Men's Health
We men are a little uncomfortable with our genitals. Girls rock skirts sans undies (thanks, Britney), but most guys wouldn't dare don a kilt. R-rated movies showcase female pink parts, but they cover Borat's junk with a black rectangle. And while women have an entire area of medicine dedicated to the health of their private regions, if it wasn't for the hernia check, we men would hardly drop trou at the doctor's office.
The result? When it comes to caring for some of our most critical equipment—the stuff we need to, you know, keep our species going—we're virtually clueless. And that ain't good, because a lot can happen to a man's penis, testicles, and prostate: itchiness, infection, pain, bumps, sores, growths, rashes, burning, drooping, swelling, clogging, and, hell, cancer. If you're not paying attention, you can wind up sick, sterile, or dead. With a little knowledge, though, you can cut much of the bad stuff off at the pass.
Start here. These nine scenarios may make you wince, but at least you'll know what to do if they happen to you.
Agonizing pain in your scrotum
The cause: Assuming you weren't just kicked there, one of your testicles is probably twisted around something called the spermatic cord, cutting off the blood supply. "Think of a ball hanging on a rope," says Tony Makhlouf, M.D., Ph.D., a urologic surgeon at the University of Minnesota medical center. "As the rope turns, it bunches, and the ball rises." This knotting—testicular torsion, it's called—instantly causes a sharp pain.
The cure: Head to an ER. "If it isn't treated within four hours, you can lose a testicle," warns Larry Lipshultz, M.D., a professor of urology at Baylor College of Medicine. "Why take a chance?" The docs at the E.R. will do an ultrasound to assess whether your testicle and cord are indeed twisted. If that's the case, a urologic surgeon will be called to untangle things. Then he'll suture each testicle to the inside of your scrotum to prevent the torsion from happening again.
Agonizing pain in your guys
The cause: The coiled tube that carries sperm from your testicles has probably become inflamed due to a bacterial infection. The most common culprits are gonorrhea, chlamydia, and, in men over 40, a urinary-tract infection that migrated. The testicles themselves can also become inflamed.
The cure: Don't just pop some Advil and try to tough it out. "If you don't treat it, the tubes can become scarred and blocked," says Dr. Makhlouf. "You could become infertile." So see your doctor, who will probably prescribe at least two weeks on an oral antibiotic to tackle the bacteria. Swelling and pain should begin to lessen within three days, but it could take months for all symptoms to subside.
Pain when you pee or ejaculate
The cause: Chronic pelvic pain syndrome, usually resulting from an inflamed prostate gland. "It's a collection of symptoms that originates from an injury, often an infection, and the problems come from how the body responds to that infection," says Daniel Shoskes, M.D., a Cleveland Clinic urologist.
The cure: Two-thirds of men will get better with antibiotics in the early stages. For those whose inflammation persists beyond initial infection, Dr. Shoskes prescribes herbal-based bioflavonoid preparations, such as Prosta-Q and Q-Urol, which reduce inflammation. Flomax and other prescription agents that block an important receptor in the region also reduce pain and can improve urinary flow. Still other men suffer from nerve and muscle spasms, requiring muscle relaxants and physical therapy.
See a urologist in any case, but you can help your own cause by taking hot baths; by avoiding alcohol, spicy foods, and caffeine; and by using a doughnut-shaped cushion when sitting for long periods of time.
Your goodies look droopy
The cause: Sometimes the valves inside the veins of the scrotum don't close properly, so blood pools and they swell. The resulting bundle of enlarged veins, or varicoceles, doesn't always hurt, but the extra blood warms the testes. This jeopardizes sperm production (which requires temps cooler than 98.6°F) and causes the testicles to hang away from the body. About 20 percent of men will experience a varicocele at some point.
The cure: "If you notice you have low-hanging fruit, see a urologist who specializes in infertility," says Harry Fisch, M.D., director of the male reproductive center at New York Presbyterian Hospital and author of The Male Biological Clock. He or she can stop blood from pooling by tying off the veins or blocking them. It's minor outpatient surgery and you can have sex again in three weeks, although you should schedule a follow-up semen analysis in three to four months. In 60 percent of infertile men, semen quality will improve after surgery, says Dr. Fisch.
Even if you're not trying to conceive, he adds, the problem should be corrected if it's painful or creates a size discrepancy between testicles.
Your semen is red and drips out
The cause: When infections begin to heal, scar tissue can form and create a blockage in the ejaculatory duct. "It's like a five-lane highway becoming a two-lane highway," says Dr. Fisch. The red tint is blood from the initial infection. Your ejaculate volume may drop below the average of half a tablespoon and continue to dribble like an NBA point guard after you achieve orgasm.
The cure: You can function with a dribbly ejaculate, but it's kind of a buzz kill. Fortunately, there's a surgical solution. The formal term is "transurethral resection of the ejaculatory ducts," but it's simpler than it sounds. "We just scrape out the scar tissue, and that opens it all up," says Dr. Fisch. You can resume sexual activity in seven to 10 days.
It's hard to maintain an erection
The cause: According to the American Urological Association, about 25 percent of erectile-dysfunction cases are psychological, and it could be anything from relationship issues to performance anxiety. For example, a man may have a sexual experience after heavy drinking and fail to get it up. "In subsequent sexual attempts without alcohol, he'll remember that episode, think something's wrong with him, and be unable to perform," says Karen Boyle, M.D., director of reproductive medicine and surgery at the Johns Hopkins Brady Urological Institute.
The cure: Once physical factors have been ruled out, try seducing her after a romantic breakfast. Your testosterone levels peak around 7 a.m., so your hormones, and your penis, will be at full attention then. In many cases, such as the aforementioned alcohol scenario, a pharmaceutical option can also offer a helping hand. "A little added self-confidence—such as receiving some extra 'lift' from Viagra—goes a long way in this arena," says Andrew McCullough, M.D., director of sexual health and male fertility at the New York University medical center. If all else fails, seek counseling to address the underlying psychological issues.
There's a red rash in your groin
The cause: If it's on your thighs, it's often tinea cruris (a.k.a. jock itch), a fungus that thrives in warm, moist environments like, say, gym shorts that haven't been washed since the Clinton administration. If it's bright red and right on the penis, it may be a yeast infection, which can be passed from women to men through unprotected sex.
The cure: Preventionwise, shed damp gym clothes and shower immediately after exercising, and dry the area thoroughly before dressing. For treatment, an over-the-counter medication like Lotrimin can work wonders. "Continue using it for one to two weeks after the rash is gone to really knock it out and prevent it from coming back," says dermatologist Peter Kopelson, M.D., of the Kopelson Clinic, in Beverly Hills. For a yeast infection, try an over-the-counter antifungal cream, applying twice daily for a week.
Don't treat either condition with hydrocortisone cream. By suppressing your immune system, "hydrocortisone will actually make the fungus worse," says Dr. Kopelson.
You think you have an STD
The causes: Have cauliflower-shaped growths on your penis, a watery drip from your penis, painful blisters on your genitals, a thick yellow drip at times, reddish chancre sores on your genitals, and raised bumps on your groin? You have, in order, genital HPV, chlamydia, genital herpes, gonorrhea, syphilis, and molluscum. You haven't been wearing a condom, have you?
The cures: We're not here to lecture you on STDs, but there are a few new things you should know. First, the FDA is reviewing the efficacy of a genital-HPV vaccine, Gardasil, for men. Currently, guys can get the three-shot treatment for a little over $300, says Stephen Tyring, M.D., Ph.D., medical director of the Center for Clinical Studies, in Houston. His research team helped secure approval for the female version of the vaccine.
Second, according to a CDC study, 8.2 percent of men between the ages of 16 and 24 are infected with chlamydia, but only 2.4 percent of those men have symptoms. And research by the New York City department of health and mental hygiene found that one in eight women treated for chlamydia were reinfected within a year. The point? If your girlfriend has had chlamydia, you should be screened and treated to avoid possibly reinfecting her.
Third, "Molluscum [a viral infection] is the newest scourge we are seeing on campus," says Joel Schlessinger, M.D., president of the American Society of Cosmetic Dermatology and Aesthetic Surgery. "The [raised bumps are] very contagious, and although they carry little or no risk, they can be a nuisance and require several treatments to fully eradicate." Keep one eye open, college boy.
There's a bulge in your groin
The cause: You should have hired movers to lift that fridge. Inguinal hernias occur when part of the intestine protrudes through a congenitally weak abdominal wall. "It's often associated with a major straining episode," says Dr. Fisch, but a simple sneeze can set it off.
The cure: If it's small and doesn't bother you, no action may be needed. If it's growing or painful, lying down with your pelvis higher than your head can reduce the discomfort, but ultimately you'll need surgery. This will come in the form of either a herniorrhaphy, in which the edges of healthy tissue are sewn together, or the more modern hernioplasty, in which a piece of synthetic mesh is laparascopically inserted to cover the entire inguinal area. (A surgeon will recommend the option best suited to repair your particular type of abdominal-wall tear.) You'll be back to work within a few days.
Posted in: Men's Issue