Combating prostate enlargement

By Ginger Manley | Posted: Wednesday March 12, 2014

January 2014

Dear Ginger:

A friend told me that a doctor told him that a man can reduce the degree of BPH by having an ejaculation every 4-5 days. He said that the prostate contracts during ejaculation, and that flexing it would maintain the tone and it would stay smaller. Is this true? If so, what do you recommend for the assisted loving crowd? Is every 4-5 days realistic? I seem to have given up nocturnal emissions years ago, so I have no help during my sleep. I realize that I need to step up my game if I want a smaller prostate. My dad had BPH and the treatment was not fun. 


Dear Dave:

For years doctors have told their male patients that exercising the prostate by frequent ejaculation can lead to better prostate health. What sounds like a good idea--and fun, too--alas is not true. At least it's not true for preventing BPH--benign prostatic hyperplasia, or the non-cancerous enlargement of the prostate. It may, however, be somewhat beneficial in preventing prostate cancer, a condition completely different from BPH. And even better, there seem to be no negative side effects from the process of ejaculation, so engaging in acts that lead to ejaculation can be done with whatever frequency one may wish.

I have covered the biology in previous columns (most recently September 2013 Mature Lifestyles,) but to summarize, the prostate is a walnut-sized gland that surrounds the urethra, the tube that carries urine from the bladder though the penis. Your friend is correct that the prostate contracts during ejaculation, pushing semen and sperm through the urethra as orgasm takes place. "Flexing it," however, does not help it maintain tone.

As men age the prostate enlarges and can press on the urethra, causing men to experience what doctors call lower urinary tract symptoms (LUTS), like urinary hesitancy, urgency, frequency, dribbling, and straining. This condition of enlarged prostate is called BPH. Treatment usually involves a combination of medications and occasionally surgery called transurethral resection of the prostate, or TURP. While neither comfortable nor easy if you are on the receiving end, it is not complicated surgery and most men are on their feet again soon.

Until 2003 there was not any good evidence for or against the myth of frequent ejaculation. Rumor had it that men who were celibate had a greater frequency of prostate related problems than did men who ejaculated on a regular basis, so health care professionals sometimes recommended regular ejaculation, either with intercourse or with masturbation, as a preventive measure. Scientists at Mayo Clinic in Rochester, Minnesota, published a paper that year in which they concluded "frequency of ejaculation has no effect on lower urinary tract symptoms, peak urinary flow rates, or prostate volume; the apparent protective association appears to be an artifact caused by the confounding effects of age." Urology(61 [2]:348-353, 2003. The study included ejaculations that occurred both with masturbation and with intercourse.

In regular language, the Mayo Clinic study showed that while older men in general report symptoms of prostate growth, the enlargement seemed to be more a result of aging itself and not a result of frequency of ejaculation. At the same time, the paper notes that men who are in "better health may engage in sexual activity more often than men who are not. Alternatively, increased sexual activity may lead to improved perceptions of health," and furthermore "(T)he association between frequency of ejaculation and satisfaction with sex life was even stronger."

While it seems clear that frequency of ejaculation has no effect on prostate health in general, there still is some question about an association of ejaculation with prostate cancer. This issue is much more complex and I will delve into it in a future column. Suffice it to say for now, to the best of my knowledge, there are no detrimental effects of ejaculation, unless a man were to do so compulsively or in a way that harms himself or others.

So there you have it. Sorry, Dave, while stepping up your game sounds fun and interesting, I don't think it will make your prostate smaller, but it may improve your relationship and your outlook on life. Men--and women--who are in better health tend to have better sex lives, so my advice is to continue to exercise, eat a balanced diet lower in red meat and with adequate nutrients and fluids, enjoy alcohol in moderation, and practice safer sex.

 I wish a very Happy New Year to all my readers. Also, Happy Homework!




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