Prostate Massage Health Benefits and Risks

A prostate massage is when a finger is put into the rectum to stimulate the prostate gland to help release fluid. It's usually done during sex to enhance pleasure. It is sometimes also called "prostate milking."

Healthcare providers do not recommend prostate massage to treat medical conditions, but some people say it helps with symptoms of an enlarged prostate, erectile dysfunction, and difficulty urinating.

This article will cover how prostate massage is done, the side effects and risks, and how to prepare to give and receive a prostate massage.

What Is the Purpose of Prostate Massage?

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The goal of prostate massage is to release extra seminal fluid (the fluid that mixes with sperm to make semen) from the ducts of the prostate gland. Many people use prostate massage during sex.

Healthcare providers do not recommend prostate massage as a treatment for urologic conditions, but some people feel it helps with inflammation, urination, and other symptoms related to the prostate.

The prostate gland is located between the bladder and the root of the penis. It makes seminal fluid to provide nutrients to sperm and transport them during ejaculation. The urethra (the tube through which urine and semen exit the body) runs through the center of the prostate.

What Conditions May Benefit From Prostate Massage?

Certain prostate conditions may benefit from prostate massage, including benign prostatic hyperplasia (BPH) and prostatitis.

Prostatitis

Prostatitis is the inflammation of the prostate gland. Prostate inflammation can be caused by a urinary tract infection (UTI) or a bladder infection or brought on by vigorous bicycle or horseback riding or the use of a urinary catheter.

For some people (especially older males) prostatitis happens for no known reason. Prostatitis can clear up on its own (unlike BPH, which is a progressive condition). However, some people may have prostatitis that keeps coming back (recurrence).

Symptoms of prostatitis include:

• Urinary frequency or urgency
• Inability to empty the bladder fully (urinary retention)
• 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)

The goal of prostatitis treatment is to reduce pain and inflammation. Treatment may include medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or neuromodulators. Your healthcare provider may also recommend alternative treatments such as a warm bath, heat therapy, or physical therapy.

Prostate massage is thought to help unblock glandular ducts, which may help relieve pressure and inflammation. One small study concluded that two or three prostate massage sessions when combined with other types of physical therapy might be helpful for people with prostatitis, although the authors acknowledged that more research is needed to confirm these results.

Urine Flow

Benign prostatic hyperplasia (BPH) is enlargement of the prostate that can lead to problems with urine flow. This condition happens with age.

The prostate is usually the size of a walnut, but in people who are in their 60s or older, the organ can get as large as a plum or even bigger. If the prostate gland gets large enough, it can compress the urethra and lead to urinary problems such as:

• Peeing eight or more times per day (urinary frequency)
• The inability to delay urination (urinary urgency)
• Frequent urination at night (nocturia)
• Trouble starting a urine stream
• A weak or interrupted urine stream
• Dribbling at the end of urination

Prostate massage may help eliminate some swelling and improve urine flow. Although there has not been much current research exploring this question, an older study from 2009 found that an at-home prostate massage device improved urinary function in people with benign prostatic hyperplasia and chronic prostatitits.

Erectile Dysfunction

Some people recommend prostate massage as a way to treat erectile dysfunction (ED). This is in addition to medically recommended treatments such as:

• Oral medications such as Viagra (sildenafil)
• Testosterone replacement
• Muse (alprostadil) suppository
• Therapy
  

Because prostate massage is often used during sex to enhance male pleasure, some people also believe it could help ED symptoms.

The prostate gland is sometimes called 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. Massaging the prostate gland with a finger (manually) or during anal sex is thought to enhance sexual pleasure and make it easier to ejaculate.

However, while it may be true that prostate massage enhances the intensity of ejaculation, there is no evidence that it can treat ED.

Diagnosing Medical Conditions

In medicine, prostate massage is most often used to help identify health conditions such as chronic bacterial infection of the prostate.

If there is a bacterial infection, a prostate massage will release bacteria into the urine, which can then be cultured and identified so that it can be managed with antibiotics.

What Are the Risks of Prostate Massage?

Prostate massage may cause side effects, such as:

• Tearing of nearby tissue: The tissues lining the prostate and rectum can easily get cut or torn. Massaging the prostate too hard can lead to soreness. 
• Prostate injury: It’s important to avoid injuring the prostate. The thin membrane covering the prostate (the prostatic plexus) is full of nerves that serve the two sponge-like chambers made of erectile tissue that run the length of the penis (corpora cavernosa).
• Nerve damage: Massaging the prostate too hard can damage nerves in the corpora cavernosa, and lead to pain and erectile dysfunction.
• Rectal bleeding: A prostate massage that's too rough can cause rectal bleeding, which increases a person's risk for a bacterial infection. It can also aggravate hemorrhoids.

Who Should Not Have a Prostate Massage

Some people should not have a prostate massage, including:

• People who have acute bacterial prostatitis. Prostate massage increases inflammation and could make the bacteria spread to the urethra, other parts of the urinary tract, as well as the bloodstream.
• People who have fissures or hemorrhoids. A prostate massage can cause bleeding and increase the risk of infection.
  
• People who do or might have prostate cancer. A prostate massage could cause tumor cells to break off and spread to nearby tissues. Some evidence has suggested that having a prostate massage before some tests for prostate cancer could increase the sensitivity of the test, making it more likely that cancer will be detected. However, a prostate-specific antigen (PSA) blood test should not be done right after a prostate massage, as doing so could lead to false-positive results.
  

What to Expect During a Medical Prostate Massage

It can be challenging to find a trained healthcare provider who can give a prostate massage. You should start by asking a provider that specializes in male reproductive health (urologist).

These healthcare providers are trained to do a digital rectal exam to check the prostate for cancer and other abnormalities. 

Most regular massage therapists do not offer prostate massage, but you might be able to find a certified prostate massage therapist to work with. You may also want to look for someone who is trained in tantric sex practices to do prostate massage. 

How to Prepare for a Prostate Massage

Some people consider prostate massage a pleasurable sexual practice. You can do it on your own or with a partner. You can also use a prostate massager, which is a device you can insert into your rectum that allows you to self-massage your prostate. Healthcare providers don't usually recommend these devices since they can cause pain and injury if used incorrectly.

There are some things you should do before you get a prostate massage. To prevent injury or discomfort from a prostate massage:

• Trim and file your fingernails to prevent scratches, cuts, or tears to the rectum or prostate.
• Wash and dry your hands thoroughly before doing a prostate massage.
• Apply plenty 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.
• Perform a light douching to remove fecal matter from the rectum before the massage.

How to Give a Prostate Massage

If you’ll be getting a prostate massage for sexual purposes, it will help to become aroused first. When you’re aroused, the prostate gland will move into a slightly upward and backward position as your penis becomes erect.

From there, here’s how to give a prostate massage:

1. Apply lube liberally around the anus.
2. Insert an index finger slowly into the anus up to your first knuckle.
3. Start masturbating (or have your partner start).
4. Pull your finger out and re-apply the lube.
5. As you or your partner continues to masturbate, place your finger back into the anus, this time up to your second knuckle.
6. Repeat steps 3 and 4 until you have inserted your finger up to the third knuckle.
7. Once your finger is fully inserted, feel for a rounded lump about 4 inches inside the rectum, up toward the root of the penis. This is the prostate.
8. 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.
   

Summary

There is very little evidence that prostate massage is an effective therapy for prostatitis, enlarged prostate, or other health conditions that affect the prostate. Some people use them as a part of sexual activity. 

If you want to try prostatic massage, know that it has risks. Do not have a prostate massage if you have bacterial prostatitis, prostate cancer, fissures, or hemorrhoids.