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. 2025 Apr 22;35(1):15.
doi: 10.1186/s12610-025-00261-6.

Prevalence of masturbation and masturbation guilt and associations with partnered sex among married heterosexual Chinese males in an outpatient clinical setting: a retrospective single center study

Zheng Zhang  1 , Nan Zhang  2
Affiliations

Prevalence of masturbation and masturbation guilt and associations with partnered sex among married heterosexual Chinese males in an outpatient clinical setting: a retrospective single center study

Zheng Zhang et al. Basic Clin Androl. .

Abstract
in English, French

Background: Solo masturbation is not an activity performed exclusively in single males but can also occur among married males, and is often associated with feelings of guilt. This study aimed to explore the prevalence of solo masturbation and associated masturbation guilt and the possible associated factors, including age, residence type (rural or urban), duration of marriage, parental status, income level, education level, body mass index, current smoking and drinking status, anxiety and depression status and their possible associations with the frequency of partnered sex among married heterosexual Chinese males.

Materials and methods: A series of males attending our outpatient clinic were included and analyzed in the study. Approximately 71.2% (334/469) of these males had engaged in masturbation during the studying period, whereas 76.6% (256/334) of those who reported engaging in masturbation reported at least some sense of guilt.

Results: Masturbation frequency was weakly positively associated with young age (OR 1.11) and education level (OR 1.24), whereas weak positive correlations were found between masturbation guilt and young age, anxiety and depression level (ORs ranged from 1.08 to 1.30). In addition, we found that the frequency of partnered sex was weakly positively associated with a masturbation frequency of less than once a month (adjusted OR 1.50) and once a month (adjusted OR 1.35). A weak positive correlation was observed between the frequency of partnered sex and a little sense of guilt (adjusted OR 1.60). In contrast, a weak negative association was observed between the frequency of partnered sex and a very big sense of guilt, with an adjusted OR of 1.67.

Conclusions: In summary, in married heterosexual Chinese males, masturbation along with its associated guilt is a relatively frequent phenomenon. We obtained evidence supporting both compensatory and complementary relationships between masturbation, masturbation guilt and the frequency of partnered sex. Masturbation and its related guilt should receive more attention in clinical practice, given its high prevalence and possible relationship with partnered sex and couple relationships.

RéSUMé: CONTEXTE: La masturbation en solo n’est pas une activité pratiquée exclusivement chez les hommes célibataires, mais peut également se produire chez les hommes mariés, et elle est souvent associée à des sentiments de culpabilité. Cette étude visait à explorer la prévalence de la masturbation solo et de la culpabilité associée à la masturbation, ainsi que les facteurs associés possibles, notamment: l’âge, le type de résidence (rurale ou urbaine), la durée du mariage, le statut parental, le niveau de revenu, le niveau d’éducation, l’indice de masse corporelle, le tabagisme et la consommation d’alcool actuels, l’anxiété et la dépression et leurs associations possibles avec la fréquence des rapports sexuels en couple chez les hommes chinois hétérosexuels mariés. RéSULTATS: Une série d’hommes venant dans notre clinique en consultation externe ont été inclus dans l’étude. Environ 71,2% (334/469) de ces hommes s’étaient masturbés au cours de la période d’étude, et 76,6% (256/334) de ceux qui ont déclaré s’être masturbés ont dit avoir au moins un certain sentiment de culpabilité. La fréquence de la masturbation était faiblement associée positivement au jeune âge (RC 1,11) et au niveau d’éducation (OR 1,24), et de faibles corrélations positives ont été trouvées entre la culpabilité de la masturbation et le jeune âge, l’anxiété et le niveau de dépression (OR de 1,08 à 1,30). De plus, nous avons constaté que la fréquence des rapports sexuels avec une partenaire était faiblement associée positivement à une fréquence de masturbation de moins d’une fois par mois (OR ajusté 1,50) et d’une fois par mois (OR ajusté 1,35). Une faible corrélation positive a été observée entre la fréquence des rapports sexuels avec une partenaire et un faible sentiment de culpabilité (OR ajusté 1,60). En revanche, une faible association négative a été observée entre la fréquence des rapports sexuels avec une partenaire et un très grand sentiment de culpabilité (OR ajusté 1,67). CONCLUSIONS: Chez les hommes chinois hétérosexuels mariés, la masturbation et la culpabilité qui lui est associée constitue un phénomène relativement fréquent. Nous avons obtenu des preuves soutenant à la fois des relations compensatoires et complémentaires entre la masturbation, la culpabilité liée à la masturbation et la fréquence des rapports sexuels avec une partenaire. La masturbation et la culpabilité qui lui est associée devraient faire l’objet d’une plus grande attention dans la pratique clinique, compte tenu de sa prévalence élevée et de sa relation possible avec les relations sexuelles en couple et les relations de couple.

Keywords: Frequency; Married males; Masturbation; Masturbation guilt; Partnered sex.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The present study was approved by the ethics committee of the second affiliated hospital of Zhejiang University School of Medicine (2023 0945) and informed consent was also obtained from the participates. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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