Prostate 101 – your need-to-know guide

What is a prostate, anyway? What does a prostate do?

Well, as you’ll soon see, the male prostate gland is integral to the ongoing support of many bodily functions, from the production of semen to the conversion of testosterone into dihydrotestosterone to support its absorption.

It also supports the passing of urine and bladder control, as an enlarged prostate may press on the urethra and cause unwanted symptoms, such as difficulty passing, stopping, or controlling urine.

Get the low-down on this essential little gland, and what happens to it as you get older, from what it does and where it is to prostate functions and prostate problems.

We’ll cover it all in Prostate 101, your need-to-know guide.

What is a prostate?

A prostate is a small gland that is only found in men.

It has multiple functions, such as surrounding the urethra, the tube that passes urine, and also supports in the creation of semen, creating a thick, white fluid that combines with sperm.¹

Where is the prostate?

The prostate gland, usually the shape and size of a walnut, is found in men directly underneath the bladder.

It surrounds the top section of the urethra, where urine is carried out of the body.²

The anatomy of the prostate

Here’s the anatomy of the prostate. As you can see, it is highly linked to the passing of urine and semen and is also relatively close to the rectum. It is for this reason that, even though the prostate gland is not in the rectum, prostate exams are often carried out using a rectal examination.³

There are three prostate zones:⁴

1. Transition zone: This is the smallest part of the prostate, roughly 10% of the entire prostate, and it is on the inside of the prostate, between the bladder and the upper third of the urethra.
2. Central zone: This area makes up approximately 25% of the prostate and includes the seminal duct and the seminal vesicles, vital in the production of semen. It is also often referred to as the ejaculatory duct.
3. Peripheral zone: Making up almost 70% of the prostate gland, this area is mostly made up of glandular tissue, meaning that it is mainly responsible for the secretion of the prostate fluid present in semen.⁵

Summary

• The prostate is only found in men and supports in the creation of semen.
• It is found directly underneath the bladder and is wrapped around the urethra.
• There are three main zones to the prostate: the transition zone, the central zone, and the peripheral zone.

What does the prostate do?

What’s the function of a prostate gland?

This little gland has three important jobs:

1. It’s needed for fertility.

The prostate gland secretes prostate fluid into semen, which helps to thin it.

This both boosts sperm’s swimming powers, and the semen’s ability to reach higher into a woman’s vagina during intercourse.⁶

2.  It stops urine and semen from getting mixed up.

During ejaculation, the prostate and sphincter muscles in the bladder work together to close the urethra. This prevents semen from travelling back up into the bladder.⁷ 

When urinating, the prostate shuts down entry to the seminal vesicles, where most semen is made,⁸ so there’s no chance of urine accidentally getting into places where it’s not wanted.⁹

3. It helps metabolise testosterone.

The prostate gland helps convert the male sex hormone testosterone into a form that the body can use more easily.

It does this by converting testosterone into a hormone called dihydrotestosterone, which is an important hormone in the development of male characteristics.¹⁰ 

In fact, around 10% of testosterone produced by the adult body each day becomes dihydrotestosterone.

Summary

• The prostate supports fertility by improving the swimming ability of sperm.
• The prostate and the sphincter work together to control the flow of semen and urine.
• It helps to metabolise testosterone by converting it into a hormone called dihydrotestosterone.

What causes an enlarged prostate?

What is a normal prostate size?

The prostate grows naturally as you age – from the size of a walnut to a lemon by the age of 60.¹¹

Around half of men over the age of 50 will experience symptoms of an enlarged prostate,¹²  which is said to be closer to the size of a baseball.

A review of studies published in Urology in 2005 found the causes of an enlarged prostate – known as benign prostatic hyperplasia (BPH) – are still poorly understood.

But researchers think it’s a combination of ageing and a change in the balance of hormones. Your genes may also be a factor.¹³

What are the symptoms of an enlarged prostate?

9 common prostate problems:

An enlarged prostate can cause problems including narrowing of the urethra,¹⁴ which can lead to urination problems including:^{15, 16}

1. A weak urine stream

As an enlarged prostate presses on the urethra, responsible for carrying urine from the body, the tube becomes narrower and allows less urine to pass at a time.

For this reason, you may have a weaker urine stream.

2. Needing to urinate more frequently or suddenly

This is caused by the enlarged prostate pressing on the urethra, the tube responsible for carrying urine out of the body.

As a result, the bladder becomes accustomed to contracting with more strength in order to pass the urine, which over time may lead to an urge to urinate even when your bladder contains little urine.

3. Waking up frequently to urinate

As the urge to urinate becomes more frequent and urgent, linked to your bladder’s desire to pass small quantities of urinate, it is common to be woken up throughout the night by this urge.

4. Straining to empty your bladder

Straining to empty your bladder is a common occurrence with an enlarged prostate as it may feel like your bladder is not completely empty.

This is because of the prostate pressing on the urethra, allowing less urine to pass at one time.

5. Stopping urination mid-flow

In some cases, an enlarged prostate may press on the urethra to the extent that it stops the flow of urination entirely, or your urethra may have weakened to the point that passing urine is incredibly difficult.

6. Difficulty starting urination

As the enlarged prostate presses on the urethra, the tube through which urine is carried out of the body becomes narrower, which may make it more difficult to pass urine.

7. Difficulty stopping urination

When your urethra has been weakened over time, it can be difficult for it to have the strength required to completely void your bladder of urine.

This leads to a prolonged passing of urine, sometimes even after you have stopped trying to urinate, leading to minor incontinence.

8. Feeling like you’re not able to empty your bladder

This is referred to as “chronic urine retention” and it can develop over time.

With this issue, your abdomen may feel swollen, and the pressure of the urine can eventually stretch your bladder muscle and weaken your bladder further.

9. Inability to urinate

In serious cases, an enlarged prostate may block the urethra entirely. As a result, the bladder muscles can become too weak to pass any urine from the body.

This may lead to serious kidney damage and if seeing this symptom, you should see your doctor – or even visit a hospital – immediately.

Summary

• The reasons behind the growth of the prostate are still unclear, but this happens naturally as men age.
• Prostate growth has also been linked to a change in hormones or a person’s genetics.
• Symptoms of an enlarged prostate are multiple, but are often linked to problems surrounding the difficulty in – or sometimes controlling – urination.

What’s the best treatment for prostate problems?

Doctors may recommend a variety of treatments, drugs, or surgery, depending on the specifics and severity of the prostate problems, which may include:¹⁷

• Drugs to support urine flow: Drugs known as alpha blockers are sometimes prescribed to relax the muscles in the prostate gland and bladder, allowing for easier urination.
• Drugs to slow prostate growth: 5-alpha reductase inhibitors are a type of drug which may slow the enlargement of the prostate, or even reduce the effects in some men. They work by lowering the production of dihydrotestosterone (DHT), a hormone linked to prostate enlargement, although it may take up to six months to witness results.
• Invasive surgery: Most commonly, this will be a transurethral resection of the prostate (TURP), which requires general anaesthesia. During this surgery, an instrument is inserted into the urethra to reduce the enlarged prostate, helping to relieve pressure on the urethra and bladder.

There are also a number of lifestyle changes that can be made to support a healthier prostate:¹⁸

• Reduce alcohol and caffeine intake as these are diuretics and may increase the urge to urinate.
• Drink small amounts of fluid throughout the day as this helps with bladder control.¹⁹
• Avoid fluids before bed to reduce the urge to urinate.
• Limit decongestants²⁰ and antihistamines²¹ as they may increase difficulty in urination.
• Try the “double void” method: Urinate, wait a moment, then try to urinate again. This can support in fully emptying your bladder.
• Where possible, limit stress, as this can trigger the urge to urinate.²²
• Regular exercise, such as pelvic floor exercises,²³ is said to support a stronger bladder.

Summary

• There are a number of treatments that may be recommended for an enlarged prostate, from drugs that aid in passing urine to invasive surgery.
• Simple changes in your lifestyle, such as diet and exercise, may also improve the symptoms seen from an enlarged prostate.

Keeping your prostate healthy

Researchers from the University of Texas found that regular exercise and alcohol in moderation may help protect the prostate.²⁴ 

And a 2012 Italian study reported that turmeric can help relieve symptoms of BPH,²⁵ while there’s an increasing amount of evidence to show that eating certain foods – such as tomatoes – can help slow prostate enlargement.²⁶ 

BPH isn’t dangerous and doesn’t increase your risk of prostate cancer, but see your GP if you are having urination problems or frequent urinary tract infections.²⁷

Summary

Didn’t we tell you this article was going to be your need-to-know guide for the male prostate?

Now you have all the information you need for continued prostate health, from what and where a prostate is to prostate function, 9 prostate problems to keep an eye out for, and potential treatments for an enlarged prostate.

For ongoing prostate health, supporting in the production of semen, testosterone absorption, and bladder control, we have a range of articles you might be interested in.

Read about “The best foods for prostate health,” “Can green tea help your prostate?” and “How saw palmetto could improve prostate health.”

Last updated: 17 August 2021