Young men might not give a second thought to their prostate, since it rarely causes health problems early on. But by the time middle age rolls around, it’s a different story.
As men hit their 40s, 50s and 60s, many experience symptoms linked to an enlarged prostate, like trouble urinating. Others develop pain and swelling related to prostate inflammation. And some men are diagnosed with prostate cancer, the odds of which increase with age.
“The problem with the prostate is it’s an organ that’s very deep in the body with a lot of important structures around it,” says Jason Wolf, MD, a urologist affiliated with Kendall Regional Medical Center in Miami, Florida. “Most guys don’t even think about it until it becomes a problem.”
So, what prostate issues should men be most concerned about? What are the biggest risk factors for problems? And most importantly, what can you do to promote good prostate health?
Common prostate problems
Located right under the bladder, the prostate is a walnut-sized gland that produces fluid to protect sperm during ejaculation. Though men can be affected by a number of different troubles with their prostate, some occur more frequently than others. These include:
- Benign prostatic hyperplasia (BPH): A non-cancerous enlargement of the prostate, BPH is believed to affect up to 14 million men in the U.S. It’s the most common prostate problem in those older than 50, and the odds of developing it increase with age. BPH is a major cause of bathroom issues in older men, since the prostate increasingly compresses the urethra as it grows, interfering with urination.
- Prostatitis: This inflammation and swelling of the prostate gland can be acute or chronic, and is sometimes triggered by bacteria, though it usually has another cause. It’s the most widespread prostate issue for men younger than 50, but can strike older men, too. Pelvic pain and urinary troubles are common symptoms.
- Prostate cancer: About 1 in 9 American men will be diagnosed with prostate cancer at some point. Many more will develop it and never be aware. Though the American Cancer Society estimates more than 31,000 men will die of the disease in 2019, it’s typically slow-growing and treatable when it’s caught early.
As for who’s most at risk for prostate problems, “a lot of it just comes down to genetics and age,” says Dr. Wolf. “If you live long enough, you may experience prostate issues at some point in your life.”
While you can’t change your genes or stop growing older, there are some lifestyle habits that may contribute to a healthy prostate, easing symptoms and lowering your odds of disease.
Consider your diet
Though eating habits don’t appear to play into the risk of BPH and prostatitis, there’s some evidence that overdoing high-fat foods—especially red meat—may increase your odds of prostate cancer. Skimping on vegetables may also raise the chances that you’ll develop the disease.
Experts often recommend sticking to a heart-healthy diet, which can help protect your prostate. This means focusing on produce, whole grains, fish and good-for-you fats like those found in avocados and nuts, and limiting added sugars, saturated fats, and red and processed meats. Men already experiencing urinary symptoms may want to cut back on other items, as well, suggests Wolf, “things like caffeine, alcohol, spicy food and acidic food.”
Some men swear by supplements to boost prostate health, he adds, “but really no one has come up with solid evidence.” In fact, going overboard with calcium or certain vitamins may actually contribute to prostate cancer risk. Speak with a healthcare provider (HCP) about whether supplementation is right for you.
Stay active
Studies suggest that men who exercise regularly have a lower risk of prostate problems. Among other perks, physical activity may help prevent BPH, reduce symptoms of chronic prostatitis and lower the risk of prostate cancer. In fact, in a large study from the UK published in the International Journal of Epidemiology in 2019, researchers found that participants with a genetic variation that increased their likelihood of being active had about half the prostate cancer risk of those who didn’t have the variation.
Exercise is also excellent for relieving stress, which can aggravate BPH and prostatitis symptoms and may be linked to the development of chronic prostatitis. The general recommendation for overall health is to shoot for at least 150 minutes of moderate or 75 minutes of vigorous physical activity each week.
Maintain a healthy weight
Obesity doesn’t appear to raise your risk of prostate cancer, but in some studies, it’s associated with higher odds of developing advanced prostate cancer, as well as dying of the disease.
Being obese may play a role in BPH, too. “The simplified thought process about people with obesity is that they have increased abdominal pressure,” says Wolf. “That pressure is sitting on your bladder and prostate and can lead to some of that bladder irritability over the years.” Obesity may also contribute to BPH by increasing inflammation.
Kick the habit
Smoking can exacerbate urinary symptoms and may influence prostatitis inflammation, but its relationship to prostate cancer is unclear. Many studies suggest it isn’t a significant risk factor for the disease. “Smoking for sure is a risk factor for other urologic malignancies, specifically in the bladder and the kidney, but not as much for the prostate,” says Wolf.
That said, tobacco may present problems in other ways. For one thing, it’s been linked to higher mortality in men with prostate cancer. One 2015 review published in European Urology Focus found that the more cigarettes patients smoked, the more likely they were to die of their condition. Another review published in JAMA Oncology in 2018 found that current smokers with prostate cancer had higher recurrence and mortality risks than former smokers.
Smoking may also hinder treatment for conditions of the prostate, as it does for many other diseases. “If people are having issues with their prostate and need certain medical therapies or surgical therapies, the smoking then may become an issue as far as ease of the treatment options and recovery,” says Wolf.
For these reasons—and due to its well-known impact on overall health—it’s often recommended that men with prostate problems quit smoking or better yet, never start.
Consider sex or masturbation
No, really. Though much more investigation is needed, some research suggests that ejaculation frequency may be linked to a lower risk of prostate cancer. For example, in a pair of Harvard studies—one published in 2004, and a follow-up published in 2016—researchers looked at the ejaculation frequency of more than 30,000 adult men over many years. They found that those who reported ejaculating more often were less likely to be diagnosed with prostate cancer than those who ejaculated less often.
It’s important to note, however: In terms of the prostate, safe sex should always be a priority. Certain sexually transmitted infections (STIs) can cause prostatitis and may lead to other problems, as well.
Be a good patient
In relation to the prostate, says Wolf, “keeping up with your overall health is important.” Attending regular well visits can help you manage existing conditions and detect new problems early, including prostate cancer.
The United States Preventive Services Task Force (USPSTF) has found that men at average risk are most likely to benefit from prostate cancer screening between ages 55 and 69.
“African American and Caribbean men have a higher risk of prostate cancer, so we usually start screening earlier,” says Wolf. The same goes for men with a history of prostate cancer in their family: “We may start sooner and we may do it every year.”
The benefits and risks of screening for prostate cancer aren’t clear-cut, however, and it’s generally recommended that men discuss it with their HCP between ages 40 and 50, depending on their risk.
Between checkups, talk to an HCP about any new or unusual symptoms that could indicate prostate troubles, like:
- Difficulties with urine flow
- Pain or blood when you urinate or ejaculate
- Persistent or severe pain around your genitals, abdomen or lower back
Seek medical help right away for signs that may point to more serious problems, such as a constant and urgent need to pee or a total inability to pee.
Ultimately, your prostate health depends largely on factors you can’t control, but adopting a few good habits can only lower your odds of problems.
