You might shudder at the idea of a doctor’s gloved finger, yet a digital rectal exam (DRE) is over in less than a minute and can flag trouble you cannot see or feel. When you know what’s coming and why it matters, you stay in control of your health journey. A DRE lets your provider feel your rectum and prostate for hard spots, swelling, or bleeding. It’s still part of many check-ups before testosterone replacement therapy (TRT) because a healthy prostate is key to safe hormone care.
Below, you’ll learn exactly how the test works, what the latest science says, and whether you really need it.
Key Takeaways
- A digital rectal exam is a quick, in-office check where the provider uses a gloved, lubricated finger to assess the rectum, anus and, in men, the posterior surface of the prostate gland.
- Preparation is minimal: you undress from the waist down, assume a side-lying or bent-over position, and the procedure typically takes a minute; it may feel pressure but should not be painful.
- This exam helps investigate urinary changes, bowel habit shifts, rectal bleeding, prostate enlargement or firm masses, and may be paired with a PSA blood test when prostate health is a concern.
- A normal exam means no noticeable lumps, hardness or irregularities; abnormalities trigger further tests such as imaging, biopsy or referral to a specialist for evaluation.
- Despite its simplicity, a digital rectal exam has limitations—many early cancers and internal abnormalities cannot be felt—so it is best used alongside other screening and diagnostic tools.
Table of Contents
What Is a Digital Rectal Exam?
A digital rectal exam is a hands-on test in which your clinician gently inserts a lubricated, gloved index finger (“digit”) into your anus to check the lower rectum and, in men, the back of the prostate gland. The finger can feel for hard lumps, tender swelling, internal hemorrhoids, or hidden bleeding that might not show up on toilet paper. Most people describe the sensation as pressure, not pain, and it takes about 15–30 seconds. No prep, no fasting, laxatives, or enemas, is needed.
Why doctors still use it
- Early clues: Although magnetic resonance imaging (MRI) and prostate-specific antigen (PSA) blood tests have become more precise, a quick finger check can still catch large tumors or advanced hemorrhoids at the point of care.
- Low cost: A DRE needs no machines, so it’s accessible in almost any clinic.
- Immediate feedback: Your provider can tell you right away if something feels off.
Limitations you should know
Recent studies show a DRE alone misses many front-of-prostate cancers, leading UK experts to call for its removal from routine screening.In 2025, Prostate Cancer UK and BAUS echoed that stance, saying it offers “no useful role” unless symptoms point to a rectal or prostate issue. That doesn’t make the test worthless, it means it works best when paired with PSA, MRI, or biopsy, especially for high-risk patients.
The step-by-step
- You stand and lean forward, or lie on your side with knees bent.
- Your provider places lubricant on a gloved finger.
- The finger slides in slowly; you take a deep breath.
- They sweep in a circle, press gently on the prostate (if present), and withdraw.
- Any stool on the glove may be tested for hidden blood.
Side effects are rare. A brief urge to pass stool or, for men, a mild need to urinate can occur and fades quickly.
Digital Rectal Exam and Testosterone Replacement Therapy
Testosterone can make a silent prostate tumor grow faster, so major guidelines still advise checking the gland before and during TRT. The U.S. Department of Veterans Affairs’ 2025 criteria list a DRE plus PSA as baseline safeguards.
Before starting TRT
- Baseline snapshot: A normal DRE and PSA set a clean starting point.
- Shared decision making: You and your clinician can weigh the tiny chance of triggering cancer growth against the big benefits of restored energy, mood, and muscle.
During therapy
Many experts suggest repeating a DRE once a year or if new urinary symptoms appear (weak flow, night urination, or pelvic pain). While some groups question its value, pairing the exam with annual PSA keeps false reassurance low.
When you might skip it
- MRI-first protocols: If your clinic uses prostate MRI for every patient, a DRE may be optional.
- Prior prostate removal: No gland means no prostate cancer risk.
- Severe anal pain or fissures: Your doc may choose imaging or flexible scope instead.
Comfort tips
- Empty your bladder beforehand.
- Focus on slow belly breathing.
- Ask for a smaller finger or extra gel if you have hemorrhoids.
Red flags after TRT begins
Blood in urine, hard nodules felt during self-exam, or PSA rising faster than 0.75 ng/mL per year all warrant an urgent follow-up, even if last year’s DRE was normal.
A Small Step for Big Health: Digital Rectal Exam (DRE)
Frequently Asked Questions
It checks that your prostate feels normal so added testosterone won’t hide or speed up a cancer.
Most people feel brief pressure, not pain. Extra gel and slow entry reduce discomfort.
The finger is inside for 15–30 seconds; the whole visit lasts only a few minutes.
No. It can miss small tumors, so PSA and imaging are still needed.
No special prep—just use the restroom first if you like.
You’ll likely get a PSA test, prostate MRI, or biopsy to learn more.
Most clinics repeat it yearly, but your schedule can be personalized.
High-resolution MRI and PSA trends can reduce the need, yet they cost more and may not spot rectal issues.
People with severe anal pain, recent surgery, or certain infections may delay or use imaging instead.
Most plans pay when it’s tied to prostate screening or TRT monitoring; ask your provider’s billing team.
