What Is the Prostate and What Does It Do?

Medically Reviewed by Poonam Sachdev on April 16, 2024
Written by Matt McMillen
9 min read

The prostate is a walnut-sized gland located under the bladder and next to the rectum of people assigned male at birth (AMAB). It surrounds the urethra, a tube that transports urine from the bladder and through the penis. The prostate plays an important role in sexual reproduction. It helps make semen, the fluid that carries sperm out of the penis — via the urethra — when you ejaculate.

The prostate is a small gland that is part of the male reproductive system. It's supposed to be about the shape and size of a walnut.

It rests below your bladder and in front of your rectum. It surrounds part of the urethra, the tube in your penis that carries pee from your bladder.

The prostate helps make some of the fluid in semen, which carries sperm from your testicles when you ejaculate.

If you have a prostate, it will almost certainly get larger as you age. It's not clear why it happens, but it may be linked to the decline in the male sex hormone testosterone as you get older. This enlargement is a condition called benign prostatic hyperplasia (BPH). The key word is benign. BPH has nothing to do with cancer and doesn't increase your risk of cancer. But it can make it more difficult to pee and ejaculate. Why? As your prostate grows, it presses on your urethra. That interferes with the flow of urine and the release of ejaculate during orgasm.

Enlarged prostate and aging

Your prostate likely will begin to get larger around age 25. Symptoms usually don’t begin before the age of 40. By the age of 60, you have a 50% chance of symptoms. That number climbs to 90% by the time you’re over 80.

Is an enlarged prostate dangerous?

It can be. If your urethra becomes severely or completely blocked, you won’t be able to pee at all. This can happen suddenly and is a medical emergency. Without prompt treatment, your kidneys may be damaged. Other serious complications of BPH include:

  • Urinary tract infections
  • Bladder stones
  • Bladder damage
  • Blood in your urine

BPH is common and can't be prevented. Age and a family history of BPH are two things that increase your chances of getting BPH. A few stats on that:

  • Some 8 out of every 10 people AMAB eventually develop an enlarged prostate.
  • About 90% of men over the age of 80 will have symptoms of BPH.
  • About 30% of men will find their symptoms bothersome.

If you have trouble peeing or have to go a lot, especially at night, these could indicate that you have an enlarged prostate. Other signs and symptoms include:

  • Your bladder doesn’t empty completely after you pee.
  • You feel the need to go suddenly with no sensation of buildup.
  • You may stop and start several times.
  • You have to strain to get any flow going.

It’s important to see your doctor if you have early symptoms of BPH. Although rare, it can lead to serious problems such as kidney or bladder damage.

BPH is different for each person. In fact, some people with very large prostates have few, if any, symptoms. But your doctor should be aware either way.

How your doctor handles your condition depends on the details of your case -- your age, how much trouble it’s causing, and more. Treatments may include:

Watchful waiting. If you have an enlarged prostate but are not bothered by symptoms, you may be advised merely to get an annual checkup, which might include a variety of tests.

Lifestyle changes. This includes cutting back on how much you drink at night and before bedtime, especially drinks with alcohol or caffeine.

Medicine. Common treatments for BPH are alpha-blockers, which ease BPH symptoms, and what’s called 5-alpha reductase inhibitors, or 5-ARIs, which help shrink the prostate. Many people with an enlarged prostate take them together.

The FDA now requires labels on 5-ARIs to include a warning that they may be linked to an increased chance of a serious form of prostate cancer. These medications are dutasteride (Avodart) and finasteride (Propecia and Proscar). The combination pill Jalyn also contains dutasteride as one of its ingredients.

Surgery. If you have severe symptoms and other treatments haven't helped, you might have to turn to surgery. Talk to your doctor about possible risks and outcomes.

This is inflammation of the prostate, sometimes caused by an infection. Prostatitis does not make you more likely to develop prostate cancer. However, it can cause serious, even deadly complications, including:

  • Sepsis, a life-threatening infection in your bloodstream
  • Inflammation of your reproductive organs neighboring your prostate
  • Sexual dysfunction
  • Abscesses in your prostate

There are four main types of prostatitis:

Acute bacterial prostatitis. This is caused by a bacterial infection that develops suddenly.

Chronic bacterial prostatitis. Also caused by a bacterial infection, it can be hard to treat and may last years.

Chronic prostatitis/chronic pelvic pain syndrome (CPPS). It is the most common type of prostatitis. About 1 in 3 people AMAB will develop this at some point in their lives.

Nonbacterial prostatitis (asymptomatic inflammatory prostatitis). While this condition causes inflammation, it does not have symptoms or require treatment.

Prostatitis symptoms

What your symptoms are depends on the type of prostatitis you have.

Acute bacterial prostatitis typically causes:

  • Fever
  • Chills
  • Body aches
  • Painful or frequent urination
  • Difficulty urinating

Symptoms of chronic bacterial prostatitis are similar to those of acute bacterial prostatitis; however, they are usually less severe and you won’t develop a fever. They include:

  • Pain while urinating
  • Frequent urination
  • Difficulty urinating
  • Painful ejaculation

Chronic prostatitis/chronic pelvic pain syndrome (CPPS) causes pain or discomfort that lasts 3 or more months. It can occur in the following parts of your body:

  • Between your scrotum and anus
  • Central lower abdomen
  • Penis
  • Scrotum
  • Lower back

Other symptoms include:

  • Painful ejaculation
  • Pain in your urethra or penis during or after urination
  • Frequent urination
  • Urgent need to pee
  • Difficulty peeing

Prostatitis risk factors

You are more likely to get prostatitis if you:

  • Are young or middle-aged
  • Have frequent urinary tract infections, a recent infection in your bladder, or an infection in your reproductive system
  • Have had prostatitis in the past
  • Have an abnormality in your urinary tract, which includes your kidneys, urethra, bladder, and ureters, which connect your kidneys and bladder
  • Have a urinary catheter, a tube inserted in your urethra to drain your bladder
  • Have HIV or AIDS

Prostatitis treatment

Your treatment will depend on the type of prostatitis that you have.

Acute bacterial prostatitis. This is treated with antibiotics for 2-4 weeks. You may require IV antibiotics. In rare cases, your doctor may need to drain an abscess in your prostate.

Chronic bacterial prostatitis. Treatment for this type takes longer and is more complicated. You may need to take antibiotics for up to 12 weeks. To prevent the return of infections, your doctor may prescribe ongoing treatment with low-dose antibiotics.

Chronic prostatitis/chronic pelvic pain syndrome (CPPS). This requires a variety of treatments to address your pain and urinary difficulties as well as the anxiety this condition can cause. Physical therapy also may be part of your treatment plan.

Your doctor can use a variety of tests to check on the condition of your prostate. A few of them include:

Digital rectal exam. Your doctor puts on a glove and gently inserts one finger into your rectum to check the size, shape, and firmness of your prostate, as well as for any lumps.

Prostate-specific antigen (PSA) test. This blood test checks the amount of a protein called PSA, which is produced by prostate cells. Higher levels may be a sign of cancer. By themselves, they are not proof you have prostate cancer.

Higher levels could also point to an enlarged prostate or prostatitis. But you may have low PSA levels despite having prostate cancer. If you opt to take this test, your doctor will discuss what your results mean.

Prostate biopsy. If you have high PSA levels or other reasons to suspect prostate cancer, your doctor may suggest a biopsy. It involves taking tissue samples from your prostate, which are analyzed to find out whether you have cancer.

Screening for prostate cancer is controversial. You may read different kinds of advice and guidance from various sources. Talk to your doctor about what is best for you. Different health organizations make different recommendations regarding screening.

American Cancer Society

It recommends that you talk to your doctor about the benefits, risks, and limits of prostate cancer screening before deciding whether to be tested. This discussion should take place:

  • At age 50 if you have an average risk for prostate cancer
  • At 45 if you have a higher than average risk of prostate cancer, including being African-American or having a father or brother who has been diagnosed with prostate cancer at 65 or younger
  • At age 40 if you have more than one first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age

American Urological Association

It recommends that men aged 55-69 who are considering screening should talk with their doctor about the risks and benefits of testing and make the decision based on their personal situation and needs.

The group doesn't suggest screening for:

  • Men and those AMAB aged 39 and younger
  • Men and those AMAB who are aged 40-54 and have only an average chance of getting cancer

For those men who have decided on screening after talking with their doctor, a routine interval of 2 years or more may be preferred over yearly tests.

Compared with annual screening, it is expected that 2-year intervals give you most of the benefits and reduce false positive results.

Routine PSA screening is not recommended for those AMAB older than 70 or for anyone who is expected to live only 10-15 more years.

U.S. Preventive Services Task Force

It recommends that men aged 55-69 should talk with their doctor about the risks and benefits of screening before making a decision, which should be based on their personal situation and needs.

Routine PSA screening is not recommended if you're older than 70.

If you have a prostate, expect that it will grow larger starting around age 25, a common condition called benign prostatic hyperplasia, or BPH. This may cause symptoms that you should discuss with your doctor. Treatment can help. Keep in mind that having BPH doesn't mean you have prostate cancer or a higher risk of prostate cancer. The two are not related. Prostatitis is a separate condition that affects your prostate and causes unpleasant symptoms. Treatment can cure it.

Can you get an erection without a prostate?

Often, the answer is yes. If you had your prostate removed as part of prostate cancer treatment, your ability to have an erection could return within a month of surgery. However, the time could stretch to a year or longer. Also, if you had trouble getting an erection before your prostate was removed, you’ll still have it after surgery. If you can’t get an erection on your own, talk to your doctor about your options, such as medications, penile implants, and pumps.

Can an enlarged prostate be cured?

No. This is a chronic condition that often gets worse over time. However, medications and procedures can ease your symptoms, stop the growth of your prostate, and even shrink it.

How can you massage the prostate?

You can do this by inserting a finger into your anus until it reaches your prostate. Gently press and massage your prostate. It has no medical benefit. However, it can be sexually stimulating, either by yourself or with a partner. Just use lots of lubricant to avoid injury.

How can you avoid prostate cancer?

Unfortunately, nothing can guarantee protection against prostate cancer. However, the American Cancer Society recommends maintaining a healthy weight, exercising regularly, and eating a healthy diet that focuses on fruits, vegetables, and whole grains while limiting processed meat, red meat, sugary drinks, and highly processed foods. Also, consider limiting calcium, both in supplement form and in your diet. Several studies have linked high dairy and calcium intake to an increased risk of prostate cancer.