The other cause for impotence of libido are excesses in masturbation. The evil results of these practices in women are fully as great as in men, although with women it is the orgasm alone that does the damage, since there is no seminal discharge or loss of vital fluids. Through the frequent application of friction to the parts, they become first hypersensitive and later hyposensitive and non-responsive to normal excitations. Accustomed to excite the genitals by manual stimuli, which may be kept up for a considerable length of time, the masturbator is, later on, impotent to reach the acme through the normal, relatively short excitations, as they take place through the internal organic events in the genitals in normal sex-activity. In women, the same as in men, the greater damage through excesses in masturbation is done by the greater frequency, because it requires no help, from an outsider, because it is not bound by time and locality, and may be practised by the undeveloped child, and last but not least, because of the constant conflict and struggle of the masturbator between the sensual impulse and the inability to desist and the feeling of womanly unworthiness, dissatisfaction and shame. Excesses in mental erethism and excessive dalliance with members of the other sex have no less injurious effects in women than in men. In the long run these excesses cause in the woman a number of nervous troubles which take the form of hysteria or assume the character of neurasthenia. These excessive practices of erethism or tactile eroticism are, also in women, worse than excesses in copulation and masturbation, because the former do not lead to the orgasm and to the relief of the nervous tension and material congestion. Another cause of impotence of libido in women is onanism or the practice of withdrawal. This coitus interruptus which rarely leads to orgasm in the woman, has the same effect upon her as excessive mental erethism or tactile eroticism, because it does not lead to relief from the nervous tension and the congestion. Excesses in onanism are, therefore, very harmful in women, while they are of lesser consequence in men. The repeated congestions of the parts in all these practices lead first to chronic hyperaemia and stasis, and in its further progress to chronic inflammations of the tissues, known under the respective names of metritis, perimetritis, parametritis, endometritis, salpingitis, and ovaritis. The inflammations constantly irritate the nerves and their centres and in this way blunt their normal sensibility. Besides the dulling of the nervous elements, these conditions give rise to great pain in commixtione, and pain and fear are the greatest enemies of libido.