How much sex is too much?

Dear Dr. G,

I am a great admirer of your sense of humour dealing with the taboo subject of sexual health in a conservative country like Malaysia.

I am hoping you can clear my doubts about the potential harm or protective effects of frequent ejaculation.

I am 41 years old and sexually “very” active. Sadly, I often feel guilt after engaging in sexual activities, as my parents used to tell me that there are harmful effects of too much sex.

As I am a father now, I am about to tell my teenage sons how to differentiate facts and old wive’s tales about sex.

I realized I am also a bit clueless about facts when it comes to sexual education.

I understand in oriental thinking, too much sex is bad for the chi and potentially damaging the kidneys.

However, I also read with interest a recent featured article about the protective effects of frequent ejaculation against prostate cancer.

I am determined to put Dr. G on the spot to debunk the myths of too much sex.

Can you clarify what is the normal frequency of sex?

Can too much sex be damaging for kidney function?

On the other hand, what is the basis of the scientific basis of frequent sex being protective against prostate cancer? I often thought that too much sex may cause cancer.

How many ejaculations per week is considered protective?

And finally, what exactly should I tell my 15- and 16-year-old sons?

Look forward to your views.

Frequent Freddie

Old wives’ tales are an assortment of superstition, misinformation and perceptions that are passed down from generation to generation. Some of the Western beliefs are rooted in the concept that sex is bad and too much of such an indulgence is doomed to future adversity, including blindness, impotency and hairy palms.

In the East, the threats are mainly focused on losing bodily strength and energy in the form of chi. In Oriental teaching, Chi is believed to originate from the kidneys, and therefore there is a fear of too much sex resulting in the impairment of kidney function. To date, there has been no scientific data to support the threats posed by Eastern or Western beliefs.

The reality is the frequency of sex is multifaceted, dependent on the state of mind and the state of health. Cultural upbringing, religious beliefs and values are the key influencing factors determining the state of mind and desire to engage in sexual activities. On the other hand, lifestyle and physical activities determine the state of health and the ability to perform more frequently between the sheets. Such cultural and physical health are clearly variable between countries across the world.

One such publication by a well-respected researcher, Rosie King, involved 2,016 men and 1,941 women across 13 countries in the Asia Pacific. APSHOW (Asia Pacific Sexual Health Overall Wellness), which included Malaysian participants, revealed many men and women in Asia-Pacific placed priorities such as career, financial well-being, physical health and family life well above sexual relationships. In countries such as China and Hong Kong, the frequency of sexual intercourse can be as low as five times per month. While in countries such as India and the Philippines, the frequency of intercourse can be as high as four times per week. In Malaysia, we comfortably snuggle in the middle of having intercourse about eight times per month for participants below forty-years-old, and six times per month for those above such age.

With the frequency of sex being the focus, it begs the question of whether too much sex is good for health. The initial hypothesis of frequent sexual activities resulting in a higher risk of prostate cancer was put to the test. One study published in the Journal of American Medical Association, collected data from 30,000 predominantly white men aged 46 to 81. The ejaculation frequency including sexual intercourse, masturbation and wet dreams was recorded over several decades. The result demonstrated men who ejaculated 21 times or more per month in their 40s had a 32% lower risk of prostate cancer, as compared to those who ejaculated around four ejaculations per month. In addition, men who reported more than 21 ejaculations a month had a 51% lower risk of cancer.

Can this all be too good to be true? Would all doctors now prescribe “more ejaculations” for cancer prevention? Not quite! The critiques of the study pointed out that the increased frequency of sexual activities is a marker of healthier men, who are more likely to have a healthier diet and exercise more. Although such counter arguments may be valid, many researchers are taking the findings of the protective effects of ejaculation seriously. Clinicians who supported the study argued that the protective effects of ejaculation may be due to frequent discharges flushing out potential cancer-causing substances in the semen. The ejaculatory climax is also known to reduce psychological tension that can slow the growth of potentially cancerous cells in the prostate. Lastly, some even believe the rapid turnover of ejaculatory fluids can prevent the occlusions of the sperm ducts within the prostate and reduce the risk of cancer.

These old wives’ tales are clearly dated from the dark days when sexual and reproductive health are subjects of unknown entities. Although there has been a quantum leap in the understanding of sexual physiology in the 21st century, sexual myths and taboos are still causing confusion and guilt. Such thoughts are often hard to erase completely from our culture and belief. Adults who are feeling guilty about their overindulgence in sexual activities often put Dr. G on the spot for opinion. His advice to the clients and parents who are guiding their teenage kids about sexual health is: “All things in moderation are healthy, including sex. The real key in life is to work out what is your definition of moderation!”