A Guide to Prostate Massage

Prostatic massage, also known simply as prostate massage, is a procedure in which a finger is inserted into the rectum to stimulate the prostate gland. The goal is to release excess seminal fluid (the fluid that mixes with sperm to create semen) from the ducts of the prostate gland. Alternative medical practitioners claim that doing so can ease prostate inflammation while alleviating pressure on the adjacent urinary tract.

Among the conditions prostate massage is said to treat are:

Prostate massage is also used for sexual stimulation to help achieve arousal, enhance an erection, or relax the rectum in advance of anal sex.

Prostatic massage came into popular use in 1894 and was soon after adopted a therapeutic technique by the Royal Institute of Massage at Stockholm.

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

As a man ages, the prostate tends to grow. In men in their 60s, 70s, and beyond, the prostate can reach the size of a plum or even larger. As it does so, it can constrict the urethra, causing urinary symptoms of BPH such as:

  • 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, bladder stones, cystitis (bladder infection), and reduced kidney function. It is not a risk factor for prostate cancer, however.

Beyond its role in men's health, the prostate gland also is involved in the sexual response cycle in men as parasympathetic nerves stimulate the production of seminal fluid just prior to ejaculation.

Possible Benefits

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

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

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

Side Effects and Risks

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

Rectal bleeding also can result from overly aggressive prostate massage, creating the risk of bacterial infection or aggravating hemorrhoids.

Furthermore, manual prostate massage is discouraged for 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.

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

Prostate Massage and Cancer

Men suspected of having prostate cancer should not be treated with (or engage in) prostate massage as this may dislodge tumor cells and inadvertently promote the spread of cancer to nearby tissues.

That said, there's some evidence 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 falsely elevated results.

Even if cancer is not an issue, care needs to be taken to avoid injuring the prostate. The thin, pliable membrane covering the prostate, 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.

Preparation

Outside of its presumed health benefits, prostate massage is considered a pleasurable sexual practice by some men. To prevent injury or discomfort, it is advisable to:

  • Fingernails should be trimmed and filed to prevent scratches, cuts, or tears to the rectum or prostate.
  • Hands should be washed and dried thoroughly prior to performing prostate massage.
  • Generous amounts of silicone or water-based lubricant (ideally non-fragranced) can also help prevent rectal damage or discomfort.
  • Latex or nitrile gloves can provide added protection.
  • Before receiving a rectal massage, a light douching can 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.

At that point:

  1. Apply lube liberally around the anus.
  2. Insert an index finger slowly to the first knuckle and start masturbating. Pull the finger out and re-apply lube.
  3. As you continue to masturbate, replace your finger back into the anus, this time to the second knuckle.
  4. Repeat steps 3 and 4 until you reach the third knuckle.
  5. 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 the prostate.
  6. 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.

A Word From Verywell

Prostate massage should never be used as a substitute for the diagnosis or treatment of an enlarged prostate or to avoid recommended health screenings for men at risk of prostate cancer. The United States Preventive Services Task Force currently advises that prostate cancer screening may be beneficial for all men between the ages of 55 and 69.

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