The prostate gland has an important role in the male reproductive system. Unfortunately, the gland is also prone to problems. The risk for some of these problems increases with age, but prostate problems can affect men of all ages.

What does the prostate gland do?

Most of the fluid found in semen is produced by the prostate gland. This fluid helps nourish sperm, keeping it healthy for conception.

The size of the prostate gland is about the same as a walnut. The gland sits below the bladder and in front of the rectum. It wraps around the urethra, the tube that carries urine and semen. Muscles in the gland help propel semen out of the body during ejaculation.

What problems can affect the prostate gland?

Common problems that affect the prostate gland include:

• enlarged prostate or benign prostatic hyperplasia (BPH)

• prostate cancer

• prostatitis

Enlarged prostate or benign prostatic hyperplasia (BPH)

The prostate gland gets larger as you age, leading to a common problem called benign prostatic hyperplasia (BPH). Half of all men between the ages of 51 and 60 have BPH. It affects 9 out of 10 men over the age of 80. The word benign means that the condition isn’t cancerous. Another word for this condition is enlarged prostate.

An enlarged prostate puts pressure on the urethra, which runs through the center of the gland. It can also irritate or block the bladder. As a result, you may find yourself needing to urinate more often, especially during the night.

Medications to treat BPH include alpha blockers to relax muscles in the prostate and bladder. Doctors also use 5-alpha reductase inhibitors, like dutasteride and finasteride, to prevent hormone changes and help shrink the prostate gland. In some cases, drugs that treat erectile dysfunction may also help.

Other symptoms of an enlarged prostate or BPH include:

• difficulty urinating, such as having to strain or push

• feeling like you have to go again after you’ve just urinated (a full bladder feeling)

• urine flow that starts and stops

• weak flow of urine

Prostate cancer

Cancer that develops in the prostate gland is prostate cancer. It’s a common cancer in men, affecting 1 in 8 males at some point in their lives. Close to 250,000 men in America will receive a prostate cancer diagnosis this year. About 60% of these men are older than 65. 

For most males, prostate cancer is slow-growing. There are some early warning signs of prostate cancer, but the disease is often difficult to detect.

When prostate cancer symptoms occur, they may include:

• blood in urine 

• chest, back, or hip pain

• difficulty urinating 

• frequent or urgent need to urinate

• increased nighttime trips to the bathroom 

• loss of bowel control (fecal incontinence)

• painful ejaculation or blood in semen

• weakness or numbness in legs or feet

Metastatic prostate cancer occurs when prostate cancer spreads (metastasizes) to bones or other parts of the body. Prostate cancer treatments vary depending on the PSA level and the stage of the cancer. Treatments include active surveillance (watchful waiting), radiation therapy (including brachytherapy), and surgery to remove the prostate (prostatectomy).

Prostatitis

Prostatitis occurs when the prostate gland becomes inflamed and swollen. There are four different types of prostatitis, with various causes. It’s estimated that half of all men will develop prostatitis at some point.

A bacterial infection, sometimes from a urinary tract infection (UTI), can cause bacterial prostatitis. Medications like antibiotics can treat this type. Some men develop chronic pelvic pain syndrome (CPPS), or chronic prostatitis. CPPS causes pain in the pelvic region, genitals, and the perineum (the area between the scrotum and the rectum).

Symptoms of prostatitis vary depending on the type and cause. Not all men have pain. Prostatitis symptoms may include:

• blood in semen

• difficulty urinating

• erectile dysfunction

• fever and chills

• frequent urge to urinate

• painful urination or ejaculation

What other problems are linked to prostate health?

Issues with the prostate gland can lead to other problems like:

• bladder stones 

• chronic pain

• erectile dysfunction, painful intercourse, or painful ejaculation

• kidney failure

• urinary tract infections (UTIs)

How can I protect the health of my prostate?

Because the prostate gland is prone to problems, it’s important to get regular prostate checkups with your doctor. These steps can help protect the health of your prostate:

• get regular screenings

• maintain a healthy weight

• move more

Get regular screenings

The American Cancer Society recommends that men who have an average risk of prostate cancer start cancer screenings at age 50. Your doctor may recommend starting screenings earlier if you have a family history of prostate cancer (especially at a young age) or if you’re Black. Black men are more likely to develop prostate cancer, and the disease tends to develop at a younger age.

Tests to diagnose prostate cancer include digital rectal exams (DRE) and prostate-specific antigen (PSA) blood tests.

Maintain a healthy weight

Being overweight increases your risk for all types of cancer. Extra pounds can also put pressure on the prostate gland and cause inflammation, which may increase your risk of BPH (benign prostatic hyperplasia).

Research from the American Cancer Society suggests that excess weight is responsible for about 5% of cancers in men. And men who are obese are more likely to develop aggressive forms of prostate cancer. The cancer is more likely to spread (metastatic prostate cancer) when you’re overweight, making the disease more difficult to treat.

Other studies suggest that people who are obese have a greater risk of the cancer coming back (cancer recurrence). Their overall chance of surviving the disease (prostate cancer prognosis) is lower.

Move more

Studies indicate that regular physical activity benefits the prostate gland. A study from Harvard University showed that men who participated in regular moderate physical activity, like walking at a moderate pace, were less likely to get BPH.

Another study out of Italy found that after 18 weeks of walking briskly three times a week, men with chronic prostatitis had less pain, anxiety, and depression, and an overall better quality of life.

Other studies suggest that brisk walking at least three hours a week can slow cancer progression and improve one’s prognosis.

From the community: “We (as men) are behind in the awareness department compared to women in that prior to being diagnosed, we (as a group) are unaware of the vital role the prostate plays in our daily lives… I was guilty of ignoring the 'wild country' between my navel and knees. It worked (most of the time) and didn't create any problem (most of the time). I ignored the 'not working' hints, signals, red flags, cries for help from the area as 'just getting old' (at least in my case).

…If we (as men) were more aware, I'm not saying we could avoid prostate cancer. What I am trying to say (somewhat poorly) is that we would not be as blindsided with a 'deer in the headlights' reaction when we are given that terrible news.” – Inspire member

Sources

• American Cancer Society recommendations for prostate cancer early detection. American Cancer Society. November 2020.

• Does body weight affect cancer risk? American Cancer Society. June 2020.

• Key statistics for prostate cancer. American Cancer Society. January 2021.

• Prostate cancer risk factors. American Cancer Society. June 2020.

• Signs and symptoms of prostate cancer. American Cancer Society. August 2019.

• Prostate cancer symptoms and signs. American Society of Clinical Oncology. September 2020.

• Explaining the link between prostate cancer and obesity. Cedars-Sinai. September 2017.

• Prostate health and disease. Harvard Health Publishing. 

• 3 ways exercise helps the prostate. Harvard Health Publishing. May 2014.

• How does the prostate work? InformedHealth.org. August 2016.

• Benign prostatic hyperplasia (BPH). Mayo Clinic. March 2019.

• Prostate problems. National Institute on Aging. July 2020.

• Prostate problems. National Institute of Diabetes and Digestive and Kidney Diseases. March 2016.

• The impact of obesity towards prostate diseases. Prostate International. March 2016.

• How to keep your prostate happy. Urology Care Foundation. September 2014.

• What is benign prostatic hyperplasia (BPH)? Urology Care Foundation. May 2019.

• What you need to know about prostatitis. Urology Care Foundation. August 2019.

• Other prostate conditions (related and unrelated). ZERO — The End of Prostate Cancer.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.