Men’s Health

Should I try testosterone treatment to treat low-normal testosterone?

DEAR DOCTOR K: I'm a 68-year-old man who has been feeling more tired and less "sexy" over the past several months. My doctor says my blood testosterone level is normal, but "low normal" -- a little bit above low. I know that some men take testosterone gel as a treatment for this. My doctor is not so keen on that. What's your opinion?

DEAR READER: I don't know nearly enough about your health or your symptoms to offer you personal advice. But I'll tell you what I think research has shown, at least so far. I'll warn you: It is a controversial area, and I reserve the right to change my mind as new research is published.

Do I need to take medication for BPH?

DEAR DOCTOR K: I have BPH. The symptoms don't interfere with my work or home life very much. My doctor says there are medicines that might reduce the symptoms, but I like to avoid taking medicines. What's your advice?

DEAR READER: Benign prostatic hyperplasia, or BPH, is the most common cause of prostate enlargement. As the name suggests, BPH is harmless; it does not lead to prostate cancer.

Are there any effective treatments for Peyronie’s disease?

DEAR DOCTOR K: I have Peyronie's disease. Are there any effective treatments for this condition?

DEAR READER: Peyronie's disease is, fortunately, relatively uncommon. About 5 percent of men in the United States may have it. The condition affects the penis. It causes inflammation and then scar tissue to form in the area of inflammation. The scar tissue accumulates and hardens, causing the penis to bend when it becomes erect, and potentially keeping it from becoming fully erect. This can make sexual intercourse difficult and painful. (I've put an illustration, below, showing the effect of Peyronie's disease.)

What can I expect during a prostate biopsy?

DEAR DOCTOR K: My last PSA test result was abnormal, so my doctor has scheduled a prostate biopsy. What can I expect? Is there anything I can do to make the procedure more comfortable and reduce the risk of complications? DEAR READER: An abnormal prostate-specific antigen (PSA) blood test result often leads to a prostate […]

What is the most effective way to treat premature ejaculation?

DEAR DOCTOR K: I've been experiencing premature ejaculation. What is the most effective way to treat this?

DEAR READER: Premature ejaculation (PE) occurs when a man reaches orgasm and ejaculates too quickly and without control. In other words, ejaculation occurs before a man wants it to happen. Several factors may contribute to this problem. Diabetes, problems with the thyroid gland or inflammation of the prostate are common culprits. Stress, depression and other emotional factors can also play a role. But most men with PE are healthy.

What should I know about testicular cancer?

DEAR DOCTOR K: I'm in my 30s. A friend of mine was recently diagnosed with testicular cancer. What should I know about this cancer? Should I be screened for it?

DEAR READER: Testicular cancer is the uncontrolled growth of abnormal cells in one or both testicles (testes). Nearly all testicular cancers start in germ cells. These are the cells that make sperm. The testicles are located in the scrotum, behind the penis.

Can a vasectomy be reversed?

DEAR DOCTOR K: I had a vasectomy many years ago. I've since remarried, and my new wife wants to have children. Can my vasectomy be reversed?

DEAR READER: A vasectomy is a minor surgical procedure that is done to make a man sterile (unable to father children). Normally, sperm -- the male reproductive cells that fertilize a woman's egg -- are made in the testicle. Sperm travel away from the testicle through a tube called the vas deferens.

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.