Men's Wellness
Inflammation of the Head of the Penis and Foreskin
It is very important that men take on an active role in managing their own health.
Read on to discover some ways in which you can be pro-active regarding important health issues of significance to men.
Prostate
Cancer
Prostate cancer is the second leading cause of
death in North American men & is the most common cancer found
in Canadian men. Nearly 400 men are diagnosed with prostate cancer
every week in & about 80 Canadian men die from this disease
weekly. While prostate cancer mainly affects men after the age of
65, there is increased risk in younger men with a family history of
the disease, who are of African ancestry or who have high levels of
testosterone.

What is the prostate?
The prostate is a
part of the male reproductive system; it is a gland about the size
of a walnut that sits below the bladder. The major function of the
prostate is to produce seminal fluid.
Screening
Early detection of prostate
cancer can be important in preventing death from this disease. All
men above the age of 50, or younger men at increased risk should
ask their doctor about being screened for prostate cancer.
Screening is typically done in one of two ways: the digital rectal
examination (DRE) & the prostate-specific antigen test (PSA).
Each of these tests has its own limitations & in certain cases,
combined screening with both tests may be recommended.
The digital rectal exam
involves the physician placing a lubricated gloved finger inside
the rectum to feel the prostate gland allowing him or
her to note its
size, shape and consistency, any nodules or tenderness. When the
physician does this exam, you may feel some mild discomfort &
the urge to urinate.
The prostate-specific antigen test is a blood test that measures the levels of prostate specific antigen, a substance made by the prostate. Cancer of the prostate, as well as certain other conditions such as prostate enlargement, can cause your levels of PSA to rise.
Possible symptoms of prostate
cancer
-Weak & interrupted urine flow
-Inability to urinate or trouble starting or stopping urination
-Urgent need to urinate
-Frequent urination, especially at night
-Blood in your urine
-Pain during ejaculation
The incidence of
testicular cancer is low (about 4 in 100 000 men), but it is most
common in younger men aged 15-35 years. You may be at greater risk
for testicular cancer if you have a history of cancer in one of
your testicles or if you have an undescended testicle. Other risk
factors include a history of inflammation of your testicles caused
by mumps, an inguinal hernia & fluid buildup in your scrotum as
a child.
Detection
If testicular cancer is
detected early, it has a very good prognosis, so it is important to
ask your doctor about having a testicular exam. This will basically
involve the physician inspecting the skin of your scrotum &
feeling each testis for any abnormalities. If there is any swelling
found in your scrotum, the doctor might use a flashlight to examine
it by darkening the room & shining a beam of light from behind
the scrotum to see how the light is transmitted through the
swelling.
Although it is best to have your doctor perform a testicular exam, it may help in early detection of any abnormalities if you learn to conduct a testicular self exam. It is best to do this just after a warm bath or shower since the heat relaxes the scrotum & makes any abnormalities easier to find. Here’s a breakdown of a basic testicular self-exam:
-Stand in front of a mirror & look for any swelling on the skin of the scrotum.
-Using your hands,
examine each testicle by cupping your index & middle fingers
under the testicle & placing your thumbs on the top.
-Roll the testicle between the thumbs and fingers noting any lumps
or pain. If one testicle happens to be bigger than the other, don't
panic, this is normal.
-At the back of the testicle, you will find a structure that
collects & carries sperm called the epididymis which should be
soft & tube-like. Note any abnormal lump.
-If you find a lump, this does not necessarily mean you have cancer
since it could be an infection for instance, but you should still
go to see your doctor about any lumps just in case. Cancerous lumps
left untreated will allow the cancer to spread & become more
serious.
-painless lump on
testicle
-heavy feeling or dull ache in lower abdomen, groin or scrotum
-infertility
Erectile dysfunction (ED) is when a man is unable to get and maintain erection of the penis long enough to have sex at least half of the time that he tries to. ED can have a negative effect on male self-image & on a man’s sex life. While many men find ED difficult to talk about, it is important to try to talk to your doctor about treatment since many men with ED can be helped. Also, if you are experiencing ED, you are not alone: most men have ED every so often & roughly 34% of Canadian men have it on a regular basis.
Causes of ED may be both physical & emotional/psychological in nature.
Physical causes of ED may include the following:
-Decreased testosterone
-Decreased blood flow to
vessels supplying the penis such as with atherosclerosis
-Problems with nerve stimulation of the penis as with brain or
spinal cord injuries
-Drinking & Smoking
-Diabetes, liver or kidney failure, Multiple sclerosis, Parkinson’s disease
-Stroke
-Testicular radiation therapy
Emotional causes of ED may include the following:
-Nervousness or self-consciousness about sex
-Stress
-Experiencing relationship problems
-Depression
Consult your doctor in order to find the ED treatment that is appropriate for you. Generally, treatment directed at an underlying physical cause might involve using drug therapy or surgery, while treatment of an emotional cause may involve other approaches such as counseling. Drugs can also be used to directly treat the ED itself such as Sildenafil (Viagara).
Premature ejaculation happens when a man ejaculates before he wishes to or too early during intercourse before his partner is satisfied. It is a common occurrence, especially in young men. The usual causes of premature ejaculation are anxiety & overstimulation.
The condition generally improves with practice, relaxation & without official treatment. Some men find the following techniques helpful in delaying ejaculation:
-Slowing excitation by thinking non-sexual thoughts
-The "stop and start" method:
--> Sexual stimulation is allowed until the man is close to ejaculation, at which point the stimulation is removed for about 30 seconds before being resumed. This is repeated until it is the appropriate time for ejaculation & stimulation is continued until ejaculation occurs.
-The "squeeze" method
--> Sexual stimulation is continued until the man is close to ejaculation at which point the man or his partner gently squeezes the end of the penis for a few before stimulation is resumed. This is repeated until it is the appropriate time for ejaculation & stimulation is continued until ejaculation occurs.
-Local anesthetic creams are sometimes used on the penis to decrease feeling & prolong the time before ejaculation.
The male urinary tract & urinary tract infections
A basic review
of the urinary system in males
Both males & females normally have two kidneys that form the
urine. This urine exits the kidneys by way of two tube-like
structures (one for each kidney) called ureters which provide a
passage for urine into the bladder where it is stored until it must
be emptied. When the bladder is ready to be emptied, urine will
flow out through another tube-like structure called the urethra. In
males, unlike females, this urethra has to pass through the
prostate gland which sits just below the bladder. The urethra then
continues through the length of the penis & finally, urine
exits the urethra at its external opening at the tip of the penis
(where semen also exits on ejaculation).
Do men get urinary tract infections?
Although urinary tract infections (UTIs) are not nearly as common
in younger men as they are in women, men can certainly be affected.
Strictly speaking, a UTI is an infection of the urinary tract
itself (ureters, kidney, bladder), but men are actually most often
diagnosed with an infection of the prostate gland, called
prostatitis.
Most UTIs happen as a result of infectious organisms gaining access
to the urinary tract through the external opening of the urethra.
Infection then spreads upwards along the urinary tract. Most of the
culprits causing UTIs are normal inhabitants of the bowel, with the
bacterium, E.coli, being the most common cause.
Some symptoms that might suggest a UTI include pain in the pubic
area, discomfort or burning on urination and increased frequency of
urination. If the infection has spread as far as the kidney or into
the prostate, more symptoms might result such as back pain, fever
or chills. If you experience this latter set of symptoms, seek
immediate medical attention.
While any man can be affected by a UTI, it is important to remember
that UTIs in men more commonly occur in individuals with anatomical
abnormalities in their urinary tract which have sometimes been
present since birth. The doctor might therefore look into ruling
out this possibility.
Treatment/Outcomes
To confirm that you have a UTI, you may have to give a urine
sample. The treatment will vary somewhat depending on the severity
& which parts of the urinary tract are affected, but luckily,
most UTIs are easily treated with oral or IV antibiotics.
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top-
Inflammation of the head of
the penis & the foreskin
Inflammation of the ‘head’ or glans of the penis is
called balanitis; inflammation of both the glans and the foreskin
is called balanoposthitis. Sometimes, as a result of balanitis, the
foreskin can get ‘stuck’ and cannot be retracted
leading to a condition called phimosis.
Balanitis happens more commonly in uncircumcised men, especially if
personal hygiene is sub-par. If the glans is not getting proper
aeration or is becoming irritated by smegma or penile discharge,
inflammation and swelling can occur. Possible causes of balanitis
other than poor hygiene include irritants like certain soaps or
perfumes, diabetes and heart conditions, adverse drug reactions,
yeast infections, human papilloma virus (HPV) infection and certain
bacterial infections. Symptoms that might be noticed in balanitis
include itching, redness, discharge, swelling, inability to retract
foreskin (phimosis), ulceration or plaques.
Simple balanitis can usually be treated with daily retraction of
the foreskin & soaking as well as with topical antifungal or
antibacterial creams as necessary. In more complicated cases where
phimosis has developed, more invasive intervention including
circumcision might be required.
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Male Breast
Disorders
Breast Cancer
Breast cancer is rare in men, with roughly 2000 new cases projected
to be diagnosed in 2007 in the U.S. It mostly affects men in the
6th/7th decades of life. Some men are more at risk for breast
cancer however, including those who have been exposed to radiation,
who have a strong family history of breast cancer or who have
higher estrogen levels due to liver disease or other
conditions.
Warning signs to be aware of include breast lumps, changes to your
nipples or the skin around your breasts and any nipple
discharge.
Male breast cancer is usually treated by masectomy (surgical
removal of the breast), but chemotherapy, radiation or hormone
therapy may also be used. The outcome for men with breast cancer
depends on the stage of their cancer at diagnosis, but is thought
to be similar to the prognosis for women.
Gynecomastia
Gynecomastia is an increase in the amount of breast tissue in males
and it is not a cancerous condition. It results when there is
increased presence of estrogen in the male body which can happen
when men suffer from liver disease, tumors in hormone-producing
glands or obesity. It can also be a side effect of certain
medications.