We would like to calm anyone’s worries regarding the curve of their  penis by letting them know that the shape of a man’s penis can vary considerably from person to person. More importantly, we want to stress that as long as the curvature of a man’s penis does not cause any discomfort or pain to the individual or their partner, the shape of their penis should not be a cause for alarm.

We would like to underscore the fact that a curved penis is actually much more common than it seems. In fact, more than 50 percent of men have a slight curve or tilt to their erection. Some curve up, some down, some to one side or the other. These men are not alone! The need for treatment or corrective procedures depends on the severity of the curvature, and most men do not require any straightening procedures. If a man has just a slight curve in any direction, it is unlikely that it has any significant effect during penetrative intercourse. However, if the curve is more severe it can make sex painful for the man and his partner. (This is especially true for penises that curve down.) If the curve of a man’s penis is causing them pain or discomfort, we recommend seeking professional medical help. A doctor will be able to provide an individual with much more specific information and treatment, if necessary.

Ultimately, the decision to seek corrective surgery for cosmetic reasons rests with the individual. While surgery can be effective, it can pose many unnecessary and serious risks, including impotence (the inability to become erect or maintain an erection for sexual intercourse). It is strongly advised that surgery be sought out in only the most severe cases in which intercourse is extremely painful or even impossible. As mentioned previously, a slight curve in the penis is very common and not a cause for concern. If it is not interfering with a man’s sex or daily life, they should know that there is no cause for concern.

Epididymal hypertension or "blue balls" refers to the testicular aching that occurs when a male is sexually aroused for a prolonged period of time, and the blood in his genitals is not dissipated because he does not orgasm. The reason this condition is termed “blue balls” is because the scrotum may turn a bluish hue from the accumulation of deoxygenated blood in the testicles. Oxygen-rich blood is bright red while oxygen-poor blood is dark red. When blood remains in the genitals because of prolonged sexual arousal, it does not circulate back to the heart and lungs and its dark appearance contributes to the bluish hue of the scrotum.

Epididymal hypertension does not usually last for very long, and the pain associated with it is often minor. Some men grow frustrated when they are sexually aroused but do not achieve orgasm. This frustration and failure to ejaculate can add psychological stress to physical discomfort and exacerbate his discomfort. The simplest remedy for blue balls is orgasm and ejaculation. Masturbation is often the most viable way to achieve orgasm, especially if one's partner is not ready for intercourse. The testicular pain will dissipate slowly after orgasm, and a single orgasm should be sufficient to relieve the tension. Without orgasm, the tension will slowly relieve itself as the individual becomes less aroused. If a man continues to experience significant or persistent pain, we recommend that they visit their doctor. 

This painful experience can have multiple sources of origin. The following suggestions are simply possibilities we believe may be the cause of this rectal pain and are not meant in any way to be an official medical diagnosis. During the excitement phase of the sexual response cycle, the penis becomes erect due to an increase in blood flow to the genital area (this process of engorgement is called vasocongestion). When the penis is fully erect but does not progress through the phases of sexual response (stopping sexual relations prior to emission and ejaculation), the increase blood supply is still present and can lead to pain in the genital area. Medically known as temporary fluid congestion, this ailment causes a mild cramp-like ache in the prostate and swelling and tenderness of the testes. The rectal pain might be physiologically linked to the prostate ache; if this is the case, we suggest masturbating (perhaps alone versus mutual masturbation with a partner) to ejaculation when ejaculation does not occur in a person’s sexual encounters with their partner.

Another possible explanation for rectal pain could be hemorrhoids. Hemorrhoids are swollen veins in the rectal canal and are classified by two sub-categories: external hemorrhoids and internal hemorrhoids. Veins that are swollen within the anal canal lead to internal hemorrhoids, while veins that swell near the opening of the anus characterize external hemorrhoids. People can experience both types at the same time or individually and are characterized by similar symptoms. These symptoms include: bleeding during bowel movements, itching, and rectal pain. The swollen anal veins of internal hemorrhoids might be the cause of that pain. Walking can create extra pressure on the swollen veins, causing mild to extreme pain. The symptoms associated with hemorrhoids might become more intense after sexual encounters due to the excess fluid congestion and pressure in the area. Hemorrhoids can be easily treated with over-the-counter creams and medications. 

Sometimes when I am having sex with my partner, I ejaculate before I would like to. Is there anything I can do to prevent this from occurring?

It is very common for a man to ejaculate before he intends to during sex. In order to combat this, there are a variety of techniques designed to help a male partner last longer before ejaculating. One method is called the “Stop-Start Technique,” in which the male’s partner stimulates his penis until he can sense orgasm is near (a man can stimulate himself as well). As soon as he feels this, stimulation must stop until the male’s arousal decreases. Once the male has returned to the plateau stage of the sexual response cycle, stimulation may begin again. (If you would like to learn more about the sexual response cycle, please click here.) Through repetition of this process, a male can slowly learn to improve his orgasmic control.

A second method of prolonging orgasm is known simply as the “Squeeze Technique.” It is similar to the “Stop-Start” method (mentioned above). Instead of ceasing stimulation near orgasm, however, either the male or his partner squeezes right below the glans (the head of the penis) or the base of the penis, until arousal has decreased. When the male is ready, stimulation may begin again. More information on these techniques can be found in our article: Premature Ejaculation.

Another factor to bear in mind is that orgasm should not be the end goal of sexual activity. Sex can often be very fulfilling and satisfying even when one or both partners do not orgasm. In fact, many partners learn to enjoy foreplay and intercourse more than the orgasm itself. Couples should try to treat the entire experience as if there is no goal in mind; they should take their time with foreplay, communicate, explore each other’s bodies, and discover what makes each other feel pleasure along the way. Lastly, it is important to remember that even after orgasm, one can still satisfy his or her partner with the fingers (manual stimulation) or mouth (oral stimulation), or even with sex toys such as dildos and vibrators.

 

More information on these methods of sexual stimulation can be found on our website:

·         Manual Stimulation

·         Oral Sex

·         Female Masturbation

·         Sex Toys

 

Male infertility can result from several factors, including low sperm count, abnormal sperm shape or size, and reduced sperm motility. These abnormalities can result from both a male’s lifestyle and genetics. While it takes the fertilization of just one egg by one sperm to achieve pregnancy, there are millions of sperm in every ejaculate that never reach an egg. A typical ejaculation contains about 100 million sperm. A low sperm count is defined as fewer than 20 million sperm per milliliter of semen. In order to maintain a healthy sperm count, make sure to avoid smoking cigarettes, decrease exposure to toxins such as pesticides, limit consumption of alcohol, and reduce activities that promote excessive heating of your scrotum—such as sitting in a hot bath or hot tub. Some studies have also shown that keeping a cell phone in a man’s pocket or computer on their lap may decrease  their sperm count by heating the testicles with electromagnetic frequencies. To maintain healthy sperm levels, it is also important to establish a healthy weight and diet and to remain physically active.

For natural methods to increase sperm count, some turn to acupuncture and nutrition. Acupuncture treatments focus on returning the entire body to a state of balance, in hopes that whole-body health (including sperm health) will increase in quality. Acupuncture may also help relieve stress, which can be correlated with a reduced sperm count. Adjusting a man’s  nutrition to increase sperm levels can include adding supplements, such as multi-vitamins, fish oil, and Selenium, to their diet. Selenium levels can be increased with the consumption of brazil nuts, liver, turkey, crimini mushrooms, and fish such as snapper, cod, halibut, tuna, salmon, sardines, and shrimp. Eating foods with zinc may also boost sperm levels. This mineral can be found in lamb, venison, pumpkin seeds, yogurt, green peas, and beef. Vitamin B (found in clams, oysters, eggs, beef, lamb, and cheese) and Vitamin C (found in plants and fruits, especially red peppers, broccoli, tomatoes, cabbage, potatoes, and citrus fruits) are two vitamins that may help improve sperm count. Herbal tonics made with maca root, schisandra fruit and seed, tribulus, or ashwagandha root may also help increase sperm count. Men should reduce the intake of foods that mimic estrogen in the male body since these can throw off their natural hormone levels. Things that mimic estrogen—and should therefore be avoided—include soy foods, hormones added to dairy and meat, pesticides, and plastic seepage from bottles and food containers. It takes about three months for sperm to mature in the testes, so a change in diet may not have visible results for at least three to six months.  

There are also alternative methods to achieving pregnancy. A man should talk to their health care provider about surgery, medication, and hormone treatments that may help increase the chances of conception. One method is intrauterine insemination, in which the male provides the doctor with a sample of his semen. From this sample, the doctor separates the healthy sperm from the semen and then places these sperm directly into the female’s uterus. This increases the chance that sperm will successfully reach and fertilize an egg. In vitro fertilization is another option, in which the female’s eggs are removed and combined with sperm in a lab. Once fertilization has occurred, one or more fertilized eggs are placed into the female’s uterus in hopes that a pregnancy will result. 

This is very common, many men have difficulty maintaining an erection directly before a sexual opportunity. He may have too many things on his mind and feel anxious before having sex. Some men worry that they aren’t experienced enough and fear judgment from their partner. Others may be intimidated by some women and experience something termed “performance anxiety.” This term is problematic because it insinuates that having sex is a performance, which is not true. Sex is not a way for a man to “show off” or “perform” by any means, rather, it is an opportunity for a man and his partner to make each other feel wonderful. To keep this from reoccurring, a man can try relaxing before attempting to have intercourse. Stretching or doing yoga may help them find inner peace and make them feel more confident. Having a grip on their psyche will have tremendous effects on a man’s sex life in various ways. Communicating with their future partner about their fears may actually make them feel relieved and more relaxed. If a man continues to feel nervous before having sex, they may want to question the suitability of their partner. A man should make sure their partner welcomes sexual contact and makes them feel welcome in the bedroom.

The “difficulty” described regarding a lack of ejaculatory fluid may be a condition called “ejaculatory incompetence” (please note this term is from the professional literature and does NOT imply any incompetence on the part of the male experiencing the problem!). Ejaculatory incompetence is defined as a male’s evident inability to ejaculate, even with the presence of an erection and sexual arousal. Another possibility is a condition called “partial ejaculatory incompetence,” which results in a “half” orgasm – that is, slight seepage of semen without true orgasmic sensations (caused by pelvic muscle contractions). Partial ejaculatory incompetence is relatively common for males and is often related to fatigue or a state of stress in the man’s life.

If there are satisfying orgasms without ejaculation, however, there could be a deeper physiological (biological) cause. One possible culprit is the phenomenon called “retrograde ejaculation,” in which semen enters the bladder upon ejaculation instead of going out through the penis. With retrograde ejaculation, the sphincter muscle that typically blocks off the opening to the bladder does not function properly, allowing all or part of the semen to travel up into the bladder instead of through the tip of the penis. If this is occurring, urine may appear cloudy after sexual climax. The presence of semen in the bladder is harmless. In some cases, though, retrograde ejaculation can cause infertility, so it is important to speak with a doctor to determine the actual underlying cause of ejaculatory difficulty. 

Blood in urine is medically referred to as hematuria and can have many different causes. Forceful or harsh coughing does not usually lead to blood in urine, so it is probable that the pain and bleeding are caused by another factor. The following are possible causes for these symptoms and are not meant as an official medical diagnoses. If the problem persists or worsens, we recommend visiting a doctor for proper evaluation and treatment.

    Urinary tract infections (UTIs), which are infections of parts of the urinary tract system, are a common cause of hematuria accompanied by painful urination. Infections of the urethra (urethritis) and infections of the bladder (cystitis) are more common and less detrimental than infections of the kidneys (pyelonephritis). The symptoms of these infections are as follows:

  • Urethritis: painful urination

  • Cystitis: pelvic pressure or pain, lower abdominal pain, urinary urgency and pain, blood or pus in urine.

  • Pyelonephritis: nausea, vomiting, fever, chills, upper back and side pain, abdominal pain, urinary urgency.

If any of these symptoms are experienced, it is important to visit a physician for treatment immediately because the infections can worsen and complications, such as kidney damage, may arise. No over-the-counter treatment or home remedy, such as drinking cranberry juice, can cure UTIs; antibiotics are vital for treatment.

Another possible cause of the hematuria are kidney stones. Kidney stones can be caused by dehydration and symptoms include fatigue, loss of appetite, dark-colored urine, light-headedness, and dry cough. Passing kidney stones through the urethra can be extremely painful and can often cause small tears in the urethra leading to hematuria. Other urological conditions such as kidney disease, enlarged prostate, or kidney injury may be possible etiologies (causes) of hematuria.