men's health questions

Visiting the doctor is not always a priority for men. In fact, men are half as likely as women to see a doctor over a two-year period, according to a survey by the Centers for Disease Control and Prevention (CDC).

For some men, the first time they visit a doctor is to address men’s health issues.

The UPMC Men’s Health Center offers a safe, discreet place for men to get treatment in a comfortable environment. Here are some common health conditions that men are often embarrassed to ask their health care providers about.

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Common Health Conditions in Men

Erectile dysfunction

As the most common sexual issue reported by men, erectile dysfunction (ED) affects about 30 million men. Although the prevalence of ED increases with age, approximately 40% of men are affected by around age 40, according to the Massachusetts Male Aging Study.

ED occurs when a man has difficulty getting or maintaining an erection for sexual activity.

In most cases, ED can be caused by medical issues, such as high cholesterol, uncontrolled blood pressure, diabetes, and obesity, as well as neurological disorders and spinal cord injuries. Men with diabetes are three times more likely to have ED. This is because high sugar levels in the blood affect the function of nerves and blood vessels in the tissues that cause an erection.

ED can be a sign of other health problems, so any man experiencing ED should treat it as a wake-up call. If you aren’t seeing a doctor regularly or are due for a checkup, now is the time to get back on track.

Psychological causes of ED can include anxiety, stress, and depression. Lifestyle choices, such as drinking alcohol excessively and smoking cigarettes, also can have an impact.

ED treatment may include oral medicines, which work to relax muscles and increase blood flow in the penis during sexual activity.

Approximately 70% of men respond well to oral ED medicines. Many of these medicines are available in generic form.

As far as supplements go, men should be careful. Some of these substances may not be regulated by the Food and Drug Administration (FDA) and may cause side effects alone or in combination with other medications. If you are considering taking a supplement, it’s best to talk to your doctor first.

Premature ejaculation and delayed ejaculation

An ejaculation during sexual activity that occurs before you want it is called as premature ejaculation (PE).

About 1 in 3 men 18 to 59 years old in the United States experience issues with PE. Sometimes men with erectile dysfunction also experience PE.

While it is not known exactly what causes PE, the following may have an effect:

  • Serotonin is a chemical produced by nerves, and low amounts of it in the brain can cause ejaculation to happen quicker.
  • Age can play a part as the older men get, the shorter their erections may last before ejaculating.
  • Psychological factors, such as depression and stress, may contribute to PE.

There are several treatments for PE.

Topical agents like numbing creams or numbing sprays can reduce sensation and usually are a fairly low-risk option with few side effects. Oral medicines require monitoring and should be managed by a doctor. There are also effective behavioral therapies.

On the other hand, if you’re experiencing difficulty ejaculating after having sex for 30 to 45 minutes, you may be experiencing delayed ejaculation.

Psychological issues, such experiencing trauma, may cause delayed ejaculation, as well as the following physical causes:

  • Blocked ducts that semen passes through.
  • Nerve damage to the pelvis.
  • Nervous system diseases, such as stroke or nerve damage to the spinal cord or back.
  • Taking certain drugs.

Treatment for delayed ejaculation might include taking medicine or adjusting a medicine taken for another condition, receiving psychological counseling, and addressing alcohol or drug use.

Low testosterone

Testosterone is the male sex hormone that is produced in the testicles. It helps boys develop body and facial hair, deeper voices, and muscle mass during puberty. Testosterone is needed to make sperm.

When men have low testosterone (low-T), they may experience the following:

  • Depression.
  • Erectile dysfunction.
  • Fatigue.
  • Irritability.
  • Low sex drive.
  • Reduced lean muscle mass.

A simple blood test can detect if you have low testosterone. Weight loss may be recommended. If losing weight and exercising don’t raise your levels, testosterone therapy (TT) may be needed. It is administered in different forms, including:

  • Intranasally as a gel that is pumped into the nostrils.
  • Topically with gels, creams, liquids, and patches.
  • With injections given weekly, biweekly, or monthly.
  • With pellets placed under the skin of your hip or buttocks.

Infertility

Men contribute to infertility issues in about 40% of infertile couples, according to the American Society for Reproductive Surgeons. The main reasons for male infertility include:

  • Absence of ducts in reproductive organs.
  • Age-related factors, including lower sperm count and quality of
    sperm count, genetic abnormalities of the sperm, erectile dysfunction,
    and changes to the reproductive tissues or organs, such as an enlarged
    prostate, which can cause problems with ejaculation.
  • Hormone imbalances or blockage.
  • Lifestyle factors, such as nutrition, weight, exercise, stress, environmental and occupational exposures, substance and drug use and abuse, and medicines.
  • Problems with testicles that affect sperm production.

If you’ve been trying to conceive for a year without protection and have not achieved a pregnancy, it’s time for both people in the relationship to see a doctor.

Peyronie’s disease

Also referred to as penile curvature, Peyronie’s disease is a disorder that occurs when scar tissue (plaque) forms under the skin of the penis. The plaque causes the penis to curve when a man has an erection, which can be painful and make intercourse challenging.

Older men are more prone to developing Peyronie’s disease, and it is less common in men who are in their 20s and 30s. Other risk factors include:

  • A family history of Peyronie’s disease.
  • A history of prostate cancer treatment with surgery.
  • Experiencing an injury to the penis.
  • Having a connective tissue or autoimmune disorder.
  • Having diabetes or erectile dysfunction.

A urologist can diagnose the condition based on your medical and family history and a physical exam. Treatment may include oral medicines, injections, or surgical options.

Kidney stones

Kidney stones are solid pieces of material, most often made of calcium, that form in the kidney. They can range from the size of a grain of sand to as large as a pearl. Most kidney stones pass on their own. But if they get trapped in the urinary tract, they can cause:

  • Intense pain.
  • Blood in your urine.
  • Fever.
  • Chills.
  • Vomiting.
  • Foul-smelling urine.
  • Burning when urinating.

These symptoms signify the need for medical attention.

Kidney stones can form because of genetics, diet, and medicine. Staying hydrated can help prevent kidney stones from developing.

Depending on the type of stones, dietary changes and medicines may help treat the condition. Shock waves and surgery are other treatment options.

Your primary care provider can refer you to a urologist who treats kidney stones. The urologist may use urine, blood, and imaging tests, such as an x-ray, ultrasound, or CT scan, to diagnose kidney stones.

Incontinence after prostate surgery

The bladder is surrounded by the prostate. If the prostate is removed or treated with radiation, the bladder’s nerves and muscles, urethra, or sphincter can be damaged. This damage can lead to urinary stress incontinence. This type of incontinence occurs when pressure pushes on the bladder and the pelvic floor muscles are not able to handle it, resulting in leakage.

Pelvic floor exercises can help strengthen the pelvic muscles. Many times, incontinence will improve within a year after of prostate surgery. If incontinence persists, surgery may be necessary.

Surgery options include:

  • Artificial urinary sphincter, in which a mechanical ring is inserted to help close the exit from the bladder.
  • Urethral sling procedure, which involves the implantation of a synthetic mesh tape to support the urethra.

Get Checked

While the internet can be a good resource when it comes to men’s health and wellness, you shouldn’t rely solely on online sources. Talk to your provider to get your questions answered.

Editor's Note: This article was originally published on , and was last reviewed on .

What is erectile dysfunction? American Urological Association.

Symptoms & Causes of Erectile Dysfunction. The National Institute of Diabetes and Digestive and Kidney Diseases.

Treatment for Erectile Dysfunction. National Institute of Diabetes and Digestive and Kidney Diseases.

What is Premature Ejaculation? Urology Care Foundation.

Delayed ejaculation. MedlinePlus.

What is Low Testosterone? Urology Care Foundation.

FAQ Quick Facts About Infertility. The Society of Reproductive Surgeons.

What are some possible causes of male infertility? Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Sharma, R., Biedenharn, K. R., Fedor, J. M., & Agarwal, A. (2013). Lifestyle factors and reproductive health: Taking control of your fertility. Reproductive Biology and Endocrinology, 11, 66.

What age-related factors may be involved with infertility in females and males? Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Kidney Stones. MedlinePlus.

Penile Curvature (Peyronie's Disease). National Institute of Diabetes and Digestive and Kidney Diseases.

Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie's disease: AUA guideline. Journal of Urology 2015;194(3):745–753.

Urinary Incontinence After Prostate Surgery: Everything You Need To Know. National Association for Continence.

Continence management following prostate surgery. Continence Foundation of Australia.

About Men’s Health Center

The UPMC Men’s Health Center evaluates and treats conditions affecting men’s sexual and reproductive health. With years of clinical experience in male sexual medicine and surgery, our team has treated a wide variety of conditions and performed thousands of surgeries. We are dedicated to providing patients the highest level of quality care. Our providers understand the intimate nature of male sexual difficulties, and we will work to help you restore your normal level of sexual function in a comfortable, educational, and discreet environment.