Penis health: Identify and prevent problems

Penis health is an important part of men’s health — and it goes beyond your ability to get and keep an erection, ejaculate and reproduce.

Penis problems can be a sign of an underlying health condition. Ongoing health issues affecting your penis also can impact other areas of your life, causing stress or relationship problems and harming your self-confidence. Know the signs and symptoms of penis problems and what you can do to protect your penis health.

What affects penis health?
Various factors can affect penis health — some modifiable 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 health. For example, surgical removal of the prostate gland (radical prostatectomy) and surrounding tissue as 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.
• Piercings. A penis piercing can cause skin infections.
• 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.
What are the most common penis problems?
Conditions that can affect your penis include:
• Erection or ejaculation problems. 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 (priapism). Other concerns might include the inability to ejaculate, premature ejaculation, delayed ejaculation, painful ejaculation and retrograde ejaculation, when semen enters the bladder instead of emerging through the penis.
• Sexually transmitted infections. Various sexually transmitted infections can affect the penis, including genital warts, gonorrhea, chlamydia, syphilis and genital herpes. Common signs and symptoms might include painful urination, penis discharge, and sores or blisters on the penis or in the genital area.
• Problems with the foreskin. A condition known as phimosis occurs when the foreskin on an uncircumcised penis can’t be retracted from the penis head. Paraphimosis occurs when the foreskin can’t be returned to its normal position after being retracted.
• Other diseases and conditions. A yeast infection can cause a reddish rash and white patches on the penis. Inflammation of the head of the penis (balanitis) might cause pain and a foul discharge. Peyronie’s disease, a chronic condition that involves the development of abnormal scar tissue in tissues inside the penis, might result in bent or painful erections. Penile cancer — which might begin as a blister on the foreskin, head or shaft of the penis and then become a wart-like growth that discharges watery pus — also is a rare possibility.

What are signs or symptoms of penis problems?
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
• Discharge from your penis
• 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. Use condoms or maintain a mutually monogamous relationship with a partner who’s been tested and is free of sexually transmitted infections.
• Get vaccinated. If you’re age 26 or younger, consider the human papillomavirus (HPV) vaccine to help prevent genital warts.
• Stay physically active. Moderate physical activity can significantly reduce your risk of erectile dysfunction.
• Practice good hygiene. 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 limit the amount of alcohol you drink. If you smoke, take the first step and decide to quit — then ask your doctor for help.
• Regular use. Frequent sex or 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.

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