SEPTEMBER is observed as Prostate Cancer Awareness Month, and I have often wondered about the relationship between promiscuity and prostate cancer, juxtaposed with the belief that frequent ejaculation may be protective against the disease. One interesting question emerging from my musings is: Could frequent sexual activity and, more specifically, frequent ejaculation reduce a man’s risk of developing prostate cancer, and, if so, does having multiple sexual partners offer the same benefit?

Last week, we explored whether frequent sex protects the prostate. And perhaps, but the relationship between sexual activity and prostate health requires careful interpretation. Researchers have not established that frequent sex prevents prostate cancer. Nevertheless, some studies have identified an association between ejaculation frequency and a lower incidence of the disease.

More ejaculation does not mean more partners

This distinction is especially relevant in societies where sexual activity and multiple partners may become intertwined with perceptions of masculinity. Having six partners does not give the prostate six times the benefit of having one.

Indeed, some epidemiological evidence cautions against interpreting multiple sexual partners as protective. A 2002 study found that a history of sexually transmitted infections (STIs) was associated with an approximately 40 per cent higher relative risk of prostate cancer. An increase in the number of sexual partners was also associated with higher prostate cancer risk. These findings, however, do not establish that multiple partners themselves cause prostate cancer.

One possible biological explanation involves infection and chronic inflammation. Some sexually transmitted infections may produce inflammatory responses within prostate tissue, and chronic inflammation has been investigated as a possible contributor to prostate carcinogenesis. This requires cautious interpretation, however, because the complex relationship among infection, inflammation and prostate cancer remains under investigation.

Therefore, if ejaculation does provide some protective effect, multiple partners are certainly not required to achieve it. Sexual activity within a mutually monogamous relationship and masturbation can result in ejaculation without the additional STI exposure associated with unprotected sex involving multiple partners.

What does the prostate actually want?

There is no scientifically established number of sexual encounters or ejaculations that can guarantee prostate cancer prevention. Nor should a man assume that ejaculating 21 times each month means he can ignore other aspects of his health.

Age remains one of the strongest risk factors for prostate cancer, with incidence increasing substantially as men get older. Family history and genetic susceptibility are also important. Men of African descent carry a particularly significant burden of disease, making prostate cancer especially relevant to Jamaica and the Caribbean. International evidence consistently demonstrates high prostate cancer incidence and mortality among populations of African descent, including those in the Caribbean. Sexual frequency alone, therefore, will not reverse the trajectory of prostate cancer.

For Jamaican and Caribbean men, the sensible message is broader. Men should know their family history, maintain a healthy weight, remain physically active, practise safer sex, understand individual risk, discuss prostate cancer screening with an appropriate healthcare practitioner, and do not wait for urinary changes or other symptoms before taking prostate health seriously.

Pleasure is not prevention

There is undoubtedly something appealing about the suggestion that an enjoyable activity might reduce cancer risk. The evidence linking frequent ejaculation with lower prostate cancer incidence is sufficiently interesting to warrant continued scientific investigation. However, it should never be transformed into the misleading claim that more sex prevents prostate cancer and it certainly should not become an excuse for multiple sexual partners.

The available evidence presents a much more nuanced picture. Ejaculation frequency and number of sexual partners are not the same exposure. Frequent ejaculation may be associated with a modest reduction in prostate cancer incidence, particularly lower-risk disease, while multiple sexual partnerships provide no established prostate-protective advantage and may increase exposure to sexually transmitted infections.

So, what does the prostate actually want? Probably not a revolving door of partners, but rather attention to overall health, safer sexual practices, awareness of personal and family risk, appropriate conversations about screening and, quite possibly, regular ejaculation.

For Jamaican men, among whom prostate cancer accounts for more than four in every ten male cancer diagnoses, that conversation should not begin in the bedroom and end there. It needs to continue in homes, clinics, workplaces, clubs, barbershops, churches and communities across the country.

By and large, men can enjoy their sex lives but they should not treat sexual frequency as a prostate cancer prevention programme.

Professor Adella Campbell is a lecturer in the College of Health Sciences, University of Technology, Jamaica.

Professor Adella Campbell.