Death Grip Syndrome: Signs, Causes and How to Fix It

Death grip syndrome is real, common and reversible. A hard, fast, dry masturbation grip re-sets your ejaculatory reflex to a pressure no partner can reproduce — so nothing builds during sex. It is conditioning, not nerve damage.

Let me say the next part plainly, because of who usually reads this. You are probably in your twenties or thirties, you have told nobody, and you have convinced yourself you have permanently destroyed the nerves in your penis. As a practicing andrologist in chennai I examine these men most weeks, and in almost every one of them the penis is structurally normal. What has changed is a setting — the amount of stimulation your nervous system now insists on before it will let go. Settings move. That is the whole of this article, and I am going to show you exactly how the setting got there, because understanding the mechanism is what stops the panic.

What death grip syndrome actually is

“Death grip” is internet slang, not a diagnosis — but the thing it describes is well documented in sexual medicine. It belongs to a category called an idiosyncratic masturbatory style: a way of stimulating yourself that a partner simply cannot copy with a hand, a mouth or a vagina (Perelman, 2016). In death grip specifically, the idiosyncrasy is force. A crushing grip. A very fast stroke. No lubricant. And very often a race to finish in ninety seconds, because you learned to masturbate in a house with thin walls and a bathroom door that did not lock properly.

Repeat that pattern for a decade and the nervous system does the only thing nervous systems do — it calibrates to the input it is given. A signal that used to be ample stops registering as enough. This side of it is measurable: vibration-perception testing of the penis — biothesiometry — is used clinically to quantify how much stimulation a penis needs before the man registers it, and work has gone into standardising how that measurement is taken (Wiggins, 2019). What you have been calling “numbness” is a raised threshold rather than a dead nerve, and those two carry completely different prognoses.

It is also not a fringe problem. In a survey of 2,743 men, roughly 11% reported a masturbation style meaningfully different from partnered sex, and that group had measurably poorer erectile function scores than men with a conventional technique (Wang, 2024). The end result — delayed ejaculation — affects around 5% of sexually active men, and in a separate Japanese national survey nearly 60% of the affected men wanted treatment while only about 12% had ever asked a doctor (Shirai, 2025). Both of those figures come from East Asian samples rather than Indian ones, so take them as the order of magnitude rather than the local rate — but the shape of them matches what walks into my clinic. That gap between suffering and asking is the part I would most like this article to close.

What are the signs of death grip syndrome?

The signs of death grip syndrome are: you climax easily alone but not inside a partner; the erection stays hard while nothing builds; ordinary touch feels muted; and the grip you need keeps getting harder and faster.

Clinically, that last picture has a name — situational anorgasmia, an inability to climax that appears only in one setting. Here is what it looks like across a real consultation.

You can, and you can’t. Alone, you finish in two or three minutes. With your wife or girlfriend, twenty minutes of intercourse produces nothing — no rising sensation, no point of no return, just friction and a slowly mounting panic. This split is the single most useful thing you can tell me, because it separates conditioning from a nerve or hormone problem in one sentence. Research on delayed ejaculation subtypes divides men into exactly these two groups: those who struggle in every setting, and those who struggle only with a partner (Rowland, 2025). Death grip lives in the second group — the situational, acquired pattern, and the one the literature treats as the less intractable of the two.

The erection is fine, which confuses everyone around you. Men with this pattern commonly report firmer erections during masturbation than during sex itself. A matched case-control study found precisely that asymmetry: among men with a traumatic-masturbation history and erectile complaints, 60.2% rated their erection hard enough for penetration during masturbation against 38.8% during intercourse, while men with ordinary erectile dysfunction scored much the same in both settings (Can, 2023). So the tablet your friend recommended will not help you, because the erection was never the broken part. Where the erection genuinely is the problem, the causes are different ones entirely — I have set out what causes erectile dysfunction in young men separately.

The escalation. Year on year the grip has tightened, the stroke has quickened, the pornography has got more extreme and the session has got shorter. Each step was a response to diminishing returns from the last one. If you recognise that escalation in yourself, you do not need a test to tell you what is going on.

Skin that tells the story. Some men arrive with a dry, thickened, slightly darkened band of shaft skin from years of friction without any lubricant. It is harmless and it settles — but it is an honest record of how much force has been going in, and I read it as such.

Ejaculation that has become work. The other thing men describe is effort: thrusting harder and faster, holding their breath, tensing the whole body, chasing a sensation that stays just out of reach. That effort is the reflex being manually driven instead of being triggered, and it is exhausting for both people in the bed.

The mechanism: how grip pressure re-sets the ejaculatory threshold

This is the part almost nothing online explains properly, and it is the part that actually helps, so stay with me.

Picture the ejaculatory reflex as a doorbell with an adjustable spring. At factory setting, a light press rings it. Now press it with your thumb as hard as you physically can, several times a week, for ten years. The spring stiffens to match what it is being given. A gentle press no longer rings it — not because the bell is broken, but because the bell has learned that gentle presses do not count.

Physiologically, ejaculation is a spinal reflex driven by sensory input from the penis and modulated heavily from the brain, and the threshold at which it fires is shaped by both the physical stimulation arriving and the mental arousal riding on top of it (Abdel-Hamid, 2018). Perelman’s formulation is the one I use across the desk: every man needs enough “friction and fantasy” to cross his own tipping point, and delayed ejaculation is what happens when what is on offer falls short of what he has trained himself to require (Perelman, 2016). Partnered sex, for all its warmth and meaning, is physically gentler than a death grip. It is not even competing on the axis you have trained.

Four separate things are being conditioned at once, and that is precisely why partial fixes fail.

What a death grip trains into the body, against what partnered sex physically delivers. The gap between the two columns is what has to close.

Element	What the death grip supplies	What partnered sex supplies
Pressure	Circumferential crushing force from a closed fist, far beyond anything a partner’s body can apply	Soft, yielding, variable containment — a fraction of that pressure
Friction	Dry, abrasive, high-coefficient skin-on-skin drag	Wet, low-friction, gliding contact
Speed and rhythm	Very fast, mechanically identical stroke, optimised to finish quickly	Slower, irregular, interrupted, never the same twice
Mental arousal	High-novelty visual input, escalating over years	One real person, familiar, no escalation available
Net effect	Threshold climbs; only this exact combination triggers the reflex	Arrives below the trained threshold — so nothing builds

Look at the rows and the treatment writes itself. Correcting one element — adding lubricant, say — while leaving the pressure, the speed and the visual escalation untouched is why so many men tell me they “tried everything and nothing worked”. They changed one variable in a four-variable equation.

There is a fourth row that deserves its own sentence. If every session for the last ten years has been paired with escalating pornography, the fantasy side has been conditioned as hard as the friction side, and the physical correction alone will leave you halfway. I handle that pattern separately in my article on porn-induced erectile dysfunction, because the recovery is not identical and the two problems travel together more often than not.

Death grip syndrome vs prone masturbation: same family, different fault

Men conflate these two constantly, and the distinction changes what I ask them to do, so let me draw the line clearly. Both sit inside what the literature calls traumatic masturbatory syndrome — a pattern first described in men who masturbated in an idiosyncratic manner, where the defining feature in those original case histories was the prone position and daily repetition over years (Sank, 1998). But they are not the same fault, and the evidence treats them separately. A matched case-control study that scored the behaviours independently found penile pressure during masturbation in 8.6% of men presenting with erectile dysfunction versus 3.3% of controls, and rubbing in a prone position in 10.2% versus 6%. Men presenting with erectile dysfunction were 2.2 times as likely as controls to report at least one atypical masturbatory behaviour (Can, 2023).

Death grip and prone masturbation compared — the fault, where it is felt, and what each one actually requires

	Death grip	Prone masturbation
The fault	Force — grip pressure, stroke speed and dry friction from the hand	Position — face-down grinding against a bed, pillow or floor
Where it is felt	Shaft and head, squeezed circumferentially by the fist	Underside and base of the shaft, crushed against a firm surface
Reported frequency in men with ED	8.6% vs 3.3% of controls (Can, 2023)	10.2% vs 6% of controls (Can, 2023)
Typical presentation	Cannot finish during penetration; sensation feels muted and distant	Cannot finish, and frequently cannot stay hard, during penetration
What I ask for	A full stop, then re-anchoring sensation to partnered intimacy	A full stop — there is no lighter version of the position

Notice that the last row now reads the same for both, and that is deliberate. I used to see the grip as the softer problem, correctable by dialling the force down. I no longer teach it that way, and I will explain why below. If the face-down position is your pattern rather than the grip, the detailed method is in my guide to prone masturbation and how to stop it, and the step-by-step version is in how to stop prone masturbation. This article stays on the grip.

Before I accept death grip, I exclude these

This is where most of the internet fails you, and it is the part I will not compromise on. “I cannot finish with my partner” is a symptom with several serious causes, and telling a man with early diabetic neuropathy that he merely grips too hard is not reassurance — it is a missed diagnosis that costs him years. Delayed ejaculation is genuinely multifactorial and the history is the diagnostic instrument (Abdel-Hamid, 2018). So before I accept a behavioural label, I work down this list.

The exclusions I work through — what else produces the identical complaint, and what tips me off in the room

Cause	What makes me suspect it instead	What I do about it
Diabetes and neuropathy	Numbness present all the time, not only during sex; tingling in the feet; thirst; strong family history. Ejaculatory dysfunction affects up to 35–50% of men with diabetes (Desai, 2023)	Fasting glucose and HbA1c — without exception in an Indian man over 30 with new ejaculatory failure
Antidepressants and other drugs	It started within weeks of a new tablet. Of the antidepressants studied, clomipramine and paroxetine carried the highest odds of ejaculatory dysfunction against placebo (Wang, 2025)	Review it with the prescribing doctor; a switch often settles it. Never stop an antidepressant on your own
Thyroid disease	Fatigue, weight gain, cold intolerance, flat mood. Delayed ejaculation is heavily over-represented in hypothyroid men compared with hyperthyroid men (Cihan, 2021)	A TSH. Cheap, fast, and a genuinely correctable answer when it comes back abnormal
Low testosterone	Libido has collapsed — not merely a stubborn reflex; poor morning erections; loss of drive and muscle	A morning total testosterone, with prolactin alongside it. But be honest about what treating it buys: replacement did not improve ejaculatory dysfunction against placebo in a randomised trial (Paduch, 2015). See low testosterone symptoms
Pornography conditioning	Arousal now depends on a particular genre or on novelty; you lose the thread with a real partner even while physically stimulated	Treat the fantasy side alongside the friction side. Population data show frequency alone is a weak predictor — it is the dependence that matters (Rowland, 2023)
Alcohol, opioids, pelvic or spinal injury	Heavy evening drinking; tramadol or codeine; a fall, a surgery or a road accident that preceded the problem	A proper history and examination. Any of these changes the plan completely

I am deliberately keeping this section short, because it is not this article’s job. If your problem turns out to be medical rather than behavioural — or if you simply want the full diagnostic workup, the tests I order and why, and the twelve causes in the order I actually find them — that is written up properly in what to do if you cannot ejaculate. Start there if the difficulty happens in every setting, including alone. Come back here if it happens only with a partner.

Once that list is clear, the conversation becomes much easier — because what is left is a habit, and habits answer to method.

What follows is the pattern I notice across those consultations — and it is not the one men expect.

How do you fix death grip syndrome?

You fix death grip syndrome by stopping the habit that created it and letting partnered sensation become the reference again. A complete stop first — no masturbation, no pornography — then rebuilding through partnered intimacy, with guidance if you stall.

That is the compressed version, and every word of it matters. Here is how I actually run it.

I want to be direct about one thing, because it is where most advice on this subject goes wrong, including advice I gave earlier in my career. The internet will tell you to switch to a lighter grip with lubricant. I do not ask men to do that any more. Every session, however gentle, re-files the same conditioned pathway and keeps the reflex pointed away from your partner. The instruction is not a better technique. The instruction is to stop — so that partnered contact becomes the only signal your body has left to calibrate to.

Stage one — the full stop, weeks one to four. No masturbation. No pornography. Not as a moral position and not as “semen retention” — simply because you cannot lower a threshold while continuing to reinforce it every second day. Partnered sex during this window is welcome and encouraged, with the pressure to finish deliberately lifted. Expect the first ten days to feel restless and the urge to arrive strongest in the evenings; that is the habit protesting, not your body failing.

Stage two — re-anchor sensation to partnered intimacy, weeks four to twelve. This is the working phase, and every element of it is partnered rather than solo. Long, unhurried foreplay. Generous lubricant during intercourse, because dry friction is precisely what your penis has been over-trained on and wet, gliding contact is what it needs to relearn. Positions that let you control depth and rhythm. And — the part men resist hardest — explicit permission not to finish. The reflex will not fire while you stand over it with a stopwatch. Where a couple needs an intermediate step, your partner’s hand taking over first and then moving to penetration bridges the gap far better than anything you can do by yourself, because it keeps the new reference point attached to her rather than to you.

Stage three — guidance if you plateau. This is where structured psychosexual therapy earns its fee, and the treatment literature puts it at the centre whenever the cause is behavioural rather than organic (Perelman, 2006). Perelman’s own protocol names discontinuing masturbation among the interventions that are often required, and is explicit that patients resist it — which is exactly why doing this with support beats doing it on willpower alone (Perelman, 2016). If you have no partner at present, the honest position is this: stop the habit, give the threshold months rather than weeks to drift back down, and do the rest of the work when there is someone to do it with. You cannot rehearse a partnered reflex in isolation.

What about tablets? Be clear-eyed. There is no drug approved for delayed ejaculation, and the evidence behind the off-label options that get used is weak (Abdel-Hamid, 2018). Anyone selling you a capsule for death grip is selling you a capsule. That is a different situation from erectile dysfunction treatment, where the drugs genuinely do work on the mechanism at fault. Where medication genuinely helps is in treating something the assessment turned up — a thyroid problem, a drug that needs switching, diabetes that needs controlling — or in supporting erections while confidence rebuilds. Never as the cure itself.

How long does it take to get rid of death grip?

Most men need six to twelve weeks: three to four weeks of a complete stop, then four to eight weeks of rebuilding. Sensation returns before ejaculation does. A decade-long habit, or heavy pornography alongside it, takes longer. A full stop of that length raises its own questions about abstinence, and I have answered those in semen retention benefits — the short version is that nothing is being stored up or lost while you reset.

What I want you to expect is a staircase, not a ramp.

The realistic recovery timeline I give men in clinic — and what most men wrongly conclude at each stage. These stages are my own clinical observation over twelve years of practice, not trial data: no published study tracks death grip recovery week by week.

Stage	What is actually happening	What men wrongly conclude
Weeks 1–2	Nothing perceptible changes. Restlessness peaks. The threshold has not moved yet	“This is not working” — and this is where most men quit
Weeks 3–4	Ordinary touch starts registering again. Men describe things feeling “louder”	“It is only in my head” — it is not; it is the threshold falling
Weeks 5–8	Arousal builds during partnered sex, often without reaching climax yet	“I have plateaued” — this is the normal middle, not a ceiling
Weeks 8–12	Partnered ejaculation returns — sometimes as early as week six, commonly with manual help first and then without	“It was luck and it will go again” — it holds, so long as the habit stays stopped
Beyond 12 weeks	No change at all, despite genuine compliance	“I must try harder” — no. This is the point to revisit the diagnosis, not the effort

Two honest caveats on that table. First, men who can already finish with a partner some of the time tend to do better than men who never can; the subtype where the difficulty extends to solo and partnered sex alike is the one the research flags as harder to shift (Rowland, 2025). Second, if twelve disciplined weeks produce nothing whatsoever, the diagnosis deserves revisiting rather than the effort doubling — and in my experience that almost always means something on the exclusion list above was missed.

Is ejaculating 5 times a day harmful?

No — ejaculating five times a day does not cause lasting bodily damage. You will be sore and tired, and little else will fit into that day. That is an absence of harm, not an endorsement, and not a target.

In twelve years of practice I have never once traced lasting physical damage to ejaculation frequency by itself. What I have traced it to, over and over, is force. The flat, deflated feeling that follows a session is not damage either — that is post nut clarity, ordinary physiology on a timer of minutes.

I include this question because it is the one men actually ask, and because the honest answer reframes the entire article. What it settles is the direction of the blame. Death grip is a technique problem, not a frequency problem, and men spend years punishing themselves for the wrong variable — counting days on a calendar while the grip that caused it goes unexamined.

The published work points the same way. In 3,586 men assessed with standardised instruments, masturbation frequency and pornography use were only weakly and inconsistently related to erectile function once age, mood and chronic illness were accounted for — age, anxiety, depression, low relationship satisfaction and medical conditions all mattered far more (Rowland, 2023). Frequency is not the variable behind a death grip. Force is.

There is also a finding here worth turning around. Among 31,925 men followed for 18 years, those who ejaculated most often — 21 or more times a month, roughly five times a week — had the lowest incidence of prostate cancer, a hazard ratio near 0.8 against men managing four to seven (Rider, 2016). Read it as an association and not as proof: those men are likely to be healthier, better partnered and more often screened, and early prostate disease itself lowers sexual frequency, so part of the arrow may run backwards. The authors recommend no number.

The same five times a week, two completely different outcomes

Because here is what twelve years in clinic has taught me that no trial has measured. That same arithmetic, reached by two different routes, gives opposite outcomes — and the difference is not the number. It is whether there is another person in the room.

The same frequency, two routes, opposite outcomes. Column A rests on published cohorts; every cell marked clinical observation is my own experience over twelve years and is not trial data.

	A — 5 times a week, with a partner	B — 5 times a week, alone with pornography
Prostate cancer incidence	Lowest of any frequency group, HR ~0.8 — an association, not proof (Rider, 2016)	Not measured. Rider counted ejaculation of any kind and most of it was partnered
Partnered frequency over time	Sustained — that is what the frequency is	Falls away as the routine takes the slot — clinical observation
Interest in the partner	Maintained, often grows	Thins. He stops initiating, then stops noticing — clinical observation
Relationship satisfaction	Tracks with partnered intimacy (Rowland, 2023)	Higher masturbation frequency went with lower satisfaction in 3,586 men (Rowland, 2023)
How he relates to women	As a person he is with	They begin registering as objects rather than people, too slowly for him to notice — clinical observation
Ejaculatory threshold	Calibrated to what a partner delivers	Climbs — the grip and the screen set the reference. This is death grip — clinical observation
Dhat-type presentation	Not something I see from this route — clinical observation	Semen-loss anxiety commonly follows — clinical observation. Dhat syndrome is a culture-bound presentation of the subcontinent, thinly researched (Kar, 2021)

Column A is published work, and even there it is association rather than mechanism. Column B, wherever it says clinical observation, is what I have watched in consulting rooms in Chennai — and I am not going to dress it as a trial finding. None of it is an accusation either. No man ever walked in intending any of it; it is what the routine does to gentle, decent people.

So no, you have not “used it up”, and no counter is running down. What has changed is the grip, the friction and the escalation — and those are the only things worth your attention. If you want the full discussion of frequency itself, I have written it up in how many times masturbation can be done in a day, and the wider question of whether the habit causes delayed ejaculation at all is answered in can masturbation cause delayed ejaculation.

Below are the questions men ask me at the end of the consultation, once the worst of the worry has lifted.

Frequently asked questions about death grip syndrome

Is death grip syndrome permanent?

No. It is a conditioned threshold, not nerve damage, and thresholds move once the input changes. In my practice the men who do not recover are almost always the men who never actually stopped — or who had an untreated medical cause sitting underneath the habit all along.

Do I have to stop completely, or can I just use a lighter grip?

Stop completely, for the reset period. A lighter grip still re-files the same conditioned pathway and keeps the reference point on your own hand rather than on your partner. Softening the technique is the compromise men reach for, and it is why so many stall at six weeks.

Can death grip syndrome cause erectile dysfunction?

It can contribute. Men with an atypical, high-pressure style report poorer erectile function scores, and firmer erections during masturbation than during intercourse (Wang, 2024; Can, 2023). But if your erection fails in every setting, including on waking, look for a vascular or hormonal cause instead of blaming the habit.

Will a vibrator or a masturbation sleeve help me recover?

No — it usually makes things worse. The entire aim is to move your threshold down toward what a partner delivers, so any device supplying more intensity than a person can works directly against you. High-intensity penile vibratory stimulation does have a place in treating delayed ejaculation, but as a supervised medical intervention for selected men, never as a home remedy (Abdel-Hamid, 2018).

Is death grip syndrome the same as prone masturbation?

No. Both are idiosyncratic styles that condition you to a sensation a partner cannot reproduce, but death grip is a force fault from the hand and prone is a position fault against a surface (Sank, 1998; Can, 2023). They are separately associated with erectile complaints, and they present slightly differently.

Should I tell my partner?

Yes, and it is the single most useful thing you will do. A partner who does not know assumes she is the reason you cannot finish, and quietly carries it. A partner who knows becomes your ally — and the performance pressure that maintains the whole problem drops away almost immediately.

Can I have children if I have death grip syndrome?

Yes. Sperm production is entirely untouched by masturbation, and masturbation does not cause infertility technique. The only fertility issue is mechanical — if you cannot ejaculate inside the vagina, conception cannot happen by that route — and that resolves as the reflex recalibrates, or is worked around with assisted methods if you cannot wait.

Does penile sensitivity actually come back?

Yes, because it was never lost in the first place. The word men reach for is desensitisation, but what actually changed is the threshold at which your nervous system registers the input — and that is what shifts over the weeks. Penile vibration-perception testing exists precisely because that threshold is a measurable quantity rather than a feeling (Wiggins, 2019).

The second question is the one I get from men who have already tried, and it is the most important one on the page.

If you have read this far, you are already ahead of the man who spends another two years searching at two in the morning and telling nobody. This is one of the most fixable problems I treat, and almost nobody who comes to me about it needed to suffer as long as they did.

Don’t work this out alone

Get it checked once, then fix it properly

A single private consultation excludes the medical causes and gives you a plan built around your own history — not a generic internet checklist.

Book a Consultationor call +91 97907 83856

Medically reviewed by Dr Shah Dupesh, MBBS, DCE, FASM, Consultant Andrologist & Sexologist at Dr Shah’s Clinic, T. Nagar, Chennai. If you cannot finish with a partner, one private consultation excludes the medical causes and settles what is actually going on.

References

1. Perelman MA. Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model. Transl Androl Urol. 2016. PMID 27652228
2. Perelman MA, Rowland DL. Retarded ejaculation. World J Urol. 2006. PMID 17082938
3. Sank LI. Traumatic masturbatory syndrome. J Sex Marital Ther. 1998. PMID 9509379
4. Can U, Kafkasli A, Coskun A, et al. Traumatic masturbation and erectile dysfunction: a matched case-control study. Int J Urol. 2023. PMID 37605604
5. Wang C, Chen X, Liu Z, Zhang Y. The association between atypical masturbation and male sexual dysfunction: a study based on men in heterosexual relationships. Arch Sex Behav. 2024. PMID 38918329
6. Rowland DL, McNabney SM, Kövi Z, Hevesi K. Are some forms of delayed/inhibited ejaculation more intractable than others? Establishing delayed ejaculation subtypes based on severity of symptomology during partnered sex and masturbation. J Sex Med. 2025. PMID 40500996
7. Rowland DL, Castleman JM, Bacys KR, Csonka B, Hevesi K. Do pornography use and masturbation play a role in erectile dysfunction and relationship satisfaction in men? Int J Impot Res. 2023. PMID 35840678
8. Abdel-Hamid IA, Ali OI. Delayed ejaculation: pathophysiology, diagnosis, and treatment. World J Mens Health. 2018. PMID 29299903
9. Shirai M, Tsujimura A, Fukuhara S, et al. Prevalence and associated factors of delayed ejaculation: insights from a nationwide internet-based, cross-sectional survey on male sexual dysfunction in Japan. Sex Med. 2025. PMID 40937118
10. Desai A, Chen R, Cayetano A, Jayasena CN, Minhas S. Understanding and treating ejaculatory dysfunction in men with diabetes mellitus. Andrology. 2023. PMID 35933708
11. Cihan A, Esen AA. Systematic review and meta-analysis for the value of thyroid disorder screening in men with ejaculatory dysfunction. Int J Clin Pract. 2021. PMID 34047440
12. Wang Q, Xu Z, Chen X, Liu L, Liu X. Effect of antidepressants on ejaculation dysfunction in patients with depression and anxiety: a systematic review and network meta-analysis. Andrology. 2025. PMID 39344496
13. Paduch DA, Polzer PK, Ni X, Basaria S. Testosterone replacement in androgen-deficient men with ejaculatory dysfunction: a randomized controlled trial. J Clin Endocrinol Metab. 2015. PMID 26158605
14. Rider JR, Wilson KM, Sinnott JA, Kelly RS, Mucci LA, Giovannucci EL. Ejaculation frequency and risk of prostate cancer: updated results with an additional decade of follow-up. Eur Urol. 2016. PMID 27033442
15. Wiggins A, Farrell MR, Tsambarlis P, Levine LA. The penile sensitivity ratio: a novel application of biothesiometry to assess changes in penile sensitivity. J Sex Med. 2019. PMID 30773499
16. Kar SK, Menon V, Arafat SY, et al. Dhat syndrome: systematic review of epidemiology, nosology, clinical features, and management strategies. Asian J Psychiatr. 2021. PMID 34563955