Your Prostate Over 40

Medically Reviewed by Poonam Sachdev on December 13, 2022
3 min read

During the first half of your life, you may hardly know your prostate is there. The walnut-sized sexual organ, located just below the bladder, makes fluid that helps protect sperm after ejaculation as it seeks out eggs to fertilize. A healthy prostate goes about its business without drawing a lot of attention to itself.

As you age, though, things often change.

Starting around age 25, the adult prostate begins to enlarge slowly. The condition is called benign prostatic hyperplasia (BPH), and it has nothing to do with cancer.

It’s not clear why the growth happens. What is clear, however, is that around age 50, many men begin to have uncomfortable symptoms as a result of this enlargement. They may have to go to the bathroom more urgently and often, especially at night -- and when they do, it’s often difficult to get a strong stream started or to empty the bladder.

This happens because the prostate gland surrounds the urethra, the tube that carries urine from the bladder and out through the penis. As the prostate grows, it compresses that tube, and that makes urination difficult.

If it gets so bad that you can’t pee at all, that’s a medical emergency. Get to an emergency room or call 911 immediately.

Urinary problems caused by BPH are known as lower urinary tract symptoms, or LUTS. Men with LUTS often have problems in the bedroom.

The link between LUTS and sexual problems is not fully understood. But many of these men have a lowered sex drive, trouble maintaining an erection, and they’re less satisfied with sex. Depression, loss of sleep due to frequent nighttime trips to the toilet, or some related physical cause may play a role.

Whatever the reason, the worse LUTS get, the more trouble a man may have in the bedroom. LUTS can be treated, so see a doctor early, before the symptoms cause a bladder problem or begin to spoil your sex life.

Prostate cancer is the second most common cancer diagnosed in men. Catching the disease in its early stages may improve a man’s chance of survival.

When you reach age 40, talk to your doctor about your family’s medical history and other key factors that will help determine your risk of developing the disease.

If you get tested, you’ll likely undergo a digital rectal exam and a PSA test, a blood-draw that measures your levels of prostate specific antigen (PSA). High PSA levels could indicate cancer, but they can also be caused by other conditions, including BPH. Talk to your doctor to make sure you understand what the results mean.

Some men notice no symptoms of prostate growth. For the many who do, though, treatments can ease the peeing process.

Lifestyle changes: Cut down on, or cut out, alcohol and coffee, and drink less fluid in the evening. Both strategies can lessen the number of trips to the toilet. Also, talk to your doctor about your current medications. Some drugs may worsen your symptoms.

Medications: The FDA has approved several medications for benign prostate growth, which help by slowing growth, shrinking the prostate, or relaxing the muscles that make urination easier. Some men may benefit from a combination of drugs.

Surgery: For men who don’t benefit from medications, there are many types of surgery to offer relief. Some are minimally invasive, others are more involved. The most common, called TURP (transurethral resection of the prostate), removes the prostate tissue that’s compressing the urethra. TURP may result in retrograde ejaculation, a condition in which semen enters the bladder rather than exiting the urethra. It is harmless, but can lead to male infertility.