The prostate might be something of an ‘out of sight, out of mind’ organ, but many men will experience changes related to it over the course of their lives. With increased attention on men's health, it's important to promote awareness of overall prostate health. Dr Harriet Connell explains what every man over 40 should know.
The fact that we are seeing more awareness-raising prostate health campaigns and a number of high profile men talking publicly about their experiences of it is really encouraging. In the last decade or so, I have noticed male patients are increasingly starting to take greater ownership of their well-being and becoming more proactive in protecting and maintaining their prostate health. So ideally, what should every man over the age of 40 be aware of?
What is the prostate?
First and foremost, what exactly the prostate is and what it does. In short, it is a walnut/chestnut-sized gland which is tucked away deep in the pelvis, beneath the bladder and in front of the rectum. It also wraps around the upper part of the urethra, the tube that carries wee from the bladder out of the body through the penis. The prostate is also a gland that helps make semen. Muscles in the prostate push semen into the urethra and out through ejaculation.
How the prostate changes with age
The prostate has a rapid growth spurt during puberty as levels of testosterone rise and it then stabilises until roughly a man’s forties where it starts to grow again. This means in a man’s twenties it is roughly walnut/chestnut-sized, by his forties it will probably have grown larger (attributed to changing hormone levels) and by the time a man hits his sixties it can be roughly the size of a lemon. Age-related hormonal changes may play a role in how the prostate changes in size and functions. For as testosterone levels naturally decline (at roughly 1-2% a year from the age of around 40)1 this may have the effect of pushing up levels of DHT (dihydrotestosterone), an androgen that plays a significant role in prostate size and development.
How to support and protect the health of your prostate
It is not fully known why some men experience differences in prostate health and others don’t, but there is increasing recognition that many aspects of health may be influenced by lifestyle. It can therefore be helpful to think in terms of supporting your wellbeing and making informed choices. To support yourself:
- Learn more about the subject: Being better informed and understanding your prostate health can help you become more aware of potential changes and support overall wellbeing.
- Regularly exercise: Research suggests that regular physical activity, including walking, is associated with general wellbeing, including aspects of men’s health such as the prostate. Even low to moderate activity, such as walking, yields results2. One study, for example, that followed 70,000 healthy middle-aged men over the course of two and a half years found that those who spent five hours or more sitting during the course of the day had a higher likelihood of experiencing certain bladder-related issues compared to those who were less sedentary3. Regular movement throughout the day, along with a balanced diet, may also support overall wellbeing and help support weight management as part of a healthy lifestyle. It may also form part of a routine that supports mental wellbeing.
- Eat well: A well-balanced diet – such as a Mediterranean-inspired one - is good for your overall health and should help you to maintain a healthy weight. Ideally, you should limit ultra-processed foods and red meat and include plenty of vegetables, fruits and healthy fats (including oily fish, nuts, seeds and olive oil). Eating plenty of cruciferous vegetables such as kale, cabbage, cauliflower, and broccoli is generally considered part of a balanced diet that supports overall wellbeing, including men's health. Broccoli, for example, is rich in antioxidants, vitamins and minerals and contains sulforaphane.
- Limit alcohol: If you do drink, try to stick to the recommended 14 units of alcohol a week. Drinking less may also support maintaining a healthy weight.
- Maintain a healthy weight: Carrying extra weight can place additional pressure on your organs.
- Find ways to effectively manage stress: Part of the ‘fight or flight’ stress response is, as many of us can testify, an urgent need to pee.
- Practise pelvic floor exercises: These can strengthen your pelvic floor muscles and give you better control over your bladder4.
- Consider a food supplement*: Some people choose to take food supplements as part of a healthy lifestyle. Certain nutrients have been found to support overall wellbeing. Ingredients often included in formulations aimed at men’s health include, for example, selenium—which contributes to normal spermatogenesis and contributes to the protection of cells from oxidative stress.
A food supplement should not be used a substitute for a varied and healthy lifestyle. Always consult your GP before taking food supplements if you are taking medication or have an existing medical condition.
- https://www.nhs.uk/conditions/male-menopause/
- https://medicalxpress.com/news/2015-04-prostate-cancer-routine-health-related-quality.html
- https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bju.14147
- https://prostatecanceruk.org/prostate-information-and-support/living-with-prostate-cancer/pelvic-floor-muscle-exercises
