Q As a young man, I used to masturbate face down on the bed. Could this have caused my erectile dysfunction? Should I talk to my son, 16, about this?

DR THOMAS STUTTAFORD

A Most children, whatever their ages, would rather not think about their parents having sexual intercourse even though, if they thought about it, they would realise that without it they wouldn’t be around.

It is arguable whether the ability to chat openly about sex in a family setting is helpful. The consensus opinion, with which I agree, is that it is, but some caution is called for. I wouldn’t recommend that any father illustrate the points he was making by reference to either his or his wife’s experiences. I am certain that your son would not want to hear about your earlier masturbatory exploits, especially if your particular idiosyncrasy, which was the trigger for your sexual fantasies when a young man, was focused on your mattress. Furthermore, although your son could probably discuss your current impotency, with any embarrassment tempered by compassion, it might not improve family dynamics, his sex life, or your own.

Adolescents have enough problems – stemming from their pubertal surge of hormones, accompanying spots and the lack of socially acceptable sexual outlets when their libido is exceptionally high – without being burdened with their father’s genital troubles.

Your earlier masturbatory techniques have some hints of frotteurism, in which people become sexually aroused from fantasies when they touch or rub themselves up against someone who hasn’t, and wouldn’t, respond to their sexual advances. They also have a suggestion of fetishism.

Frotteurism is a comparatively common condition that accounts for many of the cases of sexual assault in crowded places, such as on the Underground. Frotteurism is classified as a paraphilia, those conditions that used to be described as perversions. By definition, a paraphilia describes sexual practices in which someone is sexually aroused by contact with people, objects or from situations in which the object that excited their physical desire is unlikely to, or incapable of, displaying affection or reciprocal arousal. This definition would seem to include your mattress when you were a young man. Frotteurism, when a man rubs up against a woman, is obviously unpleasant, but what constitutes abnormal fetishism is more difficult as it shades into normal behaviour.

The textbook definition of paraphilias might also seem to include sex with blow-up dolls, dildos, artificial vulvas, silk underwear and shoes. However, if these were not the object of the passion but only the means of satisfying a totally separate fantasy, their importance would be lessened.

Most men and women masturbate. Furthermore, recent research suggests that it is at least as common in women as in men. It certainly doesn’t cause impotence. However, if when younger you could become sexually aroused only by rubbing yourself against the mattress, this would be an interesting point to raise with your GP when discussing your impotence.

Without a medical history, knowledge of your smoking and drinking habits, as well as the nature of any medicines you take, and the results of standard cardiovascular and blood tests, it is impossible to predict the cause of your impotence – but it won’t be masturbation.

Dr Thomas Stuttaford, The Times doctor, spent many years working in a genitourinary clinic

SUZI GODSON

A I’m trying to picture this one in my head. You’d start by saying something like: “Son, when I was a boy I used to masturbate... ” And he’d be out the door before you could finish the sentence, wouldn’t he?

Though I’m all for talking to kids, teenage boys and girls do not, under any circumstances, want to hear about their parents’ masturbatory habits. Nor do they want to discuss their own with their parents. Topics such as masturbation and sex should be dealt with before children get to the point where they would rather chop off their right hand than have their parents know what they use it for.

On the upside, you are probably worrying about nothing. Only a very small minority of boys masturbate face down and although there is a school of thought which suggests that masturbating prone might be linked to erectile dysfunction, very little research has been done on the subject. In 1998, Dr Lawrence I. Sank published a paper in the Journal of Sex & Marital Therapy,which established a link between masturbating in the prone position and erectile dysfunction. Dr Sank based his research on only four male patients, one of whom was a 62-year-old African-American man who had recently started his first sexual relationship after decades spent in a religious order. In 2003, Josie Lipsith and Dr David Goldmeier cited Dr Sank’s research in a paper “Male psychogenic sexual dysfunction: the role of masturbation”, which was published in the Journal of Sexual and Relationship Therapy, but still, the relationship between prone masturbation and erectile difficulties could hardly be described as well established.

On the downside, more than half of all men aged from 40 to 70 suffer from some degree of erectile dysfunction. Illness (diabetes, high blood pressure, nerve or heart conditions), medications (antidepressants, beta-blockers) or lifestyle choices (alcohol, smoking or drugs) can all cause dysfunction. In younger men, it can also be triggered by psychological problems such as stress, anxiety, relationship problems or even something as simple as feeling insecure about wearing a condom. Often erectile dysfunction is triggered by a combination of the physical and psychological. Occasional erectile difficulties caused by too much to drink or a stressful day at work start a cycle of self-doubt that aggravates the problem.

Whatever the cause of your difficulties, it is essential that you get yourself checked out by a doctor. Erectile dysfunction affects about one man in ten and is usually treatable, yet according to the Sexual Dysfunction Association, only about 10 per cent of men get any treatment for it. There are countless pharmaceutical options available, but making lifestyle changes is equally important. If you smoke, now is the time to stop. And keep alcohol to a minimum. You need to try to reduce your stress levels, too.

Regular exercise is probably the single most important way that you (and your son) can improve your health and stop your erectile function deteriorating. It also sets a great example to your son. Walking to work, taking the stairs, jogging, swimming, surfing or playing football in the park will make you both stronger, healthier and “fitter”. In every sense of the word.

Suzi Godson is the author of The Sex Book (Cassell, £16.99 and The Body Bible (Penguin, £16.99)

For more sex advice from Dr Thomas Stuttaford and Suzi Godson, visit timesonline.co.uk/love

E-mail your sexual dilemmas to body&soul@thetimes.co.uk or write to Body&Soul, The Times, 1 Pennington Street, London E98 1TT

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