Back To Top
Back To Top
In discussions about long-term health, the first few organs that spring to mind are usually the heart, the lungs, and the brain. While these are...
In discussions about long-term health, the first few organs that spring to mind are usually the heart, the lungs, and the brain. While these are all important to take care of, if you are a man, be mindful not to overlook your prostate health. The prostate is a small gland around the size of a walnut; it is just below the bladder and its main function is to produce the fluid that transports sperm. Now naturally over time there are some changes to the prostate. Understanding how these changes manifest can help you understand when something might be concerning, when to consult a medical professional, and at what age do men no longer need prostate exams. Follow this link for more on Men’s Health Medicine.
With the passage of time, all organs undergo changes. Natural changes in hormone levels in the male body lead to structural changes in the prostate gland. For most men, the prostate gland slowly gets bigger due to the cells in the gland multiplying over time. As the prostate gland surrounds the urethra (the tube carrying urine from the bladder), the enlargement of the prostate can lead to the urethra being squeezed. When this happens, it is harder for urine to flow out of the tube.
So at what age do prostate problems begin? Much of these changes are linked to aging hence statistically it is most common in older men. While problems may begin around 50, in fact most men in their 70s and 80s will have some degree of prostate problem.
Maybe you have been scared by the first section of this article or maybe you have seen news of a celebrity getting prostate cancer. It might have you wondering when to get checked yourself. In the UK there is no national screening programme for prostate cancer that men automatically get invited to on a routine basis. Instead, a prostate cancer check is evaluated on an individual case by case basis after a consultation with their GP. This is to assess the situation clinically and to weigh up the potential advantages and drawbacks to proceeding with prostate cancer investigations. Here at Meds For Less, we believe in empowering individuals to be informed healthcare users.
So at what age should you have your prostate checked?
| Age group | Average risk status | Management plan |
| Under 50 | Generally this age group is at a lower risk of prostate changes. | Investigations for prostate cancer are not routinely offered unless there are specific symptoms, significant family history, or clinical signs are present. |
| 50 – 69 | This group has a significantly higher chance of experiencing prostate enlargement compared to the younger age group. | Men can request for an evaluation and discuss the pros and cons of further investigation with their GP. |
| 70 and over | This group has the highest prevalence of prostate changes. | In this group, active symptoms are assessed with the management plan focussed on improving quality of life and ongoing clinical monitoring. Specifically, the risks of aggressive intervention may outweigh its benefits. |
When considering how often should a man get his prostate checked, current clinical guidelines in the UK suggest there is no recommended fixed schedule for frequency of checks. Management is done on a case-by-case basis, for example if an initial blood test is normal, a follow up may not be needed for a few years if there are no symptoms.
Now you might be looking at the table above and thinking at what age do men stop having prostate exams then? Again, there is no recommended upper limit as intervention is guided by the individual’s situation.
As there is no national prostate screening programme in the UK, being aware of warning signs and recognizing changes in your body are the trigger for a medical review. There are certain symptoms that may suggest an underlying structural or functional change in the prostate and should prompt you to consult a medical professional.
To determine what are signs I should get my prostate checked, see if you have experienced any symptoms in the list below:
It is important to note that many of these changes can be caused by benign conditions. However, it may still be helpful to consult your GP. More concerning ‘red flag’ symptoms include:
If you experience any of these, please seek urgent medical attention so you can be assessed.
Urinary changes may be due to a range of problems and understanding some common causes may help with the decision of when should a man have his prostate checked. Some of the most common prostate conditions include: benign prostatic hyperplasia, prostatitis, and while it is less common than the other two, it is worth discussing what happens in prostate cancer.
Benign Prostatic Hyperplasia (also known as BPH) is simply the very long name to describe the non-cancerous enlargement of the prostate. This condition is very common with age and is not inherently dangerous on its own. However, the problem occurs when the enlarging tissue of the prostate puts pressure on the urinary tube (urethra). This then leads to everyday urinary symptoms such as straining to begin urinating or a weak stream. There are many treatment options for benign prostatic hyperplasia including medicines to relax the muscles of the bladder and medicines to shrink the prostate gland.
Prostatitis is the inflammation or infection of the prostate gland. This can occur at any age unlike other prostate conditions that typically affect older adults. Prostatitis can be a sudden and short-term infection or a long-term changing condition (chronic prostatitis). Classic symptoms that could suggest infection of the prostate include: pain during ejaculation (follow this link for more information about Male Fertility), pain during urination, or pelvic pain. Typical management involves antibiotics, painkillers, and lifestyle changes.
Prostate cancer happens when cancerous cells develop and multiply uncontrollably in the tissue of the prostate gland. It is one of the most common cancers among men in the UK. The initial stages of prostate cancer may go unnoticed as the changes are typically inside the prostate capsule, this means it is less likely to cause physical blockages or other noticeable urinary symptoms. If you have any family history of prostate cancer or other cancers in the family, you may be considered at a higher risk of prostate cancer. Understanding your health and baseline risk factors is the best way to decide when should you get prostate checked before physical symptoms start to affect your life.
In the UK there is no routine national screening programme for prostate cancer despite many recent movements to push for national screening using the PSA test. Let’s break down why this is.
The Prostate Specific Antigen (also known as PSA) test is a blood test to measure the concentration of a protein produced by prostate cells. Both normal and cancerous prostate cells produce this protein. A raised PSA result can suggest that the prostate gland is irritated, and it is true that this could be due to cancer, however it does not specifically confirm whether this prostate irritation is due to cancerous or non-cancerous reasons. Many things can irritate the prostate to cause a raised PSA score including: vigorous exercise, recent sexual intercourse, or benign prostatic enlargement. It is this lack of specificity that can lead to overdiagnosis and over-investigation with invasive tests such as biopsies or MRI scans. There is also the factor of causing anxiety about a condition that might never have caused harm.
| Benefits to the PSA test | Limitations of the PSA test |
| early warning signalcatch aggressive prostate cancer early which may mean suitability for potentially curative treatment | raised PSA does not mean it is cancer, this may lead to unnecessary anxiety and unnecessary medical investigationssometimes someone can have a normal PSA but also have prostate cancer |
Overall, age is the main culprit for changes to the prostate, hence men above 70 are most likely to experience changes to the prostate. There are also certain demographics that may be at higher risk of developing serious prostate conditions. For example:
For these more vulnerable groups, investigations for prostate conditions may be pushed forward with some clinical recommendations advising on discussion of testing from age 45.
If you have noticed changes in your urinary habits or have some of the risk factors discussed in this article, it is advised that you book an appointment with your GP to discuss this. To aid the consultation, keep a urine diary for a few days including how frequently you experience symptoms (e.g Erectile Dysfunction), how frequently you urinate, and how much fluid you drink. This can support the discussion with your doctor regarding next steps in management and protection of your long-term health.