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Masturbation, ejaculation, and prostate cancer-

One study found that men who reported more than 21 ejaculations per month had a 31 percent lower risk of prostate cancer than men who reported four to seven ejaculations a month. Other studies looking for a link between ejaculation frequency and prostate cancer have yielded conflicting results, however.

Here’s an unusual (and likely popular) potential prescription: ejaculating more.  Some research is suggesting a link between ejaculation frequency and prostate cancer. Specifically, men who ejaculate more often might have a lower risk of developing the disease. 

VITALS

  • A 2016 study looked at questionnaires in which more than 31,000 men self-reported their monthly ejaculation frequency over an 18-year period. 
  • They found that men who reported more than 21 ejaculations per month had a 31 percent lower risk of prostate cancer than men who reported four to seven ejaculations a month.
  • Other studies looking for a link between ejaculation frequency and prostate cancer have yielded conflicting results. 
  • Some scientists have theorized that ejaculating frequently may empty the prostate of irritants or toxins, which might be beneficial in preventing prostate cancer though there is currently no proof for this.

What is prostate cancer?

Prostate cancer is the second-most common cancer in men after skin cancers. The American Cancer Society estimates that 174,650 men in the US will receive a prostate cancer diagnosis in 2019, and 31,620 men will die from the disease (ACS, 2019). Prostate cancer develops in the prostate gland, a walnut-sized organ that sits between the bladder and the penis, right in front of the rectum. The prostate produces seminal fluid, which nourishes and transports sperm during ejaculation. 

According to the American Cancer Society, it’s not yet clear what causes prostate cancer though the clearest risk factors include age, a family history of the disease and being African American. Of course, these are things you can’t change, but there are some other risk factors that you can. These include eating a diet that is lower in saturated fat (Shimizu, 1991), exercising regularly (Campos, 2018), and maintaining a healthy weight (Parikesit, 2015). These are pretty standard recommendations, of course.  Upping how often you ejaculate, less so. But that could change. 

Does ejaculation help prevent prostate cancer? Here’s what the science says

As part of a 2016 study published in the journal European Urology (Rider, 2016), researchers looked at questionnaires in which more than 31,000 men self-reported their monthly ejaculation frequency — first in 1992, then in a 2010 follow-up. They found that men who reported more than 21 ejaculations per month had a 31 percent lower risk (Harvard, 2014) of prostate cancer than men who reported four to seven ejaculations a month.

The science is far from being settled here and not every study agrees. For example, a 2004 study published in the Journal of the American Medical Association didn’t find an association between ejaculation frequency and prostate cancer risk (Lietzmann, 2004). An interesting twist: That study looked at the same men whose responses figured into the 2016 study — it just tracked their answers through the year 2000. So it doesn’t disprove a link between ejaculation frequency and prostate cancer; the disease is more common in older men, and frequent ejaculation might have reduced the risk of prostate cancer as the study respondents aged.

But there are smaller studies that also failed to find a link, and at least one found that results differed by age group. A 2008 study published in BJUI International (Dimitropoulou, 2008) involving 800 subjects found that young men who reported more sexual activity (both masturbation and sex) actually had a slightly higher risk of developing prostate cancer in their 20s and 30s. But more frequent sexual activity seemed to be protective against prostate cancer in the 50s and beyond. 

In 2018, researchers at Sichuan University in China published a meta-analysis of 21 studies, involving over 55,000 participants, in the Journal of Sexual Medicine (Jian, 2018). They found that “moderate ejaculation” (two to four times per week) was “significantly associated” with a lower prostate cancer risk, but that risk didn’t fall with more ejaculations. Additionally, the researchers found that men who had fewer sexual partners and started having sex later in life had a lower incidence of prostate cancer. 

But those scientists warned against jumping to conclusions because, correlation is not causation. There is no proof that frequent ejaculation can help prevent prostate cancer. But science is leaning that way because at least one large cohort study has found a connection. However, because of contradictory results like those in the studies mentioned above (you’d be forgiven for thinking you were watching a tennis match), more research is needed before definitive recommendations can be given.

Why ejaculation frequency might affect prostate cancer risk

Scientists aren’t sure why that might be, but they theorize (Garnick, 2009) that ejaculating frequently, thus regularly emptying the prostate of irritants or toxins, might be beneficial in preventing prostate cancer.

Can you prevent prostate cancer?

Because experts can’t definitively say what causes prostate cancer, they haven’t issued recommendations on how to prevent it. But according to Harvard Medical School (Schmidt, 2018), quitting smoking and eating a heart-healthy diet — focused on fish, poultry, plant-based protein, vegetables, fruits, whole grains, and salads — may reduce your risk. Getting regular exercise and using 5-alpha-reductase inhibitors have been shown by some studies to reduce the risk of prostate cancer.

When should you get tested for prostate cancer?

A blood test known as Prostate-Specific Antigen (PSA) was once routinely given to all men over age 50 to check for elevated levels of a substance in the blood that might indicate prostate cancer. That recommendation was withdrawn in the early 2010s, because the test is imprecise and could lead to overdiagnosis and overtreatment.  

But in May 2018, the US Preventive Services Task Force (USPSTF) issued its latest recommendation (Schmidt, 2018): Between the ages of 55 and 69, men should individually decide whether to screen for prostate cancer with a PSA test, after consulting with their doctor. Prostate cancer screening is not recommended after age 70 since there is no evidence it results in an increased lifespan.

References

  1. American Cancer Society Medical and Editorial Content Team. (2019). Key Statistics for Prostate Cancer. Retrieved from https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html.
  2. American Cancer Society Medical and Editorial Content Team. (2019). What Causes Prostate Cancer? Retrieved from https://www.cancer.org/cancer/prostate-cancer/causes-risks-prevention/what-causes.html.
  3. American Cancer Society Medical and Editorial Content Team. (2019). American Cancer Society Recommendations for Prostate Cancer Early Detection. Retrieved from https://www.cancer.org/content/cancer/en/cancer/prostate-cancer/detection-diagnosis-staging/acs-recommendations.html.
  4. Campos, C., Sotomayor, P., Jerez, D., González, J., Schmidt, C. B., Schmidt, K., … Godoy, A. S. (2018). Exercise and prostate cancer: From basic science to clinical applications. The Prostate, 78(9), 639–645. doi: 10.1002/pros.23502, https://www.ncbi.nlm.nih.gov/pubmed/29569731
  5. Centers for Disease Control and Prevention. (2017). Trichomoniasis – CDC Fact Sheet. Retrieved from https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm.
  6. Dimitropoulou, P. P., Lophatananon, A. R., Easton, D. undefined, Pocock, R. undefined, Dearnaley, D. undefined, Guy, M. undefined, … undefined, undefined undefined. (2008). Sexual activity and prostate cancer risk in men diagnosed at a younger age. BJU International, 103(2), 178–185. doi: 10.1111/j.1464-410x.2008.08030.x, https://www.ncbi.nlm.nih.gov/pubmed/19016689
  7. Garnick, M. (2009, September 29). Retrieved from https://www.health.harvard.edu/blog/does-frequent-ejaculation-help-ward-off-prostate-cancer-20090929112
  8. Harvard Health Publishing. (2014). Ejaculation frequency and prostate cancer. Retrieved from https://www.health.harvard.edu/mens-health/ejaculation_frequency_and_prostate_cancer.
  9. Jian, Z., Ye, D., Chen, Y., Li, H., & Wang, K. (2018). Sexual Activity and Risk of Prostate Cancer: A Dose–Response Meta-Analysis. The Journal of Sexual Medicine, 15(9), 1300–1309. doi: 10.1016/j.jsxm.2018.07.004, https://www.ncbi.nlm.nih.gov/pubmed/30122473
  10. Leitzmann, M. F., Platz, E., Stampfer, M., Willett, W. C., & Giovannucci, E. (2004). Ejaculation Frequency and Subsequent Risk of Prostate Cancer. JAMA, 291(13), 1578–1586. doi: 10.1001/jama.291.13.1578, https://jamanetwork.com/journals/jama/fullarticle/198487
  11. Parikesit, D., Mochtar, C. A., Umbas, R., & Hamid, A. R. A. H. (2015). The impact of obesity towards prostate diseases. Prostate International, 4(1), 1–6. doi: 10.1016/j.prnil.2015.09.004, https://www.ncbi.nlm.nih.gov/pubmed/27014656
  12. Rawla, P. (2019). Epidemiology of Prostate Cancer. World Journal of Oncology, 10(2), 63–89. doi: 10.14740/wjon1191, https://www.ncbi.nlm.nih.gov/pubmed/31068988
  13. Rider, J. R., Wilson, K. M., Sinnott, J. A., Kelly, R. S., Mucci, L. A., & Giovannucci, E. L. (2016). Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up. European Urology, 70(6), 974–982. doi: 10.1016/j.eururo.2016.03.027, https://www.ncbi.nlm.nih.gov/pubmed/27033442
  14. Roberts, M. (2014). Prostate cancer ‘may be a sexually transmitted disease’. BBC News. Retrieved from https://www.bbc.com/news/health-27466853
  15. Schmidt, C. (2018, November 26). Retrieved from https://www.health.harvard.edu/blog/smoking-tied-to-more-aggressive-prostate-cancer-2018112615452
  16. Schmidt, C. (2018, June 26). Retrieved from https://www.health.harvard.edu/blog/influential-task-force-issues-new-recommendations-on-prostate-cancer-screening-201806262599
  17. Sfanos, K. S., & DeMarzo, A. M. (2011). Prostate cancer and inflammation: the evidence. Histopathology, 60(1), 199–215. doi: 10.1111/j.1365-2559.2011.04033.x, https://www.ncbi.nlm.nih.gov/pubmed/22212087
  18. Shimizu, H., Ross, R. K., Bernstein, L., Yatani, R., Henderson, B. E., & Mack, T. M. (1991). Cancers of the prostate and breast among Japanese and white immigrants in Los Angeles County. British Journal of Cancer, 63(6), 963–966. doi: 10.1038/bjc.1991.210, https://www.ncbi.nlm.nih.gov/pubmed/2069852
  19. Stark, J. R., Judson, G., Alderete, J. F., Mundodi, V., Kucknoor, A. S., Giovannucci, E. L., … Mucci, L. A. (2009). Prospective Study of Trichomonas vaginalis Infection and Prostate Cancer Incidence and Mortality: Physicians’ Health Study. JNCI: Journal of the National Cancer Institute, 101(20), 1406–1411. doi: 10.1093/jnci/djp306, https://www.ncbi.nlm.nih.gov/pubmed/19741211
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  21. Twu, O., Dessi, D., Vu, A., Mercer, F., Stevens, G. C., Miguel, N. D., … Johnson, P. J. (2014). Trichomonas vaginalis homolog of macrophage migration inhibitory factor induces prostate cell growth, invasiveness, and inflammatory responses. Proceedings of the National Academy of Sciences of U.S.A., 111(22), 8179–8184. doi: 10.1073/pnas.1321884111, https://www.ncbi.nlm.nih.gov/pubmed/24843155

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