The Role the Prostate Gland Plays in Sexual Health

By: Artie Schifford
August 27, 2021

You've seen the public service announcements about prostate health, and you know that around age 50, you're supposed to start having your prostate checked each year. But you're a busy, virile man, and you're in good health, so you don't need to worry about all that just yet. Right?

Wrong. With 190,000 new cases of prostate disorders diagnosed each year in the U.S., understanding what the prostate is, what it does, and how you can protect your prostate health are essential for optimum sexual health later on, and the sooner you start, the better.

Crazy Little Thing Called the Prostate

Prostate is the Size of a Walnut

The prostate is about the size of a walnut, and it's part of the male reproductive system. It's located just below the bladder and right in front of the rectum, and it surrounds part of the urethra, which is the tube that is connected to the bladder, through which urine travels on its way out of the body.

The main role of the prostate is to secrete a fluid that nourishes and protects sperm. When you ejaculate, the prostate releases this fluid into the urethra, where it mixes with sperm to form semen. About 20 to 30 percent of the volume of semen is made up of this fluid.

At puberty, the prostate experiences a growth spurt, nearly doubling in size and weight. Ideally, the size of the prostate will remain the same for the duration of a man's life, but unfortunately, this isn't the case for most men.

Enlarged Prostate: A Growing Problem

Enlarged Prostate Size

More than half of men age 50 and over have benign prostatic hyperplasia, or BPH, which is basically an enlarged prostate. Incidents of this nonmalignant enlargement of the prostate increase as men age, and it's estimated that 80 percent of men have BPH by age 80, increasing to about 85 percent by age 85.

This enlargement of the prostate, which can grow from the size of a walnut to the size of a lemon, can cause serious problems with urination due to its squeezing of the urethra as it grows. Some common symptoms of BPH include trouble beginning to urinate, frequent urination, feeling as though the bladder is still full after urinating, sudden urges to urinate, and having to strain to pass urine.

BPH is a progressive disorder, and it can lead to serious kidney and bladder problems. But what's even worse for many men is that the lower urinary tract symptoms that often result from BPH have been linked to sexual dysfunction, including a lower libido, difficulty maintaining an erection, and reduced sexual satisfaction.

Male Impotence

Treatments for BPH range from simply keeping an eye on the enlargement via yearly prostate exams and making lifestyle changes for optimum prostate health. In severe cases, drugs known as alpha blockers can help alleviate symptoms. A drug called 5-alpha-reductase inhibitor, which shrinks the prostate, may also be prescribed, although this drug has been shown to increase the risk of prostate disorders in some studies. In cases of extreme symptoms, surgery may help.

Another Common Problem: Prostatitis

Prostatitis is an infection or inflammation of the prostate, and it can be painful and, like BPH, may result in sexual dysfunction. Prostatitis can occur in men of any age, from the late teens to old age. Symptoms include trouble passing urine, fever and chills, and sexual problems like pain or difficulty getting or maintaining an erection. This condition is neither sexually transmitted nor contagious, and treatment for prostatitis typically involves antibiotics. The sooner it's treated, the better.

Start Now: How to Maintain Prostate Health

Maintaining the health of your prostate is essential for helping to prevent serious problems that can interfere with your overall good health and cause sexual problems like erectile dysfunction and ejaculatory problems.

Exercise for Prostate

Regular exercise is essential for good general health, and it's particularly important for a healthy prostate. With regular exercise comes a healthy weight, which is another important factor in preventing prostate problems. A diet rich in selenium and fruits and vegetables can help maintain a healthy prostate, and quitting smoking will go a long way toward improving your overall health and preventing prostate and other disorders.

Beginning at the age of 50, an annual digital rectal exam, or DRE, is highly recommended for all men, regardless of whether the prostate is already enlarged. The DRE is critical for early detection of prostate disorders and for evaluating the growth of the prostate over time. The DRE allows the physician to determine the size of the prostate, detect any lumps, and evaluate its firmness.

A prostate-specific antigen test, or PSA, is a blood test that measures the proteins produced by the prostate cells, and is another essential tool for evaluating the health of the prostate over time. Your doctor will help determine whether a PSA is right for you, based on a number of factors.

Sex, Testosterone, and the Prostate
Sexual Intercourse

A Harvard study of 30,000 men showed that those who ejaculated 21 or more times a month lowered their risk of prostate disorders by one-third, compared to men who ejaculated between 4 and 7 times a month.

However, men who experience sexual dysfunction may have trouble ejaculating that much, which is where testosterone may come into play in treating male sexual and reproductive problems. Testosterone production slows down in your 40s, and by the time you reach your 50s or 60s, symptoms of low testosterone are more common and include reduced sex drive, decreased energy, lower muscle mass and bone density, and erectile dysfunction.

While there is some debate surrounding the safety of using testosterone to treat male reproductive problems and sexual dysfunction, Abraham Morgentaler, M.D., associated professor of surgery at Harvard Medical School and the director of Men's Health Boston, touts testosterone therapy as beneficial for improving the libido, enhancing mood and brain function, helping build muscle mass and bone density, and aiding in the production of red blood cells.

While the jury is still out regarding whether testosterone therapy increases the risk of prostate disorders, several small studies have recently shown that survivors of prostate disorders who were put on testosterone therapy didn't experience a recurrence of the disorder.


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