The term “women” is appropriately used by different groups of individuals, each with an answer to the title question that is unique to that group. On supplement sites, topic pages such as Prostate 911 reviews are typically written by cis-gendered men. However, the genetic makeup of an individual’s sex chromosomes determines whether or not women should be concerned with prostate health.
Every fetus starts with rudimentary sex organs that are undifferentiated. Then, under the influence of a specific portion of the X chromosome, the prostate gland and other male-specific reproductive anatomy develop. If left alone, these tissues become Skene’s glands in the female reproductive system.
Important Terminology
The prefix “cis-” is Latin for” on this side.” Consequently, a cis-gendered person identifies with the sex assigned at birth. “Trans” is Latin for “across,” “on the other side of,” or “beyond.” A transgender individual identifies with the opposite sex assigned at birth. Non-binary or genderqueer are individuals who do not feel they fit neatly into either stereotypical “male” or “female” identity. The preferred pronoun used for non-binary individuals is “they” and “them” as a singular form.
When discussing sex hormones, “androgens” refers to all male hormones, including testosterone and dihydrotestosterone. Estrogen includes all estrogenic compounds as well. Production of these hormones is genetically programmed by
gametes.
Cisgendered Females (XX)
Embryonic tissue that develops into a prostate under androgen stimulation becomes two Skene’s glands in the female genitourinary tract without hormonal influence. They have also been called vestibular glands and paraurethral glands. Skene’s glands do not resemble a male prostate gland; however, surprisingly, they display some similar functions.
Skene’s glands are on either side of the urethra within the female vulvar vault. The glands make a filtered plasma liquid high in glucose and fructose. It also contains Prostate Specific Antigen (PSA) and prostatic acid phosphatase. The tissue surrounding the glands swells during sexual stimulation compressing the glands that then release the fluid, often during orgasm.
The Skene’s glands can express enough liquid that women have called it “female ejaculation.” Healthcare professionals postulated that the fluid lubricates the urethral meatus (opening) to protect it during intercourse. It also shows some antimicrobial action preventing germs from entering the urethra during intercourse.
A few things can go wrong with Skene’s glands, but cancer is not one of them. The glands, one or both, can become infected or blocked. Due to the numerous sensory nerves in the area, a Skene’s gland abscess, like a Bartholin’s cyst abscess, can be very painful.
The short answer is no; cis women do not need prostate health.
Transgender Women (XY)
The National Institute of Health reports a large study assessing the prostate cancer rates in male-to-female transition with androgen blockade and estrogen supplementation therapy. Researchers followed two thousand two hundred eighty-one trans women over 14 years.
The results revealed a much lower incidence of prostate cancer in trans women than in an age-adjusted male population. This study supports the supposition that suppressing androgens prevents the development of prostate cancer.
When surgeons perform gender reassignment surgery, the prostate gland is left behind. Because of its location in contact with the bladder and within a network of nerves that controls sensation and muscle to the pelvis, it is safer to let it remain. Studies that show a significantly lower risk of prostate cancer in trans women support that decision.
The short answer is yes, trans women need prostate health.
Turner Syndrome (XO)
Now and then, an egg develops with a single X chromosome. Or, there is some portion of the Y chromosome, but it lacks the region of the SRY gene. Without the coding from the SRY gene, the fetus will develop female genitalia.
A phenotypic female can have XY chromosomes but with a defective SRY gene. This can be the result of an SRY mutation. The missing or faulty gene never was able to initiate differentiation from the beginning. Consequently, the prostate gland never formed.
There is no prostate tissue developed in Turner syndrome. However, those with Y mosaicism are at risk for a germ-cell malignancy called gonadoblastoma. So, the short answer is no, Turner Syndrome women do not need prostate health. However, they have other concerns to address.
Klinefelter’s Syndrome (XXY)
Klinefelter’s Syndrome produces a feminized male phenotype. The addition of another X chromosome acts to suppress androgens. Male genitalia develops, but the testes and penis are small and produce little testosterone. Klinefelter’s men are usually infertile.
The lack of circulating androgens in Klinefelter’s results in the same suppression of prostate cancer seen with trans women taking androgen suppressants. Consequently, the short answer is yes, men with Klinefelter’s Syndrome need prostate health but are at lower risk.
Intersex (XX, XY, XX/YY, XXY/XX)
True hermaphroditism is rare, but there have been at least 1,000 documented cases. These individuals have both ovarian and testicular tissue that influence reproductive organogenesis. The majority of people with intersex have “ovotestes.” The structure contains both testicular and ovarian tissue. Ovotestes develop where ovaries typically would be found.
Several sex chromosome abnormalities can produce an intersex state. However, most are mosaics with few pure XX and few pure XY. Anecdotally, most intersex are raised as male, but not exclusively.
There is no short answer to whether intersex individuals need prostate health. It depends on the underlying genetics that produced the intersex state. The answer is yes if a Y-chromosome component allows prostate tissue to form. Again, the androgen suppression from the XX chromosomal influence minimizes the risk of prostate cancer.
Self Care
Women may not need “prostate health,” so to speak; however, they require routine female sex-linked evaluations. Following the medical recommendations concerning mammograms and PAP smears is no different than men’s periodic prostate evaluations with PSA levels.
The best medical outcomes result from cancer found early in the disease process. No matter prostate, breast, or cervix, routine screening saves lives. The importance of preventive medicine cannot be overstressed.
Ensuring your body receives what it needs to keep at peak performance includes screening for common sex and age-related conditions. Now is the time for prostate and total health for everyone.
