Prostate Function: What Does This Thing Actually Do?
The prostate is a glandular organ whose primary job is to create and control fluids related to semen and ejaculation. It also works as a valve system to help with bladder control by keeping urine where it is supposed to be. Finally, the prostate helps modify the testosterone that our testicles make into a form that greatly impacts prostate growth/function, body hair growth, skin health, and has some impact on erectile function and mood. While the prostate doesn’t have a direct role in erections, if you have prostate surgery, erectile dysfunction can also be affected. While the prostate plays interesting and important roles, it is also possible to continue living a big, full life without one.
The Small Organ Doing Big Work
When is the last time you thought about your- Nevermind, we all know the last time you thought about your prostate was likely never unless you are in the middle of some health concerns. While we utilize its functions multiple times a day, we really never have to think about what the prostate does, why we have it/need it, or how we can live without it. This complex, walnut-sized organ has some interesting and helpful properties we often take for granted.
Prostate Function #1: Fluid Production, Mixing, and Transport
The prostate gland is primarily that - a gland - which makes and secretes fluid. While the prostate only makes one specific fluid (ie. prostate or prostatic fluid) this element is pretty important. Prostate fluid contains Prostate-Specific Antigen (aka: PSA), which is a little protein enzyme (imagine a little Pac-Man) whose job it is to make ejaculatory fluid/semen more slippery so that sperm can swim.
Note: PSA generally stays in the prostate and urethra before being expelled from the body during ejaculation - so why is it detected in a blood sample? Detectable levels of PSA are found in the blood only if the walls of the cells of the prostate are damaged such as by blunt trauma, cancer, or inflammation. If the walls are damaged, PSA can leak out and be absorbed into the bloodstream for recycling.
The prostate also plays an important role in ushering sperm and seminal fluid (produced in the testes and stored in the seminal vesicles) into the urethra via the ejaculatory ducts. Signals from the nerves in and around the prostate tell the seminal vesicles when to contract in order to release their stores into the ducts, which transport the sperm and fluid through the prostate to the urethra.
Prostate Function #2: Multifunction Valve System
There are two main valves that help both urine and ejaculatory fluid go where they should, when they should:
The upper prostate (contiguous with the bladder) contains the Internal Urethral Sphincter (IUS). The IUS is an involuntary smooth muscle that is closed when the body is in urine storing mode, but slowly opens to transition into urine emptying mode depending on bladder fullness signals. The IUS will also be reflexively closed during orgasm and ejaculation in order to keep semen from entering the bladder; in a sort of visa-versa way muscles within the prostate contract to prevent urine from entering the seminal ducts (insert “you shall not pass” meme here).
The lower prostate is covered in layers of voluntary, skeletal muscle from the External Urethral Sphincter (EUS). Imagine a funnel shape where the upper part is the EUS around the lower prostate and the tube of the funnel surrounds the urethra that extends out of the prostate heading for the penis. You control this muscle; squeezing it to keep urine in until the right time.
Prostate Function #3: Testosterone Modification/Metabolism
Testosterone could be considered the major hormone for building and maintaining men’s structure and health. The majority of testosterone is produced by the testicles, but the body relies on the prostate to convert testosterone into high-octane, superpowered Dihydrotestosterone (DHT). DHT plays a major role in hair growth/loss, skin health, prostate function and growth, and plays more modest roles in erection quality and emotional regulation/attitude.
Note: Without DHT (if your prostate is removed) our bodies will not lose muscle mass, bone density, change vocal pitch, or “turn soft” - as these features are supported by good ‘ol regular testosterone whose production is unchanged if we aren’t converting T->DHT.
Erections: Not Directly A Prostate Function
While the prostate is the manufacturing and production facility for a lot of the stuff we expel when we have an erection, the organ itself does not control erections. So why is erectile function nearly always compromised after a prostate surgery?
The microscopic Cavernous Nerves that control muscular and vascular aspects of erectile function are layered along the outside of the prostate. If the nerves are able to be saved (nerve sparing surgery) they are effectively “stunned” hard and can take several months to get back to functional status. If cancer has spread to the outer layers of the prostate the surgeon will not be able to spare the nerves in order to keep survival odds as high as possible.
So, it is the close proximity of the nerves and the prostate that affect erectile function after prostate surgery, even though the prostate doesn’t directly manage erections.
What happens if the prostate is affected?
While you may have spent most of your years and decades benefitting from the prostate, you probably never knew any or all of the things it was doing. But, if you live long enough, the chances are high that you will eventually have some sort of issue with your prostate including BPH or cancer. If you found this blog because you are in that stage, I’m sorry to hear that. However, I want you to know that it is absolutely possible to have a full and exciting life, even without a prostate. Some functions are not absolutely necessary, some functions can recover with time, and some things may need a dedicated plan to overcome.
Get Help With Your Prostate Issues or Treatment Side Effects
While it is possible to have a fulfilling life even with prostate concerns, sometimes you need some extra support. Dr. Nathan Gilpin is a men’s health expert dedicated to helping men navigate pelvic health issues and effects of treatment. Get the answer you are looking for and a personalized game plan so you can stop your endless scrolling and get the best, most direct advice.
The Professor’s Legal Note: The information provided in this educational article—including diagrams, movement analogies, and habit suggestions—is for general informational and educational purposes only. Prostate Prof LLC does not provide medical advice, clinical diagnosis, prognosis, or physical therapy treatment plans through this website. Reading this content does not establish a provider-patient relationship. Always consult your urologist, surgical team, or primary physician before starting any progressive pelvic exercises or hardware protocols. By using this website, you explicitly agree to our full Terms of Service, Privacy Policy, and Liability Waiver.
