The prostate is a walnut-sized gland found only in men and people assigned male at birth (AMAB). It sits just below the bladder and surrounds the urethra, the tube that carries pee through your penis. The prostate's main job is to make fluid for semen.
Your prostate grows naturally with age, usually without problems. But like any organ, it can be affected by certain conditions. Here are some of the most common ones.
Benign prostatic hyperplasia (BPH)
BPH, also known as an enlarged prostate, is when your prostate grows larger than normal in size. It's called benign because it's not cancerous. It's unclear exactly what causes BPH, but researchers believe it's related to hormonal changes as you age.
Symptoms of BPH
An enlarged prostate can press on your urethra, leading to several urinary symptoms, including:
- Frequent peeing, especially at night
- Weak pee stream
- Difficulty starting to pee
- Dribbling at the end of peeing
- Problems fully emptying your bladder
Risk factors for BPH
You're at an increased risk for BPH if:
- You're older than 40
- You have a family history of prostate problems
- You have diabetes or heart disease
- You have obesity
Prostate Cancer
Prostate cancer is the second most common cancer in men and people AMAB, after skin cancer. About 1 in 8 men and people AMAB will be diagnosed with prostate cancer in their lifetime.
Prostate cancer symptoms
At first, you might not have any symptoms. If it advances, these symptoms are common:
- Problems peeing
- Weak pee stream
- Blood in your pee or semen
- Bone pain
- Unexplained weight loss
- Problems getting an erection
Risk factors for prostate cancer
Like BPH, the risk for prostate cancer increases with age. It's most common in people older than 50.
You are also at an increased risk if you:
- Have a family history of prostate cancer
- Are Black
- Have obesity
If you have risk factors, your doctor may suggest starting prostate cancer screening at a younger age.
Prostatitis
Prostatitis is inflammation of your prostate gland. There are four types:
Acute bacterial prostatitis. This is a bacterial infection of the prostate that comes on suddenly and can cause severe symptoms, such as fever, chills, pain in the lower back or groin, and difficulty peeing.
Chronic bacterial prostatitis. This bacterial infection of the prostate develops slowly and can last months or even years. Symptoms may be similar to those of acute bacterial prostatitis, but they are usually less severe.
Chronic prostatitis/chronic pelvic pain syndrome. This type of prostatitis causes pain in the pelvic area, but there's no sign of infection.
Asymptomatic inflammatory prostatitis: This type of prostatitis has no symptoms. It is usually diagnosed during a routine exam or testing for another condition.
Symptoms of prostatitis
Symptoms depend on the type of prostatitis you have, but you may experience:
- Pain or burning while peeing
- Feeling like it's hard to pee
- Dribbling after peeing
- Having to pee often
- Cloudy pee
- Blood in your pee
- Pain in your lower back, lower belly, and groin
- Pain between your scrotum and rectum
- Pain when ejaculating
- Fever, chills, muscle aches, and other flu-like symptoms
Risk factors
Unlike most prostate problems, prostatitis happens more often in young and middle-aged men and people AMAB. You may also have an increased risk if you have:
- Had prostatitis before
- An infection of the urinary or reproductive system
- HIV/AIDS
- Had a tube (catheter) inserted to drain pee
- Had a sampling of your prostate tissue taken (biopsy)
Prostate Problems When You’re Trans or Nonbinary
Anyone with a prostate, regardless of their gender identity, can experience prostate problems. This includes cisgender men, transgender women, transgender men who have not had bottom surgery, and nonbinary people assigned male at birth.
Conditions such as enlarged prostate and prostatitis may be less common in transgender women and nonbinary individuals who are on hormone therapy that suppresses testosterone, but it’s still important to be aware of them.
Unfortunately, there aren't many studies focused on prostate health in transgender and nonbinary populations. This gap in knowledge makes it even more crucial to be proactive about your health and discuss it with health care providers.
Prostate problems symptoms for trans and nonbinary people
The symptoms of prostate problems are typically the same for everyone, regardless of gender identity. It’s important to note that some symptoms may appear differently or be less noticeable depending on your anatomy and any gender-affirming treatments.
Prostate problems diagnosis for trans and nonbinary people
Diagnosing prostate problems often involves a physical exam, including a digital rectal exam (DRE), as well as urine tests and possibly imaging tests.
It’s essential to find a health care provider who is knowledgeable and affirming of your gender identity. A gender-affirming provider will be sensitive to your specific needs and concerns and provide the best possible care. You can find a gender-affirming clinic by searching online directories or asking for referrals from LGBTQ+ community organizations.
When discussing your health concerns, be open and honest with your provider about your medical history, including any gender-affirming care you have received. This information is crucial for accurate diagnosis and treatment.
How Can I Prevent Prostate Problems?
In some ways, prostate problems, particularly BPH, are a natural part of growing older. Still, there are specific steps you can take to keep your prostate healthy.
- A diet low in saturated fat and high in fruits and vegetables may lower your risk of developing BPH. Research is ongoing to identify who might benefit from early treatment to prevent BPH.
- According to the American Cancer Society, prostate cancer can't be prevented. This is because prostate cancer's causes are still unknown. As with BPH, however, experts recommend eating a healthy diet with lots of fruits and vegetables.
- No herbal supplements have been proven to prevent prostate cancer. Studies of selenium, a mineral, have had mixed results, but the majority of the evidence shows no real benefit. Trials for drugs to prevent prostate cancer are also ongoing.
- No activity or drug is known to prevent prostatitis. Experts suggest good hygiene, including keeping the penis clean.
How Are Prostate Problems Treated?
Treatment depends on which kind of prostate problem you develop.
Treatment for BPH
BPH needs treatment only if the urinary symptoms become bothersome. BPH often responds to medications such as:
Alpha-blockers. These ease the tension around the urethra. They include alfuzosin (Uroxatral), doxazosin (Cardura), silodosin (Rapaflo), and tamsulosin (Flomax).
5-alpha reductase inhibitors. These reduce the size of the prostate itself. Examples include finasteride (Proscar) and dutasteride (Avodart).
Your doctor may also prescribe a combination of these drugs. If medication does not relieve the symptoms, surgery may be required.
Prostate cancer treatment
Prostate cancer treatment is more complex. When creating a prostate cancer treatment plan, your doctor will consider your age, overall health, and how aggressive or widespread the prostate cancer is. Some treatment options include:
- No treatment (watchful waiting)
- Surgery
- Radiation (either external-beam or implantable "seeds")
- Chemotherapy
- Hormone therapy
- Immunotherapy
- A combination of these
Treatment for prostatitis
Prostatitis is usually a bacterial infection and is most often treated with antibiotics. Your doctor can also prescribe medications to help treat the symptoms of prostatitis.
Prostate Cancer Screening: Yes or No?
Prostate cancer screening is controversial. Some doctors and organizations recommend regular screening, while others don't.
The American Cancer Society says men and people AMAB should talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested. The discussion about screening should start at age 50 for most men and people AMAB with average risk for prostate cancer, and earlier for those at higher risk.
The American Urological Association recommends that men aged 55 to 69 who are considering screening should talk with their doctors about the pros and cons of testing and proceed based on their personal values and preferences. The Association has found that screening slightly reduces the odds of death from prostate cancer but its benefits may not outweigh the potential risks, such as:
- False-positive results, which can lead to unnecessary anxiety and additional testing
- Overdiagnosis, which can lead to unnecessary treatment and side effects
- Complications from prostate biopsy, such as pain, bleeding, and infection
If prostate cancer screening is done, it involves a blood test and possibly a prostate exam by your doctor. Whether or not you test is something you and your doctor must decide together.
Takeaways
Anyone with a prostate is at risk for prostate problems. The most common ones include BPH, prostate cancer, and prostatitis. Certain factors, such as age, race, and lifestyle, increase your risk of these conditions. If you have symptoms or are worried about your risk, meet with your doctor to discuss treatment and prevention.
Prostate Problems FAQs
What is the most common prostate problem?
In men and people AMAB younger than 50, prostatitis is the most common prostate problem. In those older than 50, BPH is the most common issue.
What are the warning signs of prostate problems?
Symptoms may include having to pee more often than normal, feeling a burning sensation when you pee, seeing blood in your pee or semen, dribbling pee after you have finished, and painful ejaculation.
What can I drink to clean my prostate?
You can't clean your prostate with beverages. However, some beverages have been found to boost prostate health. Coffee and green tea contain antioxidants that can help fight cancer. Cooked tomatoes and tomato juice contain high levels of an antioxidant called lycopene.
How can I check my prostate at home?
You can't check your prostate at home. Only a health care provider can perform an exam and/or blood test to check your prostate health.
