How to Take Care of Your Prostate in Your 30s, 40s and Beyond – Before Problems Start

Ask a urologist and they’ll tell you the prostate has two main functions: producing fluid that forms part of semen, and – less officially – keeping urologists in business. That’s a lot of responsibility for a doughnut-shaped gland roughly the size of a cherry tomato. You might assume cancer is what keeps specialists busy, given that prostate cancer is the most common cancer diagnosis in men. But there’s another near-universal issue: the prostate never stops growing.

The prostate sits just below the bladder, and the urethra (the tube that carries urine out of the body) runs directly through it. As the gland enlarges, it can press on the urethra and make it harder to urinate – which is not only frustrating, but can also lead to issues such as bladder infections. The good news: regular exercise and a healthy diet can help reduce the risk of prostate problems. And it’s not just an issue for older men – younger men can experience an enlarged prostate too.

Whether you’re young or older, the main symptoms of an enlarged prostate are similar:

• A weaker stream and difficulty emptying your bladder
• Urinating more than eight times a day, often with urgency
• Nocturia – waking two or more times during the night to urinate

The first two symptoms tend to develop gradually, making them easy to miss, says Chad Ellimoottil, MD, chief of Men’s Health and Reconstruction at the University of Michigan. But disrupted sleep is often the giveaway. It’s worth noting that nocturia refers specifically to being woken by the need to urinate – if you wake for other reasons and then go, it’s less likely to be prostate-related.

The Younger-Men Problem

If you’re under around 55, urinary symptoms are often linked to inflammation of the prostate, known as prostatitis. Doctors previously assumed this was usually bacterial and treated it with antibiotics, says Dr Ellimoottil. Now, a more common cause is recognised: chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

This condition often stems from tension and irritation in the pelvic floor muscles, which can inflame the prostate. Modern habits such as prolonged sitting – whether at a desk or in a car – can aggravate the issue. Activities that put pressure on the perineum, such as cycling, may also contribute.

This inflammation can disrupt nerve signals, leading to erectile dysfunction (ED) or pain during or after ejaculation. All the more reason to address symptoms early.

What to Do

• Anti-inflammatories may help reduce symptoms – speak to your GP first
• A sitz bath (sitting in warm water) can help relax the pelvic muscles
• A physiotherapist specialising in pelvic floor health can address underlying causes and teach relaxation techniques
• Antibiotics may still be used if an infection is confirmed

The Older-Men Problem

After the age of 50, around half of men develop some degree of benign prostatic hyperplasia (BPH), a hormone-driven enlargement of the prostate. In some cases, straining to urinate can also irritate the pelvic floor, contributing to prostatitis.

What to Do

• Try ‘double voiding’: lean forward slightly while urinating, then attempt to empty your bladder again after finishing
• Urinate on a schedule (for example, every couple of hours), but consult a GP for guidance
• Consider prescription medication. Options can shrink the prostate (finasteride) or relax the prostate and bladder neck (tamsulosin, tadalafil), improving flow
• Surgery is an option if symptoms are severe or persistent. Newer, less invasive techniques using implants (UroLift), lasers (HoLEP) or steam (Rezūm) can reduce side effects and recovery time

Roughly one in eight men will be diagnosed with prostate cancer. Fortunately, many low-grade cases grow slowly and may never cause harm. ‘Most prostate cancer is something you die with, not from,’ says Christopher Koller, MD, a urologic oncologist at Hackensack Meridian Health.

Because many prostate cancers develop on the outer edge of the prostate – where they don’t initially cause symptoms – screening is important. You should consider a prostate-specific antigen (PSA) test between the ages of 45 and 50, even if you feel well. Start closer to 40 if you have a family history or are Black.

A PSA above 2.5 ng/mL for men under 60, or above 4.5 ng/mL for those over 60, may lead to further testing. If the cancer is low risk, you may opt for ‘active surveillance’, monitoring it closely to avoid unnecessary treatment. More aggressive cases may require surgery or radiotherapy, although newer treatments such as focused ultrasound or cryotherapy are also available.

It can. Surgery for BPH may lead to retrograde ejaculation, where semen enters the bladder instead of exiting the penis. It’s not harmful, and fertility is often less of a concern at this stage of life.

Cancer surgery can cause temporary erectile dysfunction, which can be frustrating even when treatment is successful. In most cases, function returns within one to two years. Medications such as sildenafil (Viagra) or tadalafil (Cialis) can help, alongside other options like injections or implants in more severe cases.

Kevin Dupzyk

Kevin is a writer and editor living in Brooklyn. In past lives he’s been an economist, computer salesman, mathematician, barista, and college football equipment manager.