What is the relationship between ejaculation, sexual intercourse, and masturbation on prostate health, and are there optimal frequencies to prevent issues such as prostatitis or benign prostatic hyperplasia (BPH)?

From the Guidelines

Regular ejaculation, whether through intercourse or masturbation, appears beneficial for prostate health, with research suggesting that ejaculating frequently may reduce prostate cancer risk and alleviate symptoms of prostatitis or benign prostatic hyperplasia (BPH). The relationship between ejaculation, sexual intercourse, and masturbation on prostate health is complex, and optimal frequencies to prevent issues such as prostatitis or BPH are not well-established. However, studies suggest that regular ejaculation may help clear potentially carcinogenic substances and old prostatic fluid from the prostate gland, potentially reducing the risk of prostate cancer and other prostate-related problems 1.

Key Considerations

• There is no clear "too much" threshold for healthy men, though excessive masturbation causing physical discomfort or interfering with daily life should be avoided.
• Prolonged abstinence may potentially increase inflammation and cancer risk, though evidence is limited.
• For men with prostatitis or other prostate conditions, ejaculation can sometimes provide symptom relief, but in cases of bacterial prostatitis or during acute flare-ups, sexual activity might temporarily worsen symptoms.
• The protective mechanism likely involves clearing potentially carcinogenic substances and old prostatic fluid from the prostate gland.

Treatment and Management

• The American Urological Association (AUA) recommends using the AUA Symptom Index or the International Prostate Symptom Score (IPSS) to assess symptom severity and frequency in men with BPH 1.
• Treatment options for BPH, such as 5 alpha-reductase inhibitors (e.g., finasteride and dutasteride), may be effective in reducing prostate size and alleviating symptoms, but may also have side effects such as sexual dysfunction 1.
• Individual responses to treatment and ejaculation frequency may vary, and men with existing prostate conditions should consult healthcare providers for personalized guidance.

Recommendations

• Men should find a frequency of ejaculation that feels natural and comfortable, and avoid excessive masturbation that causes physical discomfort or interferes with daily life.
• Those with existing prostate conditions should consult healthcare providers for personalized guidance, as recommendations may differ based on specific diagnoses and symptoms.
• Regular ejaculation, whether through intercourse or masturbation, may be beneficial for prostate health, but more research is needed to establish optimal frequencies and guidelines for prevention and treatment of prostate-related problems.

From the Research

Relationship Between Ejaculation, Sexual Intercourse, and Prostate Health

• The relationship between ejaculation, sexual intercourse, and prostate health is complex and not fully understood 2, 3.
• Some studies suggest that moderate ejaculation frequency (2-4 times per week) may be associated with a lower risk of prostate cancer 3.
• However, the evidence for the impact of sexual activity on prostate cancer risk is not overall clear, and more research is needed to fully understand this relationship 2.

Optimal Frequencies to Prevent Prostate Issues

• There is no clear consensus on optimal frequencies for ejaculation, sexual intercourse, or masturbation to prevent issues such as prostatitis or benign prostatic hyperplasia (BPH) 2, 3.
• However, some studies suggest that exercise and physical activity may be beneficial for prostate health and may help to prevent or manage prostate issues 4, 5.
• Additionally, psychological and relationship factors, such as communication with a partner and adapting to changes in sexual function, may also play a role in maintaining sexual health and preventing prostate issues 6, 5.

Exercise and Prostate Health

• Exercise has been shown to have a positive effect on sexual desire and sexual activity in men with prostate cancer 4.
• A randomized controlled trial found that exercise and psychosexual therapies may be effective in improving sexual health in men with prostate cancer 5.
• Exercise may also help to prevent or manage prostate issues, such as prostatitis or BPH, although more research is needed to fully understand this relationship 4, 5.

Sexual Activity and Prostate Cancer Risk

• A dose-response meta-analysis found that men with fewer sexual partners, older age at first intercourse, and moderate frequent ejaculation were associated with a significantly decreased risk of prostate cancer 3.
• However, the direction of causality between sexual activity and risk of prostate cancer should be interpreted with caution, as most included studies used a case-control design 3.
• More research is needed to fully understand the relationship between sexual activity and prostate cancer risk, and to determine whether modification of sexual activity factors may be a useful approach to decreasing the risk of prostate cancer 2, 3.