The prostate may seem, at first blush, like one of those mysterious organs with little, if any, importance, like the appendix or the organ of Zuckerkandle. In point of fact,
however, this little nugget of a gland performs an important function related to the motility of your sperm and ultimately, your fertility. The prostate secretes a milky fluid that is slightly acidic in the ejaculate. The fluid consists of a number of components including citric acid (which gives it it's acidity) and enzymes, including the well-know, but oft misunderstood enzyme, PSA or Prostate Specific Antigen. Most of us know PSA as the prostate tumor marker but did you know that PSA is one of the enzymes that contribute to liquefaction of the semen. Liquefaction? That sounds bad right? Like running your semen through a Vitamix blender set to frappe. Actually, liquefaction is of vital importance when it comes to fertility. Liquefaction is necessary for semen to transition easily through the cervix on their way to the egg. Non-liquefaction of the semen can reduced sperm motility (asthenozoospermia for those scrabble players). Other causes of non-liquefaction include dehydration and infection.
Hormones Out of Control!
Like most other sex organs in the male, the prostate is under the control of testosterone. Testosterone, by itself, is largely inactive. It controls the growth and function of the prostate only after activation to its active form DHT. This conversion is facilitated by an enzyme called 5-alpha-reductase, a fairly generic enzyme that controls a number of mechanisms in both men and women. This enzyme is the target for the class of medications known as 5a-reductase inhibitors which include finasteride. Other medication works to block a different set of receptors called Alpha-adrenergic receptors which controls muscle reaction in the bladder and urethra. A popular alpha-receptor blocker is Tamsulosin or Flowmax. In a subsequent posts we will discuss the different medications available including how they work...and how they don't.
In the meantime, if you have any questions about BPH for you or a family member, call Comprehensive Integrated Care at 801-810-2999