27Evidence B

Do not believe that "masturbation harms the body" or that "abstinence is the only way to improve"; what truly matters is whether it interferes with your sleep, work, and relationships

No evidence that masturbation harms the body was found. Men who ejaculate more have about 20% less prostate cancer, though some research also saw higher risk in those who did it often when young. A few people feel weak and flu-like after every ejaculation for days — a rare disease; see urology or andrology. Feeling “addicted to porn” more often comes from the clash with one’s own morals.

Cost

No cost. What you save is the money spent on "kidney-tonif…

Benefit

First the body. A U.S. study followed 31925 men through 2010. Each reported how many ejaculations a month, the…

Cost

No cost. What you save is the money spent on "kidney-tonifying" folk remedies and "abstinence" courses, as well as the long-term anxiety caused by self-reproach.

Benefit

First the body. A U.S. study followed 31925 men through 2010. Each reported how many ejaculations a month, then was grouped by count. Versus 4 to 7 times a month, those with 21 or more had prostate-cancer HR 0.81 (95% CI 0.72–0.92, about 19% lower) using counts at ages 20 to 29. Using ages 40 to 49, HR 0.78 (0.69–0.89, about 22% lower). What fell was mainly low-risk prostate cancer. The opposing side is a UK case-control study comparing 431 patients diagnosed before 60 with 409 controls. Frequent masturbation in the twenties and thirties linked to higher risk; frequent in the fifties linked to lower risk. Next, porn. A systematic review plus meta-analysis holds that many people who feel “addicted” are mostly mismatched with what they believe is right, not only that they watch a lot. A few people do feel unwell after every ejaculation, but that is not “harming the body” — it is a rare disease called post-orgasmic illness syndrome (POIS). See a doctor; do not rely on abstinence. Among 45 Dutch patients, 87% began within 30 minutes of ejaculation, 80% were exhausted and weak, 78% felt like they had a cold. At a French hospital, 37 patients took a mean 4.7 days to recover. Cause is unclear. In the Dutch study, of 33 who had skin tests, 29 (88%) were allergic to their own semen. A Chinese study of 24 patients found no semen-specific allergy antibodies; anxiety and depression scores were high. A 2025 review found only 14 treatment studies, 12 of them case reports. Of 211 sexual-medicine experts worldwide, only 18% said more than three in ten patients improve (U.S. / UK / Netherlands / France / China).

Original sources

Rider JR, Wilson KM, Sinnott JA, et al. (2016). Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up. European Urology, 70(6), 974–982. https://doi.org/10.1016/j.eururo.2016.03.027;Dimitropoulou P, Lophatananon A, Easton D, et al. (2009). Sexual activity and prostate cancer risk in men diagnosed at a younger age. BJU International, 103(2), 178–185. https://doi.org/10.1111/j.1464-410x.2008.08030.x;Grubbs JB, Perry SL, Wilt JA, Reid RC. (2019). Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis. Archives of Sexual Behavior, 48(2), 397–415. https://doi.org/10.1007/s10508-018-1248-x;Waldinger MD, Meinardi MM, Zwinderman AH, Schweitzer DH. (2011). Postorgasmic Illness Syndrome (POIS) in 45 Dutch caucasian males: clinical characteristics and evidence for an immunogenic pathogenesis (Part 1). The Journal of Sexual Medicine, 8(4), 1164–1170. https://doi.org/10.1111/j.1743-6109.2010.02166.x;Chea M, Teng M, Chesnel C, et al. (2023). Postorgasmic illness syndrome: one or several entities? A retrospective cohort study. The Journal of Sexual Medicine, 20(12), 1407–1413. https://doi.org/10.1093/jsxmed/qdad139;Xi GP, Yang RX, Zhang J, et al. (2023). Clinical characteristics, allergic response to autologous semen, and desensitization in patients with postorgasmic illness syndrome. Sexual Medicine, 11(6), qfad068. https://doi.org/10.1093/sexmed/qfad068;Ponce S, Chapalamadugu M, Levine S, et al. (2025). Treatments for postorgasmic illness syndrome: a systematic review. The Journal of Sexual Medicine, 22(7), 1236–1243. https://doi.org/10.1093/jsxmed/qdaf112;Duran MB, Rubin RS, Reisman Y, Serefoglu EC, et al. (2025). Recognition and practice patterns of sexual medicine experts towards postorgasmic illness syndrome. International Journal of Impotence Research, 37(6), 454–457. https://doi.org/10.1038/s41443-023-00753-x

Open source link
Book note

Contested. Both prostate cancer studies were observational rather than randomized comparisons, and frequency was recalled by participants. The conclusion goes only as far as ‘no evidence of harm was found’; it does not justify encouraging people to do it more. The UK authors also say the finding in the fifties may reflect illness reducing activity first. The pornography paper's abstract gives no effect size, so only the direction is reported. The benefit is rated small because the reduction mainly concerned low-risk prostate cancers, not death. The studies of post-ejaculation illness each involved only dozens of patients. The literature calls it rare, but nobody has measured its prevalence in the general population. If almost every ejaculation leaves you weak and flu-like for days, visit urology or andrology and mention POIS. Signals to seek psychiatric or psychological care are losing sleep, missing work, harming your relationship, and being unable to stop despite wanting to. For late nights, see Section 3, item 9 (do not stay up for games, short videos or pornography). For concerns about erectile problems from pornography, first follow Section 1, item 28 (check cardiovascular health when erectile function changes). For the legal consequences of sharing in groups or selling material, see Section 9, item 4 (viewing pornography yourself is a separate matter). The beneficiary is you.

My note