Prone masturbation: What it is, why it can cause erection problems, and how to change technique

Prone masturbation means lying face down and rubbing or thrusting against a surface, like a mattress, pillow, or your own hand, until you orgasm (Sank, 1998). It's a common way some men masturbate. A small clinical case series found that a specific, high-frequency prone pattern was linked to erectile dysfunction and delayed orgasm in a few men, though this isn't true for everyone who masturbates this way (Sank, 1998). Changing technique is usually the first thing a therapist will suggest.

What is prone masturbation?

Prone masturbation is lying face down and rubbing or thrusting the penis against a surface until orgasm, rather than using an upright or on-the-back position with your hand (Sank, 1998).

Men have masturbated this way for a long time. The Romans had many words for masturbation, including "trudere," meaning "to thrust" (McDaniel, 2021). There's no evidence they had one specific word just for this position. They simply had a rich vocabulary for the act in general.

Some men prefer prone masturbation because of the pressure and friction it gives. Others fall into it by accident, and it becomes a habit. Either way, using this position isn't unusual.

The truth about how common prone masturbation is

There's no reliable, verified figure for how many men masturbate in the prone position. You might see numbers like 5% to 10% online, often linked back to Kinsey's 1948 research. Other sources say 13%. Neither number can be confirmed against Kinsey's original work, and the two figures don't even agree with each other.

What we can say is that the technique comes up often in clinical discussion and online forums. It's a common enough topic that therapists and researchers keep coming back to it. But no one has a solid, confirmed percentage, so treat any specific number you see online with caution.

Can prone masturbation cause erectile dysfunction?

In a small 1998 case series, four men who masturbated prone at high frequency developed erectile dysfunction or delayed orgasm. The researcher, Dr. Lawrence Sank, called this pattern traumatic masturbatory syndrome (Sank, 1998).

This doesn't mean prone masturbation causes erectile dysfunction (ED) for everyone. Four men is tiny sample. No independent, peer-reviewed studies have replicated Sank's findings, though Sank published his own follow-up treatment protocol in 2020 (Sank, 2020).

If you want to understand ED more broadly, including causes that have nothing to do with masturbation technique, read Mojo's full guide to erectile dysfunction.

What is traumatic masturbatory syndrome?

Traumatic masturbatory syndrome is a term Dr. Lawrence Sank coined in 1998. It describes erectile or orgasm difficulty linked to an unusual masturbation style, most often a prone one (Sank, 1998).

The term has never entered a diagnostic textbook. It isn't in the DSM or the ICD, the two main manuals doctors use to classify conditions. Sank's own 2020 paper confirms there is still no peer-reviewed data on how common the syndrome actually is (Sank, 2020).

Some researchers link this kind of technique-specific difficulty to psychological erectile dysfunction, where the brain's arousal patterns get tied to one very specific kind of touch. When that exact stimulation isn't available, like during sex with a partner, arousal can be harder to reach.

Prone masturbation and physical injury: what to know

Yes, friction against a mattress, pillow, or other surface can cause irritation, bruising, small cuts, or dryness, according to psychosexual therapist Amanda Barge.

Barge also points out that we're often less sensitive to pain while aroused. That's why irritation might not be noticed until afterward, once the friction has already done some damage.

Here's how prone masturbation compares to a retrained technique, side by side. This kind of technique-specific pattern is closely related to death grip syndrome, a closely related technique-based issue, where a very tight, forceful grip becomes the only way to reach orgasm.

Changing technique: what actually helps

Sank's original approach involved gradually retraining men to masturbate on their back using their hand instead of a surface. He reported improvement in the small group of men he studied (Sank, 1998).

Here's what actually helps if you want to try this:

• Change position gradually rather than all at once. Trying to switch cold turkey often feels frustrating and can make you give up.
• Add lubrication if you're switching to hand-only stimulation. Skin-on-skin friction feels different from surface friction, and lube helps close that gap.
• Expect an adjustment period. Sensation may feel less intense for a few weeks before it starts to feel normal.
• Don't expect an overnight fix. Retraining a pattern your body has practiced for years takes patience.

Paying attention to breath, pace, and touch, not just orgasm, is part of what mindful masturbation techniques are built around. Combining mindful masturbation with a gradual change in position tends to work better than switching cold.

When should you talk to a professional about this?

If changing technique on your own doesn't resolve erection or orgasm difficulty within a few weeks, a psychosexual therapist or a structured retraining program can help.

Mojo's The Erection Reset program, developed with sex therapist Dr. Shannon Chavez, offers structured, expert-led exercises to help rebuild the connection between arousal and touch. It's not a treatment or a cure. It's a guided way to practice retraining the patterns that may be holding you back.

Talking to someone is a direct route to fixing a common, fixable pattern instead of guessing on your own.