What affects penile health?
Various factors can affect the health of the penis — some of them can be changed and some not. For example:
- Unprotected sex. You can contract a sexually transmitted infection if you have unprotected sex.
- Heart disease and diabetes. Restricted blood flow caused by diabetes and atherosclerosis — hardening of the arteries — can cause erectile dysfunction.
- Certain medications and treatments. Certain medications and treatments can affect your penis. For example, surgical removal of the prostate gland (radical prostatectomy) and surrounding tissue as a treatment for prostate cancer might cause urinary incontinence and erectile dysfunction.
- Smoking. Smoking doubles your risk of erectile dysfunction.
- Hormone levels. Hormone imbalances, such as testosterone deficiency or too much of the hormone prolactin, have been linked to erectile dysfunction.
- Psychological problems. Depression can cause a loss of libido. Likewise, if you experience an erection problem, you might be concerned that it’ll happen again — causing anxiety or depression. This can compound the problem and lead to impotence. Trauma — such as child abuse — can lead to pain associated with sex.
- Neurological conditions. Stroke, spinal cord, and back injuries, multiple sclerosis and dementia can affect the transfer of nerve impulses from the brain to the penis, causing erectile dysfunction.
- Getting older. Testosterone levels decline normally as you age. This might lead to a decrease in sexual interest, a need for more stimulation to achieve and maintain an erection, a less forceful ejaculation and a need for more time before you can achieve another erection.
- Aggressive or acrobatic sex or masturbation. If your penis is bent suddenly or forcefully while erect, the trauma might cause a penis fracture. Penis fractures are rare but can happen.
What are the signs of penis problem?
Consult your doctor as soon as possible if you have:
- Changes in the way you ejaculate
- Bleeding during urination or ejaculation
- Warts, bumps, lesions or a rash on your penis or in your genital area
- A severely bent penis or curvature that causes pain or interferes with sexual activity
- A burning sensation when you urinate or an urge to urinate when your bladder is nearly empty
- Severe pain after trauma to your penis
What can I do to keep my penis healthy?
You can take steps to protect your penis health and overall health. For example:
- Be sexually responsible. Practice safe sex by using condoms or maintain a mutually monogamous relationship with a partner who has been tested and is free of sexually transmitted infections.
- Get vaccinated. If you’re aged 26 or younger, consider the human papillomavirus (HPV) vaccine to help prevent genital warts. Even though symptoms may not show you can still transmit the virus and HPV can cause cervical cancer in women.
- Stay physically active. Moderate physical activity can significantly reduce your risk of erectile dysfunction.
- Practice good hygiene. Always wash your genital area. If you’re not circumcised, regularly clean beneath your foreskin with soap and water.
- Know your medications. Discuss medication use and possible side effects with your doctor.
- Pay attention to your mental health. Seek treatment for depression and other mental health conditions.
- Stop smoking and drink less alcohol. Too much smoking and drinking can cause impotence. Working on doing them less may improve your penile health.
- Use Regularly. Frequent sex, masturbation, or any sexual activity might help you maintain erectile function.
Remember, some penis problems can’t be prevented. However, routinely examining your penis can give you greater awareness of the condition of your penis and help you detect changes. Regular checkups can also help ensure that problems affecting your penis are diagnosed as soon as possible.
While you might find it difficult to discuss problems affecting your penis with your doctor, don’t let embarrassment prevent you from taking charge of your health.
These might include the inability to get and keep an erection firm enough for sex (erectile dysfunction) or, uncommonly, a persistent and usually painful erection that isn’t caused by sexual stimulation or arousal.
In most cases, erectile dysfunction is caused by something physical. Common causes include:
- Heart disease
- High cholesterol
- High blood pressure
- Alcoholism and other forms of substance abuse
- Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
- Certain prescription medications
- Tobacco use
Lesser-known causes include Parkinson’s disease, Multiple Sclerosis, sleep disorders, or injuries that affect the pelvic area or spinal cord.
The brain also plays a key role in triggering the series of physical events that cause an erection, starting with sexual arousal. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
- Depression, anxiety, or other mental health conditions
- Relationship problems due to stress, poor communication, or other concerns
Erectile dysfunction symptoms might include persistent:
- Trouble getting an erection
- Trouble keeping an erection
- Reduced sexual desire
A family doctor is a good place to start when you have erectile problems. See your doctor if:
- You have concerns about your erections, or if you’re experiencing other sexual problems including ejaculatory dysfunction, such as premature or delayed ejaculation.
- You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction.
Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options.
Standard treatments include lifestyle/natural changes, such as:
- Losing weight
- Quitting smoking
- Curbing alcohol intake
Certain medications may be prescribed by a doctor to increase blood flow to the penis. But they can also have side effects. Men who have experienced a stroke or have uncontrolled diabetes or low blood pressure should not take ED medications.
Non-drug treatments for ED include:
- Penile vacuum pumps
- Penile implants
- Blood vessel surgery
Even though all these methods may help some men, natural alternatives can be just as effective, but less invasive.
Two conditions can occur with the foreskin of the penis of an uncircumcised or improperly circumcised man, phimosis and paraphimosis. Uncircumcised is when the foreskin of the penis has not been removed.
Phimosis: This condition occurs when the foreskin cannot be retracted (pulled back) behind the head of the penis. Phimosis can often lead to a painful type of infection which causes the swelling of the foreskin or head of the penis. However, this condition is mostly found in children and only occasionally in adults.
Paraphimosis: This condition is when the foreskin, after being pulled back, becomes trapped and then swollen behind the head of the penis. The swelling can lead to blockage of blood flow to the penis, which can lead to serious problems. Paraphimosis is considered a true medical emergency. Circumcision (surgical removal of the foreskin) at birth or revision of a prior circumcision can prevent this condition.
Causes for phimosis may include:
- poor hygiene,
- and/or previous foreskin injury.
Any condition or activity that results in prolonged foreskin retraction (skin pulled back) can lead to the development of paraphimosis. Other causes may include:
- An improperly circumcised penis
- Vigorous sexual activity, including masturbation
- Males forgetting to return the foreskin to its normal position after retracting it
The following is a list of symptoms that males may have if they develop problems with the foreskin that usually appears swollen.
With phimosis, the male may have any or all of the following signs and symptoms:
- Difficulty with urination—including pain while urinating or blood in the urine
- Pain in the penis
With paraphimosis, males can have these additional symptoms:
- Penile pain (particularly in the glans)
- Penile discoloration (this occurs after blood flow is cut off); the penis may become whitish, bluish, gray-colored, or black.
With paraphimosis, if a person cannot return the foreskin to its original position and the glans or foreskin becomes progressively more painful, swollen, or discolored, seek immediate medical attention.
Phimosis usually does not require emergency medical treatment and many mild occurrences resolve without medical intervention. However, if the person has difficulty urinating or burning upon urination, then a doctor should be contacted within 12-24 hours.
Paraphimosis is a medical emergency. If not treated immediately, it can result in gangrene of the glans and foreskin. Apply ice to the penis to reduce swelling; however, if the ice and direct pressure technique does not relieve the problem rapidly, go immediately to the nearest hospital or to a doctor’s clinic.
The doctor may repeat the ice with a direct pressure technique.
- If that does not free the foreskin, the doctor will, in most instances, contact a urologist to perform further procedures.
Male yeast infections
Although more common for women, men can get yeast infections too, which can lead to a condition known as balanitis — inflammation of the head of the penis.
Yeast infections in men are common because the fungus that causes yeast infections (candida) is normally present on skin, especially moist skin.
Unlike with vaginal yeast infections, penile yeast infections are usually sexually acquired — when a man has sex with someone who has a yeast infection. However, you may be more likely to develop balanitis from a yeast infection if you:
- Aren’t circumcised (the foreskin of your penis has not been removed)
- Use antibiotics for prolonged periods
- Have diabetes
- Have an impaired immune system, such as with HIV
- Are overweight
- Practice poor hygiene
Signs and symptoms may include:
- Moist skin on the penis, possibly with areas of a thick, white substance collecting in skin folds
- Areas of shiny, white skin on the penis
- Redness, itching or a burning sensation around the head of the penis
- Pain during urination or sex
- Unpleasant odor of the foreskin
- Difficulty pulling back foreskin
Most male yeast infections are easily treated with over-the-counter antifungal medications that you can ask your drugstore about. If the topical or oral antifungal treatments don’t work, make sure to see your doctor.
If you and your partner both have symptoms of a yeast infection, it’s important that you both be treated to avoid reinfecting each other.
Urinary Tract Infections (UTIs)
A urinary tract infection (UTI) is an infection involving the kidneys, ureters, bladder, or urethra. Even though UTIs are much more common in women than in men, almost anyone can get one. These are the structures that urine passes through before being eliminated from the body. UTIs are caused by micro-organisms or germs, usually bacteria. The different types of UTI can include:
Urethritis – infection of the urethra- the tube that delivers urine from your bladder to the outside of the body. Urethritis can be caused by a UTI or STI.
Cystitis – infection of the bladder (most common type of UTI). If a person has a bladder infection, they could also experience low fever, and pressure and cramping in the abdomen and lower back.
Pyelonephritis – infection of the kidneys (more serious). If a person has a kidney infection, they could also experience upper back and side pain, high fever, shaking, chills, fatigue, and mental changes.
Urine is normally sterile, which means it doesn’t contain any bacteria, fungus or viruses. To infect the urinary system, bacteria usually have to enter through the urethra or, rarely, from the bloodstream. The most common culprit is a bacteria common to the digestive tract called “E. coli”. It is usually spread to the urethra from the anus.
Other micro-organisms, such as mycoplasma and chlamydia, can cause urethritis in both men and women. These micro-organisms are sexually transmitted, so when these infections are detected, both partners need medical treatment to avoid re-infection. The following factors can increase the likelihood of developing a UTI:
- Sexual intercourse (especially if more frequent, intense, and with multiple or new partners)
- Poor personal hygiene
- Problems emptying the bladder completely
- Having a urinary catheter
- Bowel incontinence
- Blocked flow of urine
- Kidney stones
- Procedures involving the urinary tract
- Suppressed immune system
- Heavy use of antibiotics (which can disrupt the natural flora of the bowel and urinary tract).
The most common symptoms of a UTI include:
- Urinating (peeing) more than usual
- Having an intense urge to urinate, even if nothing comes out
- *Any kind of pain or burning while urinating
- Urine that has a bad smell
- Fever or chills
- Nausea and vomiting
- Pain in the lower abdomen (belly)
*Pain or burning while urinating is also a symptom of an STI like chlamydia, gonorrhea, genital herpes, and trichomoniasis. If you’re experiencing this symptom, call your health care provider right away, and get tested.
If you think you have a UTI, it’s important to see your healthcare provider so they may diagnose you and provide you with treatment. If you have a UTI, your healthcare provider will prescribe antibiotics to kill the bacteria that are causing the infection. You will likely have to take the antibiotics for 3-7 days (possibly longer), but the length of time can vary depending on how bad the infection is. It’s extremely important to take ALL of the medicine that your provider has prescribed, even if you start feeling better. If you don’t finish the antibiotics, the infection could come back.
Your healthcare provider may also recommend that you drink a lot of water and empty your bladder frequently while you have a UTI. This is important for helping your bladder clean itself and will cause you to pee more often.
If you have bladder spasms (cramping pain that comes and goes in the lower part of your abdomen), your provider may prescribe medicine to help with the pain. Some medicines that help treat bladder spasms may turn your urine an orange color. This is a completely normal side effect and only lasts as long as you are taking the medicine.
Changes in libido
Low libido describes a decreased interest in any form of sexual activity. It’s common to lose interest in sex from time to time, and libido levels vary throughout life. It’s also normal for your interest not to match your partners at times. However, low libido for a long period of time may cause concern for some people. Low libido can sometimes be an indicator of underlying health conditions.
Here are a few potential causes of low libido in men:
Low Testosterone: Testosterone is an important male hormone. In men, it’s mostly produced in the testicles. Your testosterone levels factor into your sex drive.
Medications: Taking certain medications can lower testosterone levels, which in turn may lead to low libido. For example, blood pressure medications may prevent ejaculation and erections.
Depression: Depression changes all parts of a person’s life. People with depression experience a reduced or complete lack of interest in activities they once found pleasurable, including sex.
Chronic Illness: When you’re not feeling well due to the effects of a chronic health condition, such as chronic pain, sex is likely low on your list of priorities. Certain illnesses, such as cancer, can reduce your sperm production counts since your body focuses on just getting through the day.
Sleep Problems: One study found that men with obstructive sleep apnea (a chronic condition that disrupts your sleep by causing shallow breathing) experience lower testosterone levels. In turn, this leads to decreased sexual activity and libido. In the study, researchers found that nearly half of the men who had severe sleep apnea also experience very low levels of testosterone during the night.
Aging: Testosterone levels, which are linked to libido, are at their highest when men are in their late teens. Men generally notice a difference in their libido around ages 60 to 65.
Stress: If you’re distracted by situations or periods of high pressure, sexual desire may decrease. This is because stress can disrupt your hormone levels.
Treating low libido often depends on treating the underlying issue. You may need to switch medications, so seeing your doctor is wise. If your low libido has psychological causes, you may need to visit a therapist for relationship counseling.
You can also take steps to boost your libido on your own. The following have the potential to increase your libido:
- living a healthier lifestyle
- getting enough sleep
- practicing stress management
- eating a healthier diet
Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration and may result in unsatisfactory sex for both partners. This can increase anxiety which may add to the problem. It is one of the most common forms of male sexual dysfunction and has probably affected every man at some point in his life.
Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner. It may happen only in certain sexual situations or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can also cause it. In some cases, it may be related to a medical cause such as hormonal problems, injury, or a side effect of certain medicines.
The main symptom is an uncontrolled ejaculation either before or shortly after intercourse begins. Ejaculation occurs before the person wishes it, with minimal sexual stimulation.
In many cases, premature ejaculation gets better on its own over time. Treatment may not be needed. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve how well they can control ejaculation.
Your doctor may recommend that you and your partner practice certain techniques to help delay ejaculation. For example, you may learn to identify and control the sensations that lead up to ejaculation. And you may learn to communicate with your partner to slow or stop stimulation. You can try using a condom to reduce sensation to the penis. Or you can try a different position (such as lying on your back) during intercourse. Counseling or behavioral therapy may also help reduce anxiety related to premature ejaculation.
Delayed ejaculation (DE) occurs when a man needs more than 30 minutes of sexual stimulation to reach orgasm and ejaculate. Some men can only ejaculate with manual or oral stimulation. Some cannot ejaculate at all.
A lifelong problem with DE is very different from a problem that develops later in life. Some men have a generalized problem in which DE occurs in all sexual situations. For other men, it only occurs with certain partners or in certain circumstances. This is known as “situational delayed ejaculation.”
In rare cases, DE is a sign of a worsening health problem such as heart disease or diabetes.
There are many potential causes of DE, including psychological concerns, chronic health conditions, and reactions to medications.
Psychological causes of DE can occur due to a traumatic experience. Cultural or religious taboos can give sex a negative connotation. Anxiety and depression can both suppress sexual desire, which may result in DE as well.
Relationship stress, poor communication, and anger can make DE worse. Disappointment in sexual realities with a partner compared to sexual fantasies can also result in DE. Often, men with this problem can ejaculate during masturbation but not during stimulation with a partner.
Certain chemicals can affect the nerves involved in ejaculation. This can affect ejaculation with and without a partner. These medications can all cause DE:
- medications for high blood pressure
Surgeries or trauma may also cause DE. The physical causes of DE may include:
- damage to the nerves in your spine or pelvis
- certain prostate surgeries that cause nerve damage
- heart disease that affects blood pressure to the pelvic region
- infections, especially prostate or urinary infections
- neuropathy or stroke
- low thyroid hormone
- low testosterone levels
- birth defects that impair the ejaculation process
A temporary ejaculation problem can cause anxiety and depression. This can lead to recurrence, even when the underlying physical cause has been resolved.
Treatment will depend on the underlying cause. If you’ve had lifelong problems or you’ve never ejaculated, a urologist can determine if you have a structural birth defect. Your physician can determine if a medication is the cause. If so, adjustments will be made to your medication regimen and your symptoms will be monitored.
Some medications have been used to help DE, but none have been specifically approved for it. To learn more about medications for DE, speak to your doctor.
Retrograde ejaculation occurs when semen enters the bladder instead of emerging through the penis during orgasm. Although you still reach sexual climax, you may ejaculate very little or no semen. This is sometimes called a dry orgasm. Retrograde ejaculation isn’t harmful, but it can cause male infertility. Treatment for retrograde ejaculation is generally only needed to restore fertility.
Retrograde ejaculation may be caused by prior prostate or urethral surgery, diabetes, some medications, including some drugs used to treat hypertension (high blood pressure) and some mood-altering drugs.
The condition is relatively uncommon but the presence of semen in the bladder is harmless. It mixes with the urine and leaves the body with normal urination. Men with diabetes and those who have had genitourinary tract surgery are at increased risk of developing the condition.
- Little or no semen discharged from the urethra in conjunction with the male sexual climax (during ejaculation)
- Possible infertility
- Cloudy urine after sexual climax
If retrograde ejaculation is caused by drugs, removal of the specific drug may resolve the condition. Retrograde ejaculation caused by diabetes or following genitourinary tract surgery may be responsive to the use of epinephrine-like drugs (such as pseudoephedrine or imipramine). To learn more about treatment options, speak with a health provider.