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Male Masturbation/Difficulty ejaculating causing prostate trouble


QUESTION: I'm a 45 year old gay man who came out only 10 years ago. I grew up in a religiously conservative home environment and, unfortunately, suffered several episodes of sexual assault in my early youth - from 11 to 14 years of age. Though I discovered masturbation by accident at age 11, I lacked the knowledge of what was going on with my body or the language to question or describe it (both masturbation and sexual assault). I masturbated on an limited basis through my teens and twenties. At age 28, i began having painful difficulty with my prostate and blood in my semen, and after visits to multiple urologists, I was diagnosed with both low testosterone and chronic non-bacterial prostatitis. Due to my earlier sexual assaults and religious conditioning, I had remained afraid of sexual intercourse and thus celibate.

My urologist found a lot of scar tissue in my prostate and actually wrote prescriptions for hormone replacement therapy (which I still take) and "prescribed" masturbation / ejaculation daily to clear up my prostatitis. I have followed his advice, and for most of the past 15 years, i have had no further issues, particularly once I finally met a partner and began having sexual intercourse as a receptive partner.

However, my boyfriend and I broke up a year ago, and I have begun to have painful blockages in my prostate again, accompanied by weak ejaculations that are almost impossible to achieve. It is taking more than an hour (and up to three hours) of vigorous lubricated stroking before I can achieve orgasm and ejaculation, if at all. I am both reluctant and embarrassed to seek a new sexual partner, and I have not found a current urologist who will take my case seriously. I am in psychological therapy and have no reservations about masturbating, but I am quite exasperated by my inability to orgasm and ejaculate. My hormones remain at normal levels with replacement therapy. I have even tried porn and vibrators to help things respond normally without much success. Any advice on what other options I might try? This is quite painful! Thanks in advance for your perspective!

ANSWER: I would suggest experimenting with a variety of lubes to see what works best for you.  This page has suggestions:

You said you masturbated on "a limited basis" in your teens and twenties; how often was that?  Most males in that age group who don't have partners masturbate daily or about that.  Obviously, you can't change how often you masturbated when you were young, but you can change how often you masturbate now.

You might also enjoy a toy called the Super Head Honcho which you can buy for about $15 that will make stroking easier for you.

---------- FOLLOW-UP ----------

QUESTION: Thanks for your response. When I originally discovered masturbation, I did it without lube, and I quickly developed a lot of chafing on my penis as a result. My earliest experiences with masturbation, unfortunately, were the catalyst for my first sexual assault (in the shower house of an RV campground - my family took camping vacations that lasted up to a month each summer, and I had no other place to use that offered any privacy). This contributed to my reluctance to masturbate as often as I felt the urge to do so.

However, at 15, my family quit camping and I discovered Vaseline. from 15 to 19, I masturbated daily - usually twice a day. My guilt remained, but I could not stop, and increasingly I didn't want to stop. Then college happened (a conservative evangelical one at that) and all of the problems I'd experienced in my early teens came rushing back again. I was lucky if I could find privacy to masturbate once or twice a week. I didn't know it then, but that's likely when my testosterone levels began to drop and the length of time to reach orgasm and ejaculate began to dramatically increase. My sexual orientation also became a challenge during those years; I didn't recognize that I was gay; I just increasingly wondered why I was not attracted to women and it wasn't a phase or a question of "meeting the right girl" as I'd so often been told in my teens. Throughout my twenties, my frustration grew while my masturbation frequency slowed from a daily activity to once or twice weekly - and then to monthly by my late 20s. It was a depressing time, and antidepressants only made it worse, so I threw myself into my career instead. SSRI medications and erections / orgasms didn't mix well at all for me.

My first round of prostatitis took nearly a year to cure, the hormome replacement therapy helped restore daily masturbation sessions, and it also finally made me VERY aware that I was in fact attracted to men. Once I became sexually active with my former partner, we had sex 4-5 times a week, and I continued to masturbate daily as well without further trouble achieving strong orgasms or ejaculation. It was a wonderfully happy and welcome period in my life.

Since my partner and I broke up, I still try to masturbate daily, but more often than not I give up in frustration because it takes so long to climax. Even if I can achieve orgasm and ejaculate, my semen output is small and usually comes out in small solid clumps with little fluid - almost like finely chopped bits of cooked spaghetti. This is quite similar to what I experienced with prostatitis. It doesn't exactly feel good either. Frankly, I seriously miss the pleasure of orgasm and strong, normal ejaculations. I also miss my partner. I will never take an antidepressant again; that's why I'm in therapy instead. Is daily masturbation still a viable goal for men in their 40s? The desire is certainly still there for me.

Thanks for the link about lube - I do use a silicone lube listed in the link and have for several years now. Thanks also for the toy suggestion. It reminds me of the sleeves found in Fleshlights / Fleshjacks, though I've had difficulty with such devices because they require a water-based lubricant, and those dry up long before I can reach orgasm. Do you have any suggerstions for similar toys that are silicone compatible? I long to be able to come in 10-30 minutes again (like I did when I was dating my partner) rather than marathon sessions that only end in frustration!

You can probably use silicone lube with the Super Head Honcho as long as you clean it out right away.  Anyway, a Super Head Honcho sleeve costs less than $15, so it's not a big deal if it gets ruined by silicone lube.  

Many men your age still masturbate daily.  More typical in your age range is 3-4 times a week.  See if you can keep that up without any trouble.

I really doubt that your changing masturbation frequency in your teens had anything to do with your testosterone level.  

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Doug Adams, Ph.D.


I write from the point of view that masturbation is normal, healthy, and fun, and even necessary to sexual health. I am able to answer questions in all areas of sexuality.


I am the author of the web site and have been answering questions about sexuality (especially masturbation) from both males and females for over 13 years.

I have a Ph.D. in a field unrelated to sexuality from one of the leading educational institutions of the world.

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