So, some tips for men's health- as well as an attempt to eliminate some myths and misconceptions.

Men’s health

1. Stay healthy

Check regularly whether foreskin of penis (the skin covering the red portion of the penis, called “glans penis”) can be retracted backwards or not. This is for male who are not circumcised. And clean the materials (“white materials”- called smegma) collected beneath the skin regularly. If it cannot be retracted normally or during urination or intercourse, it is likely to be abnormal. And it may be a condition called “Phimosis”. If you feel you have phimosis or tight foreskin, do not force to retract it, because in doing so you will land up in more difficult and emergency situation, called “Paraphimosis”. So, only solution is to get it checked by doctor. Phimosis is common in males with diabetes and those having repeated infections. It can lead to further infections, problems during urination (that may even damage kidneys) and even cancer of penis in the long run.

Do not ignore any abnormal swelling or ulcer or pain or tumour or any white or reddish patch in penis or scrotum. But some conditions are very normal like PPP (pearly penile papules) that look like small reddish or pinkish granules at the broader end of the glans penis. Similarly it is very common to have very dark pigmentation of penis and scrotum, even in very fairly skinned persons, especially in our country.

Testicles should be checked regularly, at least once a week. Please remember, both testes are not of exactly same size and they do not lie exactly at the same level (one little above and one little low). And scrotum reacts with change of temperature. So, in cold days, scrotum contracts and you have scrotum lifted up so that testes lie at higher position. Conversely at warm days, they hang down more.

But never ignore any injury, swelling or pain in scrotum or testes. Some peculiar sensation (“pain in lower abdomen”) is common during accidental pressing of testes and this indicates testes are normal. Absence of such sensation is usually abnormal. But if testicular pain persists you should not ignore it. The pain may be due to stone in kidney or infection in urine or testes or even tumour. And sharp stabbing pain indicates that there may be torsion which is a medical emergency (twisting of testis, if not treated early, can damage testes). The causes of testicular swelling are usually hydrocele (collection of water outside testes). Infection or tumour. Remember, testicular tumour or cancer is very common malignancy in young male but it responds well to treatment. Any swelling in scrotum above testes should also be noted. Sometimes it may be varicocele (swelling of veins above testes), hernia or some cysts.

2. Urinary problems

Do not ignore if you have difficulty in urination like pain, requiring more pressure, increased frequency, difficult to start, not feeling any desire or very strong urge that is difficult to control. In younger age it is due to stone or infection or some narrowing of passage (urethral stricture). In older age, it is likely to be due to prostatic enlargement. Remember, prostate enlargement is common after 40 years but in very few cases, it may be cancer. Men with family history of prostatic cancer needs ‘cancer screening” like regular check up for detection of cancer in early stage.

Blood in urine is another problem that indicates some injury or stone, tumour or infection. Even cancer in urinary tract can cause passage of blood in urine.

3. Sexual Problems

Most of the sexually active men are often obsessed about size of the penis. But it actually maters little for satisfaction unless it is abnormally low (“Micropenis”). Do not feel that the pictures shown in internet or film are real. So all the methods of ‘’enlargement techniques” are actually bogus. If it is micropenis, it needs proper evaluation to diagnose the cause of the cause and then the cause needs to be treated to achieve actual normal size.

Masturbation is not harmful for sexual health except that it may interfere with concentration in other activities (like study and work) and sometimes can lead to premature ejaculation.

Sometimes people complain about ‘’low sex stamina”. It is a vague term. It should be either of the three like low desire, erectile dysfunction (ED) or ejaculatory problems. Low desire for sex is a condition that needs proper evaluation to diagnose the cause. Remember, ”Viagra” is not the solution for each and every sexual problem. Low desire can be successfully treated if we can address the actual cause of such ‘’low desire”.

ED is a common problem faced by many men, with increased incidence at older age. While some ED has psychological causes, majority of this can be due to some serious conditions like heart diseases, diabetes, nerve problems, hormonal problems, drugs and even some problems in penis itself etc. S, if you directly take “Viagra” without proper evaluation, you are actually damaging your health by delaying the diagnosis of heart disease or diabetes. Sometimes, it may be the earliest symptom of heart disease or diabetes. So, never ignore it.

Painful erection, especially without sexual stimulation is called ‘Priapism” and thi is a quite serious problem. Not only it is caused by diseases like blood diseases, even cancers etc; it may damage the penis seriously.

Any swelling of penis after intercourse should not be ignored, especially if it affects whole of the penis. This is called “Fracture of Penis” that is a medical emergency.

Some people are facing problems with early ejaculation that leads to very low sex timing. This premature ejaculation (PE) is easily treatable by some drugs and few tips and exercises but it needs long term treatment. Please do not think that duration of ‘’normal” intercourse would be more than one hour. Anything around 5 minutes are sufficient for satisfaction.

Similarly absence of ejaculation or presence of blood in semen or bleeding during intercourse are abnormal and needs medical attention, although these problems are relatively uncommon.

4. Infection

Infection in sex organs may have long term consequences like urinary problems, infertility, sexual problems etc and so must not be ignored. All these have been discussed in point number one “”Stay Healthy”)

5. Male Infertility

Due to changes in environment, food habits, addiction and pollution- male infertility is increasing. Semen test is integral part of male fertility testing. But remember, one abnormal semen analysis is not m=necessarily meaning that that person cannot father a baby. With advent of various treatment options, we need to know the cause of male infertility. The next plan is to treat the cause. Even if the cause cannot be treated, there is no loss of hope. Some male have normal sperm production in testes but sperms cannot come out in semen due to obstruction in the passage. In that case, collection of semen from testes can make that male father. On the other hand, if sperm is not produced inside the testes, we need to know the cause and then that cause should be corrected

6. Contraception

Condom is a very good method of contraceptive that also provides protection against infection. It prevents transmission of infection and STD (even HIV) from one partner to another. But correct use is very much important to know as often it breaks or slips due to incorrect use.

Medical methods of male contraceptives (like pills) are not very much popular, unlike females, due to very few studies and serious side effects (like permanent sterility).

Vasectomy is a very effective method of permanent family planning. It does not decrease sexual pleasure and needs very little operative time. It is very easy to do, even without need of hospitalization. But after vasectomy, the couple should use alternative contraceptive for at least 3 months, because immediately after vasectomy, the contraceptive benefits are not obtained.