Does Having Sex Help With Kidney Stones?

Sexual intercourse does appear to help pass certain kidney stones, and the evidence is stronger than you might expect for something that sounds like an old wives’ tale. Multiple randomized controlled trials have found that people who had sex three or more times a week passed distal ureteral stones at roughly double the rate of those who didn’t, with some studies showing results comparable to the standard medication prescribed for this purpose. The catch is that the benefit applies specifically to stones that have already traveled most of the way down the ureter and are lodged near the bladder, not to stones still sitting in the kidney itself.

What the Clinical Trials Found

The earliest and most-cited trial on this question, published in the journal Urology, randomly assigned patients with distal ureteral stones into three groups: frequent sexual intercourse, the drug tamsulosin, or standard care with no additional treatment. After two weeks, about 84% of patients in the sexual intercourse group had passed their stones, compared with roughly 48% in the tamsulosin group and 35% in the control group. The average time to pass a stone was 10 days in the sex group versus nearly 17 days with tamsulosin and 18 days with standard care alone.¹

A second trial found similar results: an 82% stone passage rate in the sex group versus 53% in controls after two weeks, with the gap widening to 89% versus 71% by the fourth week. The average expulsion time was about four days shorter for those having regular intercourse.² A third trial, conducted among male patients, found that sexual intercourse at least three times a week produced a passage rate of about 82%, matching the effectiveness of tamsulosin and far outperforming the roughly 52% passage rate in controls.³

Not every trial has shown statistically significant differences. One randomized controlled trial from Egypt found higher passage rates in the intercourse group (68% at two weeks versus 53%), but the difference didn’t reach the conventional threshold for statistical significance. What that study did confirm was that patients in the intercourse group needed significantly fewer painkiller injections.⁴

When the available trials were pooled together in a meta-analysis covering 240 patients, the combined data showed that patients having regular intercourse were more than six times as likely to pass a stone by two weeks and about four times as likely by four weeks, compared with controls.⁵ Those are large effect sizes by any medical standard, although the total number of patients studied is still modest.

Why It Might Work

The leading explanation centers on nitric oxide, the same molecule that plays a role in erections and in certain blood pressure medications. During sexual arousal and orgasm, nerve endings release a surge of nitric oxide. The distal ureter, the tube connecting the kidney to the bladder, is rich in nerve fibers that produce this molecule. When nitric oxide floods the area, it relaxes the smooth muscle lining the ureter wall, which effectively widens the passage and reduces the resistance a stone faces on its way out.⁶

This mechanism is actually quite similar to how tamsulosin works. Tamsulosin is an alpha-blocker widely prescribed to help pass ureteral stones by relaxing the smooth muscle in the lower ureter. Sexual stimulation appears to achieve a comparable effect through a parallel biochemical pathway. The difference is that sexual activity also triggers a cascade of other physiological responses: pelvic muscle contractions during orgasm, hormonal release including oxytocin, and increased urine flow from fluid intake and general physical exertion, all of which could contribute to pushing a stone along.

There’s also a prostaglandin component. Seminal fluid contains prostaglandins, and lab experiments on human urinary tract tissue have shown that certain prostaglandins (the E series) inhibit ureteral muscle contractions while others (the F series) increase them.⁷ The interplay is complex, but the overall picture suggests that the biochemistry of sexual activity creates favorable conditions for a stone near the bladder to complete its journey.

How It Compares to Standard Medication

Tamsulosin has been the go-to drug for what urologists call medical expulsive therapy for years. When researchers pitted sexual intercourse directly against tamsulosin, the results were striking: sex performed at least as well, and in one trial it significantly outperformed the drug. In that study, 84% of patients in the intercourse group passed their stones versus 48% on tamsulosin.¹ Another trial found them essentially equivalent, with passage rates around 82% for both approaches.³

A broader meta-analysis that included studies comparing sexual stimulation with medical expulsive therapy found no statistically significant difference between the two approaches in stone expulsion rate, expulsion time, or analgesic use.⁸ In practical terms, that means sexual activity appears to be a genuine alternative to medication for the right type of stone, not merely a feel-good supplement. Whether urologists will ever formally recommend it as first-line therapy is another question. The total body of evidence is still small, and clinical guidelines tend to lag behind individual trials by several years.

Does It Work for Women?

Most of the early trials enrolled only men, which makes sense given that the original mechanism hypothesis was tied to ejaculation. But researchers in Turkey designed a trial specifically for women, and the results held up. Women who had sexual intercourse three to four times per week showed significantly higher spontaneous passage rates for distal and intramural ureteral stones compared with controls. They also required fewer analgesic injections.⁹

This finding was important because it shifted the conversation away from ejaculation-specific explanations and toward the broader nitric oxide and smooth muscle relaxation pathway. If the benefit were purely about the mechanical force of ejaculation or the prostaglandins in semen, it shouldn’t work for women. The fact that it does suggests the key driver is orgasm-related physiology, pelvic contractions, nitric oxide release, hormonal changes, that both sexes share.

Masturbation Appears Equally Effective

Building on the same logic, researchers tested whether masturbation would produce comparable results. A prospective randomized trial found that men who masturbated three to four times per week had a stone passage rate of about 81%, virtually identical to the tamsulosin group (about 81%) and nearly double the 43% rate in controls.¹⁰

This is a meaningful finding for practical reasons. Not everyone with a kidney stone has a willing partner, and pain from renal colic doesn’t exactly set a romantic mood. Knowing that the benefit comes from sexual stimulation and orgasm in general rather than from intercourse specifically makes the advice more universally applicable. It also reinforces the mechanistic explanation. The shared element between intercourse and masturbation is orgasm, which triggers the same nitric oxide release and pelvic contractions regardless of how it happens.

Which Stones This Applies To

This is where the fine print matters. Every trial cited above enrolled patients with distal ureteral stones, meaning stones that had already left the kidney and traveled down to the lowest portion of the ureter near the bladder. Most studies focused on stones between 5 and 10 millimeters in diameter. That’s an important limitation, because the experience most people associate with “kidney stones” encompasses the entire journey from kidney to toilet, and sexual activity has only been tested on the final leg of that trip.

Stones still lodged in the kidney or stuck in the upper or mid ureter are in a different anatomical situation entirely. The nitric oxide relaxation mechanism is most relevant to the lower ureter, where the tube narrows as it enters the bladder wall. There’s no trial evidence suggesting that sex helps dislodge a stone from the kidney or speeds passage through the upper ureter. And stones larger than 10 millimeters are generally considered too big for any conservative management approach. They typically require surgical intervention or lithotripsy regardless of what else you do.

If you’ve been told you have a small stone in the distal ureter and your urologist recommends watchful waiting or medical expulsive therapy, sexual activity is a reasonable addition to discuss. If you have a large stone, an obstructing stone causing infection, or a stone in the kidney itself, the research simply doesn’t apply.

After Shockwave Lithotripsy

One interesting extension of this research looks at whether sexual intercourse helps after shockwave lithotripsy (SWL), the noninvasive procedure that uses sound waves to break stones into fragments. A randomized trial assigned patients who’d undergone SWL for distal ureteral stones into three groups: frequent sexual intercourse, tamsulosin, or standard post-procedure care. After two weeks, the stone-free rates were about 80% for both the intercourse and tamsulosin groups, compared with 63% for controls. The intercourse group also had a significantly lower rate of steinstrasse, a complication where stone fragments pile up and cause a blockage after lithotripsy.¹¹

For patients recovering from SWL, this makes intuitive sense. After the stone has been shattered into smaller pieces, the same smooth muscle relaxation that helps a whole stone pass should help fragments clear more efficiently. It also suggests that the benefit isn’t limited to a narrow clinical scenario but extends to the broader challenge of getting stone material through the distal ureter.

The Pain Relief Angle

Passing a kidney stone can be agonizing, and pain management is a major part of treatment. Several of the trials tracked how many painkiller injections patients needed during the observation period. The meta-analysis of three RCTs found that patients in the sexual intercourse groups required significantly fewer analgesic injections than controls.⁵ The Egyptian trial that didn’t find a statistically significant difference in passage rates still found a significant reduction in pain medication use.⁴

This pain-reduction effect probably reflects a combination of factors. If the stone passes sooner, there’s less time to be in pain. But orgasm also triggers endorphin and oxytocin release, both of which have analgesic properties independent of whether a stone moves. Some patients may find that the pain relief from sexual activity is the more immediately noticeable benefit, even if the stone doesn’t pass right away.

Limitations of the Evidence

For all the promising results, this body of research has real weaknesses that are worth being honest about. The total number of patients across all published trials is in the low hundreds, which is small by the standards of most medical interventions. Nearly all of the trials come from research groups in the Middle East and Turkey, and the findings haven’t been replicated in large multicenter trials across different populations. Blinding is also fundamentally impossible in this kind of study. Patients know whether they’ve been told to have sex or not, which introduces bias in reporting symptoms and pain levels.

There’s also the question of compliance and measurement. In most trials, patients were asked to have intercourse at least three times per week and self-reported their adherence. It’s the kind of variable that’s inherently difficult to standardize. And the frequency recommendation of three to four times weekly comes directly from the trial designs rather than from any dose-response analysis. Nobody has tested whether twice a week is almost as good or whether daily is better. The “three times a week” threshold is where the data exists, not necessarily where the optimal benefit lies.

Practical Considerations and When to Skip It

If you’re in the acute phase of renal colic, writhing in pain and possibly vomiting, sexual activity is obviously not realistic. The trials enrolled patients who were clinically stable and managing their symptoms well enough to go about daily life while waiting for a stone to pass. That’s the typical scenario for conservative management of a small distal stone: your urologist confirms the stone’s location and size with imaging, prescribes fluids and pain medication, and tells you to wait it out for a few weeks.

There are also situations where you should absolutely not delay proper treatment. If you develop a fever alongside a ureteral stone, that’s a medical emergency, a sign of infection behind an obstruction, and no amount of sexual activity is going to fix it. Similarly, if you have a solitary kidney, severely impaired kidney function, or a stone causing complete obstruction, surgical intervention takes priority.

For people in the right clinical situation, though, the conversation with your urologist is straightforward. The evidence supports sexual stimulation, whether through intercourse or masturbation, as a reasonable adjunct to standard care for distal ureteral stones. It appears to work through the same smooth muscle relaxation pathway targeted by conventional medication, it doesn’t have the side effects that alpha-blockers can produce (dizziness, low blood pressure, retrograde ejaculation), and at minimum it seems to reduce the amount of pain medication you’ll need while you wait.

How Kidney Stones Form and Who Gets Them

Kidney stones develop when certain minerals in urine become concentrated enough to crystallize. The most common type, calcium oxalate, accounts for the majority of cases. Risk factors include chronic dehydration, diets high in sodium or animal protein, obesity, and family history. Men are roughly twice as likely to develop stones as women, though the gap has narrowed over recent decades as obesity rates have climbed across both sexes. Recurrence is common: someone who has passed one stone has about a 50% chance of developing another within five to ten years without preventive measures.

Most small stones (under 5 millimeters) pass on their own with adequate hydration and pain control. Stones between 5 and 10 millimeters are in a gray zone where medical expulsive therapy or watchful waiting is often tried before resorting to procedures. That gray zone is exactly where the sexual activity research becomes relevant, offering one more tool for coaxing a stubborn stone through the narrowest part of the urinary tract before anyone has to bring in a scope or a lithotripter.