Prostate-specific antigen levels depending on frequency of ejaculation and time since last ejaculation

Factors such as prostatitis or benign prostate hyperplasia are known to increase prostate-specific antigen (PSA) levels, whereas the impact of sexual behavior is unclear. Aim of this study was to investigate the effect of frequency of ejaculation and time since last ejaculation on PSA levels. The first 2.500 men of the Bavarian Men's Health (BMH) Study were included in this analysis. Men after transurethral resection of the prostate, acute prostatitis or taking finasteride were excluded. Men were grouped according to sexual orientation identity, frequency and time since last ejaculation. For each group median and quartiles of PSA-level were calculated and log-transformed PSA was compared between groups in analysis of variance with F-test. Median age was 50.4 years (min: 46.6y, max: 52.4y). Median PSA was 0.87 ng/ml (Q1:0.58; Q3:1.40); in heterosexuals (94.1% of population): 0.87 ng/ml (Q1:0.57; Q3:1.39), in homosexuals (5.0%): 0.94 ng/ml (Q1: 0.64; Q3:1.48) and in bisexuals (0.9%): 0.88 ng/ml (Q1: 0.52; Q3:1.67) (p=0.148). Shorter time since last ejaculation was associated with higher PSA-levels: ≤24h (32.5%): 0.92 ng/ml (Q1:0.62; Q3:1.44), >24-48h (15.4%): 0.90 ng/ml (Q1:0.60; Q3:1.40), >48h (52.1%): 0.82 ng/ml (Q1:0.54; Q3:1.38) (p=0.006). Higher frequency of sexual intercourse was associated with higher PSA-levels: ≥ 2 times/week (14.7%): 0.92 ng/ml (Q1:0.68; Q3:1.43), > 1 time/month up to 1 time/week (44.0%): 0.85 ng/ml (Q1:0.56; Q3:1.36) and ≤ 1 time/month (41.3%): 0.87 ng/ml (Q1:0.56; Q3:1.45) (p=0.011). Higher frequency of masturbation was also associated with higher PSA-levels: ≥ 2 times/week (30.3%): 0.95 ng/ml (Q1:0.62; Q3:1.52), > 1 time/month up to 1 time/week (38.3%): 0.82 ng/ml (Q1:0.57; Q3:1.34) and ≤ 1 time/month (31.4%): 0.87 ng/ml (Q1:0.56; Q3:1.41) (p=0.005). Shorter time since last ejaculation, higher frequency of sexual intercourse and masturbation were associated with higher PSA levels. none