A Guide to Prostate Massage

How It Is Done and Why It Is Used

Prostate massage is a self-help technique that may benefit prostate health but one that few men actually consider or feel comfortable performing. Although some people will tell you that it helps "clear toxins" from the prostate, the aim of the massage is to stimulate the prostatic ducts to release excess seminal fluid (the fluid that mixes with sperm to create semen). it is believed that doing so can help relieve pressure from an enlarged prostate and help promote urination.

There are few studies that strongly support the use of prostate massage for the treatment of benign prostatic hyperplasia (BPH) or other prostatic conditions. But, for the 28% of men over 50 who experience some form of lower urinary tract symptom, a prostate massage may offer relief, but it is not a commonly employed technique.

Prostate massage can also be used as a form of sexual stimulation, either performed on oneself or by a partner.

1

About the Prostate

Illustration of the third stage of a digital rectal examination in the case of a prostate examination

BSIP / UIG / Getty Images

The prostate is a gland about the size and shape of a walnut, located between the bladder and the root of the penis. The urethra (the tube through which urine and semen leave the body) runs through the center of the prostate.

The prostate gland’s primary function is to secrete a fluid that makes up about 70% of the seminal volume. The fluid not only helps transport sperm into the vagina but also counteracts the acidity of the vagina so that mature sperm (spermatozoa) can survive. During ejaculation, the prostate squeezes seminal fluid into the urethra via the porous prostatic ducts.

The prostate will begin to grow as men age. Among men in their 60s, 70s, and beyond, the prostate can sometimes grow to the size of a plum or even larger.

The enlargement of the gland leads to symptoms of BPH as it progressively constricts the urethra and the flow of urine. Common symptoms include:

  • Frequent need to urinate
  • Increased frequency of urination at night
  • Difficulty starting urination
  • Weak urine stream
  • Dribbling at the end of urination
  • Inability to completely empty the bladder

In some cases, BPH can lead to incontinence, sexual dysfunction, prostatitis (prostate infection), bladder stones, cystitis (bladder infection), and reduced kidney function.

BPH is not a known risk factor for prostate cancer, although the two can frequently coexist. In some cases, BPH can lead to the incidental diagnosis of cancer during a rectal exam.

2

Possible Benefits

The benefits of prostate massage are often more presumed than proven. Some men claim that doing so temporarily relaxes an inflamed prostate, allowing a more steady flow of urine.

Few qualitative studies have shown any therapeutic benefit from the manual stimulation of the prostate. A 2009 study published in the Open Urology and Nephrology Journal reported that 115 men with BPH experienced improvement in their symptoms after using a proprietary prostate massage device.

(Despite the positive finding, the results were limited by the lack of a placebo control group and the subjective nature of the self-reported questionnaire. No medical evaluations of any sort were performed by the researchers.)

Other men use prostate massage to increase sexual pleasure and reach orgasm more easily. The technique, referred to as prostate milking, is often integrated into sexual play among couples.

Although prostate massage may enhance the intensity of ejaculation, there is no evidence that it can overcome problems like erectile dysfunction.

3

Side Effects and Risks

Rectal soreness is the most common side effect of prostate massage, occurring in 8.3% of the participants of the above-listed study. But, this is not the only concern related to prostate massage.

The tissues lining the prostate and rectum are very delicate and vulnerable to cuts, tears, and abrasions. Massaging the prostate too vigorously can easily lead to soreness and bleeding, the latter of which may increase the risk of bacterial infection, and it may aggravate hemorrhoids.

Even among doctors, manual prostate massage is discouraged in men with acute bacterial prostatitis as it not only increases inflammation but may promote the spread of bacteria to the urethra and other parts of the urinary tract and into the bloodstream.

While it should be avoided in acute prostatitis, some small studies have shown benefit with physicians employing this along with antibiotics in the treatment of chronic prostatitis

Similarly, prostate massage should be avoided in men suspected of having prostate cancer. Manually rubbing a tumor can dislodge cells and inadvertently promote the spread of cancer to nearby tissues.

There are some studies showing that prostate massage prior to some tests for prostate cancer can increase the sensitivity of the test (make it more likely the cancer will be picked up). The PSA should not be tested right after this procedure as it could falsely elevate it.

For this reason, a prostate self-exam is not recommended if you believe you have cancer, nor should a self-exam take the place of an exam by a physician. Instead, the U.S. Preventive Services Task Force recommends that men 55 to 69 discuss prostate cancer screening with their doctor using a blood test known as the prostate-specific antigen (PSA).

Even if cancer is not an issue, care needs to be taken to avoid injuring the prostate. The thin, pliable membrane covering the prostate, called the prostatic plexus, is rich in nerves that service the sponge-like corpora cavernosa of the penis.

Prodding or poking the prostate too vigorously can inadvertently damage the nerves of the corpora cavernosa, increasing the risk of erectile dysfunction.

4

Preparation

Man washing hands in bathroom sink, cropped

PhotoAlto / Sigrid Olsson / Getty Images

When used for sexual stimulation, prostate massage can be extremely pleasurable. However, you need to take some precautions to avoid injury.

First and foremost, you and/or your partner need to trim and file your fingernails to avoid accidental cuts and tears to the rectum or prostate. Wash and dry your hands thoroughly.

You would also need to use plenty of silicone or water-based lubricant (ideally non-fragranced) to ease the insertion of the finger into the anus. Latex gloves or a finger cot offer added protection (although the latter can sometimes slip off). Non-latex nitrile gloves can be used for people with latex allergy.

It also helps to lightly douche to remove all fecal matter from the rectum. Avoid over-douching or using too much water pressure as this can cause inflammation and promote tissue damage.

If you have health issues like fissures or hemorrhoids, wait until they have healed or check with your doctor before you engage in anal play.

Never insert a finger that has been inside of you into the anus or vagina of your partner (or vice versa) without first washing your hands and changing gloves.

5

How to Do a Prostate Massage

It helps to achieve a state of arousal before starting a prostate massage. Doing so turns the gland in a slightly upward and backward position as the penis becomes more erect.

To perform a prostate massage:

  1. Stroke your penis until it is erect or semi-erect and your arousal level is roughly six on a scale on a 10 (10 being an orgasm).
  2. Apply lube liberally around the anus with your finger.
  3. Insert your index finger slowly to the first knuckle and start masturbating. 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 four inches inside the rectum and up towards the root of the penis. This is your prostate.
  7. Gently massage the prostate in a circular or back-and-forth motion using the pad of your finger. You can also apply gentle pressure for seven to 10 seconds, again with the pad of your finger rather than the tip. Repeat to orgasm.

Prostate play can be a fun way to enhance your sex life, whether alone or with a partner. It may also offer relief to people with BPH (although there is very little evidence to substantiate this) but should only be used after discussion with your doctor and as part of routine prostate health screenings.

Prostate massage should never be used as a substitute for standard medical treatment or to self-diagnose prostate problems of any sort.

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Article Sources

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  2. Chang RT, Kirby R, Challacombe BJ. Is there a link between BPH and prostate cancer? Practitioner. 2012 Apr;256(1750):13-6, 2.

  3. Levin RJ. Prostate‐induced orgasms: A concise review illustrated with a highly relevant case study. Clin Anatomy. 2018 Jan;31(1);81-5. doi:10.1002/ca.23006

  4. Coker TJ, Dierfeldt DM. Acute Bacterial Prostatitis: Diagnosis and Management. Am Fam Physician. 2016 Jan 15;93(2):114-20.

  5. U.S. Preventive Services Task Force. Final Recommendation Statement: Prostate Cancer: Screening. Rockville, Maryland; October 2018.

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