How to Self-Examine Your Prostate

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A medically-backed guide to finding symptoms of prostate cancer and other illnesses

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Checking Your Prostate at Home

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When to Get a Prostate Screening

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Expert Q&A

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Warnings

A digital rectal exam (DRE) is one of the primary methods a doctor uses to check your prostate for cancer and other illnesses. It involves the doctor briefly inserting a finger into your rectum to feel for potential abnormalities that may be symptoms associated with prostate cancer, benign prostate hyperplasia (an enlarged prostate), and prostatitis (an inflamed prostate usually from infection).^{[1]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source} Medical professionals do not recommend trying to perform a self-exam due to the training required to reach accurate conclusions. However, if you wish to administer your own exam, this guide will describe the techniques used by healthcare professionals, as well as indicators you may need a professional prostate exam or screening.

Things You Should Know

Lay on your side with your knees pulled into your chest. Then, put on a sterile latex glove, lubricate the index finger, and insert your finger gently into your rectum.
Locate the prostate against the rectal wall toward your belly button. Feel for tenderness, bumps, hardness, or inflammation that may indicate a problem.
Get a professional exam to confirm if there is a problem. Your provider will likely perform a DRE themselves and/or a prostate-specific antigen (PSA) blood test.

Method 1

Method 1 of 2:

Checking Your Prostate at Home

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1
Consider having your doctor do the exam for accuracy and safety.^{[2]XExpert SourceRobert Dhir, MD
Board Certified Urologist & Urological SurgeonExpert Interview. 23 September 2020.} Though it may seem relatively simple to perform, prostate exams require proper technique and the ability to understand what you are feeling for. Unless you’re a medical professional, you likely can’t accurately examine your own prostate.^{[3]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- Possible complications of self-examination include bleeding due to nail punctures of cysts or other masses. This can lead to infection or other complications, which would require a trip to your doctor regardless.
- In addition, if your self exam is abnormal and you seek advice from your doctor, they will most likely repeat the exam to confirm the results anyway.
2
Undress and lay on your left side with your knees pulled into your chest. If you must examine yourself at home, assuming this position provides the easiest access to your rectum for you or a partner. This is the same position a doctor would have you lie in if you were to schedule a prostate screening (or any other rectal exam).^{[4]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}
- Alternatively, stand leaning forward with your hips flexed if it’s uncomfortable to lie down.
- There is no preparation to be done before the exam. Some assume they may have to have or hold a bowel movement beforehand, but this isn’t necessary.
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Inspect the area around your bottom for any skin conditions.^{[5]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source} Use a hand mirror or ask a partner to check for external hemorrhoids, anal fissures, skin tags, warts, or discharge.^{[6]XResearch source} These conditions will make the self-exam more uncomfortable or even painful, and you may risk puncturing these growths or infecting them if the exam is not done with care.
- Note: If you encounter any of these conditions, strongly consider stopping your self-examination and scheduling a DRE with a medical professional.
4
Put on a sterile disposable glove or have your partner put one on.^{[7]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source} Wash your hands thoroughly before touching the glove to put it on to avoid spreading germs to the glove. Even though you’ll only use your index finger for the exam, your entire hand and all fingers should be covered.
- Closely trim your fingernails before washing your hands and putting on the glove if you have long or unkempt nails. Even through the latex, you can accidentally scrape the area or puncture a cyst or other mass.
Apply a liberal amount of the lubricant, making sure the index finger is coated all the way around and down to the knuckle.^{[8]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source} A lubricant such as Vaseline or KY Jelly will allow easier, less stressful penetration into the rectum.
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Feel the walls of your rectum for abnormalities. Slowly and gently insert your index finger into your rectum. Turn the finger in a circular motion to feel for any bumps or lumps that could indicate cancer, tumors, or cysts along the walls of your rectum, working from 6 o’clock to 12 o’clock in one direction, then in the other.^{[9]XResearch source}
- If no abnormalities are present, the walls should be smooth with a consistent shape.
- Use gentle pressure. It may feel uncomfortable, but you should not feel severe pain during insertion.
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Feel the wall of your rectum toward your belly button for your prostate. Your prostate lies above or in front of this portion of your rectal wall. Abnormal findings as you feel toward your prostate include firm, bumpy, non-smooth, enlarged, and/or tender areas.^{[10]XResearch source}
- A healthy prostate is about the size of a walnut. It should have a rubbery, soft feel with a slight groove in the middle separating it into left and right sections.^{[11]XResearch source}
- Firm or hard regions on the prostate, called nodules, or asymmetrically sized halves may be an indicator of cancer or other problems.
In a professional setting, the entire exam will take approximately 10 seconds or so. Once you’ve palpated the prostate for a few seconds to check for abnormalities, there’s no need to continue the exam as this can cause further discomfort or irritation.^{[12]XResearch sourceBickley, Lynn S. Techniques of Examination. Chapter 15 The anus, rectum and prostate. Bates Pocket Guide to Physical Examination and History Taking. sixth edition. P 262-264. © 2009 Wolters Kluwer Health- Lippincott Williams & Wilkins.} Dispose of the glove and wash your hands again immediately.
Make sure to visit with your doctor for further tests and discussion. If you feel like your exam showed abnormalities, then make an appointment with your doctor right away.^{[13]XExpert SourceRobert Dhir, MD
Board Certified Urologist & Urological SurgeonExpert Interview. 23 September 2020.} Remember to tell the physician that you administered a self exam if it’s been less than two days since this can result in an elevated PSA level on other tests.

Method 2

Method 2 of 2:

When to Get a Prostate Screening

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1
Schedule a prostate screening with your doctor if you’re age 50 or over. The American Cancer Society suggests a yearly prostate screening for all men age 50 and above. However, some circumstances and risk factors may warrant screenings at an earlier age. These include:
- Age 40 for men with more than one first-degree relative (son, brother, or father) who had prostate cancer before age 65.
- Age 45 for men with a single first-degree relative who had prostate cancer before age 65.
- Age 45 for African American men due to carrying a higher risk of prostate cancer.
2
Get an exam if you have any urinary symptoms caused by the prostate, like bloody urine. Problems associated with your bladder, urethra, and penis can all potentially have ties to prostate issues.^{[14]XExpert SourceRobert Dhir, MD
Board Certified Urologist & Urological SurgeonExpert Interview. 23 September 2020.} Due to the proximity of the prostate to these systems, it can grow and press against them, causing dysfunction. With prostate issues you may experience the following:^{[15]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- Slow or weak urine streams
- Difficulty urinating
- Frequent urination at night
- Burning urination
- Blood in your urine
- Difficulty getting an erection
- Painful ejaculation
- Lower back pain
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See your doctor quickly if you have any urinary symptoms. A variety of ailments may be responsible for your symptoms that a DRE alone cannot diagnose. A DRE is just one of several tests your doctor may use to determine the health of your prostate.^{[16]XExpert SourceRobert Dhir, MD
Board Certified Urologist & Urological SurgeonExpert Interview. 23 September 2020.}
- Your doctor may order a transrectal ultrasound (TRUS) to check for suspicious tissues inside of your rectum.
- A biopsy may also be necessary to confirm or rule out cancer.
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Request a prostate-specific antigen (PSA) test during your doctor's visit. Your doctor will order a laboratory blood test to check your PSA levels (a specific protein found in your prostate) in the event of prostate abnormalities or urinary symptoms. Typically, a PSA level of 4 ng/mL or lower is considered normal.^{[17]XResearch source}
- PSA levels can cause false positive or false negative results. The United States Preventive Task Force advises against prostate screening with PSA levels alone due to these risks.^{[18]XResearch source}
- Ejaculation (recent sexual activity), prostate infection, digital rectal examination (DRE), and bike riding (due to pressure on the prostate) can cause elevations of PSA. Those without prostate symptoms and elevated PSA may require repeat testing after two days.
- Repeat elevated PSA levels may warrant a DRE and/or a biopsy of the prostate (a needle inserted to take a piece of the prostate tissue for analysis) if symptoms are present.
- Men with a PSA of less than 2.5 ng/mL may only need to be retested every two years. Get screened yearly if your PSA level is 2.5 ng/mL or higher.^{[19]XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source}

Expert Q&A

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Question
What if there is blood in my semen?
Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.
Chris M. Matsko, MD
Family Medicine Physician
Expert Answer
Sometimes prostate cancer can cause blood in the semen. I would get checked out by an urologist.
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I have some blood in my urine, but the doctor checked it under a microscope and said it's not a big deal. He said to return in a year for another check up. Is my prostate okay?
Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.
Chris M. Matsko, MD
Family Medicine Physician
Expert Answer
Blood in the urine can be due to a number of different causes including kidney stones. Your doctor will conduct a digital rectal examination and get a PSA level to determine if there is need for further evaluation.
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Warnings

Note that cancer can occur even with normal results from both the PSA test and a DRE.
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Discuss your family history, age, and any symptoms with your healthcare provider so they can make an informed diagnosis regarding your prostate health.
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