13.5: The Prostate
The prostate gland is part of sexual anatomy, and produces the fluid that nourishes and helps to transport semen. The prostate normally doubles in size during puberty. At approximately age 25, it gradually begins to enlarge again. This enlargement does not usually cause problems; however, abnormal growth of the prostate, or benign prostatic hyperplasia (BPH), can cause constriction of the urethra as it passes through the middle of the prostate gland, leading to a number of lower urinary tract symptoms, such as a frequent and intense urge to urinate, a weak stream, and a sensation that the bladder has not emptied completely. By age 60, approximately 40 percent of men have some degree of BPH. By age 80, the number of affected individuals has jumped to as many as 80 percent. Treatments for BPH attempt to relieve the pressure on the urethra so that urine can flow more normally. Mild to moderate symptoms are treated with medication, whereas severe enlargement of the prostate is treated by surgery, in which a portion of the prostate tissue is removed.
The prostate gland can be a source of great sexual pleasure, and a direct route to orgasm and ejaculation. During arousal, the prostate gland swells and this is when prostate stimulation can feel most pleasurable. One can stimulate one’s own prostate or a partner can do it, by inserting a finger in the anus and stroking towards the front of the body. Prostate massage is sometimes referred to as “milking the prostate” when it results in ejaculation or fluid coming out of the penis. When heterosexual couples do prostate massage and stimulation, it is sometimes referred to as pegging. The Ultimate Guide to Prostate Pleasure is a great resource for more information on how to safely enjoy sexual pleasure with prostate play.
Sometimes, surgery is recommended in order to treat prostate cancer. Removal of part or most of the prostate can cause the inability to achieve an erection. Working with a pelvic floor physical therapist prior to and after surgery can sometimes prevent this. Before having a prostate surgery, it can be helpful to speak to a healthcare provider regarding how it might affect erections.