The prostate gland is an important part of the male reproductive system. It is found right below the bladder, in the area in front of your rectum. A healthy, normal prostate gland is oval shaped and around the size of a walnut. A thin layer of tissue wraps around the entire prostate, making it feel smooth when it is touched or examined.
The cells of the prostate gland produce substances that form part of the seminal fluid. The seminal fluid contains sperm cells and the nutrients they need to keep alive and moving so that they can approach and fertilize an egg cell. Without the substances produced by the prostate gland, the sperm cells might not be able to perform their role in human reproduction.
The prostate gland wraps around a tube called the urethra. It is in the urethra that the prostate gland deposits its contribution to the seminal fluid. The urethra runs from the urinary bladder, and then passes through the prostate and other glands that also contribute to the seminal fluid. The urethra then runs through the penis, and ends in an opening found on the tip of the penis called the urethral meatus. It is through the urethra that seminal fluid flows and exits the body. Urine from the bladder exits through the urethra as well.
What causes the prostate to enlarge?
The prostate normally grows throughout a man’s life. When a boy reaches puberty, the prostate can grow to twice its previous size. This is to prepare the prostate for its contributing function to a man’s fertility. The prostate then experiences another big growth spurt when a man is in his mid-20s.
The growth of the prostate is due to an increase in the number of cells inside it. However, over time, the continued growth of the prostate may cause uncomfortable symptoms. Many of these symptoms relate to urination. This condition is called benign prostatic hyperplasia, or BPH.
A man usually starts having symptoms related to BPH when he is in his 40s. As he ages, the symptoms may become worse. In fact, more and more men experience significant symptoms due to BPH as they grow older. Over 50 percent of men aged 60 and above have been found to have problems relating to BPH. The elderly male population (those in their 70s and older) have as many as 90% experiencing BPH symptoms.
BPH is part of the aging process. However, researchers have not pinned down any exact cause of this condition. BPH may be related to the way a man produces testosterone, a male sex hormone. Aside from testosterone, men also produce a small amount of another sex hormone called estrogen. However, this sex hormone is found in higher levels in women than in men. Estrogen is responsible for female sex characteristics, while testosterone produces male sex characteristics.
Over time, a man’s active testosterone level decreases, and this increases the proportion of estrogen found in a man’s blood. An increased proportion of estrogen is thought to promote cell growth and multiplication in the prostate gland. This change in hormone levels as a man ages may be a cause of BPH.
Another hormone that comes from testosterone may be responsible for the growth of the prostate gland cells. This hormone is called dihydrotestosterone, or DHT. Most men continue to produce DHT even as they grow older. However, a small percentage of men do not, and it has been found that men whose bodies do not make DHT do not develop BPH.
How do I know if I have an enlarged prostate?
Your doctor may find that your prostate is enlarged during physical examination. Some doctors often recommend that men over 50 years old should have their prostate checked every year, even if they have no symptoms relating to BPH or other conditions affecting their prostate. Your doctor can check your prostate by doing a digital rectal exam, or DRE. During DRE, your doctor will insert a gloved finger into your rectum. A lubricant will then be applied to that area to make sure that you experience as little pain and discomfort as possible. Your doctor will feel the size, shape, and texture of your prostate. This exam can tell your doctor if your prostate is enlarged due to BPH, or if there are other conditions affecting your prostate. Based on this examination, your doctor will tell you if further tests are needed to determine the real condition affecting your prostate.
Signs and symptoms may also give you and your doctor clues that you may have BPH. Common symptoms of BPH are:
- difficulty urinating
- a feeling of having some urine left in the bladder, even after you have finished urinating
- leaking urine
- urinating more frequently
- seeing blood in your urine or at the tip of your penis after urination.
Is BPH cancer? Is there a reason for me to be worried?
Although BPH can cause very inconvenient and sometimes painful symptoms, BPH is not prostate cancer. It does not cause prostate cancer, nor does it increase your chances for developing prostate cancer in the future.