What are the functions of the female prostate (Skene's glands)?

Functions of the Female Prostate (Skene's Glands)

The female prostate (Skene's glands) primarily functions to produce antimicrobial secretions that protect the urethra from infections and contribute to female sexual response through ejaculation during orgasm.

Anatomical Basis and Homology

• The female prostate consists of glandular tissue located below the bladder and surrounding the urethra, homologous to the male prostate 1
• First described by Reijnier de Graaf in 1672, this structure has been confirmed in humans and several other female mammals 1
• Anatomically similar to the ventral lobe of the male prostate, showing strong macroscopic and microscopic similarities 1

Primary Functions

1. Production of Antimicrobial Secretions

• The female prostate produces a viscous, white secretion that exits from the urethra upon sexual stimulation in some women 2
• This secretion likely serves a protective function against urinary tract infections (UTIs), particularly coitus-induced UTIs 2
• The antimicrobial properties may be due to components such as zinc and other compounds found in the secretion 2

2. Female Ejaculation

• Female ejaculation involves the secretion of a few milliliters of thick, milky fluid by the Skene's glands during orgasm 3
• This fluid contains prostate-specific antigen (PSA), distinguishing it from urine 3, 4
• Female ejaculate differs from urine in its composition, containing lower levels of creatinine but elevated levels of:
  • Prostate specific antigen (PSA)
  • Prostatic acidic phosphatase
  • Prostate specific acid phosphatase
  • Glucose 2, 4

3. Immunological Function

• The female prostate expresses PSA in specialized secretory cells, indicating both secretory and protective functions 5
• These cells have strong immunological properties due to the presence of PSA 5
• This suggests a role in local immune defense of the urogenital tract 5

Clinical Significance

• The female prostate is susceptible to various pathologies including cysts, hyperplasia, and carcinoma 1
• During gynecological examination, infection of the Skene's glands can present as erythematous areas lateral to the urethra 6
• When infected, applying finger pressure into the vagina and anteriorly may produce discharge from the ducts 6
• PSA can serve as a valuable marker for diagnosing and monitoring diseases of the female prostate, similar to its use in men 5

Distinguishing Female Sexual Fluids

• It's important to differentiate between different types of female sexual fluids:
  • Vaginal lubrication: Transvaginal transudate that enables lubrication
  • Female ejaculation: Secretion from the Skene's glands containing PSA
  • Squirting: Larger volume of diluted urine expelled through the urethra
  • Coital incontinence: Involuntary release of urine during penetration or orgasm 3

Evolutionary Perspective

The retention of prostatic tissue in females may have provided evolutionary advantages:

• Women who could ejaculate antimicrobial secretions were less likely to suffer UTIs
• Women without UTIs were potentially more receptive to frequent sexual activity
• Increased sexual activity could lead to higher pregnancy rates
• Higher pregnancy rates contributed to successful reproduction 2

The female prostate remains an important yet often overlooked structure in female reproductive and urinary health, with functions that extend beyond sexual response to include protective roles against infection.