Risk Factors for the Progression of Erectile Dysfunction: The Role of Masturbation Frequency and Obstructive Sleep Apnea Syndrome
Apr 11, 2025
2 Results
In this study, 114 ED patients aged 19–84 years were included, with an average age of 35.96 ± 9.73 years and a BMI of 25.04 ± 5.14 kg/m². Among them, 56.1% were permanent residents of Guangzhou.
As shown in Table 1, the monthly income of patients in the mild ED group was significantly higher than that in the moderate to severe ED group. Meanwhile, the moderate to severe ED group had significantly higher masturbation frequency, rates of obstructive sleep apnea syndrome (OSAS), anxiety and depression levels, SAS (Self-Rating Anxiety Scale) scores, and SDS (Self-Rating Depression Scale) scores compared to the mild ED group (all P < 0.01). There were no statistically significant differences between the two groups in terms of age, BMI, place of residence, smoking or drinking history, late-night habits, history of prostitution, masturbation history, hypertension, diabetes, hyperlipidemia, chronic prostatitis, hepatitis B, circumcision, drug abuse history, or education level (all P > 0.05).
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As shown in Table 2, univariate logistic regression analysis revealed that monthly income, anxiety and depression, masturbation frequency, OSAS, SAS scores, and SDS scores were associated with the occurrence of moderate to severe ED (P < 0.05), while other factors showed no significant differences (P > 0.05). Variables with statistical significance in the univariate analysis were included in the multivariate logistic regression analysis. The results indicated that excessive masturbation (OR = 1.108, P = 0.047) and OSAS (OR = 3.194, P = 0.015) are independent risk factors for moderate to severe ED. Specifically, on the basis of a masturbation frequency of 6.60 ± 5.82 times/month, the risk of ED progression increases by 10.8% with each additional instance of masturbation. Monthly income, anxiety and depression, SAS scores, and SDS scores had no statistically significant differences in the multivariate analysis (P > 0.05).
3 Discussion
The results of this study indicate that monthly income, anxiety and depression, masturbation frequency, OSAS, SAS scores, and SDS scores are significantly associated with the occurrence of moderate to severe ED. Furthermore, excessive masturbation (OR = 1.108, P = 0.047) and OSAS (OR = 3.194, P = 0.015) are independent risk factors for moderate to severe ED.
Masturbation is a natural response that develops in men as they reach a certain age and is an expression of sexual desire. Moderate masturbation is beneficial for physical and mental health [17]. However, excessive masturbation, defined as lasting over two years with a frequency of ≥3 times/week [18], may lead to a series of physical and psychological issues. The relationship between masturbation and ED progression remains unclear, and whether excessive masturbation contributes directly to ED progression has not been conclusively established.
While some researchers [19] argue that there is no association between masturbation frequency and ED, most academics remain cautious about this conclusion. This study found that excessive masturbation is an independent risk factor for moderate to severe ED. The masturbation frequency of moderate to severe ED patients (6.60 ± 5.82 times/month) was significantly higher than that of mild ED patients (3.57 ± 3.48 times/month). However, no differences were observed when analyzing whether patients masturbated (81.1% vs. 80%, P = 0.899) or the duration of masturbation in years (8.09 ± 6.96 years vs. 9.70 ± 8.00 years, P = 0.266) (P > 0.05). This study is the first to analyze the relationship between masturbation frequency and ED progression. The multivariate logistic regression analysis results suggest that on the basis of a frequency of 6.60 ± 5.82 times/month, the risk of ED progression increases by 10.8% with each additional instance of masturbation.
The results also show that the incidence of OSAS is significantly higher in moderate to severe ED patients than in mild ED patients (75% vs. 48.6%, P = 0.007), making OSAS one of the independent risk factors for moderate to severe ED. OS
