The human prostate is a small gland in the male reproductive system, composed of glandular and connective tissues situated deep within the pelvis. It plays a supportive role in reproduction but is not required for life. The prostate undergoes changes throughout a person’s life, and its health can be influenced by several factors.
Prostate Anatomy and Function
The prostate is a soft organ, similar in size and shape to a walnut. A healthy adult prostate weighs 20 to 25 grams and measures about 4 cm wide by 3 cm high. It is located below the bladder and in front of the rectum. The urethra, the tube that transports both urine and semen out of the body, passes directly through the center of the gland.
The gland is anatomically divided into different regions or zones. These zones are composed of glandular tissue that produces fluid and smooth muscle tissue embedded in a connective matrix. The posterior portion is what a doctor can feel during a physical examination.
A primary function of the prostate is producing seminal fluid, which makes up about 20-30% of semen’s total volume. This prostatic fluid is slightly alkaline and contains enzymes, citric acid, and zinc to nourish and protect sperm. One of these enzymes, prostate-specific antigen (PSA), helps liquefy semen, which aids sperm motility.
During ejaculation, the prostate’s smooth muscles contract to expel this fluid into the urethra, where it mixes with sperm. This muscular contraction also closes the opening between the bladder and the urethra. This action prevents urine from being expelled during ejaculation and ensures semen is propelled forcefully.
Common Prostate Conditions
As individuals age, the prostate can be affected by several conditions that often affect urinary function due to the gland’s proximity to the urethra and bladder. Understanding the differences between these issues is part of managing prostate health.
Benign Prostatic Hyperplasia (BPH)
Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. This condition is very common in older men, and the prostate can grow significantly. As the gland enlarges, it can squeeze the urethra, narrowing the tube and obstructing the flow of urine.
This pressure on the urethra leads to various urinary symptoms, including:
- A frequent or urgent need to urinate, especially at night (nocturia)
- Difficulty starting urination
- A weak or interrupted urine stream
- A feeling that the bladder is not completely empty
BPH is not cancerous and does not increase the risk of developing prostate cancer.
Prostatitis
Prostatitis is the inflammation or swelling of the prostate gland, sometimes caused by a bacterial infection. It can affect men of various ages but is commonly seen in those between 30 and 50. The inflammation can result from bacteria entering the prostate from the urinary tract.
Symptoms can include urinary issues like a burning sensation during urination. However, prostatitis is often accompanied by pain in the pelvic area, lower abdomen, or back. If caused by an infection, individuals may also experience fever and flu-like symptoms.
Prostate Cancer
Prostate cancer is the development of malignant cells within the prostate tissue and is one of the most common cancers affecting men. The growth of these cells can be very slow, and many individuals may not experience symptoms in the early stages. As the cancer grows, it may cause urinary symptoms similar to BPH.
Because it can be asymptomatic for a long time, screening is often used for detection. Unlike BPH, which is a benign enlargement, prostate cancer involves the uncontrolled growth of abnormal cells.
Prostate Health Screening
Regular screening can help detect changes in the prostate, sometimes before symptoms appear. Healthcare providers use two primary methods for initial evaluation. These tools can indicate whether more definitive testing is needed but do not diagnose a condition on their own.
Digital Rectal Exam (DRE)
During this physical examination, a healthcare provider inserts a gloved, lubricated finger into the rectum to feel the posterior surface of the prostate. The provider assesses the prostate’s size, shape, and texture, checking for any hard spots or other irregularities. This part of the gland is where cancers often develop.
Prostate-Specific Antigen (PSA) Test
This blood test measures the level of PSA, a protein produced by the prostate. Elevated levels of PSA can suggest a prostate condition, as BPH, prostatitis, or prostate cancer can cause more PSA to be released into the blood. An elevated PSA level is not a diagnosis of cancer, as inflammation or enlargement can also raise it. If DRE or PSA results are abnormal, a provider may recommend further procedures like an ultrasound or biopsy.
Factors Influencing Prostate Health
A variety of factors can influence the health of the prostate gland. Some of these factors cannot be changed, while others are related to modifiable lifestyle choices.
Age is a significant non-modifiable factor, as the risk for conditions like BPH and prostate cancer increases as men get older. Family history and genetics also play a role. A person with a close relative who has had prostate cancer is at a higher risk of developing it.
Lifestyle choices can also impact prostate health. Some research suggests that diets rich in antioxidants, found in fruits and vegetables, may be supportive, while diets high in red meat and dairy products have been studied for their potential to increase risk.
Regular physical activity is another modifiable factor associated with better health outcomes. Exercise can help with weight management, which is beneficial as obesity has been linked to an increased risk of more aggressive forms of prostate cancer.