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Men's Health (cont.)

Men's Sexual Health

For the majority of men, sexual health is never considered until problems develop. The first problems may begin with puberty; many males that are becoming sexually mature may not understand that they are going through bodily and hormonal changes that occur in almost every male, and may suffer anxiety, confusion, misinformation from peers, and if slower developing, social stresses.

Parents and caregivers should look for the signs of puberty in boys and, if possible, anticipate the changes and take the time to help them understand what is happening to their bodies. This information should include topics such as human sexuality, sexual development and issues arising from sexual development. If a parent or other caregiver, for whatever reason, feels they cannot do this, they should choose another competent individual to help them inform their developing male about sexual development (for example, doctor or health counselor).

Any number of readers may think the above is bad advice and such things should only be discussed by (married) adults, while many other readers may think the discussion of such subjects comprise only part of many subjects that should be addressed. Most doctors recommend individuals be informed about their biology.

Picture of the male reproductive organs

Picture of the male reproductive organs

Men's Prostate Health

The prostate gland is a chestnut-shaped gland that is located at the base of the bladder and surrounds the urethra that allows urine to pass out of the bladder. The prostate is actually made up of multiple small glands that produce a milky-white fluid secreted into the urethra when a man ejaculates sperm through the urethra; the fluid and sperm mixture is known as semen or ejaculate. A normal prostate gland is small and soft when digitally palpated during a rectal examination.

Benign prostatic hyperplasia (BPH) is the abnormal proliferation of prostate cells (non-cancerous) and usually cause progressive enlargement of the prostate gland. The most common clinical manifestation of BPH is a set of voiding dysfunctions due to the squeezing pressure on the urethra. Untreated, obstruction resulting from BPH can lead to slow, intermittent urinary flow or acute urinary retention, which can require surgical interventions such as transurethral resection of the prostate (TURP) or prostatectomy. BPH is not a source of prostatic cancer. Usually, BPH can be managed medically with medications such as alpha-blockers and 5-alpha reductase inhibitors. In BPH, the gland is often enlarged and soft or "boggy" when digitally palpated during a rectal exam.

Prostatic cancer is a disease in which cells of the prostate gland become abnormal and start to grow uncontrollably, forming tumors in the prostate and in some men, prostate cell tumors in other organs, especially the bones. Prostatic cancer can have the same symptoms as BPH, but if the tumors proliferate, can cause death. In prostate cancer, the gland may be enlarged and have firm or hard areas when digitally palpated during a rectal exam

Men, please note the last sentence in the above three paragraphs. Yes, you should get a digital rectal examination done as part of any man's yearly physical exam especially after age 50; for some men at higher risk (African American men and men that have a family history of prostate cancer) they should get routine digital exams starting at age 40 or even earlier. Not getting the digital exam is like driving any type of used or "vintage" car in California through the mountains, deserts, and seashore for years and never stopping to check the oil level (another imperfect analogy).

Treatment for BPH ranges from watchful waiting (no treatment, observation ) to medication to reduce symptoms or surgery. Treatment for prostatic cancer ranges from watchful waiting (no treatment, observation), to surgery, radiation therapy, hormone therapy, chemotherapy and biologic therapy while new treatments are being developed (cryotherapy, high intensity ultrasound, and proton beam therapy).

Medically Reviewed by a Doctor on 9/11/2017

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