Men have long understood the importance of the ‘dress for success’ image in order to maintain their edge. Guys of all ages are more interested in taking care of themselves and indulging in image enhancing products, gadgets and treatments. However, they are less likely to grasp the concept of maintenance procedures; they prefer to get it over with in one shot. Once they dip a toe into the realm of non-surgical treatments like BOTOX®, Restylane®, and microdermabrasion and like the way they look, they will go back for more of a good thing. Don’t think for a minute that they’re doing it just for us or the scores of women in their lives. They’re doing it for themselves.
Starting a man on a skin care regimen or tweaking his existing one takes careful planning and subtle persuasion. Picking the right products can make the difference between becoming a heroine and causing a nuclear explosion. They may be sheepish about navigating the cosmetics department, but alternative shopping venues like the Internet, mall kiosks, airports, drug stores, and specialty shops offer essential advice on product selections that cater to their needs minus the frilly, fruity, and flowery stuff. They don’t want to be bothered with too many products. Start small, with an edited regimen of basics - cleansing, protection, moisturizing, post shaving, and a weekly anti-clog treatment. Most men don’t have a clue about their skin type or what works for them. They also require remedial assistance to use the right amount, or it can take a while for them to figure it out on their own. Either they slather it all over or use barely enough to get the job done. Recommend a ‘less is more’ approach. Suggest he start with the size of a dime's worth for cleansers and moisturizers, half that for hair gels to play it safe since the tendency is to overdo it. When it comes to sunscreen, if it came in a six pack they might actually use enough to cover all essential body parts.
A man's skin is different. Male skin is thicker, oilier, with larger pores, a richer blood supply, and more of a tendency to sweat, so they are less prone to wrinkling. They also have more hair all over their body. Basically, guys get grimier and need deep cleansing daily.
Deodorant soaps should never be used on the face because they can irritate skin and leave a sticky residue. For the super lazy, multi-tasking products for face, hair and body will save precious steps. Stick with oil-free formulas that won’t add shine. Beware that your favorite desert island product will have a very different effect on his face, and they are not always interchangeable. Eye gels work nicely for men, but rich eye creams that lock in moisture can increase puffiness. Skin that gets shaved on a regular basis may have red bumps, ingrown hairs and leathery patches. Razor burn can be reduced by using a cleanser in the shower, and a softening shave cream with a sharp razor. Changing the blades at least once a week is vital. The problem of shine can be addressed by using a good scrub to turn over dead cells. For blemishes, sneak in a weekly treatment product like DDF Pumice Acne Scrub (www.ddfskin.com). Adding a toner can reduce pore size, control oil slicks, and help avoid nasty ingrown hairs, but anything too harsh will strip away essential oils when the skin is most vulnerable and sensitive. Make sure he doesn’t splash on alcohol or glycolic acid right after shaving to avoid a sting.
Because men tend to be outside more than most women are, they should be encouraged to wear a high SPF on all exposed skin, especially on the face, nose, ears and scalp. Sporty sunscreen in a stick like DDF Matte Finish Photo Age Protection SPF30 is a good choice. Don't forget about the lips – add a lip balm with an SPF. Men have an increasing incidence of skin cancer, since they are less inclined to visit a Dermatologist for a full body check and more likely to scoff at the need for protection.
Saturday, February 24, 2007
Acupuncture May Improve Sperm Quality
Acupuncture may help some men overcome infertility problems by improving the quality of their sperm, according to a new study.
Researchers found five weeks of acupuncture treatment reduced the number of structural abnormalities in sperm and increased the overall number of normal sperm in a group of men with infertility problems.
They say the results suggest that acupuncture may complement traditional infertility treatments and help men reach their full reproductive potential.
Acupuncture May Ease Male Infertility
An estimated 10% of men are infertile, and the male partner is a factor in up to 50% of infertile couples, write the researchers. In many cases, the cause of male infertility is unknown.
Previous studies of acupuncture and male infertility have suggested that acupuncture can improve sperm production and motility (a measure of sperm movement).
In this study, researchers looked at the effects of acupuncture on the structural health of sperm in men with infertility of unknown cause. The findings appear in the July issue of Fertility and Sterility.
Twenty-eight infertile men received acupuncture treatments twice a week for five weeks, and 12 received no treatment and served as a comparison group.
Researchers analyzed sperm samples at the beginning and end of the study and found significant improvements in sperm quality in the acupuncture group compared with the other group.
Acupuncture treatment was associated with fewer structural defects in the sperm and an increase in the number of normal sperm in ejaculate.
But other sperm abnormalities, such as immature sperm or sperm death, were unaffected by acupuncture.
The researchers write that acupuncture treatment is a simple, noninvasive method that can improve sperm quality.
Researchers found five weeks of acupuncture treatment reduced the number of structural abnormalities in sperm and increased the overall number of normal sperm in a group of men with infertility problems.
They say the results suggest that acupuncture may complement traditional infertility treatments and help men reach their full reproductive potential.
Acupuncture May Ease Male Infertility
An estimated 10% of men are infertile, and the male partner is a factor in up to 50% of infertile couples, write the researchers. In many cases, the cause of male infertility is unknown.
Previous studies of acupuncture and male infertility have suggested that acupuncture can improve sperm production and motility (a measure of sperm movement).
In this study, researchers looked at the effects of acupuncture on the structural health of sperm in men with infertility of unknown cause. The findings appear in the July issue of Fertility and Sterility.
Twenty-eight infertile men received acupuncture treatments twice a week for five weeks, and 12 received no treatment and served as a comparison group.
Researchers analyzed sperm samples at the beginning and end of the study and found significant improvements in sperm quality in the acupuncture group compared with the other group.
Acupuncture treatment was associated with fewer structural defects in the sperm and an increase in the number of normal sperm in ejaculate.
But other sperm abnormalities, such as immature sperm or sperm death, were unaffected by acupuncture.
The researchers write that acupuncture treatment is a simple, noninvasive method that can improve sperm quality.
Should I Be Worried About An Enlarged Prostate?
With sustained improvements in lifestyle, disease prevention, and medical therapies, Americans are living longer. By the year 2020, the number of people now over the age of 60 years is expected to triple. Consequently, diseases and illnesses that are primarily seen in elderly people are becoming more prevalent. One that affects older men is benign prostatic hyperplasia, which is usually referred to by its initials BPH and is commonly known as “enlarged prostate.”
What Happens as My Prostate Enlarges?
What Is the Prostate?
The prostate is a walnut-sized gland found deep in the pelvis in men. It is located just under the bladder and surrounds a tube (urethra) through which urine exits when we urinate. The prostate is rich in nerves and muscle. The function of the prostate is not clearly understood, though it produces 20% of the fluid found in the semen and other substances that are thought to help sperm survive and make penetration easier during sexual intercourse. However, these substances are not essential for fertility. In addition, the prostate is a source of other hormones and enzymes, but these are also not crucial for men to stay healthy. It is common for our prostates to enlarge as we age. Because of where the prostate is located, men may experience problems with urination as it enlarges.
At What Age Is BPH Likely?
It is difficult to know how many men have BPH because we as men often do not have symptoms even though our prostates have enlarged. However, estimates have been made based on examining a representative sample of men in the Untied States:
- Over 30% of men in their 50s- and 46% of men in their 70s have moderate to severe BPH.
- In men who have had their bladder function tested, over half have diminished rates of urinary flow or are unable to fully empty their bladder.
- More than one in three Caucasian men over the age of 50 may have some symptomatic BPH.
- In European men, it has been estimated that 24% aged 50-59 and 40% aged 70-79 have symptoms of BPH.
What Happens as My Prostate Enlarges?
As a prostate enlarges, it goes through three different stages:
- Microscopic (small areas of the prostate are enlarged that can only be detected using a microscope)
- Macroscopic (larger areas are seen under a microscope and felt on rectal examination)
- Symptomatic (causing changes in urinary habits).
As BPH continues to progress, the microscopic areas can increase in size and stimulate certain prostate cells to grow, leading to the development of the next stage: macroscopic BPH. During this stage of enlargement, there is significant growth as well as distortion of your prostate. You may or may not have symptoms, but at this stage your doctor will be able to tell if your prostate is enlarged during a rectal examination.
BPH is considered to be in its final stage when you develop symptoms, most likely difficulty urinating. You may also experience symptoms related to other disorders common in older men, such as those caused by decreased blood supply to the prostate, inflammation or infection of the prostate, and cancer of the prostate.
The progression of BPH is related to age. BPH begins as early as 25-30 years of age in 1 out of 10 men. As we age, the presence of the first stages of BPH (microscopic BPH) increases progressively. And although the size of the prostate increases with age, the rate of growth slows down the older we get. For this reason, only 1 out of 4 men who have microscopic BPH go on to develop symptoms.
What Exactly Are the Symptoms of BPH?
The symptoms of an enlarged prostate -- generally called "prostatism" -- are thought to result from several factors. The prostate surrounds the tube (urethra) that goes from the bladder to the penis, and as the prostate enlarges, it may squeeze this tube. If your urethra becomes partially or completely blocked, you will typically experience one or more of the following symptoms:
- difficulty initiating urination
- decreased force of the urinary stream
- dribbling of urine at the end of the stream
- straining to urinate
- complete inability to urinate, also known as retention. (Urinary retention is often very painful and dangerous because it can result in a backward flow of urine, which can put pressure on the kidneys. Pressure on the kidneys can result in kidney failure, requiring immediate medical treatment.)
- painful urination
- urgency to void
- frequent urination during the day or at night
Individual patients will suffer from different symptoms because of the differences in how the prostate has enlarged and how much pressure it is putting on the urethra. And although these symptoms are typical of BPH, they may be caused by a completely different problem (like infection of the prostate or bladder) that only your doctor can determine.
If you have BPH, the particular symptoms you are experiencing and how they are affecting your quality of life are important in determining the most appropriate therapy for you. Clinicians are faced with the challenge of documenting these symptoms, in order to develop correlations between symptoms and the severity of BPH. A standard symptom questionnaire known as the American Urological Association (AUA) Symptom Index has been developed to assess specific symptoms and determine the severity of the BPH. This survey may be given to you and you will be asked questions about your symptoms within the last month, such as frequency of nighttime urination (nocturia), incomplete emptying, starting and stopping while urinating, hesitancy before urinating, inability to postpone urination, decreased force of stream, and the need for straining. Depending on your score, your BPH would be considered as mild, moderate, or severe. A total score of 0-7 would reflect mild symptoms; 8-19 would reflect moderate symptoms; and 20-35 would reflect severe symptoms.
As mentioned above, it is important for you to know that symptoms commonly associated with an enlarged prostate can also be produced by age-related changes in bladder muscle tone and by other things unrelated to urinary flow obstruction caused by BPH. In fact, many older women have AUA Symptom Scores in the moderate-to-severe range. Nevertheless, the survey is still useful when used as part of your doctor’s overall assessment.
Symptoms of BPH can also vary with time. In a 2-year study, 26% of the men with no urinary symptoms developed some problem with urination within the first year. Of men with moderate symptoms, 34% to 41% worsened, and approximately 36% improved. Almost 50% of men with severe symptoms spontaneously improved on their own to some degree over the first year. However, although symptoms may vary with time, men with moderate to severe symptoms are not as likely to improve that much.
How Dangerous is BPH?
If left untreated, symptomatic BPH may cause serious injury and even death. Bacteria in the urine are found in 9% of men with symptomatic BPH. Decreased kidney function is found in 7% of men at the time of surgical treatment for BPH. If your bladder becomes completely obstructed by an enlarged prostate, you may experience urinary retention or inability to urinate, which may result in kidney failure. In fact, 25% of acute kidney failure patients requiring hospitalization had failure related to urinary obstruction, with 14% of these men having BPH as the cause of obstruction. Another complication of BPH is bladder stones, which occur in 3.4% of men over the age of 60 compared to only 0.4% of men without BPH (similar to women at 0.3%).
Mortality from BPH is most commonly related to kidney failure, infection, and complications of surgery. The mortality rate for BPH is the United States was 3 patients per 1,000,000 in the period between 1985-1989, substantially lower than the 1950s when the mortality rate was 7.5 per 100,000. This improving trend has been noted worldwide with few exceptions and is occurring despite the fact that there are greater numbers of older men alive today.
Wednesday, February 7, 2007
Great Skin for Guys
Men have long understood the importance of the ‘dress for success’ image in order to maintain their edge. Guys of all ages are more interested in taking care of themselves and indulging in image enhancing products, gadgets and treatments. However, they are less likely to grasp the concept of maintenance procedures; they prefer to get it over with in one shot. Once they dip a toe into the realm of non-surgical treatments like BOTOX®, Restylane®, and microdermabrasion and like the way they look, they will go back for more of a good thing. Don’t think for a minute that they’re doing it just for us or the scores of women in their lives. They’re doing it for themselves.
Starting a man on a skin care regimen or tweaking his existing one takes careful planning and subtle persuasion. Picking the right products can make the difference between becoming a heroine and causing a nuclear explosion. They may be sheepish about navigating the cosmetics department, but alternative shopping venues like the Internet, mall kiosks, airports, drug stores, and specialty shops offer essential advice on product selections that cater to their needs minus the frilly, fruity, and flowery stuff. They don’t want to be bothered with too many products. Start small, with an edited regimen of basics - cleansing, protection, moisturizing, post shaving, and a weekly anti-clog treatment. Most men don’t have a clue about their skin type or what works for them. They also require remedial assistance to use the right amount, or it can take a while for them to figure it out on their own. Either they slather it all over or use barely enough to get the job done. Recommend a ‘less is more’ approach. Suggest he start with the size of a dime's worth for cleansers and moisturizers, half that for hair gels to play it safe since the tendency is to overdo it. When it comes to sunscreen, if it came in a six pack they might actually use enough to cover all essential body parts.
A man's skin is different. Male skin is thicker, oilier, with larger pores, a richer blood supply, and more of a tendency to sweat, so they are less prone to wrinkling. They also have more hair all over their body. Basically, guys get grimier and need deep cleansing daily.
Deodorant soaps should never be used on the face because they can irritate skin and leave a sticky residue. For the super lazy, multi-tasking products for face, hair and body will save precious steps. Stick with oil-free formulas that won’t add shine. Beware that your favorite desert island product will have a very different effect on his face, and they are not always interchangeable. Eye gels work nicely for men, but rich eye creams that lock in moisture can increase puffiness. Skin that gets shaved on a regular basis may have red bumps, ingrown hairs and leathery patches. Razor burn can be reduced by using a cleanser in the shower, and a softening shave cream with a sharp razor. Changing the blades at least once a week is vital. The problem of shine can be addressed by using a good scrub to turn over dead cells. For blemishes, sneak in a weekly treatment product like DDF Pumice Acne Scrub (www.ddfskin.com). Adding a toner can reduce pore size, control oil slicks, and help avoid nasty ingrown hairs, but anything too harsh will strip away essential oils when the skin is most vulnerable and sensitive. Make sure he doesn’t splash on alcohol or glycolic acid right after shaving to avoid a sting.
Because men tend to be outside more than most women are, they should be encouraged to wear a high SPF on all exposed skin, especially on the face, nose, ears and scalp. Sporty sunscreen in a stick like DDF Matte Finish Photo Age Protection SPF30 is a good choice. Don't forget about the lips – add a lip balm with an SPF. Men have an increasing incidence of skin cancer, since they are less inclined to visit a Dermatologist for a full body check and more likely to scoff at the need for protection.
Source: HealthNewsDigest.com
Starting a man on a skin care regimen or tweaking his existing one takes careful planning and subtle persuasion. Picking the right products can make the difference between becoming a heroine and causing a nuclear explosion. They may be sheepish about navigating the cosmetics department, but alternative shopping venues like the Internet, mall kiosks, airports, drug stores, and specialty shops offer essential advice on product selections that cater to their needs minus the frilly, fruity, and flowery stuff. They don’t want to be bothered with too many products. Start small, with an edited regimen of basics - cleansing, protection, moisturizing, post shaving, and a weekly anti-clog treatment. Most men don’t have a clue about their skin type or what works for them. They also require remedial assistance to use the right amount, or it can take a while for them to figure it out on their own. Either they slather it all over or use barely enough to get the job done. Recommend a ‘less is more’ approach. Suggest he start with the size of a dime's worth for cleansers and moisturizers, half that for hair gels to play it safe since the tendency is to overdo it. When it comes to sunscreen, if it came in a six pack they might actually use enough to cover all essential body parts.
A man's skin is different. Male skin is thicker, oilier, with larger pores, a richer blood supply, and more of a tendency to sweat, so they are less prone to wrinkling. They also have more hair all over their body. Basically, guys get grimier and need deep cleansing daily.
Deodorant soaps should never be used on the face because they can irritate skin and leave a sticky residue. For the super lazy, multi-tasking products for face, hair and body will save precious steps. Stick with oil-free formulas that won’t add shine. Beware that your favorite desert island product will have a very different effect on his face, and they are not always interchangeable. Eye gels work nicely for men, but rich eye creams that lock in moisture can increase puffiness. Skin that gets shaved on a regular basis may have red bumps, ingrown hairs and leathery patches. Razor burn can be reduced by using a cleanser in the shower, and a softening shave cream with a sharp razor. Changing the blades at least once a week is vital. The problem of shine can be addressed by using a good scrub to turn over dead cells. For blemishes, sneak in a weekly treatment product like DDF Pumice Acne Scrub (www.ddfskin.com). Adding a toner can reduce pore size, control oil slicks, and help avoid nasty ingrown hairs, but anything too harsh will strip away essential oils when the skin is most vulnerable and sensitive. Make sure he doesn’t splash on alcohol or glycolic acid right after shaving to avoid a sting.
Because men tend to be outside more than most women are, they should be encouraged to wear a high SPF on all exposed skin, especially on the face, nose, ears and scalp. Sporty sunscreen in a stick like DDF Matte Finish Photo Age Protection SPF30 is a good choice. Don't forget about the lips – add a lip balm with an SPF. Men have an increasing incidence of skin cancer, since they are less inclined to visit a Dermatologist for a full body check and more likely to scoff at the need for protection.
Source: HealthNewsDigest.com
Monday, February 5, 2007
Penis Size Q & A
How big should my penis be?
The size of your penis is simply determined by factors, called genetic traits, which you inherited from your parents. There is nothing you can do to increase or decrease the size of your penis-it will develop into its adult size as you change from a boy to a man through the process called puberty. Most boys start the changes of puberty between 10 and 14 years of age, though a few will start earlier or later than these ages. First, the testicles (balls) begin to enlarge and then hair starts to grow around the them. The penis then starts to enlarge, first in length and then later in thickness. Though there is much normal variation, the final penis size is reached four to six years after the testicles first started to enlarge.
This process of normal penis growth can be disturbing to many males. Since the testicles enlarge first (and later followed by growth of the penis), many young male teens do not notice the testicles growing and worry that they are not changing and that their penis is too small. If you are overweight, fat tissue can hide the penis somewhat and give an impression that the penis is smaller than it really is. Some males in your class may have started their changes of puberty well ahead of you and they may seem like they have an adult-size penis-that can be very upsetting! It is difficult to know how large a penis will be in its erect state, simply by looking at it when not erect (or when flaccid).
It is also true that adult penis size varies considerably from person to person. Just as with any body part, different people will have different penis sizes. We live in a society that pushes a myth that the male with a larger penis has a better sex life than one with a smaller penis. This is constantly noted in sexual jokes, in comments heard on TV, or in the movies and in many other places. Well, the truth is that normal penises vary tremendously in size, and sex is just as good for each of these males. You will need to wait a year or two after your overall height has stopped changing to see what final size your penis will be. If at any time during your growing, you are worried that your penis is abnormal, just go to your doctor and ask him or her directly about this. In almost every case, you will be told that it is fine.
The skin on my scrotum (balls) is getting darker. Is that normal?
Yes, it is normal for skin over the scrotum to get darker as you change from a boy to an adult. The result of puberty is an increase in chemicals called hormones. Darkening of the skin over the scrotum or balls is actually one of the first steps of puberty. It is noted to occur at the same time that skin over the balls changes from a smooth appearance to a more rough appearance (called stippling). Also at this time, the testicles or balls themselves will begin to enlarge. These changes are all the first visible signs that puberty has begun. The darkening of the scrotal skin is perfectly normal and will be followed over the next few years by even more dramatic changes: adult pubic hair, growth of the penis, hair in the armpits, larger and stronger muscles, facial hair, growth to an adult size, among others. These changes are all determined by factors called genetic traits-these traits come from your parents and determine how fast these changes will occur and what the final results will look like. So if you see this normal darkening of your scrotal skin, you will know that many changes are about to happen over the next few years-changes that start out looking small, but result in taking you from being a boy to being a man!
When do boys start growing hair around the penis?
The growth of pubic hair over the penis and testicles is a normal part of puberty-the time when boys physically change into men. Most boys begin this time of puberty between 10 and 14 years of age and notice many changes in their bodies that occur over several years. Growth of the testicles is a first visible sign of puberty, followed by growth of the penis. Though much variation is noted, pubic hair usually begins to develop several months after the testicles, or balls, begin to grow. In some boys, the hair may even start growing before any changes in the balls are noted. At first, this hair is limited in amount, is straight (or slightly curled), and soft; it is found at the base or beginning of the penis. Over the next several months or few years, it becomes much darker and curly; it also spreads over the balls and inner parts of the thighs. The final amount of hair is usually reached as other parts of puberty are completed-such as final size of the penis and testicles, final height, and facial hair. However, there is much normal variation in the amount and distribution of this hair. The timing and amount of this hair growth is determined by genetic traits inherited from your mom and dad.
Most of the other guys in the locker room have circumcised penises. I am uncircumcised. Is that normal?
All males are born with a fold of skin over the tip of the penis. Doctors call this fold of skin a prepuce, or foreskin, and the surgical removal of this skin is called circumcision. It has been practiced in many cultures for many centuries, often because of religious reasons. There are some doctors who feel that males should be circumcised for medical reasons and note that circumcision will reduce the chances of male infants getting an infection in their bladders. Some doctors feel that circumcised males will have fewer infections when sexually active and will have less cancer of the penis as adults. But-not all doctors agree with these theories and the medical debate continues regarding the medical need for circumcision. However, doctors do agree that being either circumcised or uncircumcised is normal. When you were born, your parents or guardians chose not to have you circumcised. You are part of a large number of men in the world who are not circumcised-and you are all normal. So, do not worry about this difference! It is perfectly OK!
Why does the doctor have to touch my testicles during the medical exam?
The main reason to touch your testicles (balls) during a medical exam is to check for any abnormality with them. It is important to be sure both balls are of approximate size, and that there is no unusual lump or bump on them. Cancer of the testicle can occur in teen males and it is discovered by the doctor (or even you) touching your testicles. If this cancer is found early, most can have the testicle removed and do well. Finding the cancer early is the key to the best outcome. Your doctor should advise you to check your balls on a regular basis-once a month or so. It is often easy to do this while taking a shower. You will quickly learn how your testicles feel and will be able to discover a new lump or bump on them. If you do feel a lump, see your physician immediately to have it checked out. If you notice pain in or around the testicles, have it checked out also. For example, a lump in the scrotum may not be a tumor of the testicle, but a collection of veins called a varicocele. Sometimes surgery is recommended to remove it. At any rate, expect that a physical examination will include an examination of your testicles. The doctor needs to examine them by touching to be sure they and you are healthy! In fact, if your doctor does not do this during an examination, ask him or her why this very important part of your body is being ignored!
The size of your penis is simply determined by factors, called genetic traits, which you inherited from your parents. There is nothing you can do to increase or decrease the size of your penis-it will develop into its adult size as you change from a boy to a man through the process called puberty. Most boys start the changes of puberty between 10 and 14 years of age, though a few will start earlier or later than these ages. First, the testicles (balls) begin to enlarge and then hair starts to grow around the them. The penis then starts to enlarge, first in length and then later in thickness. Though there is much normal variation, the final penis size is reached four to six years after the testicles first started to enlarge.
This process of normal penis growth can be disturbing to many males. Since the testicles enlarge first (and later followed by growth of the penis), many young male teens do not notice the testicles growing and worry that they are not changing and that their penis is too small. If you are overweight, fat tissue can hide the penis somewhat and give an impression that the penis is smaller than it really is. Some males in your class may have started their changes of puberty well ahead of you and they may seem like they have an adult-size penis-that can be very upsetting! It is difficult to know how large a penis will be in its erect state, simply by looking at it when not erect (or when flaccid).
It is also true that adult penis size varies considerably from person to person. Just as with any body part, different people will have different penis sizes. We live in a society that pushes a myth that the male with a larger penis has a better sex life than one with a smaller penis. This is constantly noted in sexual jokes, in comments heard on TV, or in the movies and in many other places. Well, the truth is that normal penises vary tremendously in size, and sex is just as good for each of these males. You will need to wait a year or two after your overall height has stopped changing to see what final size your penis will be. If at any time during your growing, you are worried that your penis is abnormal, just go to your doctor and ask him or her directly about this. In almost every case, you will be told that it is fine.
The skin on my scrotum (balls) is getting darker. Is that normal?
Yes, it is normal for skin over the scrotum to get darker as you change from a boy to an adult. The result of puberty is an increase in chemicals called hormones. Darkening of the skin over the scrotum or balls is actually one of the first steps of puberty. It is noted to occur at the same time that skin over the balls changes from a smooth appearance to a more rough appearance (called stippling). Also at this time, the testicles or balls themselves will begin to enlarge. These changes are all the first visible signs that puberty has begun. The darkening of the scrotal skin is perfectly normal and will be followed over the next few years by even more dramatic changes: adult pubic hair, growth of the penis, hair in the armpits, larger and stronger muscles, facial hair, growth to an adult size, among others. These changes are all determined by factors called genetic traits-these traits come from your parents and determine how fast these changes will occur and what the final results will look like. So if you see this normal darkening of your scrotal skin, you will know that many changes are about to happen over the next few years-changes that start out looking small, but result in taking you from being a boy to being a man!
When do boys start growing hair around the penis?
The growth of pubic hair over the penis and testicles is a normal part of puberty-the time when boys physically change into men. Most boys begin this time of puberty between 10 and 14 years of age and notice many changes in their bodies that occur over several years. Growth of the testicles is a first visible sign of puberty, followed by growth of the penis. Though much variation is noted, pubic hair usually begins to develop several months after the testicles, or balls, begin to grow. In some boys, the hair may even start growing before any changes in the balls are noted. At first, this hair is limited in amount, is straight (or slightly curled), and soft; it is found at the base or beginning of the penis. Over the next several months or few years, it becomes much darker and curly; it also spreads over the balls and inner parts of the thighs. The final amount of hair is usually reached as other parts of puberty are completed-such as final size of the penis and testicles, final height, and facial hair. However, there is much normal variation in the amount and distribution of this hair. The timing and amount of this hair growth is determined by genetic traits inherited from your mom and dad.
Most of the other guys in the locker room have circumcised penises. I am uncircumcised. Is that normal?
All males are born with a fold of skin over the tip of the penis. Doctors call this fold of skin a prepuce, or foreskin, and the surgical removal of this skin is called circumcision. It has been practiced in many cultures for many centuries, often because of religious reasons. There are some doctors who feel that males should be circumcised for medical reasons and note that circumcision will reduce the chances of male infants getting an infection in their bladders. Some doctors feel that circumcised males will have fewer infections when sexually active and will have less cancer of the penis as adults. But-not all doctors agree with these theories and the medical debate continues regarding the medical need for circumcision. However, doctors do agree that being either circumcised or uncircumcised is normal. When you were born, your parents or guardians chose not to have you circumcised. You are part of a large number of men in the world who are not circumcised-and you are all normal. So, do not worry about this difference! It is perfectly OK!
Why does the doctor have to touch my testicles during the medical exam?
The main reason to touch your testicles (balls) during a medical exam is to check for any abnormality with them. It is important to be sure both balls are of approximate size, and that there is no unusual lump or bump on them. Cancer of the testicle can occur in teen males and it is discovered by the doctor (or even you) touching your testicles. If this cancer is found early, most can have the testicle removed and do well. Finding the cancer early is the key to the best outcome. Your doctor should advise you to check your balls on a regular basis-once a month or so. It is often easy to do this while taking a shower. You will quickly learn how your testicles feel and will be able to discover a new lump or bump on them. If you do feel a lump, see your physician immediately to have it checked out. If you notice pain in or around the testicles, have it checked out also. For example, a lump in the scrotum may not be a tumor of the testicle, but a collection of veins called a varicocele. Sometimes surgery is recommended to remove it. At any rate, expect that a physical examination will include an examination of your testicles. The doctor needs to examine them by touching to be sure they and you are healthy! In fact, if your doctor does not do this during an examination, ask him or her why this very important part of your body is being ignored!
Saturday, February 3, 2007
Understanding Erectile Dysfunction
What is Erectile Dysfunction?
Erectile dysfunction means the same thing as impotence. Both erectile dysfunction and impotence mean the inability to have or keep an erection that is good enough for sexual intercourse. If you have erectile dysfunction, it does not mean that you have an inability to have orgasm or a decreased libido (sex drive) or have premature ejaculation; although if you have these other conditions, they can affect the extent of your erectile dysfunction.
What Is an Erection?
How your body actually produces an erection and then maintains it is a complicated process that depends on
- blood flow
- steroid (androgen) production
- nervous system (neurological) stimulation
- chemical signals from the brain (neurotransmitters)
- enzymes
The increase in blood into the penis also compresses the blood vessels (veins) that allow blood to circulate back out of the penis. So once blood flows in, it is trapped and cannot flow out. This allows the erection to be maintained during sexual activity.
What Are the Causes of Erectile Dysfunction?
The causes of erectile dysfunction or impotence can be divided into two broad groups: organic and non-organic.
Organic
Organic causes are related to physical problems, problems involving your body. Examples include:
- neurological deficits caused by diabetes, spinal cord injuries, or brain (cerebral) injuries
- physical injury (trauma)
- poor blood circulation caused by atherosclerotic disease often related to smoking
- inadequate blood vessel compression, which does not allow the erection to be maintained
- drug-induced changes that decrease erectile ability (listed in Table 1)
| Antidepressants | amitriptyline, doxepin, phenelzine |
| Benzodiazepines | diazepam, midazolam |
| Anti-androgens | medications for prostate cancer like flutamide (Eulexin) and leuprolide |
| Antihypertensives | atenolol, propranolol, nifedipine, enalapril, thiazide, clonidine |
| Other | digoxin, cimetidine |
Non-Organic
Non-organic causes are related to psychological factors. The non-organic causes of erectile dysfunction are less well understood. Personal issues, such as marital problems, performance anxiety, or lack of desire, can and do affect erectile ability. (This is also called psychogenic impotence.)
Evaluation of Erectile Dysfunction
My evaluation of erectile dysfunction can be extensive but initially involves a careful history and physical examination. I often order blood tests to look at hormone levels and other elements in your blood. Some examples of the many possible tests that I might use include a test to measure the largeness and frequency of your night time erections (also called nocturnal penile tumescence), Doppler ultrasound to examine blood flow, and different forms of penile pressure measurements.
What Are the Treatment Options?
Unfortunately, despite the recent press involving Viagra, there is no cure-all for impotence. Depending on your medical and surgical history, there are different treatment options that are best suited for your situation and should be discussed with your urologist. Some options may work for some individuals but may prove unsatisfactory for others. Every treatment option has its advantages and disadvantages, and each one should be considered carefully before choosing any of them.
Oral Medication
Viagra is the best known, but others will soon be available. The side effects of Viagra include headache, nausea, and vision changes. You should not use Viagra if you have heart or high blood pressure problems before discussing carefully this with your physician.
Intraurethral Medication
This is a small pellet that is placed into the penis at the tip and the medication is then absorbed. It is the same medication that is often used for injection therapy. This method avoids many of the side effects of injections but is often not as effective.
Intracavernous Medication
This is often called penile injection therapy. Using a small needle or an auto-injection device, medication is injected at the base of the penile shaft that causes increased blood flow and an erection. Possible side effects include pain, toughening of the penis (penile fibrosis), and prolonged, unwanted erections (priapism) of several hours or more that must be treated medically or sometimes surgically. The chance of this is small but real. The first injection is given at the clinic after carefully teaching you how the injection should be administered.
Vacuum Constriction Devices
These devices fit over the penis and have a pump that pulls blood into the penis. The blood pulled into the penis is trapped by a ring-like device that is placed at the base of the penis. Possible problems include bruising, difficulty in ejaculation, and decreased sensation.
Penile Prosthesis Surgery
There are different types of prostheses. All involve surgery, and each type has its own advantages and disadvantages. Semi-rigid devices are not as life-like but are associated with less injuries and complications. The various inflatable prostheses available, however, are much more life-like and tend to be more satisfying for both partners. Over a period of time, there is a possibility of infection and mechanical problems that would require another operative procedure. A penile prosthesis should be the last resort, and other treatment attempts should be made before pursuing surgery.
Thursday, February 1, 2007
Is There a Link Between Viagra and Blindness?
July 11, 2005—The Food and Drug Administration (FDA) has ordered the makers of Viagra, Cialis and Levitra to add new warnings about rare cases of sudden vision loss. A recent study also noted these vision problems, known as non-arteritic anterior ischemic optic neuropathy (NAION), in seven men who had taken Viagra.
The agency is advising patients to stop taking these medicines or call a doctor or right away if they experience sudden or decreased vision loss in one or both eyes. In a statement, the agency said that a small number of men lost their sight some time after taking Viagra, Cialis or Levitra. "It is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes or to a combination of these problems," the FDA said.
Well over 20 million men have taken these anti-impotence drugs, meaning that whatever risk there is of developing vision loss—if there is a risk at all—would seem extremely small. Still, just how serious of a condition is NAION, and what can be done in men who develop it?
What is NAION?
NAION is one of the most common causes of sudden vision loss in older Americans.
The condition leads to swelling around the optic disc, a connection point where the optic nerves reach the back of the eye. Ultimately, this swelling compresses the optic nerves and causes a rapid drop in vision. About 6,000 people develop NAION each year, according to the National Eye Institute.
How does NAION develop?
The symptoms are painless and often appear without notice. In a study led by researchers at the University of Iowa, about three quarters of NAION patients first discovered their vision was blurry and impaired after waking up in the morning. The condition starts in one eye and can cause complete blindness if both eyes are eventually affected.
Is there a risk from Viagra and other anti-impotence drugs?
No one can say for sure. Pfizer, the manufacturer of Viagra, defends the safety of its drug. "A review of 103 Viagra clinical trials involving 13,000 patients found no reports of non-arteritic anterior ischemic optic neuropathy," the company stated. "There is no evidence showing that NAION occurred more frequently in men taking Viagra than men of similar age and health who did not take Viagra."
Andrew Schachat, MD, an ophthalmologist with the Wilmer Eye Institute at Johns Hopkins University, who has no financial ties to Pfizer, is equally skeptical. "With the millions of patients who use Viagra, it is not surprising to find cases of NAION and in fact, one would expect to find some," he said.
The FDA continues to investigate whether there is a connection. Schachat said he doubts Viagra or other anti-impotence drugs cause NAION, "but a careful study would be needed."
So far, the warnings about side effects—such as NAION and erections that last more than four hours—are the same for each of the three popular anti-impotence drugs.
Why is the concern about Viagra and NAION surfacing now?
The chance that Viagra might lead to NAION was first brought up by Howard Pomeranz, MD, an eye expert at the University of Minnesota. In 2000, he reported the case of a man who developed NAION soon after he took Viagra. There have been several other reports since then.
In a study published in the Journal of Neuro-Ophthalmology this past March, Pomeranz noted seven new cases, bringing the total to 14 men who developed NAION possibly because of Viagra. On May 26, the FDA first confirmed to CBS News that they were investigating similar reports in nearly 50 men.
Does NAION lead to permanent vision loss?
Not always. Until a few years ago, it was estimated that only a small minority of patients were likely to regain their vision. But new studies have shown that a surprisingly high number of NAION patients spontaneously recover on their own.
Following some 100 or so men and women who were involved in a major trial sponsored by the National Eye Institute, researchers found that about 40 percent of NAION patients had some improvement in eye sight after three months. Indeed, they fared better than a similar number of patients who underwent an experimental procedure to prevent further vision loss.
"It's much better than we expected," said Kay Dickersin, PhD, a professor of Community Health at Brown University who has helped with the study, known as the Ischemic Optic Neuropathy Decompression Trial.
Is the vision loss substantial?
NAION can be disabling, especially if it affects both eyes. In the National Eye Institute study, whatever gains the patients had were partly lost after two years. But even with declining eyesight, most had better vision than when they were first afflicted with NAION. "These improvements are a noticeable difference," Dickersin said.
Is there any treatment for NAION?
There is no effective treatment as of yet, although researchers are examining different therapies in clinical trials.
Who is at risk for NAION?
Those who have bad eyesight already appear to have the highest chance for developing NAION. While people who have diabetes, hypertension or high cholesterol seem to be a greater risk for NAION as well, there is some debate on how much. "None of these systematic disorders are firmly associated with NAION, and diabetes could only account for only a minority of the cases," stated Simmons Lessell, MD, of the Massachusetts Eye and Ear Infirmary in an editorial for the Archives of Ophthalmology.
Is there a strong reason to suspect that Viagra raises the risk of blindness?
The seven men in Pomeranz's recent study all developed NAION soon after they took Viagra. After taking two blue Viagra pills the day before, one 50-year old man said he felt "a flashbulb go off in my eyes." The onset of vision loss within hours of taking Viagra "supports an association between use of this agent and NAION," Pomeranz wrote.
However, NAION appears suddenly in some 6,000 people a year for a variety of unknown reasons. "We don't really know what the natural history of NAION is," said Dickersin. Pomeranz is also cautious about Viagra causing NAION: "A definite casual relationship cannot be established at this time," he noted.
The Bottom Line
Recent guidelines from the American Urological Association recommended either Viagra, Cialis or Levitra as the first option for treating erectile dysfunction, which have not changed in light of the recent bad publicity about their potential link to NAION.
In general, as many as 80 percent of men will benefit from these drugs, said Drogo Montague, MD, of the Cleveland Clinic in announcing the new guidelines. Men can try injections, external pumps or a penile implants if Viagra or similar drugs fail to work. "For those men who are not helped by these agents, one or more of the remaining treatment options are almost always successful," said Montague.
The agency is advising patients to stop taking these medicines or call a doctor or right away if they experience sudden or decreased vision loss in one or both eyes. In a statement, the agency said that a small number of men lost their sight some time after taking Viagra, Cialis or Levitra. "It is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes or to a combination of these problems," the FDA said.
Well over 20 million men have taken these anti-impotence drugs, meaning that whatever risk there is of developing vision loss—if there is a risk at all—would seem extremely small. Still, just how serious of a condition is NAION, and what can be done in men who develop it?
What is NAION?
NAION is one of the most common causes of sudden vision loss in older Americans.
The condition leads to swelling around the optic disc, a connection point where the optic nerves reach the back of the eye. Ultimately, this swelling compresses the optic nerves and causes a rapid drop in vision. About 6,000 people develop NAION each year, according to the National Eye Institute.
How does NAION develop?
The symptoms are painless and often appear without notice. In a study led by researchers at the University of Iowa, about three quarters of NAION patients first discovered their vision was blurry and impaired after waking up in the morning. The condition starts in one eye and can cause complete blindness if both eyes are eventually affected.
Is there a risk from Viagra and other anti-impotence drugs?
No one can say for sure. Pfizer, the manufacturer of Viagra, defends the safety of its drug. "A review of 103 Viagra clinical trials involving 13,000 patients found no reports of non-arteritic anterior ischemic optic neuropathy," the company stated. "There is no evidence showing that NAION occurred more frequently in men taking Viagra than men of similar age and health who did not take Viagra."
Andrew Schachat, MD, an ophthalmologist with the Wilmer Eye Institute at Johns Hopkins University, who has no financial ties to Pfizer, is equally skeptical. "With the millions of patients who use Viagra, it is not surprising to find cases of NAION and in fact, one would expect to find some," he said.
The FDA continues to investigate whether there is a connection. Schachat said he doubts Viagra or other anti-impotence drugs cause NAION, "but a careful study would be needed."
So far, the warnings about side effects—such as NAION and erections that last more than four hours—are the same for each of the three popular anti-impotence drugs.
Why is the concern about Viagra and NAION surfacing now?
The chance that Viagra might lead to NAION was first brought up by Howard Pomeranz, MD, an eye expert at the University of Minnesota. In 2000, he reported the case of a man who developed NAION soon after he took Viagra. There have been several other reports since then.
In a study published in the Journal of Neuro-Ophthalmology this past March, Pomeranz noted seven new cases, bringing the total to 14 men who developed NAION possibly because of Viagra. On May 26, the FDA first confirmed to CBS News that they were investigating similar reports in nearly 50 men.
Does NAION lead to permanent vision loss?
Not always. Until a few years ago, it was estimated that only a small minority of patients were likely to regain their vision. But new studies have shown that a surprisingly high number of NAION patients spontaneously recover on their own.
Following some 100 or so men and women who were involved in a major trial sponsored by the National Eye Institute, researchers found that about 40 percent of NAION patients had some improvement in eye sight after three months. Indeed, they fared better than a similar number of patients who underwent an experimental procedure to prevent further vision loss.
"It's much better than we expected," said Kay Dickersin, PhD, a professor of Community Health at Brown University who has helped with the study, known as the Ischemic Optic Neuropathy Decompression Trial.
Is the vision loss substantial?
NAION can be disabling, especially if it affects both eyes. In the National Eye Institute study, whatever gains the patients had were partly lost after two years. But even with declining eyesight, most had better vision than when they were first afflicted with NAION. "These improvements are a noticeable difference," Dickersin said.
Is there any treatment for NAION?
There is no effective treatment as of yet, although researchers are examining different therapies in clinical trials.
Who is at risk for NAION?
Those who have bad eyesight already appear to have the highest chance for developing NAION. While people who have diabetes, hypertension or high cholesterol seem to be a greater risk for NAION as well, there is some debate on how much. "None of these systematic disorders are firmly associated with NAION, and diabetes could only account for only a minority of the cases," stated Simmons Lessell, MD, of the Massachusetts Eye and Ear Infirmary in an editorial for the Archives of Ophthalmology.
Is there a strong reason to suspect that Viagra raises the risk of blindness?
The seven men in Pomeranz's recent study all developed NAION soon after they took Viagra. After taking two blue Viagra pills the day before, one 50-year old man said he felt "a flashbulb go off in my eyes." The onset of vision loss within hours of taking Viagra "supports an association between use of this agent and NAION," Pomeranz wrote.
However, NAION appears suddenly in some 6,000 people a year for a variety of unknown reasons. "We don't really know what the natural history of NAION is," said Dickersin. Pomeranz is also cautious about Viagra causing NAION: "A definite casual relationship cannot be established at this time," he noted.
The Bottom Line
Recent guidelines from the American Urological Association recommended either Viagra, Cialis or Levitra as the first option for treating erectile dysfunction, which have not changed in light of the recent bad publicity about their potential link to NAION.
In general, as many as 80 percent of men will benefit from these drugs, said Drogo Montague, MD, of the Cleveland Clinic in announcing the new guidelines. Men can try injections, external pumps or a penile implants if Viagra or similar drugs fail to work. "For those men who are not helped by these agents, one or more of the remaining treatment options are almost always successful," said Montague.
Milk's health benefits outweigh its prostate risks
Should my husband cut back on milk to prevent prostate cancer?
The answer is no. Although a recent study seemed to link high calcium intake with prostate cancer, even the study's authors say it's too soon to stop aiming for the Daily Value of 1,000 mg (1,200 if you're over 50).
"More studies showing a prostate cancer link need to turn up before you should even consider changing calcium intake," says June Chan, ScD, of the University of California, San Francisco (Amer. Jour. of Clinical Nutrition, Oct 2001). Besides guarding bones (men get osteoporosis too), calcium appears to prevent high blood pressure and colon cancer.
The answer is no. Although a recent study seemed to link high calcium intake with prostate cancer, even the study's authors say it's too soon to stop aiming for the Daily Value of 1,000 mg (1,200 if you're over 50).
"More studies showing a prostate cancer link need to turn up before you should even consider changing calcium intake," says June Chan, ScD, of the University of California, San Francisco (Amer. Jour. of Clinical Nutrition, Oct 2001). Besides guarding bones (men get osteoporosis too), calcium appears to prevent high blood pressure and colon cancer.
Herbal Help for Prostate Health
Scientific research can be a slow process. It starts with simple observation, followed by the collection of scientific data. A few years ago, an Austrian herbalist named Maria Treben wrote a bestselling book that was translated into English as Health Through God's Pharmacy (Ennsthaler, 1998). In it, she recommended a tea prepared from the small-flowered willow herb (Epilobium parviflorum) as an effective treatment for benign prostatic hyperplasia (BPH), or prostate enlargement. The herb became very popular in Europe, but there was no evidence to support its value.
Scientists have isolated compounds known as oenotheins from the Epilobium species and, in test-tube experiments, have shown them to inhibit the enzymes aromatase and 5-alpha-reductase, both of which are involved in prostate enlargement. Clinical studies have not yet been carried out, but the signs are hopeful that the traditional use of this herb will be validated. Willow herb is not yet widely available in the US.
Scientists have isolated compounds known as oenotheins from the Epilobium species and, in test-tube experiments, have shown them to inhibit the enzymes aromatase and 5-alpha-reductase, both of which are involved in prostate enlargement. Clinical studies have not yet been carried out, but the signs are hopeful that the traditional use of this herb will be validated. Willow herb is not yet widely available in the US.
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