Sperling Prostate Center

A Man’s Sexual Behavior May Influence His Risk of Prostate Cancer

UPDATE: August 26, 2024
Originally published September 25, 2022

Since we posted the blog below, another research team tackled the same question: can a man’s sexual behavior (number of partners, ejaculation frequency) play a role in prostate cancer risk?

The newer study involved 654 men ages 40+ (262 PCa patients, 392 controls) who were followed over a 7-year period.[i] (Participants are presumed heterosexual, though partner gender was not specified.) Methods included periodic interviews, questionnaires, and blood tests for PSA, testosterone, and biomarkers of systemic inflammation).

Statistical comparison revealed similar number of marriage years in both groups, but a significantly higher average number of partners in the PCa group. The lifelong average frequency of ejaculations per month was somewhat lower for the PCa group. Of note, inflammatory markers were higher in the PCa group; chronic systemic inflammation is correlated with PCa (and other cancers).

The authors theorize that frequent ejaculation may lower PCa risk by preventing “colonization of prostatic tissue by a variety of microorganisms. Additionally, sexual activity means a certain level of physical activity, mental calmness and better communication with partners. Thus, continuing an active sex life is beneficial for feeling good about self, improved vascular health and immune function. These are all “very important for the battle with cancer cells,” the authors state. Finally, they caution about multiple sex partners as another possible precursor PCa risk factor due to exposure to sexually transmitted diseases.

Full article available as pdf here.

 

I don’t know who first asked if prostate cancer risk is connected with how often a man ejaculates. Naturally, wishful thinkers would love to believe that the more often a man masturbates or has sex with a partner, the less risk he has of getting PCa. In fact, some studies suggest this might be the case.

I have previously posted (and subsequently updated) a blog on masturbation and PCa which summarized both a questionnaire-based study, and an exploration of frequent ejaculation and genomic expression. Both studies suggested that 4 or more times per week of masturbation or other stimulation leading to ejaculation may confer some protection against PCa. However, other factors may be involved.

Additional factors add new information

I just discovered a 2018 paper published in the Journal of Sexual Medicine. The team of Chinese researchers not only examined not only frequency of ejaculation, but they also included two more factors: a) the number of female sexual partners a man has had (an obvious bias toward heterosexuality), and b) the age of first intercourse. The source of their data was a meta-analysis of previously published studies, for a cohort total of 14,976 PCa patients and 40,514 controls).

With the inclusion of number of partners, and age at first intercourse, the picture becomes more interesting. Apparently, how many different partners a man has, and how young he is when he loses his virginity, may play a role in PCa risk. According to the authors:

  • For every increment of 10 female sexual partners, the risk of PCa increases. (My comment is that the risk of catching a sexually transmitted disease increases with the number of different partners, which in turn may have an infection or inflammation effect on pelvic organs. We know that inflammation is often a precursor for cancer.)
  • The risk of PCa decreases by 4% for every 5-year delay in age at first intercourse. (My comment is that the more mature a man is when he becomes sexually active, there’s the implication that in general he will make more responsible life choices, including his personal wellness and relationship stability).
  • Moderate ejaculation frequency (2-4 times per week) was significantly associated with less PCa risk.[ii]

Thus, the relationship between sexual activity and PCa risk is more complex than simply how often a man ejaculates—or at least this applies straight men, since the Chinese team included only female partners. Their results suggest that embarking on intercourse too early in life, and a promiscuous lifestyle, are detrimental to prostate wellness. To some extent, this seems like common sense, since having sex with one female partner means having sex with every other man she has been with; who knows what she’s been exposed to? As for starting partner sex while still immature emotionally, this could lead to a larger number of partners over a lifetime. It is generally recognized that girls are less immature than boys; and, as noted by Bolland, et al. (2019), “Risky sexual behaviors are often compounded, placing adolescents at greater risk for increased prevalence of sexual behaviors during later adolescence and other behaviors that may compromise later life chances.”

In any case, I thought it was worth sharing a study that focused on more than just the number of ejaculations per week and PCa risk. Clearly, more research is needed.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] Benli E, Yuce A, Cirakoglu A, Yazici I, Nalbant I. Comparison of Sexual Behavior and Inflammatory Parameters in Prostate Cancer Patients with Control Group: Prospective Controlled Study. Urol J. 2022 May 15;19(2):101-105
[ii] Jian Z, Ye D, Chen Y, Li H, Wang K. Sexual Activity and Risk of Prostate Cancer: A Dose-Response Meta-Analysis. J Sex Med. 2018 Sep;15(9):1300-1309.

 

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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