Readers of a certain age will recall that present in almost every physician’s office from the 1950s to 1980s were back issues of the monthly Reader’s Digest, a compendium of condensed literature and non-fiction, including a semi-regular feature on human anatomy and physiology, “I Am Joe’s ___” or “I Am Jane’s ___,” with the relevant body part or system filling in the blank.

It’s time to update the tactfully euphemistic “I Am Joe’s Man Gland” for a queer male readership, particularly because the prostate occupies a special place in men’s sexual lore and practice.

Nestled between the rectum and the bladder, this walnut-size organ produces the fluid that carries sperm (produced in the testes), and its smooth muscles squeeze during orgasm to ejaculate the seminal fluid.

Infamously, the prostate is also susceptible to cancer, but typically it is a slow-growing cancer. Most men, if they live long enough, will develop a prostate cancer that is usually managed with watchful waiting. We usually die from other conditions.

Bad news and good news for gay men: While according to one 2011 study gay men are twice as likely to be diagnosed with cancer, we are significantly less likely to be diagnosed with prostate cancer (Boehmer, Miao, & Ozonoff, 2011).

Other prostate problems are more benign. A slightly enlarged prostate (known by the medical term benign prostatic hyperplasia, or BPH), normally accompanying aging, may cause some inconvenience. According to the National Library of Medicine’s Medline Plus:

Less than half of all men with BPH have symptoms of the disease. Symptoms may include:

• Dribbling at the end of urinating

• Inability to urinate (urinary retention)

• Incomplete emptying of your bladder

• Incontinence

• Needing to urinate two or more times per night

• Pain with urination or bloody urine (these may indicate infection)

• Slowed or delayed start of the urinary stream

• Straining to urinate

• Strong and sudden urge to urinate

• Weak urine stream (National Library of Medicine, 2013).

The wise patient, however, will bring up these symptoms with his primary care provider in order to rule out other more serious problems.

Prostatitis, an inflammation of the prostate, may be the product of an infection or other cause and is usually temporary. Some men find prostate massage a source of sexual pleasure. Whether it can also bestow a health benefit for men with chronic prostatitis is still not clear; Shoskes and Zeitlin (1999) found a benefit to a combine antibiotic and massage therapy, but more recently Ateya et al. (2005) could not find a significantly improved response and recommended antibiotics only. Prostate massage, moreover, may entail some risk if done too vigorously, and one risks tearing the delicate wall of the rectum.

A variety of anal probes designed to stimulate the prostate are commercially available as sex toys. Paradoxically, product web sites consulted for this article all provided disclaimers waiving the manufacturers from liability from harm in their use, with one announcing “not for internal use.”

Harvard Medical School (2011) provides advice on exercise and diet for prostate health, with benefits for cancer and prostatitis risk reduction.

In addition, some women and men find helpful exercises to strengthen the pelvic floor muscles,  the so-called Kegel exercises, both to strengthen urinary continence and for sexual pleasure (Mayo, 2012).

In conclusion, remember: A healthy prostate is a happy prostate.

References

Ateya, A., et al. (2005). Evaluation of prostatic massage in treatment of chronic prostatitis. Urology, 67, 674-678. doi:10.1016/j.urology.2005.10.021

Boehmer, U., Miao, X., & Ozonoff, A. (2011). Cancer survivorship and sexual orientation. Cancer, 117, 3796-3804.

Harvard Medical School. (2011, October 4). 10 diet & exercise tips for prostate health. Harvard Health Publications. http://www.health.harvard.edu/healthbeat/10-diet-and-exercise-tips-for-prostate-health

Mayo Clinic. (2012, September 25). Kegel exercises for men can help improve bladder control and possibly improve sexual performance: Here’s a guide to doing Kegel exercises correctly. Healthy Lifestyle: Men’s health. http://www.mayoclinic.org/kegel-exercises-for-men/ART-20045074?p=1

National Library of Medicine. (2013). Enlarged prostate. Medline Plus. http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm

Shoskes, D. A., & Zeitlin, S. I. (1999). Use of prostatic massage in combination with antibiotics in the treatment of chronic prostatitis. Prostate Cancer and Prostatic Diseases, 2(3), 159-162. doi:10.1038/sj.pcan.4500308