When to get your prostate checked: warning signs and advice

A healthy prostate plays a vital role in male fertility, producing fluid that helps keep sperm alive. But as you get older, particularly after the age of 40, you may find that your prostate starts to cause you problems. One reason for this is that the prostate continues to grow as you age. This is a normal process but for many men, an enlarged prostate can cause symptoms that affect their quality of life. This isn’t the only problem that affects the prostate, there are several other prostate issues, which can produce similar symptoms to each other. A prostate exam can help you find out what’s going on with your prostate so your doctor can then help you get relief from any symptoms you may be experiencing.

What are the most common prostate issues?

Enlarged prostate

As previously mentioned, an enlarged prostate is one of the most common prostate issues affecting older men. According to Harvard Medical School, by the age of 60, half of men have an enlarged prostate, rising to 90% by age 85. 

The prostate is a walnut-sized gland that wraps around the tube through which you pass urine. An enlarged prostate can, therefore, interfere with your ability to urinate with common symptoms including: 

• A more frequent urge to urinate, leaking urine, poor flow of urine, trouble starting to urinate, straining to urinate, and pain or burning while urinating — these symptoms most commonly occur with benign prostate hyperplasia (BPH)
• Painful ejaculation
• Frequent pain or stiffness in your lower back, upper thighs, pelvis and/or rectum

These symptoms can significantly interfere with your daily routine. However, there are treatments available, many of which involve simple lifestyle changes, such as drinking fewer alcoholic, fizzy, caffeinated and artificially sweetened drinks, drinking less in the evening and not at all two hours before bedtime, and eating more fruit and fibre. 

There are also techniques to ease your symptoms, such as double voiding, where after urinating you try to urinate again to fully empty your bladder. Bladder training can also help by giving you greater control to go for longer periods without urinating. 

If these lifestyle changes aren’t enough to provide relief from your symptoms, there are a range of medicines you can try:

• Alpha-blockers to relax the muscle at the base of the bladder and in the prostate gland
• Anti-cholinergics to relax overactive bladder muscles
• 5-alpha reductase inhibitors to reduce the size of the prostate
• Diuretics taken during the day to speed up urine production so less urine will be produced at night
• Desmopressins taken at night to slow down urine production 

If medications are ineffective, there are also surgical procedures, such as transurethral resection of the prostate (TURP). 

Prostatitis

Prostatitis occurs when your prostate becomes swollen and inflamed. There are two types: acute prostatitis which comes on suddenly and is caused by an infection, and chronic prostatitis which comes and goes over several months and is usually not caused by an infection.

Symptoms of acute prostatitis include severe pain when urinating and defecating, as well as constant severe pain in your lower back, lower abdomen, penis, anus and/or testicles. You may also be unable to pass urine, have a fever and generally feel unwell. You should contact your GP immediately and depending on the severity of your symptoms, you may need to go to hospital. Painkillers and antibiotics will usually resolve your symptoms in two to four weeks.

Chronic prostatitis can result in similar symptoms as an enlarged prostate, with additional symptoms including pelvic pain after sex, difficulty getting an erection and pain in the area between your anus and scrotum which gets worse after sitting for a long time. This condition can sometimes resolve on its own but if it persists, painkillers and alpha-blockers can help.

Prostate cancer

Symptoms of prostate cancer overlap with symptoms of an enlarged prostate, namely a more frequent urge to urinate and straining to urinate, as well as feeling that your bladder is never fully empty.  You may also notice blood in your semen or urine.

If you have these symptoms, it is more likely that you have an enlarged prostate. However, it is still possible that you may have prostate cancer, especially if you have a family history of this disease. This is why it is important to have these symptoms investigated by your doctor, starting with a prostate exam. You may then need a blood test and biopsy. Early detection is key to successful treatment. 

Prostate cancer is most common in men in their late 70s and has a high survival rate, according to Cancer Research UK. As prostate cancer is slow to grow, many men do not require treatment and instead have regular check-ups with their doctor to keep a close eye on their cancer. For those men that do require treatment, surgery is carried out to remove the prostate, followed by radiotherapy.

How to keep your prostate healthy

A key part of keeping your prostate in good health is to be aware of any changes when you urinate or any discomfort in your lower abdomen, pelvis and anal area. If you notice anything that concerns you, visit a doctor. At Spire Healthcare, you can get the help you need with our men’s health services, which provides specialist care for men with prostate, penile, testicular and bladder problems.

You can also take steps to prevent prostate issues by making changes to your lifestyle that promote good general health, which is thought to have a knock-on effect on promoting good prostate health. There are three main approaches: 

1. Stay a healthy weight

A healthy weight varies according to your height, build and muscle mass. But in general, the Body Mass Index (BMI) is a good indicator of what is healthy. This is calculated by dividing your weight in kilograms by your height in metres squared. A healthy BMI is between 18.5-24.9.

2. Eat a balanced diet

A healthy diet should include a balance of fruits, vegetables, wholegrain, dairy (or dairy alternatives), beans, pulses and oily fish. Try to keep processed foods, especially processed meats, to a minimum, and reduce the amounts of foods in your diet that are high in saturated fats, salt and sugar. It is also important to stay hydrated by drinking six to eight glasses of water, low-fat milk and/or sugar and alcohol-free drinks.

3. Stay physically active

Exercise can help you keep your BMI in the healthy range. While there is evidence that regular, vigorous exercise that gets your heart rate up has the most benefits, any form of regular physical exercise helps, such as brisk walks, jogging and swimming.

The benefits of a balanced diet, regular exercise and maintaining a healthy weight will do more than reduce your risk of prostate issues. They will also help keep the rest of your body healthy too.