Troubleshooting the Penis

Welcome to the final episode of embarrassing subject month. So far we’ve dealt with an embarrassing itch, movements gone wrong, and when pee makes surprise visits; today I cover what many consider the mother of all embarrassing subjects: “male problems.” Or would that be the “father” of all embarrassing subjects.

Troubleshooting the Penis

When I say “male problems,” I am not talking about the inability to put the toilet seat down, properly match clothes, or to ask for directions when hopelessly lost. Sorry, I honestly have no answer for those problems short of hypnosis or huge bribes. I am talking about a man’s … “manhood.” I have noticed over my years of practice that men are extremely emotionally sensitive to the form and function of their reproductive organ, so much so that problems in this area end up being a major source of depression.

The questions I get asked about a man’s organ fall under three main categories:

1. Size

2. Shape

3. Function

What is a Normal Penis Size?

OK, I am sure you’ve seen the commercials about the men who are taking some amazing herbal drug that makes them get larger and how happy that makes their partner. Worry over size is an insecurity that these companies capitalize on. Teenage boys seem especially worried about their size, thinking their perceived small size is due to some cruel mutation their parents are hiding from them. Unlike girls, who seem to be able to talk about anything with each other, it’s a subject few guys want to talk about, despite this insecurity.

So what is the normal size? Normally men are 3-4 inches long when flaccid and 5-7 inches when erect. Teenage boys stop growing down there between 16 and 18 years of age–it’s one of the last things to develop during puberty.

Does Size Matter?

So what about the famous question: does size matter? Studies seem to indicate that most partners don’t really care about size, although some sources say that of the two extremes, being too large can be more of a problem. A wide range of sizes can get the job done.

Shape

There is one significant condition that affects penis shape, and it is called Peyrnone’s Disease. In this condition, the phallus gets a curve in it and is painful when erect. There are a number of causes, and many of them can be significantly improved with either medical or surgical treatments. See your doctor if you have this problem.

Common Problems with Function

There are two main areas in which a man has problems with the function of his reproductive organ: problems with sexual climax and erectile problems. Problems with climax break down into two categories: too early and too late.

Climaxing Early

What is Premature Ejaculation?

Climaxing too early, a condition called premature ejaculation, is a problem that has a combination of physical and psychological factors. Despite often being a physical problem at the start, it causes men to become insecure and anxious. That anxiety makes the problem worse, and has been a thorn in the side of many relationships.

Premature Ejaculation Treatment

In the past, the treatment for premature ejaculation was therapy using both psychological and sexual therapists (which many men would refuse to do). Things changed radically 20 years ago with the introduction of the antidepressant, Prozac. Besides being a breakthrough drug for the treatment of depression and anxiety, people also noticed it delayed climax in both men and women. Though that was a bad side effect for many of the people on the drug, it was an incredible change for men with premature ejaculation. The mainstay of treatment for this condition now is to use Prozac or other drugs in its class.

Problems Reaching Climax

Which leads to the other side of the issue: delayed climax.  Delay in climax is not a common problem in men except for those taking certain medications. As I said, the antidepressants related to Prozac are the main culprits, but there are also some blood pressure and prostate medications that can significantly affect a man’s climax. In any of these cases, the benefit of the drug may outweigh the risk, but be sure to talk to your doctor for any of these problems.

What is Erectile Dysfunction?

This brings us to the final issue: erectile problems. The discovery of medications to treat erectile dysfunction (a condition sometimes called impotence) has made this formerly hidden problem into a topic of frequent discussion in my office. Men still get a certain expression when they are about to bring up the subject–I can usually tell very quickly when a man is going to ask about it–but they do ask, which is a good thing.

ED is defined as the inability of a man to achieve or maintain an erection. There are a number of possible causes, including:

• Psychological issues – Performance anxiety is often a main cause of ED. I suspect this is the cause when I see a sudden onset, or if ED happens in a younger man.

• Medications – Eight of the twelve most commonly prescribed drugs have ED listed among the side effects, so any medication, especially blood pressure medications, should be suspected with the onset of ED

• Problems with blood flow— Circulation problems are the main cause of ED. I will cover this later in this article.

• Other chronic diseases, such as diabetes and neurological problems.

These are not all mutually exclusive causes, as men with circulation problems are often on blood pressure medications, and the onset of ED can create significant performance anxiety in men. The good news (as I am sure you are aware) is that there are now very effective medications for the treatment of ED.

But let me end this article with a caution: since ED is often a sign of blood flow or circulatory problems, it can be an early sign of life-threatening conditions. Men with ED have a significantly higher rate of atherosclerosis, which leads to heart attack and stroke. It is commonly recommended that all men with ED should be evaluated for heart disease and its risk factors.

The medications for ED are generally quite safe, even for men with known heart disease, but can have serious interactions with some medications so check with your pharmacist or doctor before taking medications like Viagra, Cialis, and Levitra.

That’s all I’ve got for “male problems.” These are great questions and important issues. Having them shouldn’t make you embarrassed; they should just get you talking with your doctor. Really, the closed doors of an exam room should always be an invitation to talk about anything that worries you. Dealing with personal subjects is a major part of what we do, so don’t let your embarrassment keep you from talking about them.

If you have topics, embarrassing or not, that you want me to cover, send them to housecalldoctor@quickanddirtytips.com, or you can submit them to me on twitter or my Facebook page.

Let me once again remind you that this podcast is for informational purposes only. My goal is to add to your medical knowledge and translate some of the weird medical stuff you hear, so when you do go to your doctor, your visits will be more fruitful. I don’t intend to replace your doctor; he or she is the one you should always consult about your own medical condition.

Catch you next time! Stay Healthy!