Sex and Prostate Cancer: Can More Love-Making Reduce Your Risk?

Key Points

• A 2016 study suggested a link between frequent ejaculation and a lower risk of prostate cancer.
• As it turns out, the old "correlation, not causation" phrase comes into play in this case.
• Living a generally healthy lifestyle remains the best way to prevent prostate cancer and other potentially deadly diseases.

In a world of seemingly constant bad health news—increasing obesity, declining life expectancy, increasing risk of heat-related illness—it's refreshing to see any medical news that seems kind of nice. For example, how about news that links having sex with a reduced risk of prostate cancer?

Is it too good to be true?

Men who ejaculated more frequently were less likely to develop prostate cancer, a 2016 study suggested. Hundreds of articles touted the results as almost prescriptive, as if they were marching orders to get busy 21 times per month to stay healthy.

Again: too good to be true?

We'll revisit that study and see if it still holds up and if there might be other lessons to be learned.

What did the study say about sex and prostate cancer?

The original study looking for links between ejaculation and prostate cancer stemmed from a cohort of 31,925 men who answered a questionnaire in 1992 and were followed through 2010.

They were asked to self-report their monthly average ejaculation frequency, evaluated at three points in time: ages 20 to 29, ages 40 to 49 and the year before the questionnaire was published.

Of these men, 3,839 developed prostate cancer. The data suggested the men who reported ejaculating 21 times or more per month had a 20 percent lower chance of developing prostate cancer, a figure that held in several age groups—but don't drop your pants just yet.

"I think that's one of those classic studies where correlation doesn't prove causation," said Katherine Rotker, M.D., a urologist with Yale Medicine in New Haven, Connecticut, who specializes in male infertility and reproductive health. "When you try to isolate one activity out of a person's lifestyle and prove that as causative of anything, you can get a lot of correlative studies that are exciting to read but not necessarily that clinically relevant."

Recommended

• Unequal Access, Unequal Outcomes: Race and Prostate cancer: Black men are at higher risk for the deadly disease—and geography matters too.
• Gleason Score. Aggressiveness. What Is My Doctor Talking About?: Understand the ways doctors stage and rate prostate cancer and how they talk about it.
• How Common Is Recurrent Prostate Cancer and How Is it Treated?: If your disease comes back, treatment might depend on the initial therapy.

What's the problem with the study?

The tricky part with studies like this one is that the eye-grabbing result is so attractive we tend to gloss over nuances that might factor in. Many clinicians and even well-respected institutes cautiously agree that the 2016 study and others like it appear to be legitimate, peer-reviewed and based on valid data and research.

Others point out that there's still no direct link to frequent ejaculation as the cause of the lower cancer rates.

A key finding of the 2016 study that often gets overlooked is that there was only a difference in the rates of less aggressive prostate cancer—the rates of the more deadly kind remained the same. If it's truly ejaculation that's causing the lower rates of cancer, why would it only work on one kind?

Who doesn't want to hear that coming more often is good for you?

"There have been some studies that have shown a decreased risk of prostate cancer diagnosis later in life for men who have had a high frequency of ejaculation early in life," said Scott D. Miller, M.D., the medical director of Wellstar Urology in Atlanta. "However, no mechanism has been discovered, and no difference in death from prostate cancer has been demonstrated. There was no difference in incidence of the more aggressive forms of prostate cancer."

Does a lack of sex—and ejaculation—cause cancer?

The short answer is no, sex or masturbation with ejaculation won't cause cancer.

The longer answer is there is not a glimmer of evidence showing that not ejaculating often is a prostate cancer risk factor. Some people speculate that ejaculating may flush out chemicals that build up in the prostate, but there's no hard evidence proving it, nor is there any proof that not ejaculating causes prostate cancer.

If you broaden the scope of the question, you can start to see how ejaculating often correlates to other health issues, even if it may not be directly related to prostate cancer.

"There is no harm to more frequent ejaculation," Miller said. "More importantly, sexual activity is associated with better cardiovascular health, stress reduction, improved emotional health and overall longevity."

There's a valuable lesson here when it comes to understanding studies like this. Trying to tease out a single magic bullet to grant us this or that health benefit may be less worthwhile than simply looking after our overall health.

"It's really hard in sexual studies and male infertility studies to isolate a single risk factor for people who have very full lives and exposure histories," Rotker said. "So there's probably more of a correlation between more frequent ejaculation and things like activity level and health status and testosterone level than it is that more masturbating prevents prostate cancer."

The bottom line

What this study may have shown us is simply that healthier men are more likely to ejaculate more frequently.

At the same time, they're less likely to get sick. Putting aside family history, age and genetics, men may be more at risk for prostate cancer if they're obese, if they smoke, eat a poor diet or if they're exposed to certain chemicals, according to the American Cancer Association.

Who doesn't want to hear that coming more often is good for you? For indirect reasons, it may be. Just don't assume it's going to prevent cancer.