Masturbation is related to psychopathology and prostate dysfunction: comment on Quinsey (2012).

In an interesting discussion about which criteria should guide the diagnoses of paraphilias, Quinsey (2012) observed that‘‘in order for a condition to be considered a mental disorder, the condition must represent the failure of some mental mechanism to perform the function for which it was designed by natural selection and the condition must cause some deprivation of benefit (defined in terms of the society within which the affected individual lives)’’ (p. 218). Furthermore, it is noted that, from an evolutionary perspective, a deprivation of benefit should carry costs of reduced fitness (Quinsey, 2012). Consequently, Quinsey concluded that most actual and proposedDSMparaphiliasdonotclearlymeet thesecriteria,because it is not clear if they diminish reproductive fitness by reducing the likelihood of penile-vaginal intercourse (PVI) with fertile partners. In sodoing,heoffers theexampleofmasturbationasbeinga healthy behavior that appears to have no such interference. He asserted that masturbation is healthy by‘‘for example, lessening the likelihood ofdevelopingprostatecancer, improving mood, developing sexual interests, and perhaps even ridding oneself of tired sperm’’ (p. 219). However, these unreferenced claims contrast sharply with the best available empirical evidence. It is difficult to reconcile the view that masturbation improves mood with the findings in both sexes that greater masturbation frequency is associated with more depressive symptoms (Cyranowski et al., 2004; Frohlich & Meston, 2002; Husted & Edwards, 1976), less happiness (Das, 2007), and several other indicators of poorer physical and mental health, which include anxious attachment (Costa & Brody, 2011), immature psychological defense mechanisms, greater blood pressure reactivity to stress, and dissatisfaction with one0s mental health and life in general (for a review, see Brody, 2010). It is equally difficult to see how masturbationdevelopssexual interests,whengreatermasturbation frequency is sooftenassociatedwith impairedsexual function inmen (Brody & Costa, 2009; Das, Parish, & Laumann, 2009; Gerressu, Mercer, Graham, Wellings, & Johnson, 2008; Lau, Wang, Cheng, & Yang, 2005; Nutter & Condron, 1985) and women (Brody & Costa, 2009; Das et al., 2009; Gerressu et al., 2008; Lau, Cheng, Wang, & Yang, 2006; Shaeer, Shaeer, & Shaeer, 2012; Weiss & Brody, 2009). Greater masturbation frequency is also associated with more dissatisfaction with relationships and less love for partners (Brody, 2010; Brody & Costa, 2009). In contrast, PVI is very consistently related to better health (Brody, 2010; Brody & Costa, 2009; Brody & Weiss, 2011; Costa & Brody, 2011, 2012), better sexual function (Brody & Costa, 2009; Brody & Weiss, 2011; Nutter & Condron, 1983, 1985; Weiss & Brody, 2009), and better intimate relationship quality (Brody, 2010; Brody & Costa, 2009; Brody & Weiss, 2011). Moreover, although less risk of prostate cancer was associated with greater number of ejaculations (without specification of the sexualbehavior) (Gilesetal., 2003), it isPVIfrequency that is specifically associated with reduced risk, whereas masturbation frequency is more often related to increased risk (for a review on the subject,seeBrody,2010). Inthisregard, it is interestingtonote that masturbation isalsoassociatedwithotherproblemsof theprostate (higher prostate specific antigen levels and swollen or tender prostate)and,comparedwiththeejaculateobtainedfromPVI, theejaculate obtained from masturbation has markers of poorer prostatic function and lesser elimination of waste products (Brody, 2010). The only sexual behavior consistently related to better psychological and physical health is PVI. In contrast, masturbation is frequently associated with indices of poorer health (Brody, 2010; Brody & Costa, 2009; Brody & Weiss, 2011; Costa & Brody, 2011, 2012). There are several possible psychological and physiological mechanisms, which are a likely consequence R. M. Costa (&) ISPA-Instituto Universitário, Unidade de Investigação em Eco-Etologia, Rua do Jardim do Tabaco 34, 1149-041 Lisbon, Portugal e-mail: [email protected]