Men’s Health

What could cause male infertility?

DEAR DOCTOR K: My wife and I have tried to get pregnant for over a year. We're going to be tested soon to see if anything is wrong. I'm worried that the problem lies with me. What are some reasons for a man to be infertile?

DEAR READER: About one in seven couples in the United States is unable to conceive a child after trying for one year. The infertility is caused by either the man alone (about 40 percent of the time), by the woman alone (about 40 percent of the time) or by both partners (about 20 percent of the time). So it is possible that something about you is responsible for your wife's difficulty with becoming pregnant.

Is it ok that I’ve stopped ejaculating even when I orgasm?

DEAR DOCTOR K: For the past few months, I haven't been ejaculating, even when I have an orgasm. Why not? What's wrong?

DEAR READER: It sounds like retrograde ejaculation. To explain that, we need to talk about anatomy. There is one tube, the urethra, which leads from the bladder and through the center of the penis. The urethra carries urine out of the body. Two tubes, one on each side of the urethra, lead from the seminal vesicles and open into the urethra. The seminal vesicles are tiny glands that make semen. (The prostate gland helps make semen, too). Semen is a thick fluid that helps nourish sperm. Semen really has no other purpose: It is produced onlyto help sperm.

What are the differences in erectile dysfunction drugs?

DEAR DOCTOR K: Is there a difference between the drugs that are available for erectile dysfunction?

DEAR READER: Erectile dysfunction (ED) is a problem faced, to one degree or another, by many middle-aged and older men. Since sildenafil (Viagra) was launched in 1998, men have been turning to medication to help address this problem. There are currently four ED drugs on the market: sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra).

Why delay treatment for slow-growing prostate cancer?

DEAR DOCTOR K: I was recently diagnosed with prostate cancer. My doctor says my cancer is slow-growing and that we should just monitor it for now. Why not treat it right away?

DEAR READER: I know this will sound odd, but cancer is not always bad for your health. There are types of cancer that can cause no symptoms, that grow slowly (if at all) and that are unlikely to spread. There are types of cancer that you will never know you had. You will die with these cancers, but you won't die from them.

Does testosterone therapy really work?

DEAR DOCTOR K: I've seen a lot of commercials advertising testosterone therapy for "low T." Does it live up to its promise? Should I be on it?

DEAR READER: I've seen the commercials, too. They promise that testosterone therapy for low blood levels of testosterone, or "low T," will make you feel more alert, energetic, mentally sharp and sexually functional. Testosterone therapy is a good option for some men, but there are also risks.

Does eating fish help prevent prostate cancer?

DEAR DOCTOR K: Does eating fish help prevent prostate cancer?

DEAR READER: You've certainly heard me encourage readers to eat plenty of fish, particularly fatty fish such as salmon and mackerel. That's because many good studies have found that people who eat fish frequently have lower rates of many serious diseases, including heart disease and several types of cancer. A recently published study from the Prostate Cancer Prevention Trial (PCPT) was described in the media as coming to the opposite conclusion. I don't agree, but to explain why, I first need to talk about the substances in fish that are thought to be beneficial for humans.

What are the different options of penile implants?

DEAR DOCTOR K: Can you discuss penile implants? I haven't had success with other treatments for erectile dysfunction.

DEAR READER: Medications, injectable drugs and devices such as vacuum pumps can effectively help most men who cannot get or maintain an erection. In particular, the three different pills for erectile dysfunction (ED) are effective about 70 percent of the time. Have you talked with your doctor about increasing the dose of the medicines you have taken? And has your doctor done tests to determine the cause of your erectile dysfunction?

I’m a 52-year-old man — What causes a stinging sensation and dripping after I urinate?

DEAR DOCTOR K: I am a 52-year-old man. When I finish urinating, I drip much more then I used to. And I have a stinging sensation in my urethra. What could cause this?

DEAR READER: What you're experiencing is a very common complaint. As we age, several things happen. One is some enlargement of the prostate gland. This is called benign prostatic hyperplasia, or BPH. Your doctor can perform a digital rectal exam to assess the size and texture of your prostate gland.

Is acupuncture an effective treatment for erectile dysfunction?

DEAR DOCTOR K: Is acupuncture an effective treatment for erectile dysfunction?

DEAR READER: During an erection, arteries supplying blood widen, and veins leading blood away from the penis clamp down. As a result, more blood is inside the penis, causing it to swell and become firm. It sounds simple, but getting to an erection requires extraordinary orchestration of blood vessels, nerves, hormones and, of course, the psyche. Here is an illustration of this process:

I’m a man– Why are my breasts suddenly bigger?

DEAR DOCTOR K: I'm a man. Why are my breasts suddenly getting bigger?

DEAR READER: Everything that happens to a woman's breasts can also happen to a man's breasts, including cancer. Enlargement of a man's breast is known as gynecomastia (guy-ni-co-MAST-ia). It is usually harmless and is often reversible. It's an oversimplification, but basically a breast is filled with breast glands and fat.