“Doc, I keep hearing about the prostate… what exactly is it, and when should I start paying attention to it?” It’s a question I hear a lot in my clinic, especially from men hitting their 40s and 50s. And it’s a great question! It’s one of those body parts we don’t think much about until, well, we have to. So, let’s chat about it, just like we would in an exam room.
Understanding Your Prostate
So, What is a Prostate Anyway?
Alright, let’s get to know this little gland. The prostate is a small but important part of the male reproductive system. Think of it as being about the size of a walnut, though it can grow as you get older.
What’s Its Job?
You might be wondering, “What does this prostate actually do for me?” Good question. Its main gig is to add extra fluid to your semen – that’s the fluid that’s released when you orgasm. This special prostatic fluid isn’t just there for volume; it contains things like enzymes, zinc, and citric acid. These help nourish sperm cells and also lubricate the urethra (that’s the tube your pee and semen travel through to exit your body).
The muscles in your prostate also play a role; they help push semen into and through the urethra during orgasm. So, it’s got a couple of key functions for reproduction.
Do Women Have One?
Nope, women don’t have a prostate gland. They have something called Skene’s glands, which some folks sometimes refer to as the “female prostate.” These glands are near the urethra in women. We think they might help with urination and cleanliness, and possibly even play a part in sexual response, maybe providing fluid for female ejaculation. But they’re distinct from the male prostate.
A Closer Look: Anatomy of the Prostate
Where Exactly is It Hiding?
Your prostate is tucked away below your bladder and in front of your rectum. And, as I mentioned, your urethra runs right through the middle of it. Its location is why, if it gets enlarged, it can sometimes cause trouble with urination.
What Does It Look Like?
If we could peek inside, you’d see your prostate has a few sections, or lobes – five to be exact: one in the front (anterior), one in the back (posterior), two on the sides (lateral), and one in the middle (median). It’s made up of a mix of connective tissues and glandular tissues. And it’s all wrapped up in a stretchy sheet of connective tissue called the prostatic fascia.
How Big Are We Talking?
As I said, it starts out about walnut-sized. But here’s something important: after about age 40, it’s pretty common for the prostate to get larger. We call this benign prostatic hyperplasia, or BPH. It can grow from walnut-sized to even lemon-sized in some men. Now, “benign” means it’s not cancerous, and having BPH doesn’t increase your risk of getting prostate cancer. It’s just a common part of aging for many men.
And How Much Does It Weigh?
It’s pretty light, weighing in at about 1 ounce, or 30 grams. That’s about as heavy as five U.S. quarters. Not much, right?
When Things Go Wrong: Common Prostate Conditions
Like any part of the body, the prostate can have its share of issues. It’s good to be aware of them.
Common conditions that can affect your prostate include:
- Prostate cancer: This is actually the second most common cancer affecting men. Scary thought, I know, but early detection makes a huge difference.
- Inflammation (prostatitis): This is when the prostate gland gets inflamed. There are a few different types:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic pelvic pain syndrome (CPPS)
- Asymptomatic inflammatory prostatitis (this one doesn’t cause symptoms but shows up on tests).
Prostatitis is the most common urinary tract problem in men younger than 50, and the third most common for those over 50.
- Benign prostatic hyperplasia (BPH): We touched on this. It’s that non-cancerous enlargement that can squeeze the urethra and cause urination problems. Almost all men will develop some prostate enlargement as they get older. It’s just a fact of life for many.
Warning Signs: What to Look Out For with Your Prostate
Okay, this is important. How do you know if your prostate might be acting up? Here are some common warning signs:
- Pain in your penis, testicles, or the perineum (that’s the area between your testicles and rectum).
- Feeling like you have to pee all the time.
- Pain when you pee (dysuria) or when you ejaculate.
- A slow or dribbling pee stream. You might feel like you’re not quite emptying your bladder.
- Difficulty getting the pee stream started.
- Waking up frequently at night to pee. This can really disrupt sleep.
- Erectile dysfunction (ED).
- Seeing blood in your urine or semen (hematospermia). This always needs checking out.
- Pain in your lower back, hip, or chest – sometimes this can be related, especially if cancer has spread, though that’s less common as a first sign.
If you notice any of these, please don’t just ignore them or hope they go away. Come in and let’s talk.
How We Check Your Prostate Health
If you come to me with concerns, or for a routine check-up, here are some common tests we might use to check on your prostate:
- Digital Rectal Exam (DRE): I know, I know, nobody’s favorite. But it’s a quick and valuable check. I’ll gently insert a gloved, lubricated finger into your rectum to feel your prostate gland. I’m feeling for its size, shape, and any bumps or hard areas that might suggest something like cancer.
- Prostate-Specific Antigen (PSA) blood test: Your prostate makes a protein called PSA. We can measure the level of this protein in your blood. Higher PSA levels can be a sign of cancer, but – and this is a big “but” – they can also be raised if you have BPH or prostatitis. So, it’s a piece of the puzzle, not the whole picture.
- Biopsy: If other tests are concerning, we might need to get a small sample of your prostate tissue. This is done with a needle. A specialist called a pathologist (a doctor who studies tissues and cells) will then look at the sample under a microscope to check for cancer cells.
Treating Prostate Problems
Treatment really depends on what’s going on. There’s no one-size-fits-all.
For Prostate Cancer:
- Active surveillance: If cancer is found early and seems slow-growing, sometimes the best approach is to monitor it closely with regular screenings, scans, and maybe repeat biopsies every one to three years.
- Brachytherapy: This is a type of internal radiation. Tiny radioactive “seeds” are placed directly into your prostate. This helps target the cancer while trying to spare the healthy tissue around it.
- Focal therapy: This aims to treat only the cancerous area of your prostate. Options include things like high-intensity focused ultrasound (HIFU), cryotherapy (freezing), laser ablation (using heat), and photodynamic therapy (PDT).
- Prostatectomy: This is surgery to remove your prostate.
For Prostatitis:
This depends on the cause and type. We might recommend:
- Medications: Some drugs can help relax the muscles around your prostate and bladder, which can improve urine flow. If it’s a bacterial infection, antibiotics are key.
- Stress management: Sometimes, stress and anxiety can make symptoms worse. Counseling can be helpful.
- Exercises: Pelvic floor exercises can sometimes help reduce muscle spasms.
For Benign Prostatic Hyperplasia (BPH):
- Medications: Certain medicines can help shrink the prostate or relax the bladder neck to make peeing easier. Some work by affecting the hormones that cause prostate growth.
- Surgery: If medications aren’t enough, there are surgical options to remove the obstructing prostate tissue that’s blocking urine flow.
- Water vapor therapy: This is a newer, minimally invasive option. A special instrument is inserted through your urethra into the prostate. It releases steam vapor, which gently kills excess prostate cells and helps shrink the gland.
We’ll always discuss all the options available for you and figure out the best path forward together.
Keeping Your Prostate Healthy: What Can You Do?
You’re probably wondering if there’s anything you can do to keep your prostate in good shape. Yes, there are definitely things that can help!
- Get regular prostate screenings: We generally recommend most men start screenings around age 50. However, if you have a family history of prostate cancer (like a father or brother who had it), or if you’re African American (a group with higher risk), we might suggest starting these conversations and screenings earlier, maybe around 40 or 45. Let’s talk about what’s right for you.
- Exercise regularly: Staying active is good for your whole body, including your prostate. Studies show that men who are more physically active are less likely to develop BPH.
- Eat a healthy diet: Focus on plenty of fruits, vegetables, and healthy proteins. Some research suggests certain foods might be beneficial for prostate health.
- Quit tobacco products: If you smoke or use other tobacco products, please consider quitting. Tobacco use may increase your risk of developing prostate cancer, not to mention a host of other health problems.
What About Supplements?
I get asked about supplements for prostate health a lot. The thing with dietary supplements is that they don’t have to go through the same rigorous testing and approval process as prescription medications. So, there isn’t a ton of solid scientific data on many of them. Some might show very minor benefits for some men, but for most, they probably won’t make a huge difference in overall prostate health. Always best to talk to me before starting any new supplement.
A Couple More Common Questions
Can You Live Without a Prostate?
Yes, you absolutely can. If prostate cancer is diagnosed, one of the treatment options might be to surgically remove the entire prostate gland (a prostatectomy). Common side effects after this surgery can include erectile dysfunction and problems with urinary incontinence (leaking pee). These are things we discuss very carefully before any decision is made.
How Can I Feel My Own Prostate?
This is a tricky one. While you can technically feel your prostate, either from the outside (externally) or through your rectum (internally), it’s not something you can use to accurately check your own prostate health.
Externally, the easiest spot is the back half of your perineum, near your rectum. It might feel soft or rubbery. Internally, it’s about two inches inside your rectum, between your penis and rectum. Again, it should feel soft or rubbery. You might feel a sudden urge to pee if you touch it.
Many people do find prostate stimulation sexually satisfying, and that’s a separate conversation. But for health checks? Please leave that to a healthcare professional. We’re trained to know what we’re feeling for. If you have any concerns at all, just come in.
Take-Home Message: Your Prostate Pointers
So, what are the key things to remember about your prostate?
- It’s a small gland, part of the male reproductive system, crucial for producing some of the fluid in semen.
- It’s normal for it to grow larger with age (BPH), which isn’t cancer but can cause urinary issues.
- Common problems include BPH, prostatitis (inflammation), and prostate cancer.
- Pay attention to warning signs like frequent/painful urination, weak stream, or blood in urine/semen.
- Regular check-ups and screenings (like DRE and PSA tests) are important, especially as you get older.
- A healthy lifestyle – good diet, exercise, no tobacco – can support your prostate health.
You’re not alone in navigating this. If you have questions or concerns about your prostate health, that’s what I’m here for. Let’s keep the conversation going.