— Overview, Benefits, Risks, and More

By Emily Morse, PhD

Prostate massage is a procedure in which a finger is inserted into the rectum to stimulate the prostate gland either for sexual stimulation or to treat medical conditions such an enlarged prostate, prostatitis (prostate inflammation), erectile dysfunction, and urination hesitancy (difficulty urinating).

This article will discuss the medical and sexual purposes of prostate massage. It also covers how the procedure is done, along with the risks and side effects that may come with it.

Purpose of Prostate Massage

The goal of prostate massage is to release excess seminal fluid—the fluid that mixes with sperm to create semen—from the ducts of the prostate gland. This is thought by some to ease inflammation, promote urination, and relieve symptoms of prostate conditions.1

The prostate gland is located between the bladder and the root of the penis. It produces seminal fluid that nourishes and transports sperm during ejaculation.2 The urethra (the tube through which urine and semen exit the body) runs through the center of the prostate.2

Certain prostate conditions are thought to benefit from prostate massage, including benign prostatic hyperplasia (BPH) and prostatitis.3

Benign Prostatic Hyperplasia (BPH)

BPH is the enlargement of the prostate with age. While the prostate is usually the size of a walnut, for those in their 60s or older, the prostate can reach the size of a plum or even larger. This can cause the compression of the urethra and urinary problems such as:4

• Urinary frequency: Peeing eight or more times per day
• Urinary urgency: The inability to delay urination
• Nocturia: Frequent peeing at night
• Trouble starting a urine stream
• A weak or interrupted urine stream
• Dribbling at the end of urination

Prostatitis

Prostatitis is the inflammation of the prostate gland. It can be caused by a urinary tract infection (UTI) or a bladder infection. But, it can also be due to things like vigorous bicycle or horseback riding or the use of a urinary catheter.5

For some people, prostatitis can occur spontaneously for no known reason, mainly in older males. Unlike BPH which is progressive, prostatitis can clear (although some people may experience recurrence).5

Symptoms of prostatitis include:5

• Urinary frequency or urgency
• Urinary retention: Inability to empty the bladder fully
• Trouble starting a urine stream
• A weak or interrupted urine stream
• Dribbling at the end of the urine stream
• Pain in the groin, lower abdomen, or lower back
• Painful ejaculation
• Urinary tract infection (UTI)

Sex and the Prostate Gland

Some people also regard the prostate gland as the “male G spot.” The prostate, penis, and urethra are all attached to a group of nerves called the prostatic plexus that are activated during orgasm.6

Massaging the prostate gland manually (with a finger) or during anal sex is thought to enhance sexual pleasure.

Evidence of Benefits

The current evidence supporting the therapeutic benefits of prostate massage remain weak and largely subjective.

One study published in the journal Open Urology and Nephrology reported that 115 males with BPH experienced an improvement in symptoms after using a prostate massage device.7

However, the significance of the findings was limited by the lack of a control group, medical tests, or exams of any kind. The researchers instead relied on questionnaires filled out by the participants.

Some contend that prostate massage can treat conditions like erectile dysfunction, which can sometimes arise due to BPH medications. Although prostate massage may enhance the intensity of ejaculation, there is no evidence it can overcome problems like erectile dysfunction.8

Possible Side Effects

The tissues lining the prostate and rectum are delicate and vulnerable to cuts, tears, and abrasions. Massaging the prostate too intensely can easily lead to soreness. In the study described above, for example, 8.3% of participants reported discomfort after a prostate massage.7

Overly aggressive prostate massage can also cause rectal bleeding, creating a risk of bacterial infection or aggravating hemorrhoids.

Furthermore, manual prostate massage is discouraged for males with acute bacterial prostatitis. The massage increases inflammation and may promote the spread of bacteria to the urethra, other parts of the urinary tract, and the bloodstream.9

That said, a few small studies of the effects of prostate massage performed by a physician have shown it to be beneficial as a therapy for chronic prostatitis when paired with antibiotics.10

Contraindications and Risks

Males suspected of having prostate cancer should not be treated with (or engage in) prostate massage, as this may cause tumor cells to break off and spread to nearby tissues.

There’s some evidence that prostate massage, prior to certain tests for prostate cancer, may increase the sensitivity of the test, making it more likely the cancer will be detected.

However, a prostate-specific antigen (PSA) blood test should not be conducted immediately after a prostate massage, as this could lead to false-positive results.11< Even if cancer is not an issue, it's important to avoid injuring the prostate. The thin, pliable membrane covering the prostate—the prostatic plexus—is full of nerves that serve the sponge-like corpora cavernosa of the penis.

Massaging the prostate too intensely can damage nerves in the corpora cavernosa—two chambers composed of erectile tissue that run the length of the penis. Damage to the corpora cavernosa can result in pain and erectile dysfunction.

How to Prepare for a Prostate Massage

Prostate massage is considered a pleasurable sexual practice by some men. If you try it, to prevent injury or discomfort, you should:

• Trim and file fingernails to prevent scratches, cuts, or tears to the rectum or prostate.
• Wash and dry hands thoroughly prior to performing prostate massage.
• Apply generous amounts of silicone or water-based lubricant (ideally fragrance-free) to help prevent rectal damage or discomfort.
• Consider wearing latex or nitrile gloves for added protection.
• Before receiving a prostate massage, perform a light douching to remove fecal matter from the rectum.

Never engage in a prostate massage if you or your partner has fissures or hemorrhoids. Doing so can cause bleeding and may increase the risk of infection.

How to Do a Prostate Massage

If performing prostate massage for sexual purposes, it often helps to achieve a state of arousal first. Doing so moves the gland into a slightly upward and backward position as the penis becomes erect.

1. Apply lube liberally around the anus.
2. Insert an index finger slowly to the first knuckle and start masturbating.
3. Pull the finger out and re-apply lube.
4. As you continue to masturbate, replace your finger back into the anus, this time to the second knuckle.
5. Repeat steps 3 and 4 until you reach the third knuckle.
6. Once the finger is fully inserted, search for a rounded lump roughly 4 inches inside the rectum and up towards the root of the penis. This is the prostate.
7. Gently massage the prostate in a circular or back-and-forth motion using the pad of a finger. You can also apply gentle pressure for seven to 10 seconds, again with the pad of a finger rather than the tip.

Summary

There is very little evidence to support the claims that prostate massage is an effective therapy for prostatitis, enlarged prostate, or other conditions that affect the prostate.

It is clear, however, that prostatic massage comes with risks for males who have bacterial prostatitis, prostate cancer, fissures, or hemorrhoids. For them, prostate massage should be avoided, as it can worsen their condition.

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