What is the relationship between ejaculation and prostate health?

From the Guidelines

Regular ejaculation is beneficial for prostate health, with frequent ejaculation (about 21 times per month or more) potentially lowering the risk of developing prostate cancer compared to less frequent ejaculation (about 4-7 times per month). This relationship is thought to be due to the flushing out of potential carcinogens and bacteria from the prostate gland during ejaculation, which helps maintain prostate health 1. Ejaculation also helps reduce inflammation and prevents the buildup of prostatic fluid. The use of 5-alpha-reductase inhibitors, such as finasteride, has been studied for prostate cancer chemoprevention, but the primary benefit of ejaculation on prostate health is not dependent on medication 1.

Key Points

• Frequent ejaculation may help reduce the risk of prostate cancer
• Ejaculation through sexual intercourse, masturbation, or nocturnal emissions all appear to provide similar benefits
• Regular prostate screenings, a healthy diet, regular exercise, and avoiding smoking are also important for comprehensive prostate health care
• The relationship between ejaculation and prostate health is thought to be due to the flushing out of potential carcinogens and bacteria from the prostate gland during ejaculation 1

Considerations

• While frequent ejaculation may be beneficial, it is just one factor in prostate health
• The use of 5-alpha-reductase inhibitors, such as finasteride, has been associated with adverse effects, including decreased libido, erectile dysfunction, and decreased ejaculate volume 1
• However, the benefits of regular ejaculation on prostate health are not dependent on the use of these medications 1

From the FDA Drug Label

• sexual dysfunction that continued after discontinuation of treatment, including erectile dysfunction, decreased libido and ejaculation disorders (e. g. reduced ejaculate volume).
• male infertility and/or poor seminal quality were reported rarely in men taking finasteride tablets for the treatment of BPH. Abnormal ejaculation includes ejaculation failure, ejaculation disorder, retrograde ejaculation, and ejaculation decrease. As shown in Table 1, abnormal ejaculation was associated with Tamsulosin Hydrochloride Capsules administration and was dose-related in the U. S. studies.

Ejaculation and Prostate Health:

• Finasteride may cause ejaculation disorders, including reduced ejaculate volume, as reported in postmarketing experience 2.
• Tamsulosin has been associated with abnormal ejaculation, including ejaculation failure, ejaculation disorder, retrograde ejaculation, and ejaculation decrease, in a dose-related manner 3.
• Both finasteride and tamsulosin may affect male fertility, with reports of male infertility and poor seminal quality 2.

From the Research

Ejaculation and Prostate Health

• The relationship between ejaculation frequency and prostate health has been studied in various research papers 4, 5, 6, 7, 8.
• A study published in the European Urology journal in 2016 found that ejaculation frequency may be inversely related to the risk of prostate cancer, with men who reported higher ejaculatory frequency being less likely to be diagnosed with prostate cancer 4.
• Another study published in the Journal of Clinical Medicine in 2021 found that ejaculatory disorders are common in men with benign prostatic hyperplasia (BPH) and that medical and surgical treatments for BPH can affect ejaculatory function 5.
• A review of the effects of 5-alpha reductase inhibitors on erectile function, sexual desire, and ejaculation found that these medications can cause sexual side effects, including decreased libido and ejaculatory dysfunction 6.
• A meta-analysis published in The Journal of Sexual Medicine in 2018 found that moderate ejaculation frequency (2-4 times per week) was associated with a lower risk of prostate cancer, although the direction of causality between sexual activity and prostate cancer risk is unclear 7.
• A cross-sectional study published in the journal Urology in 2003 found that frequent ejaculation was associated with a lower prevalence of moderate to severe lower urinary tract symptoms, but this association was found to be an artifact caused by the confounding effects of age 8.

Ejaculation Frequency and Prostate Cancer

• The study published in European Urology in 2016 found that the hazard ratio for prostate cancer incidence for men who reported 21 or more ejaculations per month was 0.81 (95% CI 0.72-0.92) compared to men who reported 4-7 ejaculations per month 4.
• The meta-analysis published in The Journal of Sexual Medicine in 2018 found that moderate ejaculation frequency was associated with a lower risk of prostate cancer, with an odds ratio of 0.91 (95% CI 0.87-0.96) 7.

Ejaculation and Benign Prostatic Hyperplasia

• The study published in the Journal of Clinical Medicine in 2021 found that ejaculatory disorders are common in men with BPH and that medical and surgical treatments for BPH can affect ejaculatory function 5.
• The review of the effects of 5-alpha reductase inhibitors found that these medications can cause sexual side effects, including decreased libido and ejaculatory dysfunction, which can be a concern for men with BPH 6.