A Comprehensive Analysis of the Potential Risks of Erectile Dysfunction Based on the Erection State During Masturbation: A Cross‐Sectional Study

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Introduction Erectile dysfunction (ED) has a high incidence and complex etiology. Traditional assessments, based on intercourse scenarios, often neglect erectile function during masturbation, possibly leading to misdiagnosis. This study aimed to comprehensively assess ED based on erection during masturbation. Method A single‐center cross‐sectional study was conducted at the First Affiliated Hospital of Anhui Medical University, with the study period spanning from June 2024 to June 2025. The International Index of Erectile Function‐5 (IIEF‐5) scale (which was administered separately for intercourse and masturbation to capture scenario‐specific function) and nocturnal penile tumescence and rigidity (NPTR) monitoring were adopted to classify the ED subtype (Group A: NPTR (abnormal) + ED during masturbation; Group B: NPTR (abnormal) + no ED during masturbation; Group C: NPTR (normal) + ED during masturbation; Group D: NPTR (normal) + no ED during masturbation). A structured questionnaire survey was implemented to gather information on potential risk factors of the study participants, followed by statistical analysis of the association. Results Among the 525 participants we studied, 371 suffered from ED. These patients were generally older, had a higher body mass index (BMI), a higher smoking rate, and lower physical activity levels. Subtypes differed in IIEF‐5 scores, comorbidities, and related factors: Group A represents the most severe ED, and its IIEF‐5 score is also the lowest (8.16 ± 3.87). Group A was associated with organic diseases; Group B with sexual desire disorder; Groups C and D with psychological disorders. Conclusion This is the first study to use masturbation erection to classify ED types, each with unique characteristics and causes, providing a basis for personalized diagnosis and treatment.

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