Ejaculation Frequency and Risk of Prostate Cancer

Discussion in 'Men's Health Forum' started by Michael Scally MD, Mar 29, 2016.

  1. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Ridera JR, Wilsona KM, Sinnotta JA, et al. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up. European Urology. March 2016. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up - European Urology

    Background: Evidence suggests that ejaculation frequency may be inversely related to the risk of prostate cancer (PCa), a disease for which few modifiable risk factors have been identified.

    Objective: To incorporate an additional 10 yr of follow-up into an original analysis and to comprehensively evaluate the association between ejaculation frequency and PCa, accounting for screening, clinically relevant disease subgroups, and the impact of mortality from other causes.

    Design, Setting, and Participants: A prospective cohort study of participants in the Health Professionals Follow-up Study utilizing self-reported data on average monthly ejaculation frequency. The study includes 31 925 men who answered questions on ejaculation frequency on a 1992 questionnaire and followed through to 2010. The average monthly ejaculation frequency was assessed at three time points: age 20–29 yr, age 40–49 yr, and the year before questionnaire distribution.

    Outcome Measurements and Statistical Analysis: Incidence of total PCa and clinically relevant disease subgroups. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

    Results And Limitations: During 480 831 person-years, 3839 men were diagnosed with PCa. Ejaculation frequency at age 40–49 yr was positively associated with age-standardized body mass index, physical activity, divorce, history of sexually transmitted infections, and consumption of total calories and alcohol. Prostate-specific antigen (PSA) test utilization by 2008, number of PSA tests, and frequency of prostate biopsy were similar across frequency categories. In multivariable analyses, the hazard ratio for PCa incidence for ≥21 compared to 4–7 ejaculations per month was 0.81 (95% confidence interval [CI] 0.72–0.92; p < 0.0001 for trend) for frequency at age 20–29 yr and 0.78 (95% CI 0.69–0.89; p < 0.0001 for trend) for frequency at age 40–49 yr. Associations were driven by low-risk disease, were similar when restricted to a PSA-screened cohort, and were unlikely to be explained by competing causes of death.

    Conclusions: These findings provide additional evidence of a beneficial role of more frequent ejaculation throughout adult life in the etiology of PCa, particularly for low-risk disease.

    Patient Summary: We evaluated whether ejaculation frequency throughout adulthood is related to prostate cancer risk in a large US-based study. We found that men reporting higher compared to lower ejaculatory frequency in adulthood were less likely to be subsequently diagnosed with prostate cancer.

    Take Home Message: In a large prospective study with long-term follow-up, men who reported more frequent ejaculation in adulthood had a lower risk of total incidence of prostate cancer. Ejaculation frequency represents a potentially modifiable risk factor for prostate cancer.
  2. KillaBig

    KillaBig Member AnabolicLab.com Supporter

    I'm at very low risk if any at all.
    Good Read
    Eman likes this.
  3. New to HRT

    New to HRT Member

    My prostrate should live to be 100. Not sure about the rest of me.
  4. Saltyseadog

    Saltyseadog Member

    Sailors cure for everything!
  5. Raven101

    Raven101 Member

    I hate my fuckin prostate, nothing but trouble. That said, my psa is low at .6 and no genetic predisposition. 50 years old.
  6. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    To explore previous findings that men who ejaculate more frequently have lower risk of prostate cancer, we evaluated molecular alterations in the prostate tissue according to each man's frequency of ejaculation prior to diagnosis. We identified biological processes that could link ejaculation frequency and prostate cancer.

    Sinnott JA, Brumberg K, Wilson KM, et al. Differential Gene Expression in Prostate Tissue According to Ejaculation Frequency. European Urology. https://www.europeanurology.com/article/S0302-2838(18)30353-1/fulltext

    In a prospective study of 31 925 men with 18 yr of follow-up, higher ejaculation frequency (EF) throughout adulthood was associated with lower rates of prostate cancer.

    To further explore this association, we evaluated whole transcriptome gene expression in the prostate tissue from study participants who developed prostate cancer between 1992 and 2004 (n = 157 tumor tissue, n = 85 adjacent normal).

    We tested for trends in gene expression according to the level of EF as self-reported in 1992 for ages 20–29 yr, 40–49 yr, and the year prior to the questionnaire, 1991.

    There were no associations between EF and gene expression in areas of tumor after accounting for multiple testing. In contrast, in the adjacent normal tissue, 409 genes and six pathways were differentially expressed at a false discovery rate ≤0.2 across categories of EF in 1991.

    These results suggest that ejaculation affects the expression of genes in the normal prostate tissue. The identified genes and pathways provide potential biological links between EF and prostate tumorigenesis.
  7. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    It’s true! You can go blind.

  8. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Jian Z, Ye D, Chen Y, Li H, Wang K. Sexual Activity and Risk of Prostate Cancer: A Dose–Response Meta-Analysis. The Journal of Sexual Medicine. Redirecting

    Introduction - The role of sexual activity (SA) on prostate cancer (PCa) risk is still controversial.

    Aim - To determine the associations among number of female sexual partners, age at first intercourse, ejaculation frequency (EF), and the risk of PCa.

    Methods - A systematic literature search on MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted to identify the relevant studies published before April 2018. We calculated the summary odds ratio (OR) and 95% CI to determine the association between SA and PCa risk. A 2-stage dose-response meta-analysis was performed to explore the trend from the correlated log OR estimates.

    Main Outcome Measures - Outcome measures included characteristics of included studies, associations among number of female sexual partners, age at first intercourse, as well as EF and PCa risk.

    Results - A total of 21 case-control studies and 1 cohort study with 55,490 participants (14,976 patients and 40,514 controls) were included in this meta-analysis. Linear and significant dose–response associations were found among number of female sexual partner as well as age at first intercourse and PCa risk, an increment of 10 female sexual partners associated with a 1.10-fold increase of PCa risk (OR 1.10, 95% CI 1.01–1.21), and the risk of PCa was decreased by 4% for every 5-year delay in age at first intercourse (OR 0.96, 95% CI 0.92–0.99).

    Although no linear association was observed between EF and the risk of PCa, moderate EF (2–4 times per week) was significantly associated with a lower risk of PCa (OR 0.91, 95% CI 0.87–0.96).

    Clinical Implications - Modification of SA factors would appear to be a useful low-risk approach to decreasing the risk of PCa.

    Strengths & Limitations - This is the first dose–response meta-analysis performed to describe the association between SA and PCa risk. However, the direction of causality between SA and risk of PCa should be interpreted with caution because most included studies used case-control design.

    Conclusion - Meta-analysis of the included studies indicated that men with fewer sexual partner numbers, older age at first intercourse, and moderate frequent ejaculation were associated with a significantly decreased risk of PCa.