Does abstinence from sex increase the risk of prostate cancer or diseases?

Sexual Activity and Prostate Cancer Risk

Moderate ejaculation frequency (2-4 times per week) is associated with a lower risk of prostate cancer, suggesting that sexual abstinence is not beneficial for prostate health. 1

Relationship Between Sexual Activity and Prostate Cancer

Evidence on Ejaculation Frequency

• A dose-response meta-analysis found that moderate ejaculation frequency (2-4 times per week) was significantly associated with a lower risk of prostate cancer (OR 0.91,95% CI 0.87-0.96) 1
• Frequent ejaculation appears to be protective against the development of prostate cancer rather than increasing risk 2
• There is no evidence supporting that sexual abstinence is beneficial for prostate health; in fact, the evidence suggests the opposite 1

Other Sexual Activity Factors and Prostate Cancer Risk

• The number of sexual partners shows a linear dose-response relationship with prostate cancer risk - an increment of 10 female sexual partners was associated with a 1.10-fold increase in prostate cancer risk (OR 1.10,95% CI 1.01-1.21) 1
• Age at first intercourse also shows a significant association - the risk of prostate cancer decreased by 4% for every 5-year delay in age at first intercourse (OR 0.96,95% CI 0.92-0.99) 1
• Multiple sexual partners may have a protective effect against prostate cancer, excluding the risk of sexually transmitted infections 2

Quality of Evidence and Limitations

• Most studies on sexual activity and prostate cancer risk are case-control studies rather than prospective cohort studies, which limits the ability to establish causality 1
• There is insufficient agreement in survey design and data reporting across studies examining masturbation and prostate cancer risk 3
• The evidence regarding sexual activity's impact on prostate cancer is less robust compared to other lifestyle factors such as smoking and physical activity 4

Other Lifestyle Factors Affecting Prostate Cancer Risk

Physical Activity

• Evidence supports that exercise might be a useful factor in the prevention of prostate cancer and tumor progression 4
• An active lifestyle is recommended as it may improve cancer-related outcomes 4

Smoking

• While data on smoking and prostate cancer development are conflicting, there is robust evidence that smoking is associated with aggressive tumor features and worse cancer-related outcomes 4
• The negative impact of smoking appears to persist for up to 10 years after cessation 4

Clinical Implications

• Sexual rehabilitation should be addressed by the primary care team for men with prostate cancer, as treatments often lead to sexual dysfunction 5
• Sexual partners should be included in brief sexual counseling, even when mechanical treatments for erectile dysfunction are prescribed 5
• Modification of sexual activity factors appears to be a useful low-risk approach to potentially decreasing the risk of prostate cancer 1

Conclusion for Clinical Practice

• Moderate sexual activity with regular ejaculation (2-4 times per week) may be beneficial for prostate health 1
• Sexual abstinence does not appear to provide any protective benefit against prostate cancer and may potentially increase risk 2, 1
• Patients should be advised that maintaining moderate sexual activity is part of a healthy lifestyle that may contribute to prostate health 1