Understanding prone masturbation and its impact on sensation

Having a bat is nothing to be embarrassed about. It's a normal part of human sexuality. Practically everybody does it at some point, with an estimated 80% of males and 58% of females having masturbated at least once by age 17 [1]. 

Masturbation is a perfectly healthy way of exploring and expressing one’s sexual self, and it comes with a variety of health benefits. It’s why various state governments have made an effort to promote and destigmatise the practice, including Queensland Health’s “Give Yourself a Hand” campaign [2].

While there are many ways to masturbate, one that has gained attention is prone masturbation. Some have suggested that it causes sexual health problems, like male erectile dysfunction and a loss of sensation. But does it really? Here’s what you must know.

What is prone masturbation (traumatic masturbatory syndrome)? 

Prone masturbation gets its name because you lie on your stomach and rub your erect penis against a pillow, mattress, or even the floor. Some men might also cup their penis and thrust into their hands to stimulate sexual intercourse with a partner, or use sex toys. The resulting friction stimulates the penis, bringing you to ejaculation.

Contrary to popular belief, although most people focus on men performing this type of masturbation, some women also do it. It essentially works the same way, but this type of masturbation occurs by pressing the clitoris in the same way.

Approximately 72% of men and 42% of women have masturbated in the past year, per the Second Australian Study of Health and Relationships [3]. We know that the vast majority masturbate at least semi-occasionally, meaning it’s not a stretch to assume that many Aussies are also experimenting with prone masturbation.

Some research has pointed toward prone and other non-conventional forms of masturbation in the development of traumatic masturbatory syndrome, or TMS.

What is traumatic masturbatory syndrome?

Traumatic masturbatory syndrome isn’t a hoax, but it isn’t universally accepted either. It originates from a 1998 study by Dr. Lawrence Sank, an American psychologist [4]. The theory goes that this is a type of sexual dysfunction caused by prone masturbation.

Dr. Sank proposes that the sheer pressure placed on the penis and the unnatural texture caused by mattress sheets, towels, and other surfaces lead to desensitisation of the penis. Ultimately, this leaves long-term consequences like delayed orgasms and erectile dysfunction.

You might notice that the theory and mechanism of action track with the well-known “death grip syndrome”, where excessively hard grips during self-pleasure result in desensitisation and sexual problems further down the line. 

Is traumatic masturbatory syndrome real?

Some people think that this is one of those urban myths, but it’s not. According to Columbia University, it’s not a hoax [5]. It’s just that this remains a proposed theory that isn’t broadly accepted by the scientific community.

How common is prone masturbation?

The short answer is we don’t really know. Although we have plenty of statistics on the prevalence of masturbation generally, we know little about so-called “atypical” masturbation methods, including prone masturbation.

In one study, 10.97% of the general population engaged in different forms of atypical masturbation, with around 5% reporting prone masturbation [6].

Why do some people masturbate in the prone position? 

Decoding why people engage in a particular sexual practice is never straightforward. It’s a psychological question that attracts a range of theories. Prone masturbation has been studied so little that we’re essentially throwing out ideas and seeing what sticks.

Some of the most popular theories that have been put forward include:

• Early Habit Formation – Some people might discover masturbation while in this position. It’s this accidental habit formation that leads to the association with sexual pleasure.
• Increased Pressure – Prone masturbation puts more pressure on the penis and pelvis, making this type of sexual activity especially attractive for satisfying sexual urges.
• Hands-Free Experience – It’s just another form of experimentation. Unlike lying face-up masturbation, you don’t actually need to use your hands for stimulation. To some people, it’s a closer replication of oral sex or sex with a partner.
• Fantasising – Some people report that not having to use their hands or becoming used to the prone position allows them to fantasise more easily. Popular scenarios in this position include passiveness and receiving sexual stimulation from behind.
• Sexual Habits – Familiarity breeds repetition, and vice versa. Simply put, if you make it a habit, there’s a stronger chance that it becomes your “go-to” technique for masturbation. 

Why is prone masturbation also known as traumatic masturbatory syndrome?

You’ll see articles equating prone masturbation and traumatic masturbatory syndrome as the same thing. These two terms are seen as interchangeable because of the theory that it causes sexual dysfunction due to the intense pressure and friction involved in this technique.

Some studies have already drawn a correlation between the two, with one study highlighting that atypical masturbatory behaviours are more common in young men reporting erectile dysfunction to their GPs [7].

Understanding the concerns around prone masturbation

Masturbate prone, and you’ll see plenty of articles online telling you it’s a one-way street to sexual dysfunction.

The truth is that the evidence is flimsy because correlation doesn’t equal causation. One of the most popular studies aiming to prove this point was a Turkish study of 448 men. They drew the conclusion that erectile dysfunction was much more likely when people engaged in sexual behaviours like prone masturbation. However, the problem is that this study didn’t determine whether the masturbation caused the dysfunction, or vice versa [8].

So, let’s look at why some believe that prone masturbation affects sensation and sexual function.

How can prone masturbation affect sensation? 

Is prone masturbation bad for sensation? It may impact sensation in a variety of ways. Chiefly, the problem lies with the body adapting to high-pressure, high-friction stimulation. If it becomes the norm, then anything less won’t elicit the same feelings.

The penis might become less responsive to normal penetrative sex as the nerve pathways become adaptive to the higher pressures of prone stimulation. And this could result in forms of sexual dysfunction. Approximately 54% of men aged 18-55 reported at least some form of sexual difficulty lasting three months or more, making it more common than many think [9].

How can prone masturbation affect sexual function?

Traumatic masturbatory syndrome has been linked with sexual function problems. The most prominent of these issues is erectile dysfunction. Today, it’s one of the most common issues, with the Royal Australian College of General Practitioners (RACGP) reporting that 23.3% of men aged 35-80 had it [10].

It also tracks with another study related to prone masturbation. It found that these masturbation practices increased the likelihood of erectile dysfunction [11]. However, beware that this study didn’t use a control group of healthy men, so the findings are flawed.

Other issues that have been flagged include:

• Delayed ejaculation
• Performance anxiety
• Pelvic floor strain (rare)

Signs that prone masturbation may be affecting your sexual health 

Masturbation is perfectly healthy in moderation and when performed safely. When prone masturbation starts to impact your sexual health, you might be wondering if it’s your technique that’s causing it.

The problem is that sexual health is complex, meaning the only real way to conclude that your technique is the cause is to book an appointment with your GP. However, here are some of the warning signs:

• Trouble reaching orgasm
• Erectile dysfunction
• Post-masturbation numbness/tingling
• Soreness/comfort
• Sexual anxiety
• Compulsive behaviour
• Avoidance of partnered intimacy

Your GP can discuss the issues you’re facing and make suggestions based on your specific situation. It might include counselling with a sex therapist, medications like Pilot’s ED treatment, or changes to your lifestyle.

How to stop prone masturbation (if you feel like you need to)?

If you feel the need to stop prone masturbation for one reason or another, it’s important to remember that male masturbation overall is perfectly healthy. Switching techniques doesn’t have to mean cutting out the habit entirely.

The first step is identifying your “why.” Pinpoint why you want to stop, whether it’s due to issues in your sexual relationships, physical discomfort or something else. Acknowledging why you wish to stop can help point you in the right direction and provide the motivation you need.

The next step is to determine which treatment route you want to pursue. For many, it’s just a matter of exploring alternative masturbation techniques, such as traditional face-up masturbation. Experimenting with different touches and sensations can reset the nerve pathways and offer new pleasures. 

Of course, if there are deeper issues at play, it might be time to contact your GP for the help you need. If you’re suffering from physical or psychological issues linked to your masturbation habits, the intervention of a medical professional will always yield better results.

Don’t be embarrassed about talking to your GP. These are the issues they deal with constantly. There’s nothing to feel ashamed about.

Promoting open conversations on sexual health 

With that in mind, the journey starts with talking about your sexual health problems. If you’re worried that prone masturbation might be harming more than it’s helping, it’s time to speak up about it.

Talk to your GP and explore your options. Opening up about your sexual health worries is the first step to getting the treatment you need.

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