Common Questions about the Male Anatomy

2014-07-28

Having “blue balls” is just a term for being sexually frustrated. Yet, if you ever have noticed any discoloration such as the testicles appearing to be a shade darker, accompanied by a low, dull pain, medical experts believe that the buildup of blood flow to the male sex organs puts pressure on the testicles if not released. Simple ejaculation can relieve the pressure. Having an erection for a long time could also make oxygen in the blood become absorbed in the genitals making the blood in that area appear bluish. However, this is not normal without say a penis ring or some other toy that restricts blood flow or when taking erectile dysfunction drugs such as Viagra. Blue balls is just one of the common questions lots of guys have about the male anatomy that they often never get answered, at least not in the medical sense. Another normal questions men often ask is how long it should take after having an orgasm to be able to perform again.  According to Weill Cornell Medical College urologist Richard K. Lee, M.D. “Unless you’re 14, you’re probably going to need at least an hour or two to become erect after ejaculating.” A man’s “latency period” can also be prolonged by alcohol intake or previous masturbation. If it takes far longer than a few hours, like days for the equipment to be active again, you should definitely bring the matter up with your physician.

Lots of guys wonder what the penis’s most sensitive area is. According to research out of Michigan State University, it depends whether or not you are circumcised. The small incision area on the underside of the head is the most sensitive place if you have been circumcised. For those that haven’t been, the entire head will be extremely sensitive. The head of an uncircumcised penis is covered in foreskin and so remains sensitive. However, a circumcised one comes into contact with your underwear and other substances making it less sensitive. Lastly, a lot of men want to know how much semen should be released when they ejaculate. Luckily, scientists have an answer. It should be somewhere between 1.5 to 5 cubic centimeters or around one fifth of an ounce. If the amount of semen you are ejaculating seems rather small by comparison, try to space out your orgasms says Dr. Lee. A man’s testosterone level plays a role in semen production as well. As men grow older their testosterone level drops mildly over many years. This is a natural phenomenon. But it often reduces the amount of semen produced and therefore ejaculated after sexual intercourse. Some men are suspect about this phenomenon but it’s a normal, natural occurrence. However, if you do experience significantly less ejaculate after your orgasms and the drop is precipitous, you should consult a physician or your urologist about it.

Syphilis is on the Rise

The rate of syphilis today is on the rise, being twice that of what it was at its lowest point in the U.S. in the year 2000. Mainly the rise is among men who have sex with men (MSM) bisexual and gay men, while the rates continue to plummet for all other groups. Johns Hopkins University School of Medicine professor Jonathan Zenilman, MD told MedPage Today, “Syphilis has gone from being a disease of heterosexual inner-city folks (prostitutes and their clients, for instance) to primarily a disease of gay men.” There are many important factors to consider here. First, these men generally tend to have a lot of partners. They have unprotected or riskier sex more often and there are a large number of members in this community that are HIV positive. This isn’t exactly a phenomenon without precedent. In fact, we saw a rise in syphilis in the MSM community before, in the free-wheeling 70’s. HIV/AIDS was what put the kibosh on that, and made gay and bisexual men limit the number of partners and take part in protected and less risky sex. The fear of contracting HIV helped and the precautions that ensued helped to decrease the rates of other sexually transmitted diseases. But today the CDC says syphilis has made an impressive comeback. Today the rate is 5.3 cases per 100,000 people, double the rate it was in 2000 when the rate was 2.1 cases per 100,000. Men attributed 91% to the rise in syphilis between 2005 and 2013, with men ages 20 to 24 years old playing a key role.

According to Dr. Zenilman, “When a sexually transmitted disease starts rising, there are three central questions to be asked. Did the bug change? Did the people change? And was there a public health management or structural change?” Gonorrhea evolved, making it antibiotic resistant to many but for a few drugs. But Syphilis hasn’t changed and the treatment remains the same, a single shot of Benzathine penicillin G, and three shots for a secondary case. Syphilis takes two to three weeks to develop after the initial infection. According to Zenilman there’s no reason to be alarmed as “you can pretty much control an epidemic.” But what has changed is society. With the advent of social media it’s easier for those in the MSM community to find each other and have anonymous sex. The fear of HIV contraction has decreased and so gay and bisexual men are having riskier sex than they once did. In San Francisco for instance, HIV testing is routine, it’s become part of the culture. But there’s still a stigma attached to syphilis. Doctors recommend being tested every three to six months for the disease for someone who is MSM. There are many men today who with social media, dating apps and websites meet partners with ease. So they may not have all the information to let someone know about a problem or an issue that may affect their health. San Francisco Department of Public Health has been using AOL chat rooms and other means to let the anonymous sexual partners of infected people know that they need to get tested.

Those Over 60 are Still Sexually Active

2014-07-22

Britain’s TV network Channel 4 recently conducted a study that claims that those over 60 years of age are still sexually active and this study may reveal a phenomenon also happening on this side of the pond. This was true no matter their sexual orientation. It may run against conventional wisdom but in fact, those who conducted the study claimed that these folks in their 60’s and 70’s were experiencing a sexual Renaissance. 500 Britains over age 60 were polled and 76 participants were interviewed in-depth. The results of this study will be a show on Channel 4 called the “Secret Sex Lives of Parents and Grandparents.” 51% of those polled were still active sexually, with many of these experiencing a rebirth in that area of their lives. Vikki, 70, was quoted in saying, “I can say that sometimes in the street I think ‘oh yeah, that would be a nice person to go to bed with.’” A gay man, Joey, 69, from London said of his sex life and the reason why he decided to rekindle it, “I got to a point where I thought I’m going to kick the bucket fairly soon.” So he decided to get on the casual encounters app Grindr. “I’m averaging, I would say, four men a week,” he told the Channel 4 program. Though they themselves may feel sexually liberated, this age group doesn’t find society approving of it.

Many women feel that they can’t be seen as sexual beings after menopause. 67-year-old Margaret told the program, “We still feel as though we have a right to be a sexual being as well as everything else. We’re not just grannies. I’m not anyway! Younger people nowadays must think ‘oh god, that’s gross, you know, granny’s at it.”‘ Peter in his 70’s at that time, and Stella met online and got married—a story that is becoming less and less unusual for this age group. After years of abstinence Peter found it a bit nerve wracking to try again. He explains, “I can remember sitting on the sofa with Stella and discussing this and saying well I really don’t know whether anything works anymore. So we decided to find out basically.” Just like with every other age group, the internet has made dating and hooking up much easier. But as a result, just like in other age groups the age 50-90 year old set is seeing an increase in sexually transmitted diseases, a rate that has doubled in a decade. According to sexual health nurse consultant Justin Gaffney, “There is a degree of naivety in the older population in that they just don’t see that they are at risk of sexual infections.” In fact, as they age older people become more susceptible to STDs. Another problem, older people may be less educated as they younger compatriots about sex. One problem Gaffney explains is that he has seen cases where older people have used common household items; cooking oil, shampoo and hand cream as lube. However, these can cause rashes or even be damaging to such sensitive areas. According to Gaffney, “There does need to be perhaps a focus on trying to make services more older people-friendly.”

Exercises that Boost the Libido

2014-07-17

Commercials don the airwaves about ED drugs and articles fill websites and newspapers about ways to boost the libido, but there are exercises that can do so, and without any harmful side effects. If you want a stronger sex drive, work an exercise regimen into your weekly routine. Doctors say about a half hour a day five days per week will keep you in tip-top shape. For those men who do take medication for erectile dysfunction, exercise is often recommended in tandem with the medicine. In one study, men who exercised after receiving hormone therapy to treat prostate cancer were far more likely to enjoy sexual activity than those who were not active. What’s more, losing weight can really help boost the libido. Many doctors and urologists say lifestyle changes such as eating a healthy diet, getting plenty of exercise, sleeping an adequate amount and controlling stress can turn ED around. Extra fat, particularly around the abdomen, absorbs testosterone. What’s more, it tells the brain to stop producing the sex hormone. But losing weight helps release more testosterone into the blood stream. Testosterone is not only the male sex hormone, it is linked with desire. One study suggests stretching and deep breathing could also improve the libido. In this study, 80 male participants were split into two groups. Those that took part in stretching and deep breathing exercises enjoyed stronger sexual desire.

Kegels or pelvic floor exercises aren’t just for women anymore. They can increase the male sexual experience as well. Kegels strengthen the muscles of the pelvic floor, the muscles of the lower abdomen which control the bladder and the rectum as well. Kegel exercises were once only used to help women in labor. Now they also strengthen the lower muscles for both men and women in order to experience greater sexual pleasure. Those men who have had a prostatectomy can use Kegel exercises to regain control of the muscles down there again and help restore sexual function. There are many articles and videos on how to do them online. You can practice them in traffic, in meetings, or anywhere and no one will ever know. Do you get enough sunlight? Not only does ten minutes a day in the sun create enough vitamin D in your body for the day, it also increases neurotransmitter production, alertness, and increases your energy level. Daily sunlight exposure, exercise and the proper amount of dietary protein have been determined to be as effective as medical treatments according to some studies. Remember that the biggest erogenous zone is the mind. So relieve yourself of stress in healthy ways such as getting exercise. Anxiety and depression are emotional issues that can sink your libido. Find natural, healthy ways to relieve these and give your libido a boost. Some calming exercises like yoga for instance can help.

ED and Statins

20% of men in their 40’s suffer from erectile dysfunction (ED), making it far more common than you think. An unhealthy lifestyle can certainly cause ED. Oftentimes ED comes on occasionally or mildly and a man will experience if from time to time. Most men don’t discuss this issue with their friends or others for support due to embarrassment. But it is actually quite common at this age. There are those men who fail to bring up the issue with their doctor either. But this is a huge mistake. ED can be an early warning sign of another, deeper issue. Heart disease, hypertension, smoking, diabetes and dyslipidemia can all be underlying and far more serious, even life threatening issues that may be causing ED. Two main arteries run across the side of the penis supplying it with blood which in turn create an erection. These are thinner than the coronary arteries or those of the heart. So it makes sense that these arteries would be occluded meaning strained due to plaque buildup way before the coronary arteries in the heart. Oftentimes urologists actually use the severity of ED to see how bad the development of heart disease has gotten, called schemic heart disease. There are lots of factors that contribute such as an unhealthy diet, a sedentary lifestyle and a lack of exercise.

If you are experiencing this problem and it is determined that an early onset of heart disease is the cause, your doctor may prescribe a statin. These are medicines that lower a person’s bad cholesterol level thereby limiting the fatty deposits or plaque that buildup in the arteries. Statins are very effective in controlling one’s cholesterol level. According to the National Institute for Health and Care Excellence (NICE), 10% of those who risk a heart attack within the next ten years should be put on a statin. Most physicians believe statins have minor to moderate side effects though a recent study in the British Medical Journal found that 20% of harmful side effects occur due to the overuse of statins. Insomnia, nausea, fatigue and muscle aches are the most common side effects. The advantages of using this medication though far outweigh the drawbacks according to most physicians. There are varying reports as to whether ED is alleviated or made worse through the use of statins. Many patients say they experience ED after taking a statin for a week. Another report found that statins improved the hardness of an erection by 30%. There are erectile dysfunction medications available for those who experience ED on a statin.Regular exercise, losing weight, a healthy diet and taking care of your emotional and psychological health can help combat or even alleviate ED as well.

First Ever Premature Ejaculation Medication

Premature ejaculation (PE) is a common male sexual dysfunction. This can be defined as ejaculation soon after penetration during intercourse leading to a lack of sexual fulfillment on the part of one or both parties. PE can severely hurt a man’s self-esteem, relationship and decrease his quality of life significantly. It can be caused by psychological factors such as performance anxiety. There are also physical factors that may cause it. Or it can be a combination of the two. It can also be caused by physiological problems. Serotonin, the neurotransmitter often thought of as responsible for happiness and a sense of well-being, is also a chemical messenger carrying messages across the central nervous system. Messages can make it across synapses or the gaps between nerve cells known as neurons due to this neurotransmitter. Research has shown that having adequate serotonin in the body delays ejaculation. Patients who suffer from premature ejaculation have low levels of serotonin. Dapoxetine is a new medication, the first ever developed to conquer premature ejaculation. Dapoxetine increases serotonin in the synapses helping to alleviate the symptoms of PE. Men with PE between the ages of 18 and 64 can take dapoxetine. This isn’t a medication you take all of the time. Instead it is what is called “dose on demand.” You take it as needed. It should be taken one to three hours before partaking in sexual activity.

This drug has been proven to work on the initial dose. 6,000 men have taken it and it is now available in 50 countries around the world. The drug doesn’t accumulate in the body. Instead it dissipates quickly. If you are experiencing PE talk to your doctor or urologist.  Physicians use the Premature Ejaculation Diagnostic Tool (PEDT), a questionnaire consisting of five questions to help diagnose PE and recommend the proper treatment. Don’t just rely on a doctor or specialist. Take control of your own health and condition. Think about whether or not you think the root of the problem may be psychological or physiological. Understand that there are also other things you can do to help control PE. Kegel pelvic floor exercises, once the realm of helping women give birth and recover from birth, are also recommended for men with PE or that experience urinary incontinence. The strengthening of this muscle and controlling it can help stave off orgasm. There are numbing agents, creams, gels and special condoms that you can use to help make you last longer. Make sure to follow the directions carefully or else you may be numbing your partner as well. If the issue is psychological, counseling may help. Depression, anxiety and stress can all lead to PE. Using other sexual techniques or switching up your sexual repertoire may also help.

The Medical Tests Every Man Needs

2014-07-15

By Amanda MacMillan
Photo by Getty Images

Admit it, guys: You don’t even like going to the doctor when there’s something wrong, let alone for preventative check-ups. But being proactive about your health—by getting recommended screenings for serious conditions and diseases—could mean you’ll spend less time at the doctor’s office down the road.

Depending on age, family history, and lifestyle factors, people need different tests at different times in their lives. Here’s a good overview for all men to keep in mind.

Diabetes

You may never need a screening for diabetes if you maintain a healthy weight and have no other risk factors for the disease (such as high cholesterol or high blood pressure). But for most men over 45—especially overweight men—a fasting plasma glucose test, or an A1C test, is a good idea, says Kevin Polsley, MD, assistant professor of internal medicine at Loyola University Health System in Chicago.

The U.S. Department of Health and Human Services also recommends diabetes screenings for overweight adults younger than 45 who have a family history of the disease, or who are of African American, Asian American, Latino, Native American, or Pacific Islander descent.

Fasting plasma glucose and A1C are both blood tests that should be done in your doctor’s office. The A1C test does not require fasting beforehand, but if your doctor wants to test you using fasting plasma glucose, you will be asked not to eat or drink anything but water for eight hours beforehand.

Sexually Transmitted Infections

Even if you’ve been in a monogamous relationship for years, it’s not a bad idea to get tested if you haven’t already done so. Many common sexually transmitted infections can go undiagnosed for years. For example, people can go as long as 10 years without showing symptoms of HIV. The U.S. Preventive Services Task Force recommends that everyone ages 15 to 65 be screened for HIV at least once. This is especially important, Dr. Polsley says, if you have had unprotected sex, used injected drugs, or had a blood transfusion between 1978 and 1985.

In addition, the Centers for Disease Control and Prevention recommends a one-time hepatitis C screening for all adults born between 1945 and 1965, regardless of risk factors. “Believe it or not, there’s a lot of hepatitis C cases out there in which people either don’t have symptoms yet or don’t know what’s causing their symptoms,” says Dr. Polsley. “Screening for STIs is something I offer as routine at just about every physical, regardless of a patient’s age or health history.”

Body Mass Index

You don’t need to make an appointment to figure out your body mass index, a measure of body fat based on your height and weight. Regardless of whether you calculate this stat yourself or your physician does the math for you, it’s important to be aware of this number, says Dr. Polsley.

A BMI between 18.5 and 24.9 is considered normal weight. Although this calculation isn’t perfect—and can sometimes label healthy people as overweight or vice versa—most doctors agree that it’s still an important component of assessing overall health. “It can be a very good opportunity to discuss diet and exercise, and to show our patients how important these things are,” Dr. Polsley says.

Cholesterol 

The American Heart Association recommends men have their cholesterol levels tested every four to six years once they turn 20. “Men have an overall higher risk for cardiovascular disease than women, and high cholesterol is often a big part of that,” Dr. Polsley says. But your doctor may want to screen you earlier (and more often) if you have heart disease risk factors such as diabetes, tobacco use, or high blood pressure.

Cholesterol is measured by a blood test, and your doctor may ask you not to eat for 9 to 12 hours beforehand. Generally, a cholesterol test will measure your levels of total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol, and triglycerides. Depending on your results, your doctor may make dietary recommendations or prescribe a cholesterol-lowering medication like a statin.

Blood Pressure

Like high cholesterol, high blood pressure is often a symptomless condition—but luckily, the test for hypertension is quick and painless, involving a rubber cuff that squeezes the arm and measures the flow of blood through a large artery in the bicep. “You should have your blood pressure checked pretty much every time you see your doctor,” says Dr. Polsley, starting at age 18.

Don’t get to the doc often? Have it checked at least every two years, or yearly if your numbers were previously considered borderline (a top “systolic” number above 120 or bottom “diastolic” number higher than 80).

You can check your blood pressure at health fairs, in pharmacies, or at home with a monitoring device. If your systolic pressure cracks 130 or your diastolic goes over 85, your doctor may recommend lifestyle modifications—like exercising more and eating less salt—or they might prescribe medication.

Colonoscopy 

Most men should be screened for colon cancer beginning at age 50, but those with a family history of the disease may benefit from earlier testing. Men and women alike tend to dread this test—in which a small camera is inserted into the anus and explores the large intestine for polyps or other signs of cancer—but Dr. Polsley says it’s not as bad as it sounds.

“The preparation for the test is actually the worst part,” he says: You’ll need to empty your bowels completely before the exam, which may involve not eating solid foods for one to three days, drinking lots of clear liquids, or taking laxatives. “The actual colonoscopy shouldn’t be too uncomfortable, because you’re sedated through the whole thing.”

But here’s the bright side: If your doctor doesn’t find anything suspicious, you won’t need another colonoscopy for up to 10 years.

Prostate Exam

Screening for prostate cancer is more controversial than for other cancers, says Dr. Polsley, and some studies have shown that these tests can be expensive and unnecessary, and may do more harm than good. But he suggests that all men over 50 at least talk with their doctors about the pros and cons of these tests—usually either a digital rectal exam (in which the doctor inserts a gloved finger, or digit, into the rectum to feel for lumps and abnormalities) and a PSA test, which measures a protein called prostate-specific antigen in the blood.

Prostate cancer screenings can and do save lives, but they may also result in false-positive or false-negative results. And because many cases of prostate cancer progress very slowly, some men (especially older men) don’t benefit from aggressive treatment. Whether you decide to get screened for prostate cancer should be a decision you make with your doctor, says Dr. Polsley. In the meantime, it’s important to know the symptoms of an enlarged prostate—like having to urinate frequently or having trouble urinating—which could also signal cancer.