For most people, being touched by a bodywork practitioner is an incredibly relaxing experience. However, a significant number of men have an embarrassing, visible response to massage therapy. Although most practitioners understand the likelihood that some men may develop an erection during a session, that understanding could turn to anger if they encounter a client who has ejaculated. But for a number of men, such an unsolicited release could have been an involuntary, asexual physiological reaction to the massage. By learning more about this possibility, massage therapists with a client who accidentally ejaculates can maintain compassion while upholding their professional ethics and infection control standards.

Intentional or Accidental

If a client ejaculates during your session, the first thing a practitioner must do is figure out if his/her client has any sexually related motives. In the article, A Common Male Physiological Response to Massage, eight important steps are outlined to help massage therapists address inappropriate behavior and determine a client’s intent. Upon identifying a client seeking a sexual outlet, the therapist’s ethics and safety are his/her first priorities. When addressed professionally while maintaining firm ethical boundaries, affected men without sexual intentions are likely to be surprised and embarrassed by their body’s actions.

Many men are trying to understand why their body betrayed them while receiving bodywork. Unfortunately, there is little information available about why some ejaculate without purposeful genital stimulation or sexualized thoughts. Despite medicine’s dismissal of this situation as a rare anomaly, more men are emerging from their shame to try and find an explanation.

The Physiology of Ejaculation

Technically, ejaculation is the process of sperm transport from the epididymis to the urethral meatus, resulting in expulsion of semen. Ejaculation occurs in two phases:

  1. Seminal emission, which is mediated by the sympathetic nervous system.
  2. Propulsatile ejaculation, which is controlled by the parasympathetic nervous system.

Men who have experienced unexpected, unwanted ejaculation during a massage typically claim that it occurs when they are in the prone position with the therapist working on their low back, buttocks or upper thighs. Considering the location of the afferent and efferent nerves responsible for ejaculation, these locations are not surprising:

  • Via the sympathetic nervous system, autonomic impulses responsible for seminal emission exit the spinal cord between the tenth thoracic vertebrae and the second lumbar vertebrae.
  • Propulsatile ejaculation is caused by somatic input of the parasympathetic nervous system between the second and fourth sacral foramen.

In addition to its sympathetic and parasympathetic involvement, the pathways for ejaculation are also cerebrally mediated. As evidenced by nocturnal emissions, the ejaculatory reflex may be solely initiated by central nervous system input. While sexualized thoughts often occupy the mind prior to ejaculation, some sexual health experts believe that the brain’s role in ejaculation is more associated with a mental “letting go.”

At first glance, ejaculation appears to be out of line with bodywork. However, the level of relaxation that can be induced by massage therapy is a quintessential example of someone mentally letting go of his tension. From a physiological perspective, ejaculation could be initiated by combining deep relaxation with massage therapy’s activation of both the sympathetic and parasympathetic nervous systems.


For clients prone to involuntary ejaculation, the following five suggestions may be helpful:

  1. Strict draping practices and rolled-up towels to create an additional boundary near the genitals will ease any anticipatory excitement.
  2. Change massage location and/or technique when muscles tighten, breathing becomes more rapid or the client suddenly fidgets when working on the lower back, gluteus maximus and upper hamstrings.
  3. When client is prone, limit torso rocking techniques to prevent unintentional genital stimulation.
  4. Use additional barriers to quarantine or absorb accidental ejaculate.
  5. Remember to treat anything that has been ejaculated on as infectious, including removal of sheets and towels with gloves, table and linen sterilization and thorough hand washing after cleanup.

If a client ejaculates, the situation can be awkward and possibly upsetting for the massage therapist. However, it could be completely humiliating for the massage recipient and prevent him from ever seeking massage therapy again.

After determining that an unsolicited release was not sexual, addressing this issue promptly can put the therapist and his/her clients at ease. Since a man’s physiology could cause involuntary ejaculation during bodywork, a practitioner who explains this to his/her client thus maintains ethical boundaries, exhibits compassion, takes steps to prevent its reoccurrence and follows infection control practices – and enforces his/her own professionalism. Additionally, tackling this topic facilitates the client’s recognition that there is nothing wrong with him and helps him let go of any shame surrounding his body’s unsolicited release.

Recommended Study:

Advanced Anatomy and Physiology
Ethics: Therapeutic Relationships
Infectious Disease: Hepatitis

References:, Clinical physiology and pathophysiology of ejaculation and orgasm, Stacy Elliott, MD, Retrieved October 21, 2008, The University of Hawai’i, March 2001., A Common Male Physiological Response to Massage, Nicole Cutler, L.Ac., Retrieved October 22, 2008, Natural Wellness, 2008.$=relatedarticles&logdbfrom=pubmed, Descending pathways modulating the spinal circuitry for ejaculation: effects of chronic spinal cord injury, Johnson, RD, Progress in Brain Research, 2006.