If you’re 50 or older, it’s time to talk to your doctor about whether you should get a prostate exam. Sure, the idea of it can feel uncomfortable or even embarrassing. But avoiding it may mean missing the chance to detect prostate problems early — when treatment is most effective.
During a prostate exam, your doctor will manually check the prostate gland — a walnut-sized organ that surrounds the urethra — to look for signs of prostate cancer or enlargement. The exam is quick, straightforward, and often provides valuable information about your health.
Why a Prostate Exam Matters
The prostate exam is one of the most common ways to screen for prostate cancer and other prostate conditions. Prostate cancer is the second most common cancer in men, and while it often grows slowly, some types can spread aggressively. Detecting changes in the prostate before symptoms worsen can make a big difference in outcomes.
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A prostate exam isn’t just about cancer. It can also help diagnose benign prostatic hyperplasia (BPH), or an enlarged prostate, which is very common in men as they age.
Who Should Get a Prostate Exam?
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Men over 50: Most doctors recommend starting the conversation at this age.
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Black men: Because they face higher risks, they should consider a prostate exam beginning at age 45.
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Men with family history: If your father, brother, or another close relative has had prostate cancer, you may need to start even earlier.
Symptoms That Suggest You Need an Exam
Sometimes, the signs of prostate trouble show up before your annual check-up. If you’ve noticed any of the following, it may be time to ask about a prostate exam:
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Urgent or frequent need to urinate
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Weak or interrupted urine flow
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Trouble starting urination
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Dribbling or leaking
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Waking up often at night to urinate
These symptoms are common in men with an enlarged prostate but can also overlap with other prostate issues.
RELATED: Signs You May Have an Enlarged Prostate
The American Cancer Society’s Position on Prostate Exams
Not long ago, doctors recommended that every man over 50 get a yearly digital rectal exam (DRE). That has changed. Today, the American Cancer Society recommends individualized decisions. Instead of a blanket guideline, men are encouraged to discuss the prostate exam with their doctors and weigh the benefits and risks.
Why? Prostate cancer often grows slowly. In some cases, treatment may cause more problems than the disease itself. The key is deciding — with your doctor’s guidance — whether a prostate exam makes sense for you.
How to Prepare for a Prostate Exam
The prostate exam requires little preparation. Still, a few steps can help:
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Tell your doctor if you have hemorrhoids, anal fissures, or tears, since these may make the exam more uncomfortable.
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Avoid sex for 48 hours before your exam. Ejaculation can temporarily raise PSA (prostate-specific antigen) levels, which may affect results if you’re also having a PSA blood test.
What to Expect During the Exam
The digital rectal exam is quick, typically lasting less than a minute. Here’s what happens:
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Your doctor will ask you to bend over the table or lie on your side.
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Wearing gloves and using lubrication, your doctor will gently insert a finger into the rectum.
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They will check the prostate for size, shape, and texture.
A smooth, normal-sized prostate is usually a sign of good health. A lump, hard area, or overall enlargement may indicate the need for further testing.
The PSA Test: An Alternative to the Prostate Exam
While the prostate exam is useful, many doctors also recommend the PSA blood test. PSA is a protein produced by the prostate, and high levels can indicate cancer, BPH, or infection.
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Men over 50 are often advised to get annual PSA tests.
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High-risk men (Black men and those with family history) may need to start at age 40 or 45.
The PSA test is generally more effective than the digital rectal exam in detecting cancer, but many doctors use both together for a clearer picture.
RELATED: 8 Ways You Can Prevent Prostate Cancer
What If the Exam Finds a Lump?
Finding a lump during a prostate exam doesn’t automatically mean cancer. In fact, about half of all suspicious bumps turn out to be harmless.
If your prostate exam and PSA test suggest cancer may be present, your doctor will likely order a biopsy. A biopsy takes a small tissue sample for closer examination under a microscope — the only way to confirm whether cancer is present.
Bottom Line: Don’t Skip the Prostate Exam Conversation
The prostate exam may not be the highlight of your annual check-up, but it could be one of the most important. For some men, it offers peace of mind. For others, it’s the first step toward diagnosing a problem that might otherwise go unnoticed.
If you’re 50 or older — or 45 if you’re Black or have a family history of prostate cancer — ask your doctor whether a prostate exam is right for you. It only takes a minute, but it could have a lasting impact on your health.
