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What is the prostate?

The prostate is a small gland that forms part of a man’s reproductive system. It is about the size of a golf ball and surrounds the tube that empties urine from the bladder, called the urethra.

It is normal for the prostate to swell as a man gets older, but if the swelling gets too big, it can block the urethra, making it difficult to pass urine. This swelling is called benign prostate enlargement or BPE.

BPE is not cancer. In most cases, BPE is not a serious health concern and is a treatable condition.

What does the prostate do?

The prostate makes a thick white fluid that mixes with sperm from your testicles to make semen. It also produces a protein called prostate-specific antigen or PSA. PSA helps reduce the thickness of semen, so it is thinner and more fluid.

Male reproductive system
Pathway of sperm

Do men have hormones?

Hormones are chemicals that carry messages around the body. In men, a hormone called testosterone is made by the testicles and controls how the prostate works. Testosterone is responsible for a man’s sex drive and getting an erection. For this reason, you may hear testosterone called a “sex hormone”.

Do trans women have a prostate?

Yes. If you are a trans woman or a non-binary individual assigned male at birth, you have a prostate.
Some trans women may have had genital reconstructive, or gender reassignment, surgery. Although converting a man’s anatomy to a woman’s anatomy involves removing the penis and the testicles, this surgery does not remove the prostate.
If you are taking hormones or testosterone blockers, these may reduce the risk of prostate cancer by lowering your testosterone levels. It is still very important to have a prostate check if you have any known symptoms or are at increased risk of prostate cancer.
We know it can be a difficult conversation to have, but we encourage you to speak to your doctor.

Urine
Urine, or pee, is often called a waste product. This is because it is produced by the kidneys, which are responsible for filtering toxins from the blood.

Protein
Proteins are found in every cell in the body.

Antigen
Typically, an antigen is a substance that causes your immune system to produce antibodies.
Although PSA is called an antigen, biochemically, it is an enzyme which means it causes a chemical
reaction. In the prostate, this chemical reaction is the reduction in the thickness of the semen.

This information was produced by the European Association of Urology (EAU) and updated in May 2021.

This chapter contains general information about prostate cancer. If you have any specific questions about your individual medical situation you should consult your doctor or other professional healthcare provider. No website or leaflet can replace a personal conversation with your doctor.

Contributors:

  • Mr. Eamonn T. Rogers, Galway (IE)
  • Assoc. Prof. P. Cornford, Liverpool (UK)
  • Mr. John Dowling, Dublin (IE)
  • Dr Keith Ritchie, BSc, MB BS, retired GP and metastatic prostate cancer patient, Kent (UK)

This information has been reviewed by a lay panel.

The development of this chapter was funded by Ferring Pharmaceuticals. Its content has been independently developed and approved by the EAU Patient Office.