban areas reported to engage in masturbation more often. The frequency of specific sexual activities did not differ between reports by women and men for vaginal, oral, anal, and foreplay activities. However, men reported engaging in masturbation more often than women. CONCLUSION: The frequency of sexual activities is similar in women and men for vaginal, oral, anal, and foreplay activities. However, men reported engaging in masturbation more often than women. ART could only slightly affect quality of sexual life. Both partners should be informed.

The masturbatory premature ejaculation diagnostic tool (MPEDT): A novel psychometric tool to evaluate premature ejaculation during masturbation.

BACKGROUND: Premature ejaculation (PE) is a highly prevalent male sexual dysfunction. Its current definition, together with the most used diagnostic tools, does not include nonvaginal sexual intercourse such as anal sex, self-masturbation and/or partnered-masturbation, and other forms of sexual stimulation. However, diagnostic psychometry currently available is exclusively evaluating PE in the vaginal coitus. OBJECTIVES: To validate a new tool, the masturbatory premature ejaculation diagnostic tool (MPEDT), by assessing the control over ejaculation and its psychological effects during self-masturbation, rather than heterosexual vaginal intercourse. MATERIALS AND METHODS: We studied 135 male patients aging from 18 to 40 years seeking medical care for PE in the Infertility and Sexual Medicine Department from June to September 2020. All the participants were asked to fill the premature ejaculation diagnostic tool PEDT and MPEDT questionnaires to estimate the PE symptoms during, respectively, intercourse and self-masturbation. The reliability/validity, the factor analysis of the tool, and the diagnostic sensitivity/specificity of MPEDT were calculated. RESULTS: The overall Cronbach alpha was 0.884. In our adjusted model, both root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) were lower than 0.08, while goodness of fit index, adjusted goodness of fit index, non-normed fit index (NNFI), and comparative fit index (CFI) were higher than 0.9. The area under the ROC curve (AUC) is 0.943 ± 0.015. The results suggest MPEDT points being ≤5 as "normal," ≥7 as "PE during self-masturbation," and 6 as "suspected PE," with the sensitivity of 91.9% and specificity of 88.1%. DISCUSSION: An efficient diagnostic psychometric tool is needed for the individuals who, based on the impaired control over ejaculation during self-masturbation, may also suffer from PE during partnered intercourse. MPEDT is able to evaluate the existence of PE symptoms not necessarily during heterosexual intercourse but rather during self-masturbation, possibly aiding to the diagnosis, as well as planning and follow-up of a prompt therapeutical strategy. CONCLUSION: MPEDT could be considered a new, objective, and reliable diagnostic tool for the evaluation of the existence of PE symptoms.

The dangers of being a sperm donor.

This article argues that that there are two important reasons why many potential donors refrain from donating and why many donors value not being outed as a sperm donor. The first reason is the stigma attached to sperm donation. The second is the attribution of fatherhood to the donor. Attributional fatherhood is based on the rejection of the basic rule underlying the practice of sperm donation, i.e. the donor is not the father of the offspring. Attributional fatherhood ascribes the status of father exclusively on the basis of the genetic connection between the donor and the offspring. The violation of the 'responsible father' rule generates moral blame and may result in conflicts, disapproval and rejection. The presence of this view in different groups is demonstrated. Possible solutions for this issue are briefly presented. Given the geneticization of relationships in society in general, this phenomenon may increase in the future, thus putting pressure on the practice of sperm donation.

[Subjective orgasm experience in the context of solitary masturbation]. / Experiencia subjetiva del orgasmo en el contexto de la masturbación en solitario.

BACKGROUND AND OBJECTIVE: The subjective orgasm experience refers to the evaluation of sensations caused by orgasm from a psychological approach. The objective of this study was to examine the subjective orgasm experience in the context of solitary masturbation taking into account sex and age, as well as to compare this experience with perceived experience in the context of a sexual relations. MATERIAL AND METHODS: The sample was composed of 874 heterosexual adults from the general Spanish population (441 men [50.5%], 433 women [49.5%]). It was distributed into two age ranges: 18-34 and 50-93years. Participants completed a survey composed of a Background questionnaire and the Spanish version of the Orgasm Rating Scale. RESULTS: It was shown that sex (p<.001) and age (p<.001) influence subjective orgasm experience in the context of solitary masturbation. Women and young people showed greater intensity. Furthermore, significant differences in the subjective orgasm experience between the context of solitary masturbation and the context of a sexual relations were found. It was estimated as more intense in a sex-with-partner context. CONCLUSIONS: The subjective orgasm experience in the context of solitary masturbation is different to the one experienced in the context of a sexual relationship, being more intense in women and in young people.

The Impact of the COVID-19 Quarantine on Sexual Life in Italy.

OBJECTIVE: The aim of the study is to evaluate how individual and couple's sexuality had changed during the COVID-19 pandemic-related quarantine. METHODS: A quantitative correlational research study was conducted, using a web-based survey. RESULTS: About 1576 participants were involved: 1018 women (64.6%) and 558 men (35.4%). A significant decline in the mean well-being scores during the quarantine, compared to before, was reported. A positive correlation between the well-being scores and the number of sexual intercourse (SI) before and during the quarantine was found. The mean number of SI decreased significantly during the quarantine. The main reasons were: poor privacy (43.2%) and lack of psychological stimuli (40.9%). About 1124 respondents (71.3%) did not report sexual desire (SD) reduction. A positive association between SD and SI during the quarantine was found. About 61.2% did not report autoerotism reduction. In those who reported decreased masturbation activity, the main causes were poor privacy (46.4%) and lack of desire (34.7%). We found that men presented lower SD during the quarantine, than women (P < 0.01). CONCLUSION: Potentially, the more time available might lead couples to reconnect at an intimate level and to improve their sexuality. However, the majority of quarantined participants experienced reduced number of SI per week, with poor household privacy and lack of psychological stimuli as cited causes, even as a majority did not report reduced autoeroticism.

Frecuencia sexual de los adolescentes españoles durante el confinamiento por COVID-19 / Sexual frequency of Spanish adolescents during confinement by COVID-19

La situación de confinamiento debido a la COVID-19 ha supuesto un gran cambio en los estilos de vida de los jóvenes. Sin embargo, poco se conoce del impacto que el aislamiento ha tenido en la sexualidad de los adolescentes. Por ello, el objetivo de este trabajo es conocer la frecuencia sexual de los adolescentes durante el confinamiento y sus posibles consecuencias, todo ello con una perspectiva de género. 134 adolescentes españoles, entre 16-20 años, respondieron a una encuesta on-line ad hoc sobre sexualidad, siendo el 59.7% chicas. Un 67.2% de los participantes se consideraba heterosexual, un 91.2% estaba confinado/a con sus padres, un 59.7% estaba soltero/a y un 40.3% tenía pareja estable. Durante el confinamiento, se ha observado un incremento de la frecuencia de masturbación y de las actividades sexuales online, pero estos cambios solo han resultado estadísticamente significativos en los chicos. Entre las causas de este incremento, encontramos razones como "por aburrimiento", "para relajarme", o "debido a un aumento de apetito sexual", siendo los chicos los que más lo justificaban con razones emocionales. Esta mayor frecuencia sexual les generaba mejor estado de ánimo y estar más relajados, aunque gran parte de los chicos refirieron que las actividades sexuales les resultaban menos satisfactorias. Cabría seguir estudiando las posibles consecuencias negativas que pueden surgir de estos cambios en la frecuencia sexual, y analizar el papel que podrían estar jugando las emociones. Todo ello con la intención de diseñar campañas de promoción de la salud sexual en tiempos de confinamiento

The confinement situation due to COVID-19 has brought a great change in the lifestyles of young people. However, little is known about the impact that isolation has had on adolescent sexuality. The objective of this work is to know the sexual frequency of adolescents during confinement and its possible consequences, including gender perspective. 134 Spanish adolescents, between 16-20 years old, responded to an ad hoc online survey on sexuality, being 59.7% girls. 67.2% of the participants considered themselves heterosexual, 91.2% were confined to their parents, 59.7% were single and 40.3% had a stable partner. During confinement, an increase in the frequency of masturbation and online sexual activities has been observed, but these changes have only been statistically significant in boys. Among the causes of this increase, we find reasons such as "due to boredom", "to relax", or "due to an increase in sexual appetite", with boys justifying it the most with emotional reasons. This higher sexual frequency generated a better mood and more relaxation, although many boys reported that sexual activities were less satisfactory. It would be necessary to continue studying the possible negative consequences that can arise from these changes in sexual frequency, and to analyze the role that emotions could be playing. All this to design campaigns to promote sexual health in times of confinement

Does Low-Cost Sexual Gratification Make Men Less Eager to Marry? Pornography Use, Masturbation, Hookup Sex, and Desire to Be Married Among Single Men.

Coinciding with declining rates of marriage and coupled sex in the U.S., some scholars have proposed that the growing availability of "low-cost sexual gratification" or "cheap sex"-sexual activities such as hookups, pornography use, and masturbation that demand little effort or investment-will lead men to find marital commitment less appealing. Using data from two nationally representative surveys of American adults (2012 New Family Structures Study, N = 349; 2014 Relationships in America Survey, N = 1402), the current study tested the thesis that unmarried men's pornography use, masturbation habits, or frequency of recent hookup sex would be associated with a lower likelihood of them finding marriage desirable. This thesis was unsupported. In both surveys, masturbation and hookup sex were not associated with unmarried men wishing to be married, while pornography use was robustly and linearly associated with a higher likelihood of wanting to be married. This association was apparent at both the bivariate level and after taking into account sexual satisfaction, relationship status, beliefs about marriage, and a host of other potential confounds. Findings suggest that, rather than making marriage less desirable, some forms of "low-cost sexual gratification" such as pornography use to predict a comparatively higher desire for marriage. The implications of these findings are considered in light of sex-exchange theories of marital commitment and the large body of previous research connecting pornography use to more liberal, non-monogamous sexual attitudes.

What Does Research Tell Us About Women's Experiences, Motives and Perceptions of Masturbation Within a Relationship Context?: A Systematic Review of Qualitative Studies.

This systematic review provides an overview of what qualitative research has revealed about partner-related factors around women's masturbation and explores how these factors relate to women's behavior, perceptions, and motives toward masturbation. Eleven studies were identified and secondary thematic analysis was used for synthesis. Women's perceptions often focus on the (potential) negative influences of masturbation on current or future relationships. Motivations some women reported for masturbating due to partner-related factors were diverse. Findings suggested that some women modify their masturbation behavior when in a relationship. The implications of these findings for sexual health educators and clinicians are discussed.

Abstinence from Masturbation and Hypersexuality.

Despite the lack of evidence for negative health effects of masturbation, abstinence from masturbation is frequently recommended as a strategy to improve one's sexual self-regulation. We adopted a framework of perceived problems with pornography to collect first hints about whether abstinence from masturbation stems from a psychological and behavioral "addiction" or conflicting attitudes. In an online questionnaire survey recruited via a non-thematic Reddit thread (n = 1063), most participants reported that they had tried to be abstinent from masturbation. As visible from zero-order correlations and multiple linear regression, motivation for abstinence was mostly associated with attitudinal correlates, specifically the perception of masturbation as unhealthy. While there were associations with hypersexuality, no significant correlation with behavioral markers such as maximum number of orgasms was found. Higher abstinence motivation was related to a higher perceived impact of masturbation, conservatism, and religiosity and to lower trust in science. We argue that research on abstinence from masturbation can enrich the understanding of whether and how average frequencies of healthy behavior are pathologized.

Why and How Women Masturbate, and the Relationship to Orgasmic Response.

Masturbation, as a significant sexual activity within its own right, has garnered substantial interest as a research topic only within the past 10-20 years. In this in-depth analysis of masturbation in women, we examined relationships among frequencies of, reasons for, and activities during masturbation, and investigated how such parameters predict orgasmic pleasure, latency, and difficulty. Participants were 2215 women at least 18 years of age participating in a 42-item opt-in online survey that collected detailed information about women's orgasmic response during masturbation and partnered sex. Higher frequency of masturbation was related to lower satisfaction with partner, greater importance of sex, and higher levels of general anxiety/depression. Frequency of, reasons for, and activities during masturbation predicted both orgasmic pleasure and orgasmic difficulty during masturbation. The pattern of results enabled the development of three typologies of women who differ systematically with respect to their masturbation and partnered sex behaviors.

Postcoital Symptoms in a Convenience Sample of Men and Women.

INTRODUCTION: Postcoital dysphoria (PCD) is a condition characterized by inexplicable feelings of tearfulness, sadness, and/or irritability. Previous research has mostly focused on these 3 symptoms, failing to explore other symptoms that can occur after sexual activity. AIM: The aim of the present study was to get a more in-depth understanding of postcoital symptom variety, to compare the type and frequency of these symptoms in men and women, and to explore the context in which they manifest. METHODS: A convenience sample of 223 women and 76 men filled in an online survey consisting of a list of 21 symptoms and a set of additional questions. MAIN OUTCOME MEASURE: The study outcomes were obtained using a study-specific questionnaire to assess postcoital symptoms, consisting of a list of 21 symptoms that form 4 domains and 2 additional questions that assess personal and interpersonal distress. RESULTS: Of all participants, 91.9% reported any postcoital symptom over the past 4 weeks and 94.3% ever since they had been sexually active. The most common symptoms in women were mood swings and sadness, whereas in men, it was unhappiness and low energy. Men and women differed in the frequency of postcoital symptoms experienced ever since being sexually active, with women reporting more sadness, mood swings, frustration, and worthlessness. For 73.5% of individuals, the postcoital symptoms were present after consensual sexual intercourse, for 41.9%, after general sexual activity, and for 46.6% also, after masturbation. Of all participants, 33.9% said that they only experienced the symptoms after orgasm. CLINICAL IMPLICATIONS: Postcoital symptoms are clearly more varied than previously suggested and are not related to classic "dysphoria" only. Hence, we propose to cease calling the phenomenon "postcoital dysphoria" and suggest to simply use the term "postcoital symptoms." STRENGTH & LIMITATIONS: This is the first study ever to provide a more in-depth exploration of postcoital symptom variety. The sample was relatively small, and the representativeness and, therefore, generalizability of the results was limited, given that a convenience sample was used. CONCLUSION: Our results indicate that postcoital symptoms are a multifaceted phenomenon which shows similar expression in men and women. The symptoms are clearly more varied not related to classic "dysphoria" only. Burri A, Hilpert P. Postcoital Symptoms in a Convenience Sample of Men and Women. J Sex Med 2020;17:556-559.

Is the Link Between Pornography Use and Relational Happiness Really More About Masturbation? Results From Two National Surveys.

Numerous studies have observed a persistent and most often negative association between pornography use and romantic relationship quality. While various theories have been suggested to explain this association, studies have yet to empirically examine whether the observed link between pornography consumption and relationship outcomes has more to do with solo masturbation than actually watching pornography. The current study drew on two nationally representative data sets with nearly identical measures to test whether taking masturbation practice into account reduces or nullifies the association between pornography use and relational happiness. Controls are included for sex frequency and satisfaction, depressive symptoms, and other relevant correlates. Results from both the 2012 New Family Structures Study (NFSS; N = 1,977) and the 2014 Relationships in America survey (RIA; Ng = 10,106) show that masturbation is negatively associated with relational happiness for men and women, while pornography use is either unassociated or becomes unassociated with relational happiness once masturbation is included. Indeed, evidence points to a slight positive association between pornography use and relational happiness once masturbation and gender differences are accounted for. Findings suggest that future studies on this topic should include measures of masturbation practice along with pornography use and that modifications to theories connecting pornography use to relationship outcomes should be considered.

Masturbatory Behavior in a Population Sample of German Women.

BACKGROUND: Human masturbation is and has been a very heatedly and controversially discussed topic in human sexuality. Studies investigating aspects of human masturbatory behavior and female sexual pleasure remain scarce. This lack of knowledge opens the door to further controversies and misconceptions. AIM: To conduct an explorative study on female masturbatory behavior to gain more insight into this nonreproductive sexual behavior and provide an empiric basis for future research. METHODS: A total of 425 German women (mean age 26.6 years), 61.4% of whom were in a committed relationship, completed a comprehensive 76-item online survey consisting of study-specific, self-constructed questions and validated and standardized questionnaires. MAIN OUTCOME MEASURE: Correlation and comparative analyses were performed. Results are presented numerically as means and percentages. RESULTS: The majority (94.5%) of women indicated having masturbated at least once in their life, with a mean age at first masturbation of 14 years. 85.9% of women described masturbation as "genital self-stimulation until reaching orgasm." The majority of women reported masturbating 2 or 3 times a week (26.8%) or once a week (26.3%). Factors independently associated with masturbation frequency were relationship status, orgasm frequency, openness to new experience, and body acceptance. Almost all women (91.5%) reported masturbating also when in a relationship. For the 5.5% of women who had never engaged in autoerotic stimulation, the 2 main reasons were "I hardly every feel sexual desire" and "sex is a partner-only thing." 7.6% reported never experiencing an orgasm during masturbation, whereas 50.3% indicated that they always reached orgasm during autostimulation. The reasons cited for engaging in masturbation were manifold, ranging from sexual desire to relaxation and stress reduction. The most common fantasy included the partner; however, 20.7% fantasized about being "defenseless," and 8.7% thought about a "disturbing" scenario that they chose not to elaborate further. CLINICAL IMPLICATIONS: For many women, masturbation does not represent "a partner substitute" to seek sexual pleasure, but rather is a stress coping and relaxation strategy. STRENGTHS & LIMITATIONS: This is one of the very first studies to provide more in-depth insight into a variety of aspects related to female masturbation. The representativeness of the data is limited to this particular sample of German women. CONCLUSION: Our findings highlight the huge diversity in terms of masturbation frequency, motivations, styles, and preferences that can be observed in this particular population sample of German women. Burri A, Carvalheira A. Masturbatory Behavior in a Population Sample of German Women. J Sex Med 2019;16:963-974.

Exploring Sexual Behaviour and Associated Factors among Adolescents in Saudi Arabia: A Call to End Ignorance.

Little is known about sexual behaviour, attitudes, and associated factors among adolescents in Saudi Arabia. A cross-sectional study using a multistage sampling technique was conducted among 453 male adolescents selected from high schools in Riyadh, Saudi Arabia. About 54.1% of the adolescents practiced masturbation daily and 38% had experienced sexual contact, while 67% had friends who had experienced sexual contact. The majority of adolescents (72.2%) believed men engage in sexual experience before marriage, and only 11.5% discussed sexual health issues with their parents. Most adolescents believed in the effectiveness of sex education (92.3%) and the need for school-based sex education (85.6%). The logistic regression analyses showed adolescent sexual activity was independently associated with age [adjusted odds ratio (AOR) = 1.5, 95% confidence interval (CI): 1.3-1.8, p < 0.001), daily masturbation (AOR = 2.1, 95% CI: 1.3-3.2, p < 0.004), friends who engaged in sexual activity (AOR = 2.8, 95% CI: 1.4-4.6, p < 0.001), and belief that men experience sexual contact before marriage (AOR = 5.1, 95% CI: 2.8-9.3, p < 0.001). The findings indicated that male adolescents had negative attitudes toward sexual activity and were involved in risky sexual behaviour. To mitigate these issues, schools and community networks should be involved in the delivery of a culturally sensitive sexual health-promoting programme.