Learn About Prostate Health and Self-Examination

Understanding the Prostate and Its Role in Male Health

The prostate is a small, walnut-shaped gland that is part of the male reproductive system. It sits just below the bladder and surrounds the urethra, which is the tube that carries urine out of the body. The prostate produces a fluid that makes up about 30 percent of semen, the fluid that carries sperm during ejaculation. This fluid helps nourish and protect sperm, making it essential for reproduction.

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The prostate gland is controlled by hormones, particularly testosterone. As men age, the prostate naturally changes. It may grow larger, a condition called benign prostatic hyperplasia or BPH. This growth is common and not the same as prostate cancer. According to the American Cancer Society, about 1 in 8 men will receive a diagnosis of prostate cancer during their lifetime, though many cases grow slowly and may not cause serious harm.

Understanding what the prostate does helps explain why problems with this gland can affect urination and sexual function. When the prostate becomes enlarged, inflamed, or develops cancer, it can interfere with the flow of urine or create other symptoms. This is why health care providers recommend that men learn about their prostate and become aware of changes in their body.

The prostate is located in a position where problems can affect several body functions. It is surrounded by important nerves and blood vessels that are involved in sexual function. It also sits near the bladder, so prostate issues often show up as urinary symptoms first. Men who understand the basic anatomy are better prepared to notice changes and discuss them with a doctor.

Practical Takeaway: The prostate is a gland unique to men that produces fluid for semen and is controlled by testosterone. Understanding its location and function helps you recognize when something might be wrong and why certain symptoms may occur.

Common Prostate Conditions and Their Symptoms

Men can experience several different prostate conditions, each with distinct characteristics. Benign prostatic hyperplasia (BPH) is one of the most common. In this condition, the prostate gland grows larger but is not cancerous. It affects more than half of men in their 60s and about 90 percent of men in their 80s, according to the National Institute of Diabetes and Digestive and Kidney Diseases. BPH occurs because of changes in hormone levels as men age. The enlarged prostate can squeeze the urethra and make it harder to urinate.

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Prostatitis is inflammation or infection of the prostate. There are different types: acute bacterial prostatitis comes on suddenly due to a bacterial infection; chronic bacterial prostatitis involves repeated infections; and chronic pelvic pain syndrome causes pain but no bacterial infection. Men with prostatitis may experience pain in the lower back, testicles, or between the scrotum and rectum. They may also have urinary urgency and frequency, especially at night.

Prostate cancer is a disease where malignant cells grow in the prostate gland. Many prostate cancers grow slowly, while others grow more rapidly. According to the National Cancer Institute, an estimated 288,300 new cases of prostate cancer were diagnosed in 2023 in the United States. However, prostate cancer death rates have been declining, and survival rates have improved significantly with earlier detection and treatment options.

Common symptoms across these conditions include:

• Difficulty starting or stopping urination
• Weak urine stream
• Frequent urination, especially at night (called nocturia)
• Urgency to urinate
• Pain or burning during urination
• Pain during ejaculation
• Blood in urine or semen
• Persistent pain in the lower back, hips, or pelvic area

It is important to understand that having some of these symptoms does not mean a man has cancer or a serious condition. Many of these symptoms can result from BPH, urinary tract infections, or other treatable conditions. However, men who notice changes in urinary function or experience persistent symptoms should contact their doctor for evaluation.

Practical Takeaway: Three main prostate conditions are BPH (enlarged prostate), prostatitis (inflammation or infection), and prostate cancer. Knowing the symptoms of each can help you recognize when to seek medical attention.

Risk Factors and Who Should Be Concerned

Several factors increase a man's likelihood of developing prostate problems. Age is one of the most significant risk factors. The risk of prostate cancer increases sharply after age 50. Men in their 60s have a higher risk than those in their 50s, and the risk continues to rise with age. According to the American Cancer Society, about 6 out of 10 prostate cancers are diagnosed in men age 65 or older. For BPH, the risk also increases with age, with symptoms becoming more common in older men.

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Family history plays an important role in prostate cancer risk. Men whose father, brother, or son had prostate cancer have a higher risk of developing it themselves. If multiple family members had the disease, or if they were diagnosed before age 65, the risk is even greater. Men with a family history of prostate cancer may want to discuss screening options with their doctor at an earlier age than the general population.

Race and ethnicity also influence prostate cancer risk. African American men have higher prostate cancer incidence and mortality rates compared to men of other races. According to the Centers for Disease Control and Prevention, African American men are about 1.7 times more likely to be diagnosed with prostate cancer and about 2.7 times more likely to die from it than white men. Men of Scandinavian descent also have higher rates. These differences may relate to genetic factors, hormone levels, and access to health care.

Other risk factors include:

• Obesity: Some studies show a link between being overweight and more aggressive prostate cancer
• Diet: A diet high in red meat and dairy, and low in fruits and vegetables, may increase risk
• Physical inactivity: Men who exercise regularly may have lower risk
• Smoking: Some research suggests current smokers may have higher mortality from prostate cancer
• Hormone levels: Higher testosterone levels and certain hormonal conditions may increase risk

Men with multiple risk factors should be especially attentive to prostate health and should discuss screening and self-examination with their doctor. However, having risk factors does not mean a man will definitely develop prostate disease.

Practical Takeaway: Age, family history, and race are the strongest risk factors for prostate cancer. Men with these risk factors should discuss screening with their doctor and be alert to symptoms.

Screening and When to See a Doctor

Prostate cancer screening involves testing to find cancer before a man has symptoms. The two main screening tests are the prostate-specific antigen (PSA) blood test and the digital rectal examination (DRE). Both tests have benefits and limitations, and experts do not always agree on whether all men should be screened.

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The PSA test measures a protein produced by the prostate. PSA levels can be elevated due to cancer, but also due to BPH, prostatitis, or even urinary tract infections. A PSA test alone cannot diagnose cancer. The American Cancer Society recommends that men at average risk discuss the potential benefits and limitations of screening with their doctor at age 50. Men at higher risk—including African American men and those with a family history—may want to have this discussion starting at age 40 or 45. Men with a very short life expectancy (less than 10 years) may not benefit from screening.

The digital rectal examination involves a doctor inserting a gloved, lubricated finger into the rectum to feel the prostate gland. This allows the doctor to check for lumps, hard spots, or other abnormalities. While this examination can be uncomfortable, it takes only a minute or two. Some doctors use this test along with the PSA test, while others rely mainly on the PSA test.

Men should consider seeing a doctor if they experience:

• Difficulty urinating or inability to