DISORDER OF THE PENIS

The penis is one of the external structures of the male reproductive system. The penis has three parts: the root, which attaches to the wall of the abdomen; the body, or shaft; and the glens penis, which is the cone-shaped end (head). The opening of the urethra, the tube that transports semen and urine, is at the tip of the glens penis.

The body of the penis is cylindrical in shape and consists of three internal chambers. These chambers are made up of special, sponge-like erectile tissue. This tissue contains thousands of large caverns that fill with blood when the man is sexually aroused. As the penis fills with blood, it becomes rigid and erect, which allows for penetration during sexual intercourse. The skin of the penis is loose and elastic to accommodate changes in penis size during an erection.

Semen, which contains sperm (the male reproductive cells), is expelled through the end of the penis when the man reaches sexual climax (orgasm). Disorders of the penis can affect a man’s sexual functioning and fertility.

Penis

The penis (plural penises or penis) or phallus is the male popularity organ, and in mammals, the male organ of urinary excretion. It is homologous to the female clitoris, as it develops from the same embryonic structure. the male sexual organs comprise both the penis and the testes. The penis is capable of erection for use in sexual intercourse.

Structure

The human penis is built of three columns of erectile tissue:

  • the two corpora cavernosa and
  • one corpus spongiosum which lies below them.

The end of corpus spongiosum is enlarged and cone-shaped and forms the glans penis. The glans supports the foreskin or prepuce, a loose fold of skin that can retract to expose the glans. It aids in sexual insertion, keeps the glans moist and provides a gliding action which is said to increase sexual pleasure for the man and his partner as well. For various culturual, religious, and more rarely medical reasons, the foreskin is sometimes partly or completely removed; this is called circumcision. Removal of the same tissue in females is considered a genital mutilation and is outlawed in many countries. The area on the underside of the penis, where the foreskin attaches, is called the fermium (or frenulum). The inner portion of the foreskin near the sulks is a highly innervated area known as the ridged band. Removal of the foreskin by circumcision also usually removes the ridged band and injures or removes the frenelium.

The urethra, which is the last part of the urinary tract, traverses the corpus sponges and its end lies on the tip of the glens penis. It is both a passage for urine and for the ejaculation of semen. Sperm is produced in the testes and stored in the attached epidermis. During ejaculation, sperm are propelled up the vas deferens, two ducts that pass over and behind the bladder. Fluids are added by the seminal vesicles and the vas deferens turns into the ejaculatory ducts which join the urethra inside the prostate gland. The prostate as well as the bulb urethral glands add further secretions, and the semen is expelled through the penis.

Erection

                                                                                                     

A man gets an erection when the penis enlarges and stiffens.

It is a complex process that happens as a result of changes within the muscles, nerves and blood vessels of the penis.

The regulation of blood flow into and out of the penis is what makes an erection possible.

  1. Specialized tissues in the shaft of the penis trap blood. This      increases the pressure within the penis and causes it to lengthen and then become firm.
  2. Following orgasm or the withdrawal of sexual stimulation, the process is reversed. Blood flows out of the penis and back into your circulation so the penis becomes soft.

How an Erection Happens

                                                                                            

  1. Touch, sights, sounds, erotic memories, fantasies etc, cause sexual excitement.
  2. These stimuli increase signal output from a part of the brain called the Para-ventricular nucleus.
  3. These signals then pass through special autonomic nerves in the spinal cord, the pelvic nerves and the cavernous nerves that run along the prostate gland to reach the corpora cavernous and the arteries that supply them with blood.
  4. In response to these signals, the muscle fibers in the corpora relax, allowing blood to fill the spaces between them.
  5. Muscle fibers in the arteries that supply the penis also relax, and there is an eight-fold increase in blood flow to the penis. The increased blood flow expands the corpora, then stretches the surrounding sheath (the tunica).
  6. As the tunica stretches, it blocks off the veins that take blood away from the corpora cavernous. This traps blood within the penis, the pressure becomes very high and the penis becomes erect.

                                                                                         

  1. During an erection pressure in the penis is at least twice the pressure of blood in the main circulation. This is possible because the muscles of the pelvic floor contract around the base of the corpora cavernous.
  2. At orgasm, the signaling from the brain changes dramatically. There is a sudden increase in noradrenalin production from nerves in the genitalia. This seems to both trigger orgasm and contract the muscle fibers in the corpora cavernous and their supplying arteries.
  3. The pressure within the corpora drops, which also relaxes the tunica and so allows blood to flow out of the penis

A semi erect penis

                                                                                       

Erection is a stiffening and hardening of the penis which occurs in the sexually aroused male. Erection enables sexual intercourse, though it is not essential, and some other sexual activities.

Size

In comparison to body size, the human male penis is among the largest of the primates. From polling, the average human male penis is 5 1/2 inches (14 cm) in length when fully engorged with blood during arousal, though this varies quite a bit.

The size of a flaccid human penis has an even greater variation in both length and width that often does not predict the size of a fully aroused member. For example, a man with a relatively small flaccid penis may have an above average length penis when fully aroused. The opposite is also true.

Penile Disorders

                                                                                            

During growth and development, the penis growths in length and width. At the end of puberty, the average erect penis is about six inches long, while the flaccid or non-erect penis may be much smaller. Many teen males worry about their penis size often noticing the differences while showering with others after sports. In fact, penis size is not related to masculinity, fertility or ability to give or obtain sexual gratification. Some males are concerned about the shape of the penis since some are straight and others have a slight curve. These are normal variations and have absolutely no effect on function.

All males are born with a foreskin. This skin covers the glans or head of the penis as well as the shaft of the penis. An adolescent male should be able to retract the foreskin away from the glans so that he can clean smegma which is a substance secreted by the foreskin. Many males are circumcised at birth either due to custom, religious belief or a medical concern

                                                                                           

There are some medical issues that could occur with an uncircumcised male. If the foreskin cannot be retracted away from the glans, then the patient may have phimosis or a tight foreskin. By the time males enter grade school, about ninety percent of those who are uncircumcised are able to retract the foreskin. By adolescence, if the foreskin cannot be retracted, then circumcision is probably indicated since phimosis may cause discomfort during urination or sexual activity.

Occasionally a tight foreskin is forcibly retracted and becomes stuck behind the head of the penis. This causes pain and swelling which further inhibits the boy’s ability to place the foreskin back into its natural position. This could occur when a male with phimosis has his first sexual intercourse. A physician should be consulted immediately for care. An emergency circumcision may be indicated.

In uncircumcised males, the end of the foreskin, which is called the prepuce, covers the head of the penis. The prepuce secretes smegma and provides a warm and moist environment, which could allow for infection under certain conditions. Uncircumcised males can be infected with yeast from their female sexual partner. The yeast produces an infection termed balanitis around the head of the penis. The symptoms include burning, itchiness and swelling of the head of the penis. Treatment includes good hygiene and the application of an antifungal cream. The sexual partner should also be treated.

The penis may be subject to injury during sexual activity or sports. In uncircumcised males, a bacterial balanitis can occur. This usually will respond to good hygiene and topical antibiotics. All males could be subject to bacterial or viral infection of the penis that could occur from sexual activity. Human bites to the penis can transmit bacteria, or chafing from sex combined with poor hygiene could lead to local skin infection. Treatment could include topical or oral antibiotics. In contact sports, teens should be sure to wear an athletic cup to protect the penis from injury.

Contact allergies may affect the penis. The symptoms will include itchiness, burning and redness. Probably the most common contact allergy is a reaction to latex condoms. If this occurs, then discontinuing latex condoms and substituting natural skin condoms will be helpful. During sex, males also could react to lubricant jellies or nonoxynol-9 from condoms, other spermicides, feminine sprays or douches. It is important to find out the cause of the reaction and then avoid that substance.

Males who urinate in the outdoors could be subject to poison ivy dermatitis affecting the penis. This will also cause itchiness, blisters and redness. Males need to recognize poison ivy, oak and sumac plants. Topical anti-itch preparations including calamine lotion or over the counter hydrocortisone should give relief to the symptoms.

It is very rare in adolescents, but a malignant skin cancer called melanoma could occur on the penis. The amount of sunburn a child has sustained during his preadolescent years could affect the likelihood of developing a melanoma. Since most males do not sunbathe without a bathing suit or shorts, sunburn to the penis is less likely. Nonetheless, a male should utilize sunscreen on his genitals if he sunbathes in the nude. If a male develops a suspicious appearing mole on his penis, he should notify his physician.

Many male adolescents are worried about sexually transmitted infection (STI). The penis is a likely site for STI to appear. A yellow mucoid discharge from the urethra associated with painful urination can occur with gonorrhea while a scant almost painless discharge occurs with chlamydia urethritis.

Other STI can cause skin changes on the head and shaft of the penis. Genital herpes produces painful blisters that can remain for several weeks. A painless smooth ulcer characterizes syphilis while chancroid has a painful and irregular ulcer. Genital warts occur more commonly along the shaft of the penis and occasionally around the urethra. They are usually fleshy colored in appearance and painless and are likely to be transmitted to a sexual partner unless a condom is used. One should be certain to contact a physician for further advice. Warts should be differentiated from pink pearly penile papules, which many adolescents develop around the head of the penis. These small one- to three-millimeter bumps are totally harmless, are not a sign of STI and cannot be transmitted to a sex partner.

   

An insect called the mite causes scabies, which produces an itchy red bumpy rash in the genitals including the penis. This is different from crab lice, which are insects that bite the skin around a pubic hair to obtain blood, and then lay their eggs called nits, which are attached to the pubic hair. Lice also cause itchiness and a clinician should be contacted for treatment.

The human immunodeficiency virus (HIV) may enter the body through cuts in the penis that could occur during sexual activity. There are no telltale symptoms on the penis if an adolescent has been infected with HIV. A condom would protect the male from acquisition of HIV as well as other STI’s including hepatitis B.

A few adolescents develop a painful condition called priapism, which is a prolonged involuntary erection that is not associated with sexual stimulation. Although most adolescents who develop priapism do not have any disease producing the problem, a few teens with sickle cell disease or other blood problems can acquire a tendency for priapism. A physician should be consulted for treatment. It is perfectly normal for male adolescents to awaken with an erection, which usually subsides after urination. Some adolescents develop impotence of the inability to attain an erection under sexual stimulation. In most cases this is not due to a medical disease, rather it is due to anxiety.

                                                                              

PREMATURE EJACUALTION

Premature ejaculation is one of the most frequent sexual problems in men and couples, accounting for 40% of the complaints found in sexual therapists’ offices.

Premature ejaculation happens to be commonplace in youth, in meetings with new partners or after a period of abstinence. When it is extended into mature age and becomes present in more than half of sexual meetings, it becomes thus a chronic condition and a sexual disorder.

DEFINITION

Many men occasionally ejaculate sooner during sexual intercourse than they or their partner would like. As long as it happens infrequently, it’s probably not cause for concern. However, if you regularly ejaculate sooner than you and your partner wish — such as before intercourse begins or shortly afterward — you may have a condition known as premature ejaculation.

Premature ejaculation is a common sexual disorder. Estimates vary, but some experts think it affects as many as one out of three men. Even though it’s a common problem that can be treated, many men feel embarrassed to talk to their doctors about it or seek treatment.

Once thought to be purely psychological, experts now know that biological factors also play an important role in premature ejaculation. In some men, premature ejaculation is related to erectile dysfunction.

You don’t have to live with premature ejaculation — treatments including medications, psychological counseling and learning sexual techniques to delay ejaculation can improve sex for you and your partner. For many men, a combination of treatments works best.

Symptoms   

There’s no medical standard for how long it should take a man to ejaculate. The primary sign of premature ejaculation is ejaculation that occurs before both partners wish in the majority of sexual encounters, causing concern or distress. The problem may occur in all sexual situations, including during masturbation — or it may only occur during sexual encounters with another person.

Doctors often classify premature ejaculation as either primary or secondary:

  1. You have primary premature ejaculation if you’ve had the problem for as long as you’ve been sexually active.
  2. You have secondary premature ejaculation if you developed the condition after having had previous, satisfying sexual relationships without ejaculatory problems.

Causes

Experts are still trying to determine exactly what causes premature ejaculation. While it was once thought to be only psychological, we now know premature ejaculation is more complicated and involves a complex interaction of both psychological and biological factors.

Psychological causes 

  1. Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life such as:
  2. Situations in which you may have hurried to reach climax in order to avoid being discovered
  3. Guilty feelings that increase your tendency to rush through sexual encounters
  • Other factors that can play a role in causing premature ejaculation include:
  • 1. Erectile dysfunction. Men who are anxious about obtaining or maintaining their erection during sexual intercourse may form a pattern of rushing to ejaculate which can be difficult to change.
  • 1. Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance, or caused by other issues.

Biological causes

  1. Experts believe a number of biological factors may contribute to premature ejaculation, including:
  2. Abnormal hormone levels
  3. Abnormal levels of brain chemicals called neurotransmitters
  4. Abnormal reflex activity of the ejaculatory system
  5. Certain thyroid problems
  6. Inflammation and infection of the prostate or urethra
  7. Inherited traits

Rarely, premature ejaculation is caused by:

  1. Nervous system damage resulting from surgery or trauma
  2. Withdrawal from narcotics or a drug called trifluoperazine (Stelazine), used to treat anxiety and other mental health problems

Although both biological and psychological factors likely play a role in most cases of premature ejaculation, experts think a primarily biological cause is more likely if it has been a lifelong problem (primary premature ejaculation).

Risk factors

Various factors can increase your risk of premature ejaculation, including:

Impotence.

  • You may be at increased risk of premature ejaculation if you occasionally or consistently have trouble getting or maintaining an erection. Fear of losing your erection may cause you to rush through sexual encounters. As many as one in three men with premature ejaculation also have trouble maintaining an erection.

Health problems

  • If you have a medical concern that causes you to feel anxious during sex, such as a heart problem, you may have an increased likelihood of hurrying to ejaculate.

Stress

Emotional or mental strain in any area of your life can play a role in premature ejaculation, often limiting your ability to relax and focus during sexual encounters.

Certain medications.

  • Rarely, drugs that influence the action of chemical messengers in the brain (psychotropics) may cause premature ejaculation.
  • Complications

While premature ejaculation doesn’t increase your risk of serious health problems, it can cause distress in your personal life, including:

    • 1. Relationship strains. The most common complication of premature ejaculation is relationship stress. If premature ejaculation is straining your relationship, ask your doctor about including couple’s therapy in your treatment program.
    • 2. Fertility problems. Premature ejaculation can occasionally make fertilization difficult or impossible for couples who are trying to become pregnant. If premature ejaculation isn’t effectively treated, you and your partner may need to consider infertility treatment.

Prevention

    • In some cases, premature ejaculation may be caused by poor communication between partners or a lack of understanding of the differences between male and female sexual functioning. Women typically require more prolonged stimulation than men do to reach orgasm, and this difference can cause sexual resentment between partners and add pressure to sexual encounters. For many men, feeling pressure during sexual intercourse increases the risk of premature ejaculation.If you’re not able to resolve sexual problems on your own, talk with your doctor. He or she may recommend seeing a therapist who can help you and your partner achieve a fulfilling sexual relationship.
    • Open communication between sexual partners, as well as a willingness to try a variety of approaches to help both partners achieve satisfaction, can help reduce conflict and performance anxiety. If you’re not satisfied with your sexual relationship, talk with your partner about your concerns. Try to approach the topic in a loving way and to avoid blaming your partner for your dissatisfaction.

Tests and diagnosis

    • Doctors diagnose premature ejaculation based on a detailed interview about your sexual history. Your doctor may ask a number of very personal questions and may want to include your partner in the interview. While it may be uncomfortable for both of you to talk frankly about sex, the details you provide will help your doctor determine the cause of your problem and the best course of treatment. A mental health professional may help make the diagnosis.
      • 1. How often you have premature ejaculation
      • 2. Whether you have premature ejaculation only with a specific partner or partners
      • 3. Whether you have premature ejaculation every time you have sex
      • 4. How often you have sex
      • 5. How you feel premature ejaculation affects your enjoyment of sex and your quality of life
      • 6. Whether you also have trouble getting and maintaining an erection (erectile dysfunction)
      • 7. Your use of prescription medications and recreational drugs

      To evaluate whether psychological factors may influence your premature ejaculation, your doctor or mental health professional may also want to know about:

      • 1. Your religious upbringing
      • 2. Your early sexual experiences
      • 3. Your sexual relationships, past and present
      • 4. Any conflicts or concerns within your current relationship

If you have both premature ejaculation and trouble getting or maintaining an erection, your doctor may order blood tests to check your male hormone (testosterone) levels or other tests.

What’s a normal ejaculation?

From the perspective of physical functioning , ejaculation takes place in two stages. In the first stage occurs the expulsion of the seminal fluid (semen) from accessory reproductive organs – prostate, seminal bladder, and ejaculatory canal – into the urethra. At the second stage, there’s a progression of this fluid throughout the extension of the urethra to the urethral meatus, which is the orifice in the glans through which also the urine exits. This physiological process is accompanied by a subjective sensation of deep pleasure known as orgasm.

How do I know if I suffer from premature ejaculation?

There’s no specific time prior to ejaculation for defining it as a sexual problem. The problem is defined by your and your partner’s perception that the ejaculation was faster than expected and that it wasn’t controlled. Sometimes the penis doesn’t even get around becoming erected, and the movement of approaching and the touch of the sheets are enough to put an end to what could be a pleasant moment. At times, the man maintains the erection for a few minutes, begins the penetration, but ejaculates shortly after, becoming frustrated and letting his partner down. Feelings of guilt and anxiety become constant. Greater difficulties may arise subsequently, such as erection dysfunction (impotence) and loss of intimacy for the couple.

Why does premature ejaculation occur?

Darwin followers (English evolutionist that proposed the natural selection theory – 1859) explain that premature ejaculation was an old defense method against predators.Those individuals that took too long to ejaculate into their partners would be more vulnerable to aggressions from enemies and wild beasts.Other reasons assumed as causes of premature ejaculation are:

  • 1. Abnormal increase in the sensitivity of the glens,
  • 2. Sexual inexperience,
  • 3. First experience with partner that stimulates a fast intercourse, 4. Guilt or negative feelings towards the partner.

Seldom is there a medical condition accounting for premature ejaculation, such as acute prostatitis or multiple sclerosis. As a matter of fact, there isn’t only one scientifically proven cause for premature ejaculation.

Does it have a cure?

Treatment exists, both with drugs and psychotherapy. The first line of treatment is reorientation and reeducation of the man or couple for a normal sexual function. Situations in which the shorter or unsatisfactory ejaculation time is considered to be normal are elucidated (common in the young, sex with new partners, or following a long abstinence). When premature ejaculation becomes steady, that is, occurs in more than half of sexual meetings, a more specific treatment is made necessary.

The second line of therapy is the so-called cognitive behavioral treatment. A set of exercises and tasks should be performed at home for control of the ejaculation time. Below are some merely illustrative examples:

Distraction Technique

During the sexual relation, the man is told to set his mind on some situation that deviates him from sex, as somebody’s death, a partner that isn’t of his liking, or bills to pay. As soon as he perceives that he’s losing the erection, he focuses on the partner again. He should use this distraction method a few times so that he can extend the penetration time prior to ejaculation.

Squeeze technique

The man must compress the glans base for 4-5 seconds immediately after the first sensation of arousal. With this procedure he’s going to make it harder for the blood to enter the penis, delaying ejaculation a little.

Stop-start technique

It consists of instructing the man to stay in a position above his partner in order to have control over the sexual motion. He must start the penetration and stop the movements altogether near the moment of greatest arousal. He can use the diversion technique concomitantly.

The goal of these tasks is to get the man to be aware of the moment preceding the first stage of ejaculation, becoming able to voluntarily control his ejaculation and avoiding frustration for his partner and himself.

A third line of treatment can be combined with these exercises: drugs. There’s a wide range of medications that have as side effect a delay in ejaculation time. Such drugs must be administered only with judicious medical prescription, as they present many other effects on the organism.

Some of them (e.g. tricyclic antidepressants) are contraindicated for people with heart rhythm problems. Some topical medications (ointments) based on herbs or anesthetics haven’t been proven to be effective for premature ejaculation treatment.

Anyway, this sexual dysfunction has a good prognosis, that is, shows good cure rates for most individuals that seek specialized advice. Usually, 6 to 10 sessions suffice to improve a man’s and couple’s sex life.

Treatment

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ERECTILE DYSFUNCTION

What  is impotence (ERECTILE DYSFUNCTION)?

Impotence is the inability to achieve or maintain an erection sufficiently rigid for sexual intercourse, ejaculation, or both. Sexual drive and the ability to have an orgasm are not necessarily affected. Impotence is medically defined as the inability to sustain an erection sufficient for intercourse on at least 25% of attempts.

Impotence is not new in medicine or human experience, but it is not easily or openly discussed. Cultural expectations of male sexuality inhibit many men from seeking help for a disorder that can, in most cases, benefit from medical treatment. The term “impotence”; comes from Latin and means loss of power; a more accurate term is “erectile dysfunction.” The condition is normal and usually temporary, so it is highly unfortunate that the common term for it implies a sweeping diminution in a man’s overall capabilities.

The Penis & Erectile Function 

The Structure of the Penis.

The penis is composed of the following structures:

  1. A pair of parallel spongy columns called the corpus cavernous .
  2. A central chamber called the corpus spongiosum , which contains the urethra, the tube that carries urine from the body

Erectile Tissue. These structures are made up of erectile tissue Erectile tissue is rich in tiny pool-shaped blood vessels called cavernous sinuses . Each of these vessels are surrounded by smooth muscles and supported by elastic fibrous tissue composed of a protein called collagen.

Erectile Function.  

The penis is either flaccid or erect depending on the state of arousal. In the flaccid, or unrest, normal penis, the following occurs:

  1. Small arteries leading to the cavernous sinuses contract, reducing the inflow of blood.
  2. The smooth muscles regulating the many tiny blood vessels within the penis are also contracted.

During arousal the following occurs:

  1. The man’s central nervous system stimulates the release of a number of chemicals, including acetylcholine and nitric oxide.
  2. These chemicals relax the smooth muscles in the penis. This allows blood to flow into the tiny pool-like cavernous sinuses, flooding the penis.
  3. This increased blood flow nearly doubles the diameter of the spongy chambers.
  4. The veins surrounding the chambers are squeezed almost completely shut by this pressure.
  5. The veins are unable to drain blood out of the penis and so the penis becomes rigid and erect.

Important Substances for Erectile Health

A proper balance of certain chemicals, gases, and other substances is critical for erectile health:

Collagen.

Collagen is the major component in structural tissue in the body, including in the penis. Excessive amounts, however, form scar tissue, which can impair erectile function.

Oxygen. 

Oxygen-rich blood is one of the most important components for erectile health. Oxygen affects two substances that are important in achieving erection:

  1. Oxygen suppresses transforming growth factor beta 1 (TGF-B1). TGF-B1 is a component of the immune system called a cytokine and is produced by smooth muscle cells. It appears to stimulate collagen production in the corpus cavernosum, which can lead to erectile dysfunction.
  2. Oxygen enhances prostaglandin E1. Prostaglandin E1 is produced during erection by the muscle cells in the penis. It activates an enzyme that initiates calcium release by the smooth muscle cells, which relaxes them and allows blood flow. Prostaglandin E1 also suppresses production of collagen.

Oxygen levels vary widely from reduced levels in the flaccid state to very high in the erect state. During sleep, oxygen levels are high and a man can normally have three to five erections per night, each one lasting from 20 to 40 minutes.

Testosterone and Other Hormones. Normal levels of hormones, especially testosterone, are essential for erectile function, though their exact role is not clear.

WHO BECOMES IMPOTENT?

A large 2000 survey suggested that nearly 620,000 American men between ages 40 and 70 experience erectile dysfunction of any degree each year, and an estimated 20 million and 30 million men in the US have erectile dysfunction at some point during their life.

Being older is primarily associated with impotence in most men. At a major professional meeting in 2000, experts reported survey results finding that 44% of men over age 50 experienced some degree of erectile dysfunction, but less than a quarter of them discussed their problems with a physician. Many felt this was simply an aging problem. Nevertheless, impotence is not inevitable with age. In another survey of men over 60 years old, 61% reported being sexually active, and nearly half derived as much if not more emotional benefit from their sex lives as they did in their 40s.

Severe erectile dysfunction in elderly men often has more to do with disease than age itself. For example heart disease, diabetes, and hypertension can cause sexual dysfunction and are more likely to occur in older than younger men.

So many physical and psychological situations can cause erectile dysfunction, in fact, that a man should consider brief periods of impotence to be as normal as having a cold. In fact, a cold is one common condition that can cause temporary impotence. It is safe to say, then, that every man experiences erectile dysfunction from time to time. [ See What Are Life Style and Psychologic Factors Contributing to Erectile Dysfunction? and What are the Physical Causes of Impotence?.]

WHAT ARE LIFE STYLE & PSYCHOLOGIC FACTORS CONTRIBUTING TO ERECTILE DYSFUNCTION?

Differentiating between Physical and Psychological Causes of Erectile Dysfunction

Over the past decades, the medical perspective on the causes of impotence has shifted. Common wisdom used to attribute almost all cases of impotence to psychological factors. Now investigators estimate that between 70% and 80% of impotence cases are caused by medical problems.

It is often difficult to determine if the cause of erectile dysfunction is a physical or psycho logic one, or even some combination. The following may be helpful:

  1. Psychological impotence tends to be abrupt and related to a recent situation. The patient may be able to have an erection in some circumstances but not in others. Being unable to experience or maintain an erection upon waking up in the morning suggests that the problem is physical rather than psychological.
  2. Physical impotence occurs gradually but continuously over a period of time. If impotence persists over a three-month period and is not due to a stressful event, drug use, alcohol, or medical conditions, then the patient needs medical attention by a urologist specializing in impotence.

In virtually every case of impotence, there are emotional issues that can seriously affect the man’s self-esteem and relationships, and may even cause or perpetuate erectile dysfunction. Many men tend to fault themselves for their impotence even if it is clearly caused by physical problems over which they have little control.

Emotional Disorders

Anxiety. Anxiety has both emotional and physical consequences that can affect erectile function. It is among the most frequently cited contributors to psychological impotence. Anxiety over sexual performance is often referred to as performance anxiety and may provoke an intense fear of failure and self-doubt. It can sometimes set off a cycle of chronic impotence. In response to anxiety, the brain releases chemicals known as neurotransmitters that constrict the smooth muscles of the penis and its arteries. This constriction reduces the blood flow into and increases the blood flow out of the penis. Simple stress may even promote the release of brain chemicals that negatively affect potency in a similar way.

Depression. Depression is strongly associated with erectile dysfunction. In one study, 82% of men who reported moderate to severe erectile dysfunction also had symptoms of depression. Depression can certainly reduce sexual desire, but it is often not clear which condition came first.

Problems in Relationships

Problems in relationships often have a direct impact on sexual functioning. Partners of men with erectile dysfunction may feel rejected and resentful, particularly if the affected man does not confide his own anxieties or depression. Both partners commonly experience guilt for what they each perceive as a personal failure. Tension and anger frequently arise between people who are unable to discuss sexual or emotional issues with each other. It can be very difficult for the man to perform sexually when both partners harbor negative feelings.

Socioeconomic Issuses

Losing a job or having lower income or education increases the risk for impotence.

Smoking

Heavy smoking is frequently cited as a contributory factor in the development of impotence, mainly because it accentuates the actions of other disorders of the blood vessels, including high blood pressure and atherosclerosis.

Alcohol

Alcohol has also been implicated in causing impotence. In small doses, alcohol releases inhibitions, but in doses larger than one drink, it can depress the central nervous system and impair sexual function.

Lack of Frequent Erections

Infrequent erections deprive the penis of oxygen-rich blood. Without daily erections, collagen production increases and eventually may form a tough tissue that interferes with blood flow. The spontaneous erection men experience while sleeping or awake may be a natural protection against this process.

WHAT ARE THE PHYSICAL CAUSES OF ERECTILE DYSFUNCTION?

Oxygen Deprivation & its Causes

Erectile dysfunction most commonly occurs when the penis is deprived of oxygen-rich blood. When oxygen levels to the penis are low, an imbalance occurs in two important substances, TGF-B1 and prostaglandin E1:

TGF-B1 levels increase, which trigger production of collagen, a tough protein that forms all connective tissue, including scar tissue.

In addition, there is a reduction in prostaglandin E1, a chemical that suppresses collagen production and relaxes the smooth muscles to allow blood flow resulting in an erection.

When TGF-B1 levels increase and prostaglandin E1 levels decrease, smooth muscles waste away and collagen is overproduced, causing scarring, loss of elasticity, and reduced blood flow to the penis. A number of conditions can deprive the penis of oxygen-rich blood.

Blockage of Blood Vessels (Ischemia)    

The primary cause of oxygen deprivation is ischemia, the blockage of blood vessels. The same conditions that cause blockage in the blood vessels leading to heart problems may also contribute to erectile dysfunction. For example, when cholesterol and other factors are imbalanced, a fatty substance called plaque forms on artery walls. As the plaque builds up, the arterial walls slowly constrict, reducing blood flow. This process, known as atherosclerosis, is the major contributor to the development of coronary heart disease. It may also play a role in the development of erectile dysfunction.

Common Medical Conditions That Contribute to Erectile Dysfunction

Diabetes.

Diabetes may contribute to as many as 40% of impotence cases . Between one third and one half of all diabetic men report some form of sexual difficulty. Atherosclerosis and nerve damage are both common complications of diabetes; when the blood vessels or nerves of the penis are involved, erectile dysfunction can result.

High Blood Pressure.

Erectile dysfunction is more common and more severe in uymen with hypertension than it is in the general population. Many of the drugs used to treat hypertension are thought to cause impotence as a side effect; in these cases, it is reversible when the drugs are stopped. More recent evidence is suggesting, however, that the disease process that causes hypertension itself is the major cause of erectile dysfunction in these men. Newer anti-hypertensive agents, including angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) are less associated with erectile dysfunction. In fact, ARBs may be particularly effective in restoring erectile function in men with high blood pressure who suffer from impotence.

Parkinson’s Disease.

As a risk factor for impotence, Parkinson’s disease (PD) is an under-appreciated problem. It is estimated that about one-third of men with PD experience impotence. The physical cause of PD-related impotence is most likely an impaired nervous system. Depression and lowered self-esteem also contribute to erectile dysfunction in these patients.

Other Medical Conditions.

Multiple sclerosis (MS), which affects the central nervous system, also precipitates sexual dysfunction in as many as 78% of male patients. Corticosteroids, which are common treatments for MS, may improve sexual function. Other medical conditions that contribute to erectile dysfunctions include spina bifida, a history of polio, and chronic kidney failure.

Physical Causes of Erectile Dysfunction

The origins of erectile dysfunction are twofold: physical and psychological. Up to thirty years ago, psychological factors were thought to be most important. Sex therapists Masters and Johnson went so far as to claim that nine out of ten men with erectile dysfunction had a psychological problem. For example, men with depression are very often impotent. But nowadays, we know that even though the psychological aspect is very important, a lot of men with erectile dysfunction have physical problems.

Of course, it isn’t necessarily as simple as you might think to separate the two, because erectile dysfunction causes changes in a a man’s emotional state: all of us who have found ourselves impotent on occasion will know the anxiety and depression this can produce. One can therefore legitimately ask whether stress, anxiety and depression cause erectile dysfunction or whether they are a result of it.

But in all cases, we should keep in mind the way in which erections develop so we can see how these basic principles may be affected by physical or psychological factors. First, the erectile tissue may not fully fill with blood because arterial blood flow to the penis is partially impeded. This means a man will not get an erection. On the other hand, when a man loses his erection before orgasm and ejaculation, he most likely has some problem in his venous occlusive mechanism: this is the system that keeps blood in the penis and thus holds his erection firm. A failure in either of these areas can cause erectile dysfunction.

Blood vessel abnormalities as a cause of erectile dysfunction

As we said above, if the arteries which carry blood to the penis are blocked or damaged, or if the veins which drain blood from the penis are damaged, a good erection may fail to develop, or be maintained, respectively. Most often, a blockage of the arteries which carry blood to the penis is responsible: as little as fifteen percent blockage (occlusion) of these very small blood vessels can cause a problem with erectile dysfunction. This blockage is often caused by risk factors like smoking cigarettes, high blood pressure, diabetes, and elevation of blood cholesterol levels. Injury caused by pelvic trauma or pelvic radiation therapy may also be responsible.

Most men with erectile dysfunction caused by a reduction in arterial blood flow will show other cardiovascular problems in the body. For even if they have not had a heart attack, impotent men often have a history of coronary artery disease, and some men with erectile dysfunction have poor blood circulation to their feet and legs, again as a result of arterial occlusive disease.

A past pelvic fracture which has blocked one of the arteries carrying blood to the penis may also cause erection problems: this is sometimes seen in young patients, in their twenties, who have undergone pelvic trauma or fracture. And as is fairly well known, diabetic men may show erectile dysfunction as an effect of damage to the nerve and vascular supply to the penis. Diabetic men, and some older men, have large amounts of scarring, or fibrosis, on the inside of the walls of the arteries which supply the blood to the penis. Scarring, caused by arterial plaque buildup, can reduce the internal diameter of the arteries.

Patients with high lipid levels in their bloodstream are definitely at increased risk of arteriosclerosis, because the excess lipid builds up in the internal walls of the arteries and eventually leads to a blockage. Hypertension – high blood pressure – is yet another risk factor. It’s no surprise, therefore, that almost half of one series of impotent men who were the subject of a research study had hypertension. But it’s not the increase in circulating blood pressure itself that is the cause of erectile dysfunction; in fact, it’s the arterial stenosis found in men with high blood pressure that is most likely to be the origin of their erectile dysfunction.

As we said above, failure of the mechanism that closes the veins that allow blood to drain from the penis is one of the more common causes of vasculogenic erectile dysfunction. In some men, the the veins are never fully clamped as the arterial blood flows into the penis early in the erection – though this is mostly a problem for older men, it may be seen in relatively young men who have had erection problems through their entire life. These men tend to report that a normal erection begins to develop, but after seconds of sexual activity (at most, a minute or so), they will lose their erection. Surgery may be one answer for this kind of problem.

Peyronie’s disease is characterized by non-elastic scar tissue forming on the inner surfaces of the tunica albuginea, which in turn prevents adequate compression of the veins under the tunical surface. This means the arterial blood is not held within the penis in the normal way.

In an anxious man, the trabecular smooth muscle of the penis and the vascular spaces of the penis may not relax sufficiently to allow adequate sinusoidal expansion, in which case the subtunical veins will not become compressed sufficiently to maintain an erection. This may happen when a man is overanxious. In effect, his adrenalin impairs relaxation of the smooth muscle of his penis in response to the stimulation of nitric oxide.

Interestingly, smoking cigarettes, apart from causing widespread arterial blockage, may also prevent the cavernous smooth muscle from dilating enough. Once more, there is not enough clamping of the penile veins to permit the increase in intracavernous arterial pressure which is required for an erection.

Hormonal Abnormalities

Hypogonadism (Testicular Failure).

Hypogonadism in men is a deficiency in male hormones, usually due to an abnormality in the testicles, which secrete these hormones. It affects 4 to 5 million men in the United States. In addition to impotence, hypogonadism causes reductions in energy, sex drive, lean body mass, and bone density. Hypogonadism can be caused by a number of different conditions. Among them are the following:

  1. Disorders in the pituitary or hypothalamus glands.
  2. Malnutrition.
  3. Genetic factors.
  4. Myotonic dystrophy.
  5. Orchitis (inflammation of the testicles).
  6. Physical injury.
  7. Mumps.
  8. Radiation treatments.

Exercise-induced hypogonadism

Only a few cases of exercise-induced hypogonadism have been identified in men, but some researchers believe certain athletes may be at risk, including those who began endurance training before full sexual maturity, have very low body weight, and have a history of stress fracture.

Low Testosterone Levels.

Only about 5% of men who see a physician about erectile dysfunction have low levels of testosterone, the primary male hormone. In general, lower testosterone levels appear to reduce sexual interest, not cause impotence. A 1999 study, however, suggests that testosterone levels are not an accurate reflection of sexual drive.

Other Hormonal Abnormalities.

Other hormonal abnormalities that can lead to erectile dysfunction in men are the following:

High levels of the female hormone estrogen may cause impotence (which may occur in men with liver disease).

Abnormalities of the pituitary gland that cause high levels of the hormone prolactin are particularly likely to cause impotence.

Other, uncommon hormonal causes of impotence include abnormalities of the thyroid gland and the adrenal glands.

HOW SERIOUS IS ERECTILE DYSFUNCTION?

Impotence can be a symptom of serious medical conditions, such as atherosclerosis, diabetes, and hypertension. It can also indicate injury, age-related changes in tissue, or long-term effects of smoking, heavy drinking, or unhealthy diet. Psychological effects can be significant; erectile dysfunction can have a devastating impact on a relationship and can cause extreme depression, which may become chronic if not treated. When a consistent pattern of sexual dysfunction extends over a prolonged period of time, a serious physical or emotional disorder may be indicated.

HOW IS ERECTILE DYSFUNCTION DIAGNOSED?

Physician Interview 

The physician typically interviews the patient about many physical and psycho logic factors. The patient must be as frank as possible for his physician to make a diagnosis. He should not interpret these questions as intrusive or too personal if he expects to obtain help. These questions are very relevant and important for determining the proper approach. Even when erectile dysfunction has a clear physical cause, relationships and psychological factors can also have an effect.

Medical and Personal History. The physician should take a medical and personal history and may ask about the following:

  1. Past and present medical problems.
  2. Medications or drugs being used.
  3. Any history of psychological problems, including stress, anxiety, or depression.

Sexual History. In addition the physician will ask about the patient’s sexually history, which may include the following:

  1. The nature of the onset of the dysfunction.
  2. The frequency, quality, and duration of any erections, and whether they occur at night or in the morning.
  3. The specific circumstances when erectile dysfunction occurred.
  4. Details of technique.
  5. The patient’s motivation for and expectations of treatment.
  6. Whether problems exist in the current relationship.

Interviewing the Sexual Partner. If appropriate, the physician might also interview the sexual partner. In fact, including the partner in the interview process may help the physician to better decipher underlying causes and in turn better recommend treatment choices.

Physical Examination 

The physician should perform a careful physical exam, including examination of the genital area and a digital rectal examination (the doctor inserts a gloved and lubricated finger into the patient’s rectum) to check for prostate abnormalities.

Laboratory Tests

Blood Tests for Hormonal Abnormalities.

Blood tests may be used to measure testosterone levels and, if necessary, prolactin levels to determine if there are problems of the endocrine system. A 1999 study suggests that testosterone level is an inadequate measure of sexual drive and that more research is needed to determine the value of routine assessments of this hormone in erectile dysfunction or low sexual drive. The physician may also screen for thyroid and adrenal gland dysfunction. In addition, various specific tests for erectile dysfunction can be performed.

Tests for Medical Conditions that may be Causing Erectile Dysfunction. Evidence of other medical conditions should be sought, particularly hypertension, diabetes, atherosclerosis, and nerve damage.

Monitoring Nighttime Erections

Tests that monitor night-time erections may be used to determine if the causes of erectile dysfunction are more likely to be psychological. Neither of the following methods is helpful in determining a physical cause for erectile dysfunction.

Snap-Gauge Test. 

The snap-gauge test monitors the man’s ability to achieve an erection during sleep. It is a very simple test.

  • When the man goes to bed, he places bands around the shaft of his penis.
  • If one or more breaks during the course of the night, it provides evidence of an erection. In this case, a psychological basis for the erectile dysfunction is likely.

RigiScan Monitor.

A more sophisticated and more expensive device is the RigiScan monitor, which makes repetitive measurements of rigidity around the base and tip of the penis. This test is quite accurate but may fail to detect mild cases of erectile dysfunction.

Penile Brachial Index  

The penile brachial index is a measurement that compares blood pressure in the penis with the blood pressure taken in the arm. Problems with the arterial flow to the penis can be detected using this method.

Imaging Techniques

Imaging tests may be used in certain cases, but they are expensive and often limited to younger men. Anyone considering these tests should have them done in a specialized setting with professionals experienced in the use of the diagnostic instruments and in analyzing the data from them.

Dynamic Infusion Cavernosometry and Cavernosography. Dynamic infusion cavernosometry and cavernosography (DICC) is usually only given to young men in whom some blockage of the penis or physical injury of the pelvic area is suspected. After an erection is induced with drugs, the following four steps are taken:

  • The penile brachial index is taken.
  • The storage ability of the penis is gauged.
  • An ultrasound of the penile arteries is performed.
  • An x-ray of the erect penis is taken.

Unfortunately, this test and other similar imaging techniques used to determine blood flow in the penis are currently not very effective or accurate in diagnosing and determining treatment.

Ultrasound.

Venous insufficiency of the corpora cavernous in a patient with erectile dysfunction. Despite a satisfactory arterial response, there is continuous venous flow during the erection in the deep dorsal vein of the penis.

Ultrasound alone may prove to be useful in detecting some causes of erectile dysfunction, such as leakage from blood vessels.

WHAT ARE THE GENERAL GUIDELINES FOR TREATING ERECTILE DYSFUNCTION?

Approach to Treatment

The cause of impotence dictates the mode of treatment. The first step is to define the cause, if possible, and then try the simplest and least-risky solution.

Before a certain treatment is prescribed, the following factors should be considered:

  • Any pre-existing illnesses and medications.
  • The degree of comfort with the treatment method.
  • Partner satisfaction, and safety profiles need to be considered. Experts strongly recommend that the patient’s partner be involved to help with any necessary sexual adjustment.

No matter what the treatment, embarking on a healthy lifestyle is the first and critical step for maintaining and restoring erectile function.

Treatment

Treatment for Erectile dysfunction by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

WEAK ERECTOIN

The weakness of erection during sexual intercourse can occur when the two small arteries do not receive the flow of blood from the heart and the aorta. The weakness in erection is the lining of blood vessels too weak to get to the penis.

Weak erection could be defined as inability to keep an erection strong enough to continue sex during love-making. This is sensitive part of the body must be in good conditions to keep the erection such as nerves pulses in the brain, spinal column around the penis, fibrous tissue muscles and veins near the corpora must be also in good conditions to allow full erection penis to take place and its occur when any of this activities disturbed.

Research has shown that weak erection has affected millions of men in the world today. It occur occasionally with man having experience at early stage does not mean that one has weak erection; it is normal and should not be worry, but if its more than two months, one can consult a specialist.

Weak Erection is Aged Problem

The new ways of handling this problem that causes failure in life has being discovered in recent time. The strong bond has been broken, to openly discuss the problems among themselves. Men have openly talked about the weak erection among themselves on the subject matter, initially they were ashamed, embarrassed and feeling incomplete. The treatments of this peculiar life problem are available in order to overcoming the inadequate situations, because to discuss about the problem is acceptable and willingness to search for better solutions in recent time.

What are the causes of weak erection?

The disruption of blood flow to the penis vein is a major cause of weakness of penis during sexual intercourse. Although, there are other causes to the weakness in erection such as suffering from diabetes for a long period of time which must have damage the nerve system, cardiovascular disorder, prostate cancer operations, side effects of using hard drugs, multiple sclerosis, hormonal disorders, alcohol and drug abuse, emotional problems such as depression, anxiety, fear of guilt, low self-esteem; and also old age plays importance rule in the development of weak erection in a man’s life, because weak erection occur so much in the age bracket of 40 – 65 years. This age group seems to live in total weakness of penis due to their past activity in their early age.

Causes of Weak Erection

A weak erection problem is caused by insufficient blood flow to the penile sponge-like tissues. And when it doesn’t get a high enough level of blood flow, the penis cannot get expand fully. Also, if the sponge tissues can’t hold the blood this also make to restrains the penis from growing to its full size.

There are a wide variety of factors that can cause the arteries and veins to get constrict and reduce blood flow. Notably, smoking and a high fat diet contribute to the reduction of blood flow. Venous leaking brought onto by a penile injury can keep a penis from holding blood flow, even sufficient flow, and this can also cause a hard weak erection. There are several other reasons why a man might suffer from weak erections; any medications such as these depression medication, illegal drug usage such as marijuana smoking.

A weak erection is very unpleasing because the while it is considered an erection, it is not hard enough to provide the adequate stimulation for a sexual partner that also damages self-esteem and confidence. A weak erection can also cause the anxiety that can lead to premature ejaculation, not to mention that weak erections can be really physically responsible for premature ejaculation, too. A man he is suffering from this condition will often contract the PC muscles in order to aid in engorging his erection. By doing so, the man will also subject added pressure and stress on the prostate gland. This added load on the prostate will also mimic orgasmic contractions and precum will lubricate the urethra, signifying the inevitable ejaculation.

Remedy for Weak Erection: The main problem with a weak erection is to dealing with it at home. There are other many ways to combat a weak erection. A man can take the male enhancement supplements such as Kohinoor Gold Capsules that may improve the total blood flow to his penis so that his erections will really once again be hard. Kohinoor Gold Capsules will also improve his control, size, and the girth of his penis. And He can also learn combinations of techniques that he can use to strengthen and improve his ejaculation control so that he will last longer.

If, indeed, you feel that your inability to hold to a firm erection is related to your “over-masturbation”, then the simplist thing for you to just do would be to reduce the frequency of masturbation.

Who suffering from Weakness in Erection

i. Those involve highly in use of drugs and alcoholic,

ii. Those suffering from trauma or surgery damage on the vein around the penis,

iii. Those living in depression, stress and anxiety,

iv. Those who smoke heavily with serious disorders such as High Blood Pressure, and

v. Those who lives overweight, etc

What are the Symptoms of Weak Erection? 

Many men take much of stimulants for direct actions when having sexual intercourse, when there are no symptoms of weakness in erection, and practice of this method for long time may cause weak erection. Alternatively, if a man notice sign in weakness of erection or organism taking longer time to achieve erection during love-making, which some stimulation drugs being apply to increase volume of ejaculation, then, specialist should be contacted immediately.

How Weak Erection Diagnosed?

Consulting medical experts on weakness in erection for proper cross-examination on your medical and sexual details to figure out the source of problem is necessary. Please be honest when discussing with your medical consultant so as to enable him conduct correct diagnosis.

Your doctor may want to carry out a several medical examination to rule out any possible effects which will result conducting many tests for proper results to determine your blood count, liver enzymes, free testosterone in the blood and urinalysis.

Ultrasonography test should be carried out in order to ascertain the arterial circulation in the genital organs, neurological evaluation to assess nerve damage, cavernosometry to determine the penile vascular pressure in the blood flow to and fro the penis to be traced with an injected dye may be scheduled. Erection during sleeping is another way of testing but does not guaranteed perfect result. It is very necessary to conduct psychosocial examination to reveal the causes of weak erection problems.

How to Cure Weak Erection

Use of stimulants and other means to achieve quick erection during sexual intercourse causes weak erection; why not discuss with your consultants of the possibility of your weakness of penis and present treatment taken. Frequent use of stimulant during sexual intercourse accounts for 35% of weakness of penis during love-making among men.

Changes in lifestyle may reverse weak erection such changes may be to stop smoking, loss of weight, exercises, reduces stress, sleeping well, attending physical and medical seminars, group discussions, and medical examinations.

Surgeries are rare to cure weak erection, and can be recommended when necessary. But there are some drugs to revitalize the weakness. However, some drug having worse side effect when used, may be recommended before using it. Research shown that mechanical vacuum devices involve several parts which must be intact during sexual intercourse; and oral testosterone is option to cure it, but this may cause liver damage. Weak erection is commonly among young men in recent time.

Living with Weak Erection

You need to talk to your partner and also study material on weak erection. You should discussing and asking questions from your medical consultants. If possible you can meet community health researcher for possible advice and prescriptions for appropriate treatments. Research confirms that weak erection is not disease to be hopeless in life. There is hope to lives with Weak Erection.

WEAK ERECTION

OVER VIEW 

When having sexual intercourse many things must be present to succeed. First and foremost being a sexual partner, but not too far behind that is a firm erection. Men who are impotent know how disastrous erectile dysfunction can be on a person’s confidence and sexual life. However, what can be almost as frustrating is achieving an erection, yet it not being firm or full enough to enjoy using it. This phenomenon is very common and manifests itself in the form of a weak erection; when the penis is engorged with blood but not to the extent that it creates a firm erection for pleasurable intercourse.

A weak erection is caused by insufficient blood flow to the penile sponge-like tissues. When the penis doesn’t get a high enough level of blood flow, the penis cannot expand fully. Also, if the sponge tissues can’t hold the blood, this also restrains the penis from growing to its full size. There are a variety of factors that can cause the arteries and veins to constrict and reduce blood flow. Notably, smoking and a high fat diet contribute to reduction of blood flow. Venous leaking brought on by a penile injury can keep a penis from holding blood flow, even sufficient flow, and this can also cause a weak erection.

A weak erection is very unpleasing because while it is considered an erection, it is not hard enough to provide adequate stimulation for a sexual partner that damages self-esteem and confidence. A weak erection can also cause anxiety that can lead to premature ejaculation, not to mention that weak erections can be physically responsible for premature ejaculation, too. A man suffering from this condition will often contract the PC muscles in order to aid in engorging his erection. By doing so, the man will subject added pressure and stress on the prostate gland. This added load on the prostate will mimic orgasmic contractions and precut will lubricate the urethra, signifying the inevitable ejaculation.

Fact. Weak erections can ultimately lead to impotency.

How to deal with a weak erection before it goes too far? There are many ways to combat a weak erection; herbal remedies such as Power E will improve blood flow to the penis to help erections become hard. Power E may also improve penis control, size, and girth. Other ways to battle weak erection are through disciplined techniques used to strengthen the penis and improve ejaculation control.

Some examples of these techniques are Sexual Chi Kong and Natural Ejaculation Control. Both techniques allow one to prevent ejaculation, and at the same time increase sexual response from their partner.

Practicing these techniques consistently will bring pleasure to a sexual partner that goes way beyond just intercourse. After all, sexual pleasure comes more from intimacy and technique. This will help men overcome the problems that weak erections often times cause.

There are other reasons why a man might suffer from weak erections; any medications such as depression medication, illegal drug usage such as marijuana smoking. These both could directly result in weak erections.

It’s time to make a hard decision, but one that could eventually lead to a hard penis. Do you want to continue with an unfulfilling erection (for you and her) or do you want to start remedying the situation? Click on our Herbal Products or Techniques page to read more about the positive effects they have on sexual pleasure. A weak erection is no way to go through your sex life.

How To Have Stronger Firmer Erections?

This is a common complaint among all men, especially while age creeps up on us.  Your erection strength might not always be what you want it to be, but don’t worry, you can take action to ensure you get firmer erections almost every time.  Physiologically, getting an erection is a pretty simple process: it’s a matter of blood flooding into your penis and filling up empty “pockets” in your penis that are designed to hold the extra blood.  The more blood that’s forced into your penis, the harder your erection will be.

Sometimes your body won’t force enough blood into your penis and you’ll be left with a weak erection.  Sometimes weak erections don’t pose a major problem, but others might be so weak that it’s basically a semi-flaccid erection and might not be strong enough for sexual intercourse.  You need a certain degree of hardness for penetration, not to mention that weak hard-ons are a little bit embarrassing…..you pull out and your flimsy erection droops weakly towards the floor – not exactly something that will inspire confidence in either you or your partner.

There is a misconception that weak erections are an inevitable part of sex, especially with age.  This isn’t true as there are a few things you can do to prevent your erectile difficulty (NOT the same as erectile dysfunction).

Strong Erections With These Natural Methods

You can get strong erections with these natural methods. Tips for making the penis grow in length and width have been around since the ancient Egyptians. In our modern age we have more choices. Many good products are available on the internet.

But did you know there are ways to make your penis hard with a strong erection, for next to nothing, at home? Here are some penis tips that work.

No matter what penis pill or penis exercise you use if you want to get the maximum results from it your health has to be reasonably good. There are no shortcuts. Get your health up to a decent level and all your penis efforts will double or triple in results .

There are basics of health that need to be covered. Certain fundamentals that will help. Leave these out and your penis enlargement program is going to be like a ship full of holes trying to stay afloat. I call them ” Unusual Penis Enlargement Tips” because the wisdom they contain is often overlooked.

Unusual penis tip one. Eat a good diet. Make sure you get sufficient protein. As a guy you need more protein than a woman. Good sources of protein are fish, chicken, eggs, and milk. Protein powders , made from whey, are popular. Eating well is one of the basics of looking after yourself.

Unusual penis tip two. Get plenty of sleep. No pill or facial cream can substitute for deep and unbroken sleep. Plenty of sleep is essential in any penis enlargement program

Unusual penis tip three. Get some fresh air. Do you remember the last time when you walked out in the fresh air? Clean oxygen is essential for proper function of the whole body. What is good for your body, is also good for your penis.

Unusual penis tip four. Minimize stress. Easier said than done. But there are a host of options available today as never before. Yoga, dance,and the gym are some options. Find out what works for you.

Unusual penis tip five. Have fun. Statistics show that 80% of the population works in a job they hate. Hate creates negative energy. You want to have fun at something. Anything. Pick something to do, if you are not already, that gives you a lot of fun and pleasure . It will influence your outlook on life and this in turn will have a positive impact on your sexual performance.

Unusual penis tip six. Exercise your mind. You feed your body why not your mind? Read, meet interesting people, do interesting activities.Women enjoy stimulating and intelligent conversation. Sexual stamina in the bedroom combined with good conversation make a man very attractive to a female.

In this time poor age you might find it a challenge to do all of the unusual penis tips for a stronger erection listed. Pick one or two for starters. Master them and then go onto the next . This will build your confidence . And it is confidence that will help make your penis erection, and lovemaking, better than ever.

Best Foods For Fixing Erectile Dysfunction – Get Rock Hard Erection By These Natural Remedies

There are certain diseases which put a big question mark on the manhood of men and erectile dysfunction is also one of them. This is a very disturbing disease for men and men either don’t get any erection at all or they have difficulty in keeping or maintaining hard erection during the love making session. All this creates an indescribable embarrassment for them as they can’t give any satisfactory justification to their partner.

Mother nature is our best friend and has produced many natural foods for men on this earth for fixing their erectile dysfunction problem. These foods coupled with a few sex boosting exercises work wonders in fixing the erectile dysfunction problem naturally without taking any over the counter drug. Below is synoptic review of benefits of these best foods produced by Mother Nature for fixing the erectile dysfunction:

1. Take Coffee Moderately   

Take this for erectile dysfunction, but don’t consume too much of it. The caffeine boost your metabolism, gets the blood flowing more and could also increase your endurance by releasing fat stored up which will provide you energy.

2. Eat Bananas Daily-

It is a magic food for erectile dysfunction sufferers and can greatly help in fixing erectile dysfunction problem naturally. You can eat bananas for lunch, breakfast, etc. Guys who gain strong and hard erections often have healthy hearts, so eat bananas which are a great source of potassium. Potassium is excellent for the heart and blood circulation, therefore a close buddy for fixing your erectile dysfunction. Consuming potassium reduces sodium levels and prevents your blood pressure high blood pressure and thus it reduces the risk of heart problems.

3. Powerful Oysters 

Oysters are natural buddies for fixing erectile dysfunction, because it is rich in Zinc and vitamin B6, both of which are crucial for raising testosterone, and without which you would not have any sex drive .If Oysters gross you out, you can take nuts and seeds alternatively.

4.Eat Beans & Whole meal bread

In order for your penis to be a rock hard monster, you need thiamine for a healthy nervous system, so add beans and whole meal bread in your daily intake to help your nervous system function properly.

5.Cute Cherries

Cherries are loaded with tons of colorful chemicals derivatives which protect your artery walls, helping stop depositing of plaques that leads to clogged arteries. Take them in moderate quantities in your day to day diet plan or alternatively for fixing your erectile dysfunction problem you can also add peaches, nectarines and plums etc in your diet plan.

6. Magical Ancient Food

The Fish: This fish is great for people suffering from erectile dysfunction. It contains omega-3 fatty acids which make the blood less sticky, thus enhancing blood flow to the penis. Consume fish like fresh tuna, mackerel, and trout for achieving strong erections and healthy heart.

7.Add Onions In Your Diets:

Even though it is a lot more pain when you chop them, but their benefits will play a smile on your lips. It has phytochemical, and it thins the blood and enhances blood circulation in the body, also making it less likely to clog and clot. It is an ancient natural remedy for erectile dysfunction.

8. Consume Porridge-

Believe it or not Porridge also helps in fixing erectile dysfunction problem. It is a rich source of soluble fibre that reduces cholesterol keeps your blood vessels smooth and stretchy. Therefore, Porridge is greatl for men suffering from erectile dysfunction.

Moreover a simple sex boosting plan coupled with the above dietary recommendations would greatly help men in getting strong erection naturally without taking any over the counter drug. Erectile Dysfunction No More is such a manual which contains a complete plan of sex boosting exercises to cure erectile dysfunction and end premature ejaculation naturally.

 

Don’t Despair About Erection Problems. You CAN Cure Them!

We know that when your penis isn’t co-operating with you, it’s natural to worry about sex. In fact, you probably think about sex (or the lack of it) more than you would normally. You might even have tried to overcome your erection problems with some new experiences. One thing many men do when they find their erections are becoming unreliable is to have an affair – often with a younger woman. Maybe you’ve paid for sex. Maybe you’ve tried Viagra. Or perhaps you’ve taken to surfing the internet for porn or trying new sex games with your partner. There’s no problem with any of this except that it won’t solve your erection problems!

What will work are the treatment methods described on this website. Even if all your old certainties around sex have disappeared, you can still get back to having normal, healthy erections with our help. That’s 100% true, even if:

·         you don’t get erect even when you have vivid sexual fantasies

·         you don’t get erect when you see your partner’s naked body

·        you don’t find the thought of sex (or even intercourse itself) arousing

·         you’ve developed premature ejaculation

·       you have physical problems which are causing your erectile dysfunction

·         you have declining testosterone and a low sex drive

·         you have emotional problems which are causing your erectile dysfunction

·         you’re angry and depressed, irritable or unhappy

·         you haven’t had sex for weeks, months or years

·         you don’t want to have sex with your current partner

·         you’re having a mid-life crisis

·         you simply don’t know why your erections are unreliable

·         you lose your erection during sex or when putting on a condom

·         you avoid sex for fear of losing your erection

·         you can’t get erect even when your partner gives you oral sex

·         you have sexual or emotional abuse issues from childhood

·         you have sexual or emotional conflicts about women

Erectile dysfunction or, even worse, complete impotence are so devastating they can make you think your sex life is over. (Maybe even your life is over!) But with the right approach to treatment and an understanding of how you can solve these problems, you will find your erections return to normal pretty quickly. We show you how you can easily solve erectile dysfunction – and we describe how you and your partner can resolve the emotional issues that are disrupting your relationship. If you’re looking for harmony, this is essential reading.

Things You May Not Know About Erection Problems

There are many myths in society about maleness and masculinity which contribute to men’s erection problems. Each one of these myths is simply untrue. As you read through this list, see if any of them may have affected your beliefs about what is expected from you as a man.

·         A man should be able to give his partner an orgasm each and every time they have sex

·         A man should be able to get it up and keep it up even if his partner is unresponsive or doesn’t really like sex

·         A man’s penis should be erect from the beginning of sex right through to the time he ejaculates

·         A man can only have sexual intercourse if he has a fully erect penis

·         A man can always enjoy sex, whether inside or outside a relationship

·         A man with erection problems is not a masculine man

·         A man should be able to have sex with any woman who is willing and available

·         A man should be able to get an erection on demand, every time

·         A man should never be nervous when having sex

·         A man should be able to stay hard when having sex with a woman even if she doesn’t like sex, doesn’t arouse him or doesn’t respond to him sexually

We will show you why each and every one of these beliefs is untrue and how they contribute to men’s erection problems. Sometimes, the things that cause you to experience erectile dysfunction have nothing to do with you – like a sexual partner who doesn’t enjoy intercourse or won’t take part in oral sex. There are solutions even for these problems, and we will show you how both you and your partner can enjoy sex fully when you get your erections back to full power!

Treatment

Treatment for Weak Erection by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

BENT OR CURVED PENIS

Penis curvature, or a bent penis, is one of those unpleasant problems plaguing men, filling them with anxiety and driving away peace of mind.

A visible curve in the penis is bound to make any man less eager to take down his pants in front of a lady. What if she starts laughing? What if she recoils from it? Nobody likes to be seen as a freak or as something to be laughed about. Although the man in question is in no way responsible for this problem, others can’t help but see this as a dubious physical feature.

1. A bent or curved penis can damage a sexual relationship by:

2. Causing discomfort to the female partner during intercourse

3. Creating pain and discomfort for the man during erection or ejaculation

4. Damaging the man’s self-esteem and sexual self-confidence

5. Disrupting the couple’s physical and emotional bonding and relationship

Factors that commonly cause a bent penis

Unfortunately, the factors that cause a bend or curvature to develop in the penis are totally outside the control of the man to whom this condition occurs.

Men are sometimes troubled by the notion that the problem has somehow been created by masturbation. This leads to feelings of guilt and remorse, causing even more damage to sexual self-confidence and, consequently, sexual performance. It is essential to clearly understand that masturbation does not cause any physical deformity of the penis and is in no way harmful to health. Masturbation is normal and generally beneficial.

Penile curvatures are caused either by natural factors during the growth of the boy through adolescence to manhood or by a condition knows as Peyronie’s disease.

1. The natural curvature occurs when the two chambers of the penis (corpora cavernosa) develop at different rates through the years, thus bending the penis toward the slower developing chamber. The reasons for this uneven development are not known and this tendency cannot be forecast or prevented. However, there are treatments available for correcting the problem once it occurs.

2. Peyronie’s disease is a condition named after Francois de la Peyronie, surgeon to Louis XIV of France, who was the first man to describe a treatment in 1743. While the cause of this disease is not well understood, its mechanism is perfectly clear.

The “tunica albuginea” is the tough layer of connective tissue that contains the sponge-like Corpora Cavernosa. For reasons unknown, scar tissue begins to form in the “tunica albuginea”, which prevents the normal expansion of the penis during erections and, in time, bends the penis to one side or the other.

Although the disease is somewhat painful at first, the pain eventually goes away on its own. The only remaining effects of this disease are the curvature, which is visible when the penis is erect, and possibly a shortening of the penis in the flaccid state.

Symptoms

1. Could feel a hard lump or plaque under the skin

2. A lump may either occur suddenly after trauma, or take months to develop.

3. Pain is a common symptom that happens when the penis is erect.

4. Swelling can occur above the scar.

5. Penis may be narrowed or bent.

6. Multiple curves are possible.

7. Base of the penis could be rigid or hard.

8. Penis is not flexible.

9. Impotence or loss of sexual desire can occur.

10. Depression

  • 11. Marital problems

Causes  

1. Trauma during sexual intercourse — accidental bending or hitting the penis may cause internal bleeding and scar formation.

2. Surgery — especially around the genitals (penis, prostate, testicles) and pelvic surgery (area of the body between the two hips)

3. Genetics (abnormality of genes) — there may be an association with another disease known as Dupuytren’s contraction (scarred and curved 4th finger) linked to a protein known as HLA-B27 antigen

Other causes for a bent or curved penis.

Restrictive Clothing – When boys get erections, their penises are restricted inside their tight underpants. They often bend their penises over to the left or right to hide the erection in their pants. This affects the development of their young penises. Blood can flow only through the 1 side of the spongy tissue and1 side of the penis develops better.

Injury – Acute or repetitive trauma (hitting or bending) causes localized bleeding inside the penis. This leads to fibrin deposition (scar tissue) in the tissue space that accumulates after additional trauma. Collagen is also trapped and pathologic fibrosis follows and even the formation of calcium deposits. In addition, with age there is a decrease in the elasticity of collagen fibers

Other Causes – Vasoactive substance injection therapy, vitamin E deficiency, the use of beta-blocking agents and autoi

How to diagnosis is made

The patient’s general doctor will consult with an urologist.

1. History

2. Symptoms

3. Trauma

4. Surgery

5. Illnesses

6. Medications and allergies

7. Habits, especially sexual

8. A medical exam reveals a curve or scar.

9. The size and shape of the penis is documented.

10. There may be contractions of 4th finger.

11. Test

12. Picture of the penis may be taken.

13. Urologist may inject a substance in the penis called

14. Prostaglandin E1, and then use a machine called a Doppler (uses sound) to see the internal structure of the penile cavities.

15. Calcium deposits can be seen in old scars.

Risk Factor

1. Repeated trauma

2. Urological or pelvic surgery

3. Vigorous sex especially when female is on top and bending backwards

4. Dupuytren’s contraction

CURVATURE OF THE PENIS

Peyronie’s disease is a severe curvature of the erect penis. It’s named after an Italian physician to King Louis XIV of France. This physician was the first to note the disorder back in the 1700s. While it is somewhat common, it is not often mentioned.

A minor bend in the erect penis is perfectly normal, as few penises are straight as an arrow. In some cases of Peyronie’s, however, the penis can form a “J” or a corkscrew, making intercourse impossible.

What causes a curved penis?

The cause of Peyronie’s disease is unknown. Some physicians theorize the cause of the curvature may be from trauma to the penis, perhaps if the penis is bent backward during rough sex. The injury causes an inflammation in the tunica, and subsequently leads to scarring.

There are other theories, and some reports suggest that men who take beta-blocking medications for high blood pressure develop Peyronie’s.                                                              .

How is the penis constructed.

The penis is composed of three cylindrical cavities. The two on top are called the corpus cavernosa, and the one on bottom the corpus spongiosum, which contains the urethra (the tube that urine flows through).

The two top corporal cavities expand to trap and hold the blood that produces an erection in the male. The bottom body, corpus spongiosum, functions mainly for the passage of urine. Each of these corporal bodies is surrounded by a very elastic covering called the tunica albuginea.

On top of the two corporal cavernosa are the superficial nerves and blood vessels of the penis.

Why does the penis curve?

In Peyronie’s disease, the normal elastic tissue of the tunica is replaced by scar tissue. Normally with erection the elastic tissue of the penis expands and elongates symmetrically resulting in a straight erection. Because the plaque, or scar tissue, is not elastic, but rather hard, it will not stretch with erection.

The disease starts as a small bump or constriction on the shaft of the penis below the skin, which expands to form a flat deposit that’s sometimes as large as the diameter of a silver dollar. This “plaque” invades and replaces the elastic covering of the penis with inflexible material. When a man with Peyronie’s has an erection, the plaque does not expand, so the penis curves to one side.

How does a curved penis affect sexual intercourse?

A third of men with Peyronie’s have pain with their erections. A few men with Peyronie’s become impotent. In some cases, the head of the penis does not fill with blood.

Because inflammation is initially associated with the scar tissue, there can be some discomfort with erection and distension. Many patients complain not only about the curvature of the erection but the loss of length and girth. These are all results of the inelastic tissue and lack of distention that results.

Most patients with Peyronie’s disease can continue to function sexually with the curvature in the penis. Rarely, some patients with greater distortion are unable to have satisfactory sexual intercourse.

Does a curved penis cause impotence?

Recent studies indicate that some men with Peyronie’s disease lose the ability to trap the blood in the penis. It can, however, be difficult to distinguish the man who has a leakage problem from one who is quite anxious about his penis and loses his erection secondary to anxiety and stress.

Most of the time the plaque is on the top surface of the penis causing an upward bend. However, plaques can occur at any point on the penis. In some patients the penis beyond the plaque will not become as rigid.

How common is a curved penis?

Peyronie’s disease is an extremely common ailment. At the Male Health Center, physicians see about five patients a week with this problem.

Most patients are middle-aged, though the youngest patients we have seen are in their twenties, and there are a number of still sexually active men in their eighties with the disease.

Some men first notice the sudden onset of a curved erection even though the previous erection was straight. In other men, the curvature may be slight at first, but then it keeps getting worse. Eventually, the curve stops, and gets no worse. In most cases, the active process of Peyronie’s disease lasts less than a year. At the time the process stops, the scar tissue may remain or in some cases disappear.

How can you straighten a curved penis?

Treatment

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PERONIE’S DISEASE

Peyronie’s (pa-ro-NEEZ) disease causes a bent penis during erection. A hard, fibrous layer of scar tissue (plaque) develops under the skin on the upper or lower side of the penis. When the penis is erect, the scar tissue pulls the affected area off at an angle, causing a curved penis. The plaque, formed by thickened layers of soft tissue in the penis is noncancerous (benign). The condition can cause pain and make sexual intercourse difficult.

Sometimes Peyronie’s disease improves without treatment, so your doctor may initially recommend a wait-and-see approach. Treatments of Peyronie’s disease involve nonsurgical and surgical approaches.

Symptoms

The signs and symptoms of Peyronie’s disease may appear overnight or develop more slowly. These may include:

  1. Painful erection
  2. A bend or curve in your penis during erection
  3. A thick band of hard tissue on one or more sides of your penis
  4. Indentation, or an “hourglass-shaped” penis during erection
  1. Impaired ability to obtain an erection (erectile dysfunction, or ED)
  2. Shrinking or shortening of your penis
  3. Scar tissue that develops on the top of the penis will cause the penis to bend upward. Plaque on the underside of your penis will cause it to bend downward. Sometimes scar tissue occurs on both sides of the penis, causing an indentation or “bottleneck.”

In many cases, pain caused by Peyronie’s disease may decrease after a short period of time. However, the curvature may persist even if the pain subsides. In some men with a milder form of the disease, inflammation may improve without causing a lot of pain or permanent bending.

The Basic Facts

  • Men with Peyronies disease generally seek medical attention for pain or bending of the penis during erection, which results from inflammation and scarring in a particular part of the male anatomy known as the tunica albuginea.
  • Francois de la Peyronie, surgeon to Louis XIV of France, first described treatment for this disorder in 1743.
  • This condition is most commonly acquired at about age 55. A man can be born with curvature of the penis, though this is not Peyronies disease.
  • Severity varies – only a minority of the men afflicted with this problem are unable to engage sexually. Through an effect on the erection mechanism it can reduce rigidity (hardness), but it rarely causes impotence.
  • It is somewhat uncommon, affecting somewhere between one and three men in a hundred.
  • In addition to producing curvature, Peyronies disease may change the shape of the erection in other ways: indentation, diameter reduction, or loss of length.
  • Peyronies disease can have a strong psychological impact.
  • Some cases are mild, healing without treatment within a year of onset. Most cases produce at least some degree of persistant curvature.
  • 9. A noticeable lump, or plaque within the penis is commonly detected. Contrary to prevalent anxieties, it is noncancerous, and unrelated to cholesterol – containing arterial plaque
  • 10. Peyronies disease can run in families, though most cases do not appear to be hereditary.
  • 11. This condition is not associated with serious internal disorders. 10 –20% of men develop scarring of either the hands (Dupuytren’s contractures) or of the feet.
  • 12. The goal of therapy is to maintain sexual function. In some cases, education about the disease and reassurance is all that is required. Rarely, when long-term deformity prevents intercourse, surgery is recommended.

Peyronie’s disease, a condition of uncertain cause, is characterized by a plaque, or hard lump, that forms on the penis. The plaque develops on the upper or lower side of the penis in layers containing erectile tissue. It begins as a localized inflammation and can develop into a hardened scar.

Cases of Peyronie’s disease range from mild to severe. Symptoms may develop slowly or appear overnight. In severe cases, the hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc during erection. In many cases, the pain decreases over time, but the bend in the penis may remain a problem, making sexual intercourse difficult. The sexual problems that result can disrupt a couple’s physical and emotional relationship and lead to lowered self-esteem in the man. In a small percentage of patients with the milder form of the disease, inflammation may resolve without causing significant pain or permanent bending.

The plaque itself is benign, or noncancerous. A plaque on the top of the shaft (most common) causes the penis to bend upward; a plaque on the underside causes it to bend downward. In some cases, the plaque develops on both top and bottom, leading to indentation and shortening of the penis. At times, pain, bending, and emotional distress prohibit sexual intercourse.

One study found Peyronie’s disease in 1 percent of men. Although the disease occurs mostly in middle age, younger and older men can develop it. About 30 percent of men with Peyronie’s disease develop fibrosis (hardened cells) in other elastic tissues of the body, such as on the hand or foot. A common example is a condition known as Dupuytren’s contracture of the hand. In some cases, men who are related by blood tend to develop Peyronie’s disease, which suggests that genetic factors might make a man vulnerable to the disease.

Men with Peyronie’s disease usually seek medical attention because of painful erections and difficulty with intercourse. Since the cause of the disease and its development are not well understood, doctors treat the disease empirically; that is, they prescribe and continue methods that seem to help. The goal of therapy is to keep the Peyronie’s patient sexually active. Providing education about the disease and its course often is all that is required. No strong evidence shows that any treatment other than surgery is effective. Experts usually recommend surgery only in long-term cases in which the disease is stabilized and the deformity prevents intercourse.

A French surgeon, François de la Peyronie, first described Peyronie’s disease in 1743. The problem was noted in print as early as 1687. Early writers classified it as a form of impotence, now called erectile dysfunction (ED). Peyronie’s disease can be associated with ED; however, experts now recognize ED as only one factor associated with the disease—a factor that is not always present.

A cross-section of the penis (left) displays the internal cavity that runs the length of the penis and is divided into two chambers (corpora cavernosa) by a vertical connecting tissue known as a septum. It is believed that, during trauma such as bending, bleeding might occur at a point of attachment of the septum to tissue lining the chamber wall (center). The bleeding results in a hard scar, which is characteristic of Peyronie’s disease. The scar reduces flexiblility on one side of the penis during erection, leading to curvative (right).

Causes of the Disease

Many researchers believe the plaque of Peyronie’s disease develops following trauma (hitting or bending) that causes localized bleeding inside the penis. Two chambers known as the corpora cavernosa run the length of the penis. The inner-surface membrane of the chambers is a sheath of elastic fibers. A connecting tissue, called a septum, runs between the two chambers and attaches at the top and bottom.

If the penis is abnormally bumped or bent, an area where the septum attaches to the elastic fibers may stretch beyond a limit, injuring the lining of the erectile chamber and, for example, rupturing small blood vessels. As a result of aging, diminished elasticity near the point of attachment of the septum might increase the chances of injury.

The damaged area might heal slowly or abnormally for two reasons: repeated trauma and a minimal amount of blood flow in the sheath-like fibers. In cases that heal within about a year, the plaque does not advance beyond an initial inflammatory phase. In cases that persist for years, the plaque undergoes fibrosis, or formation of tough fibrous tissue, and even calcification, or formation of calcium deposits.

While trauma might explain acute cases of Peyronie’s disease, it does not explain why most cases develop slowly and with no apparent traumatic event. It also does not explain why some cases disappear quickly or why similar conditions such as Dupuytren’s contracture do not seem to result from severe trauma.

Some researchers theorize that Peyronie’s disease may be an autoimmune disorder.

Diagnosis

Peyronie’s disease can be confirmed by a qualified urologist, without recourse to expensive tests or xrays. It has a characteristic history:

1. Pain with erection

2. Bending and or indentation of the erection

3. Loss of penile length

4. In some cases, pain is absent

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There are specific findings on examination:

  1. One or more hardened areas, or plaques, within the wall of the erection chamber
  2. Reduced elasticity of the flaccid penis

The most common angle is between 0 and 60 degrees :             example60°:

Photographs, usually taken at home by the patient, can establish the degree and type of distortion present. They become an important record of the condition, and are helpful for tracking response to therapy.

Xrays or ultrasound pictures are not madatory, but they can show when plaque calcification has occurred. This finding, which relates to the potential reversibility of the condtion, is also important when surgery is being considered.

Testing the integrity of the erection mechanism is occasionally recommended prior to surgery.

Anatomy

The penis has two major internal divisions, each responsible for a different function. The corpora cavernosa, which can be likened to hydraulic cylinders, create structural rigidity. The corpus spongiosum contains the urethra, or excretory channel.

The corpora cavernosa are cigar-shaped tubes of strong connective tissue, filled with spongy muscle-lined cavities. Relaxation of vascular muscle causes inflow of blood and expansion of the corpora’s inner sponge during erection. As a result its wall, the tunica albuginea, is stretched tightly enough to produce rigidity. In addition to defining the shape of the erect penis, the tunica also has a key role in limiting blood outflow during erection.

The paired corpora are joined within the penis, but separate at its junction with the body. At its base they diverge right and left, and attach to the corresponding pelvic bones. These two points, along with a midline suspensory ligament between the joined corpora and the pubic bone, form a sturdy three-point anchor.

The urinary channel or urethra runs under the corpora cavernosa, while most of the penile blood vessels and nerves run along the top side.

Producing An Erection

In simple terms, this consists of trapping pressurized blood within the confines of a limited space. The chambers that accomplish this anatomically are known as the corpora cavernosa. Given the proper signal the spongy, blood filled spaces relax and open up, allowing the free inflow of blood.

The chambers expand, pulling the tunica albuginea tight. It’s tension makes the corpora hard (resistant to indentation) and rigid (resistant to flexion). Secondarily, it pinches off the veins that normally let blood exit the chambers, trapping blood inside and contributing to the state of engorgement.

Can Peyronie’s disease cause impotence?

Impotence, defined as the inability to maintain a hard enough erection to have intercourse, is uncommon in Peyronie’s disease. Yet it frequently affects the erection mechanism in a less serious way. Scientific studies have shown that at some point in time, up to 40% of men with Peyronie’s disease have experienced some degree of erectile dysfunction. Usually, this consists of a reduction in maximum hardness. It is usually a temporary effect, and rarely causes enough softening to preclude normal intercourse. When associated with severe bending however, it can be a problem. Persistant difficulty with erectile rigidity can usually be treated medically

The cause for the erectile dysfunction of Peyronie’s disease is “venous leakage.” In other words, the blood that should normally be trapped within the taut confines of the tunica albuginea is leaking slowly out. By locally hardening the tunica, plaques may prevent the exit veins from pinching off in the normal fashion.

Damaging effects of mechanical stress

When fully expanded, the rigid corpora cavernosa forms something like an inflatable I beam. Mechanical forces on this structure will create a unique region of tissue stress at the top of the “I”. The majority of the tunica albuginea compresses with stretch during erection, but the topmost strip is subject to an opposite, delaminating force.

Fibrin deposition, the first step in the wound healing process and the precursor to Peyronie’s plaque, usually develops in this area. The mid- topof the penis is the area most commonly involved by Peyronie’s disease.

If Peyronie’s plaque forms in the hoop (circumfrential) direction, it causes indentation or segmental loss of penile diameter. These so-called hourglass areas have a profound effect on over all penile rigidity. The resistance to bending of an inflatable tube is related to its cross sectional area. Because of this, indented areas make the erect penis easier to bend, even at high internal fluid pressures.

By looking at the expanding corpora as a series of stacked elements, it is possible to calculate how much tunica must lose its elasticity to produce a given amount of bending. A plaque about six centimeters long is required in order to produce a 90 degree bend. In other words, little plaques cannot cause big bends.

Treatment

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Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

BLOOD VESSEL ABNORMALITIES OF PENIS

Problems with either the arteries carrying blood to the penis or the veins draining blood from the penis can easily prevent a satisfactory erection. The most common of these problems is blockage of the arteries carrying blood to the penis. The small arteries carrying blood into the penis at the time of an erection must dilate from five to ten times their normal resting diameter. Even as little as 15 % percent occlusion of the small blood vessels is enough blockage to cause a problem.

Such partial arterial blockage is the most common cause of organic impotence and is usually associated with risk factors such as cigarette smoking, diabetes, hypertension (high blood pressure), or even marked elevation of blood cholesterol and fat levels. Other risk factors associated with reduced arterial flow are a history of blunt pelvic trauma or pelvic radiation.

The majority of men who have erection problems as a result of reduced arterial blood flow will also have more generalized cardiovascular problems throughout the body. Frequently, impotent men also have a history of coronary artery occlusive disease with or without a history of prior heart attacks. Some individuals with erection problems also have a history of poor blood circulation to their feet and legs, resulting from arterial occlusive disease. Occasionally, a patient has a focal isolated blockage of one of the arteries carrying blood to the penis. This is usually seen in young patients, in their twenties, who have sustained blunt pelvic trauma such as a past pelvic fracture. Diabetic men can have impotence secondary to both effects on the nerve supply to the penis, as well as the vascular supply. Diabetic men, as well as older men, have an increased amount of scarring, or fibrosis within the walls of the arteries to the penis. Plaque buildup on these different areas further reduces the inside diameter of the arteries.

Patients with hyperlipidemia, or marked elevation of lipid (fat) levels in the blood have a definite well-described risk for arteriosclerosis. The extra lipid builds up in the wall of the artery and eventually causes a significant degree of blockage. High blood pressure (hypertension) is another established risk factor for arteriosclerosis. A recent study reported that in one series of impotent men about 45 percent had a history of hypertension. In patients with hypertension, it is not the increased blood pressure itself that contributes to erection problems. Rather, the associated arterial stenosis found in patients with hypertension is thought to be the cause of the erection problems.

Failure of the mechanism that clamps down on the veins that drain blood from the penis has been proposed as one of the more common causes of vasculogenic impotence. Some men may develop large venous channels that are never quite fully occluded as the arterial blood flows into the penis during the beginning phase of erection. Often, this problem is seen in relatively young patients who have experienced erection problems over their entire life. Such patients may report relatively normal initiation of an erection, but within a few seconds or up to a minute or so lose the erection without ejaculation. These venous leak type problems may be surgically corrected.

In Peyronie’s disease, non-elastic scar tissue forms, primarily along the surface of the tunica albuginea, resulting in inadequate compression of the veins below the tunical surface, therefore preventing entrapment of the arterial blood in the normal fashion. On the other hand, if the trabecular smooth muscle and the vascular spaces of the penis are unable to relax sufficiently, the sinusoidal expansion will be inadequate and the subtunical veins will not be compressed enough to maintain an erection. This may occur in the overanxious individual with excessive adrenaline and excitement. Alteration of the neuro receptors in the smooth muscle may give an adverse response and, in effect, impair relaxation of the smooth muscle in response to the usual nitric oxide stimulation.

Interestingly cigarette smoking, in addition to causing generalized arterial blockage, may also cause the cavernous smooth muscle to lose its ability to dilate. Again, the net effect is the same -not enough clamping of the penile penile veins to allow for the heightened intracavernous arterial pressures necessary for an erection.

Causes  

To initiate and maintain an erection, the penis must fill with blood. Nerve signals stimulate this engorgement. They prompt the blood vessels in the penis to expand so blood can fill it. Meanwhile, other blood vessels constrict, trapping blood inside.

The following factors can cause erectile dysfunction:

Venous Leak

If a leak in the blood vessels in the penis allows blood to escape, an erection may not be attainable, or may not last long. This can be caused by injury or disease.

Neurovascular Function

  1. Erection cannot be attained if nerve signals do not prompt blood vessels to expand or if blood flow to the penis is reduced.
  2. Nerve dysfunction can also diminish feeling in the penis resulting in impotence.
  3. Diabetes can interfere with nerve signals.
  4. There may be a complete loss of nighttime erections.
  5. Arteriosclerosis (hardening of the arteries) can cause reduced blood flow.
  6. Peripheral neuropathy , spinal cord injury, and surgery can also damage nerves.
  7. Many medications also cause erectile dysfunction.

Blood Vessels and Nerves of Male Pelvis

Psychological Factors

The brain initiates many of the nerve signals required for a successful erection. Emotional problems may play a role in men who suddenly develop impotence.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include

Age: 65 and older

  1. Medical conditions:
  • Diabetes
  • Arteriosclerosis (hardening of arteries)
  • Chronic kidney disease
  • Liver failure
  • Peyronie’s disease (bending of the penis caused by scar tissue)
  • Endocrine disorders
  • Neurological disorders (ie, multiple sclerosis , peripheral neuropathy , stroke )
  • Hypertension
  • Psychiatric disorders (ie, anxiety , depression )

2.Traumatic conditions:

  • Vascular surgery
  • Pelvic surgeries (particularly for prostate cancer )
  • Spinal cord injury

3.Behaviors:

  • Alcohol use
  • Illegal drug use
  • Anabolic steroid use
  • Heavy smoking
  • Interpersonal conflicts with a sexual partner

4.Medications:

  • Antihypertensives
  • Antihistamines
  • Antidepressants
  • Tranquilizers
  • Antipsychotics

Symptoms

Symptoms include:

  1. A less firm penis
  2. Fewer erections

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Expect questions about the frequency, quality, and duration of your erections. Your answers may help determine if primarily psychological or physical factors are causing your impotence.

The doctor will examine your penis, testes, and rectum. If a physical cause is suspected, the doctor may order laboratory tests. These laboratory tests will include hormone levels such as thyroid function tests, prolactin levels, and testosterone levels.

Nocturnal Penile Tumescence Testing

This test can distinguish psychogenic impotence from those due to neurovascular causes.

Imaging

Sometimes Doppler imaging may be done to look at the blood flow and to make sure that there is no obstruction in the arteries or veins that supply the penis.

Treatment

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MASTURBATION

Masturbation refers to sexual stimulation, especially of one’s own genitals and often to the point of orgasm, which is performed manually, by other types of bodily contact (except for sexual intercourse), by use of objects or tools, or by some combination of these methods.[1] Masturbation is the most common form of autoeroticism, and the two words are often used as synonyms, although masturbation with a partner (mutual masturbation) is also common. Animal masturbation has been observed in many species, both in the wild and in captivity.

Etymology

The word masturbation is believed to derive from either the Greek word mezea (μεζεα, “penises”) or the Latin manus (“hand”) and the Latin turbare (“to disturb”). A competing etymology based on the Latin manu stuprare (“to defile with the hand”) is said by the Oxford English Dictionary to be an “old conjecture”. The esoteric and little-used synonym manustupration is similarly derived from manus stuprare. While “masturbation” is the medical term for this practice, many other terms and expressions are in common use. “Onanism” is a term with religious roots. In the vernacular, terms such as “pleasuring oneself”, “wanking”, and “jerking off” are common. See masturbate in Wikisaurus for many others.

Masturbation Techniques

 Goya’s Dos Mujeres y Un Hombre depicting two women laughing at a masturbating man.

Ways of masturbating common to members of both sexes include pressing or rubbing the genital area, either with the fingers or against an object such as a pillow; inserting fingers or an object into the anus (see anal masturbation); and stimulating the penis or vulva with electric vibrators, which may also be inserted into the vagina or anus. Members of both sexes may also enjoy touching, rubbing, or pinching the nipples or other erogenous zones while masturbating. Both sexes sometimes apply lubricating substances to intensify sensation. Reading or viewing pornography, or sexual fantasy, are often common adjuncts to masturbation. Often people will call upon memories during masturbation. Masturbation activities are often ritualised. Various fetishes and paraphilias can also play a part in the masturbation ritual. Some potentially harmful or fatal activities include autoerotic asphyxiation and self-bondage. Some people get sexual pleasure by inserting objects into the urethra (the tube through which urine and, in men, semen, flows).[5] If these objects are urethral sounds, the practice is known as “sounding”.[6] Other objects such as ball point pens and thermometers are sometimes used, although this practice can lead to injury and/or infection.[7] Some people masturbate by using machines that simulate intercourse. Men and women may masturbate until they are close to orgasm, stop for a while to reduce excitement, and then resume masturbating. They may repeat this cycle multiple times. This “stop and go” build up can achieve even stronger orgasms. Rarely, people quit stimulation just before orgasm to retain the heightened energy that normally comes down after orgasm[8] due to the release of prolactin hormone. Doing this could lead to temporary discomfort due to pelvic congestion. Austrian psychoanalyst Wilhelm Reich in his 1922 essay Concerning Specific Forms of Masturbation tried to identify healthy and unhealthy forms of masturbation. He tried to relate the way people masturbated to their degree of inclination towards the opposite sex and to their psycho-sexual pathologies.

Male

Male masturbation techniques are also influenced by a number of factors and personal preferences. Techniques may also differ between circumcised and uncircumcised males, as some techniques which may work for one can often be quite painful for the other.

The most common male masturbation technique is simply to hold the penis with a loose fist and then to move the hand up and down the shaft until orgasm and ejaculation take place. The speed of the hand motion will vary from male to male, although it is not uncommon for the speed to increase as ejaculation nears and for it to decrease during the ejaculation itself. When uncircumcised, stimulation of the penis in this way comes from the “pumping” of the foreskin. This gliding motion of the foreskin reduces friction. When circumcised, there is more direct contact between the hand and the glans, thus a personal lubricant is sometimes used to reduce friction. Sometimes, if too much pressure is applied, it may be rubbed sore for a time. Circumcised or not, men may rub or massage the glans, the rim of the glans, and the frenular delta. Another technique is to place just the index finger and thumb around the penis about halfway along the penis and move the skin up and down. A variation on this is to place the fingers and thumb on the penis as if playing a flute, and then shuttle them back and forth. Another common technique is to lie face down on a comfortable surface such as a mattress or pillow and rub the penis against it until orgasm is achieved. This technique may include the use of a simulacrum, or artificial vagina.

Renaissance art depicting two boys engaging in sex play (fresco, Museum of Villa Giulia, Rome).

There are many other variations on male masturbation techniques. Some men place both hands directly on their penis during masturbation, while others use their free hand to fondle their testicles, nipples, or other parts of their body. Some may keep their hand stationary while pumping into it with pelvic thrusts in order to simulate the motions of sexual intercourse. Others may also use vibrators and other sexual devices more commonly associated with female masturbation. A few extremely flexible males can reach and stimulate their penis with their tongue or lips, and so perform autofellatio. The prostate gland is one of the organs that contributes fluid to semen. As the prostate is touch-sensitive, some directly stimulate it using a well-lubricated finger or dildo inserted through the anus into the rectum. Stimulating the prostate from outside, via pressure on the perineum, can be pleasurable as well. Semen is sometimes ejaculated onto a tissue or some other item. A somewhat controversial ejaculation control technique is to put pressure on the perineum, about halfway between the scrotum and the anus, just before ejaculating. This can, however, redirect semen into the bladder (referred to as retrograde ejaculation). If repeated on a regular basis, this technique could cause long term damage due to the pressure put on the nerves and blood vessels in the perineum. A dry orgasm is one that is reached while withholding ejaculation (or where retrograde ejaculation has taken place). Proponents of dry orgasm say that this is a learnable skill that can shorten the refractory period.

Mutual Masturbation

Mutual masturbation is a sexual act where two or more people stimulate themselves or one another sexually, usually with the hands. This may be done in situations where the participants do not feel physically able, that it is socially inappropriate or they do not want full sexual intercourse, but still wish to enjoy a mutual sexual act. It is also part of a full repertoire of sexual intercourse, where it may be used as an interlude, foreplay or simply as an alternative to penetration. For some people, it is the primary sexual activity of choice above all others, perhaps because it enables the individuals to see each other face to face and leaves the hands free to caress, as in frottage. Mutual masturbation is practiced by people of all sexual orientations. If used as an alternative to penile-vaginal penetration, the aim may be to preserve virginity or to prevent pregnancy. Some people choose it as it achieves sexual satisfaction without actual sex, possibly seeing it as an alternative to casual sex.

Masturbation Frequency, Age & Sex

Frequency of masturbation is determined by many factors, e.g., one’s resistance to sexual tension, hormone levels influencing sexual arousal, sexual habits, peer influences, health and one’s attitude to masturbation formed by culture. Medical causes have also been associated with masturbation. Different studies have found that masturbation is frequent in humans. Alfred Kinsey’s studies have shown that 92% of men and 62% of women have masturbated during lifespan. Similar results have been found in British national probability survey. It was found that 95% of men and 71% of woman masturbated at some point in their lives. 73% of men and 37% of woman reported masturbating in the four weeks before their interview, while 53% of men and 18% of woman reported masturbating in previous seven days. “Forty-eight female college students were asked to complete a sexual attitudes questionnaire in which a frequency of masturbation scale was embedded. Twenty-four of the women (the experimental group) then individually viewed an explicit modeling film involving female masturbation. One month later, all subjects again completed the same questionnaire. Subjects in the experimental group also completed a questionnaire evaluating aspects of the film. Results indicated that the experimental group reported a significant increase in the average monthly frequency of masturbation, as compared to the control group. This same group, however, reported that the film had no effect on sexual attitudes or behavior.” A 2004 survey by Toronto magazine NOW was answered by an unspecified number of thousands. The results show that an overwhelming majority of the males – 81% – began masturbating between the ages of 10 and 15. Among females, the same figure was a more modest majority of 55%. (Note that surveys on sexual practices are prone to self-selection bias.) It is not uncommon however to begin much earlier, and this is more frequent among females: 18% had begun by the time they turned 10, and 6% already by the time they turned 6. Being the main outlet of child sexuality, masturbation has been observed in very young children. In the book Human Sexuality: Diversity in Contemporary America, by Strong, Devault and Sayad, the authors point out, “A baby boy may laugh in his crib while playing with his erect penis (although he does not ejaculate). Baby girls sometimes move their bodies rhythmically, almost violently, appearing to experience orgasm.” A Canadian survey of Now magazine readers (cited above), has it that the frequency of masturbation declines after the age of 17. Many males masturbate daily, or even more frequently, well into their 20s and sometimes far beyond. This decline is more drastic among females, and more gradual among males. While females aged 13–17 masturbated almost once a day on average (and almost as often as their male peers), adult women only masturbated 8–9 times a month, compared to the 18–22 among men. Adolescent youths report being able to masturbate to ejaculation around six times per day, though some men in older middle age report being hard pressed to ejaculate even once per day. On the other hand healthy 21-28 year old males are able to masturbate at least 8-10 times per day if they are not stressed. The survey does not give a full demographic breakdown of respondents, however, and the sexual history of respondents to this poll, who are readers of an urban Toronto lifestyle magazine, may not extend to the general population. It appears that females are less likely to masturbate while in a heterosexual relationship than men. Popular belief asserts that individuals of either sex who are not in sexually active relationships tend to masturbate more frequently than those who are; however, much of the time this is not true as masturbation alone or with a partner is often a feature of a relationship.

Contrary to conventional wisdom, several studies actually reveal a positive correlation between the frequency of masturbation and the frequency of intercourse. One study reported a significantly higher rate of masturbation in gay men and women who were in a relationship. Among some cultures, such as the Hopi in Arizona, the Wogeno in Oceania, and the Dahomeans and Namu of Africa, masturbation is encouraged, including regular masturbation between males. In certain Melanesian communities this is expected between older and younger boys. One interesting twist is the Sambia tribe of New Guinea. This tribe has rituals and rites of passage surrounding manhood which involve frequent ejaculation through fellatio. Semen is valued and masturbation is seen as a waste of semen and is therefore frowned upon even though frequent ejaculation is encouraged. The capacity and need to ejaculate is nurtured for years from an early age through fellatio so that it can be consumed rather than wasted. Semen is ingested for strength and is considered in the same line as mothers’ milk.Other cultures have rites of passage into manhood that culminate in the first ejaculation of a male, usually by the hands of a tribal elder. In some tribes such as the Agta, Philippines, stimulation of the genitals is encouraged from an early age. Upon puberty, the young male is then paired off with a “wise elder” or “witch doctor” who uses masturbation to build his ability to ejaculate in preparation for a ceremony. The ceremony culminates in a public ejaculation before a celebration. The ejaculate is saved in a wad of animal skin and worn later to help conceive children. In this and other tribes, the measure of manhood is actually associated more with the amount of ejaculate and his need than penis size. Frequent ejaculation through masturbation from an early age fosters frequent ejaculation well into adulthood. Masturbation is becoming accepted as a healthy practice and safe method for sharing pleasure without some of the dangers that can accompany intercourse. It is socially accepted and even celebrated in certain circles. Group masturbation events can be easily found online. Masturbation marathons are yearly events and are occurring across the globe. These events provide a supportive environment where masturbation can be performed openly among young and old without embarrassment. Participants talk openly with onlookers while masturbating to share techniques and describe their pleasure.

Evolutionary Purpose

Masturbation may increase fertility during intercourse. Female masturbation alters conditions in the vagina, cervix and uterus, in ways that can alter the chances of conception from intercourse, depending on the timing of the masturbation. A woman’s orgasm between one minute before and up to 45 minutes after insemination favors the chances of that sperm reaching her egg. If, for example, she has had intercourse with more than one male, such an orgasm can increase the likelihood of a pregnancy by one of them. Female masturbation can also provide protection against cervical infections by increasing the acidity of the cervical mucus and by moving debris out of the cervix. In males, masturbation flushes out old sperm with low motility from the male’s genital tract. The next ejaculate then contains more fresh sperm, which have higher chances of achieving conception during intercourse. If more than one male has intercourse with a female, the sperm with the highest motility will compete more effectively.

Health & Psychological Effects

Benefits

The physical benefits of masturbation and having an orgasm or ejaculating creates heightened arousal while epinephrine courses through the body, producing the flushed face, shallow breath and post-climactic euphoria. It is held in many mental health circles that masturbation can relieve depression, stress and lead to a higher sense of self-worth (Hurlbert & Whittaker, 1991). Masturbation can also be particularly useful in relationships where one partner wants more sex than the other – in which case masturbation provides a balancing effect and thus a more harmonious relationship. Mutual masturbation, the act by which two or more partners stimulate themselves in the presence of each other, allows a couple to reveal the “map to [their] pleasure centers”. Witnessing a partner masturbate is an educational activity to find out the method a partner pleases him- or herself, allowing each partner to learn exactly how the other enjoys being touched.In 2003, an Australian research team led by Graham Giles of The Cancer Council Australia concluded that frequent masturbation by males appears to help prevent the development of prostate cancer. The study also indicated that this would be more helpful than ejaculation through sexual intercourse because intercourse can transmit diseases that may increase the risk of cancer instead. Also, frequent ejaculation is more easily obtained and sustained over time with the aid of masturbation. A study published in 1997 found an inverse association between death from coronary heart disease and frequency of orgasm even given the risk that myocardial ischaemia and myocardial infarction can be triggered by sexual activity. Excerpt, “The association between frequency or orgasm and all cause mortality was also examined using the midpoint of each response category recoded as number of orgasms per year. The age adjusted odds ratio for an increase of 100 orgasms per year was 0.64 (0.44 to 0.95).” That is, a difference between any two subjects appeared when one subject ejaculated at around two or more more times per week than the other. Assuming a broad range average of between 3 to 5 ejaculations per week for healthy males, this would mean 5 to 7 ejaculations per week. This is consistent with a 2003 Australia article on the benefits against prostate cancer. Masturbation is also seen as a sexual technique that protects individuals from the risk of contracting sexually transmitted diseases. Support for such a view, and for making it part of the American sex education curriculum, led to the dismissal of US Surgeon General Joycelyn Elders during the Clinton administration. Sexual climax, from masturbation or otherwise, leaves one in a relaxed and contented state. This is frequently followed closely by drowsiness and sleep – particularly when one masturbates in bed. Some people actually consider masturbation as a cardiovascular workout.[39] And while doctors have no proof of this actually being true, those suffering from cardiovascular disorders (particularly those recovering from myocardial infarction, or heart attacks) should resume physical activity (including sexual intercourse and masturbation) gradually and with the frequency and rigor which their physical status will allow. This limitation can serve as encouragement to follow through with physical therapy sessions to help improve endurance.

Blood Pressure

Both sex and masturbation lower blood pressure. A small study has shown that in one test group, recent full intercourse resulted in the lowest average blood pressure in stressful situations. Masturbation then led to lower blood pressure than did no recent sexual activity.

Herbal Treatment for Masturbation

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EFFECTIVE ERECTION THERAPIES

Stages of an Erection

It’ sperfectly natural for men who suffer from small erections to seek erection therapy. Actually, it’s the best thing they can do because they cannot expect the problem to go away on its own. The first question that any man feels the need to ask is why is this happening. However, the answer is not that simple and straightforward and the problem can be absolutely anywhere in the system that makes erections possible.

But in order to understand the system that drives erections, we should take a closer look at each stage of the process. There are four stages to an erection and they involve different parts of our bodies because sex, like many other processes, has to involve the brain and the nervous system before any visible effect is present. Unfortunately, problems can appear at every step of the way.

The first stage of an erection is sexual arousal. Whether by means of your thoughts or your senses (sight, hearing, touch) the sexual stimulus reaches your brain and puts the whole system in motion. The brain is not only the seat of consciousness, but also the governor of your body and nearly every action starts here. Sigmund Freud, the father of psychoanalysis, said that sex is all in the head and he was quite right.

The second stage of an erection has the brain signaling the start of the actual, physical erection. The central nervous system passes on the order to the nerves that extend from the sacral plexus and into the pelvic area and nitric oxide is released into the blood vessels supplying the penis. The oxide dilates the vessels, thus increasing the quantity of blood that reaches the penis and speeding up the flow rate.

In the third stage of the erection the Corpora Cavernosa, the two sponge-like pieces of tissues in the penis, fill up with blood. The tissues stretch, the penis becomes rigid and assumes the position fit for penetration. The level of nitric oxide in the blood vessels drops, which makes the vessels tighten back up. Blood is trapped inside the penis and ensures the rigidity needed for intercourse.

The fourth stage of the erection is the final one. After ejaculation (and sometimes before the ejaculation), the blood starts to leave the penis and the rigidity vanishes. The Corpora Cavernosa are emptied and return to their normal size. The penis becomes flaccid once more and all that remains is the tingling sensation that follows the friction at skin level and the engorgement with blood.

Erection therapy, such as penile fitness exercises, can help you overcome your problems and get rid of small erections. If the problem lies with the size of the Corpora Cavernosa and the amount of blood these tissues can absorb, then you can use exercises to expand the tissue both in length and girth.

Bigger Corpora Cavernosa mean a bigger penis and, consequently, bigger erections that are bound to impress women and boost your self-esteem, thus eliminating a potential psychological cause of small erections.

Furthermore, if the problem is poor blood flow in the pelvic area, penile fitness exercises are an excellent way of increasing the amount of blood commonly routed by the body to that particular place. As exercises require more blood than usual, the body learns to satisfy this demand over the long term.

If you are looking to find a 100% natural solution to your erectile dysfunction problems then please visit Curing Impotence With Exercises a site dedicated to helping you achieve strong and lasting erections on demand.

Stages of Erection Quality

As men age, they may go through three distinct stages of erection quality—Sexual Prime, Early Sexual Decline, and Increased Sexual Dysfunction. The good news is, there are steps you can take to help sexual dysfunction and reclaim the PEQ you had in your prime.

Here’s a breakdown of each stage, and some tips on how to stay in your sexual prime.

Stage One: Sexual Prime

Approximate ages: 18-30

Symptoms Experienced: From puberty (ages 10-14) through the 20s there is an increasing frequency of nocturnal penile erections (NPE). This period is often described as Sexual Prime. Erections during this stage are frequent and spontaneous events. They occur in response to sexual stimuli and also during rapid eye movement sleep (REM sleep). The frequency of REM sleep erections peaks at puberty, and is related to the peak in testosterone levels.

Physiology: Testosterone levels and the ability to maximally dilate blood vessels are at their peak during the Sexual Prime stage. Generally men are in excellent health at this time.

Stage Two: Early Sexual Decline

Approximate ages: 30-50

Symptoms Experienced: Many men over the age of thirty are experiencing a decline in their sexual function. This change can be very subtle. There is a significant drop in the total number of NPE erections related to a drop in testosterone. The ability to achieve one erection quickly after the first subsides may be diminished. Many men who take lifestyle risk (smokers, abuses of alcohol and/or other drugs), or who suffer from other medical conditions (diabetes, high blood pressure, or who have cholesterol or lipid problems) may start to have increasing difficulty achieving erections. The underlying problem is most often an early sign of inadequate blood flow into the penis. This may be the result of narrowed arteries and also a reduced ability to dilate those arteries in response to the nerve signals. These changes often go unnoticed as they occur gradually over a long period of time. A number of men in this group are completely unable to achieve adequate erections.

What can be done to prevent these changes: Stop smoking, exercise regularly, maintain a healthy weight, eat a balanced diet, and seek appropriate medical attention to address health problems. If these items are not addressed they can lead to an increased risk for diabetes, vascular disease, and erectile dysfunction

Stage Three: Increased Risk of Sexual Dysfunction

Approximate age: 50 plus

Symptoms Experienced: More that 50 percent of men over the age of 40 experience some degree of sexual dysfunction, with the numbers rising significantly as men age. Commonly conditions associated with vascular disease start to become apparent in these men. These include coronary artery disease, high blood pressure, and vascular disease. More men are being diagnosed with diabetes, and cholesterol and lipid disorders. If these conditions are not treated aggressively, they will significantly increase the risk of men suffering heart attacks, strokes, and complications from peripheral vascular disease. Erectile dysfunction may be one of these complications, and is commonly the first symptom men go to the doctor to seek help with. Unfortunately, a substantial number of men with erectile dysfunction are not currently seeking treatment or help.

What can be done to prevent these changes: Stop smoking, achieve and maintain your ideal body weight, exercise regularly, and seek medical attention for your health issues. Review all your medications with your doctor, as some may actually worsen your erectile dysfunction. Additionally there are safe, effective medications that will help the majority of men overcome their erectile dysfunction.

Knowing how an erection occurs can help you understand how ED happens. How does the penis change from soft to swollen to erect? This change requires a healthy mind-body “team effort” led by the brain. Upon receiving signals from the brain, the blood vessels, nerves, and hormones work together to cause and maintain an erection.

An erection requires a healthy mind-body “team effort” led by the brain. Upon receiving signals from the brain, the blood vessels, nerves, and hormones work together to cause and maintain an erection.

The Soft (Flaccid) Penis

If nothing is causing a man to become aroused, then his body’s erection “team” of brain, nerves, blood vessels, and hormones won’t begin working to cause an erection. The amount of blood flowing into his penis equals the amount flowing out. His penis remains soft.

Penile nerves carry no messages of sexual stimulation or arousal. Blood flows through narrow blood vessels in the penis’ spongy chambers (corpora cavernosa and corpus spongiosum). The same amount of blood that enters the penis through its arteries leaves it through its veins.

The Swollen (Tumescent) Penis

During arousal, messages brought by nerves cause the blood vessels and spongy chambers to dilate (open up). This creates room for more blood. Arteries carry blood into the spongy chambers. Beins drain some of the blood from the penis.

A man becomes aroused through his senses (such as sight or touch) or his thoughts (such as memories or fantasies). During arousal, messages brought by nerves cause the blood vessels and spongy chambers to dilate (open up). More blood flows into his penis than flows out. His penis starts to swell.

The Erect (Rigid) Penis

As stimulation continues, nerves keep carrying messages of arousal between the penis and brain. Blood still flows through arteries into the spongy chambers. But the swollen corpora block the veins. This traps blood within the penis. It becomes and stays rigid.

As arousal continues, nerves keep carrying messages of arousal between the penis and brain. Blood keeps moving into the man’s penis. Blood-swollen tissues press against the veins. Some of the blood is kept from flowing back out. Filled with blood, his penis becomes rigid. The man is able to have intercourse.

Understanding an Erection

The penis is made up of spongy tissue that holds blood. When the penis is flaccid (soft), blood flows in and out of the tissue. During sexual excitement, extra blood flows into the tissue. The extra blood makes the tissue swell so the penis becomes erect (rigid) and firm enough for intercourse.

A Flaccid Penis

A Normally Erect Penis

Erection process

To simply the erection process and explain where and how an erection can fail, we will look at the process in three stages:

Stage 1 – Arousal

Physical or psychological stimulation (arousal) activates neurotransmitters in the brain, which send signals to control hormone levels, nerve responses and blood vessels throughout the body.

What can go wrong? – Signals may fail and a poor quality erection will result, if:

Other signals interfere with this messaging system (stress, tiredness and anxiety are common)

The man’s state of mind is not aroused

The man’s hormones are unbalanced

Stage 2 – Tumescent Stage

This is the first visible part of an erection and is known as the tumescent stage. After the vascular system receives a signal from the brain, it focuses significant blood flow into the penis. The cavernosal bodies (corpa cavernosa) in the shaft of the penis start filling up with blood and the penis becomes swollen, but is not usually hard enough for penetration.

What can go wrong? – The cavernosal bodies may not fill with enough blood, if:

  • Several nerve systems do not interact successfully
  • There is deficient blood flow entering the penis

Stage 3 – Maintaining Erection

As the cavernosal bodies fill up with blood, they squash the veins within the penis against the fascia (membranes) inside the penis. Blood is then trapped within these blood vessels, which makes the penis hard and erect. When stimulation ends, or following ejaculation, pressure in the penis decreases, blood is released, and the penis resumes its placid shape.

What can go wrong? – The penis may not remain erect, if:

Either blood vessel system (arteries or veins) are not functioning well

Blood pressure is not maintained in the penis (‘venous leak’)

The man’s state of mind is not arouse

Treatment

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SEXUAL PROBLEMS IN MEN

Can Sexual Problems Be Cured?

The success of treatment for sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.

Can Sexual Problems Be Prevented?

While sexual problems cannot be prevented, dealing with the underlying causes of the dysfunction can help you better understand and cope with the problem when it occurs. There are some things you can do to help maintain good sexual function:

  •  Follow your doctor’s treatment plan for any medical/health conditions.
  •  Limit your alcohol intake.
  • Quit smoking.
  • Deal with any emotional or psychological issues such as stress, depression, and anxiety. Get treatment as needed.
  • Increase communication with your partner.

When Should I Call My Doctor?

Many men experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the man and his partner, and have a negative impact on their relationship. If you consistently experience sexual function problems, see your doctor for evaluation and treatment.

Men’s sexual problems

     

Men, in general, talk about their sexual conquests but not their sexual concerns. They tend to keep up the strong male image, including the impression that they are fantastic in bed and that they have no problems (except they “can’t get enough”). Yet, males usually feel responsible for sex–for approaching the woman, arranging the place, skillfully handling the foreplay, and producing both orgasms. Moreover, too many macho males think sex is all that really matters in a relationship; sharing feelings and problems, being tender and caring, doing things together that she likes to do, getting to know each other deeply, etc. are seen too often as silly women’s stuff. These men just don’t get it: good loving is not in the penis, it is in the heart and the mind. If sex were just coming to a climax, then we’d just masturbate. Sex is a mental-interpersonal process, not just a brief physical act. With males having all these responsibilities, misconceptions, and sexist attitudes, the truth is men have a lot of sexual problems. Continue reading

Lack of sexual interest

A few people experience very little sexual drive, even in new romantic relationships. But most of us are obsessed with sex in the early infatuation stages of a relationship. We eagerly spend hours every day touching, kissing, holding, fondling, and sexually arousing our new love. Yet, after a few years, the burning interest wanes. Sex becomes routine. Why? We don’t understand it, but it happens to all of us to some extent, e.g. the frequency of intercourse declines from once a day (for a short while) to once a week years later. It is an expected transformation. The change is so gradual we hardly notice it. Suddenly we realize that the person who once drove us crazy can undress in front of us and we hardly notice. Some people go for weeks without wanting sex, some reject their partner’s advances. Continue reading

Dealing With Specific Sexual Problems

There is a tendency to think “I’m the only one who has this sexual problem or thought.” In a society were youth and beauty are worshiped, one may also think “young people are great in bed; old people have sexual problems (or no sex at all).” In reality, about 30% of all males and 40% of all females sometimes lack sexual desire, 37% of college students have trouble occasionally getting an erection or getting lubricated, 30% or more of sexually active college women don’t orgasm regularly, 23% of college men ejaculate too soon, and 20% or more of both sexes have doubts about their sexual adequacy (Koch, 1982; Rubenstein, 1983). So our sexually liberated society hasn’t freed us from sexual worries, it may multiply them. But, there’s hope, 75% of the elderly, who are still sexually active, say lovemaking gets better with the years (Starr & Weiner, 1982).

It is no wonder we have sexual problems. Sexual activities by children and young people, even private masturbation, is described negatively and forbidden–even considered a serious sin. It is estimated that 11% of men and 23% of women are sexually molested as children. 22% of women have been forced by a lover to do some sexual act they didn’t want to do. Sexual experimentation may give little pleasure and lots of distress, including rejection, guilt, and unwanted pregnancy. In short, our sex drives are a testimony to our physiology and raging hormones (and to the emphasis on sexual seduction in our entertainment), not to our wholesome child rearing, our enlightened sex education, or to our psychosexual history.

Of course, everyone has heard of the “mid-life crisis.” Sometimes, about age 40, “sexual burnout” occurs. This is when sex with a long-term partner becomes boring, the relationship seems emotionally empty, and both may feel tired and sexually hopeless or inadequate. Barry McCarthy (1982), a psychotherapist, reports that many couples seeking counseling have devoted very little time to improving their sex life or their relationship. Yet, many seeking therapy (80%) have found the time to have affairs, hoping to spice up their sagging sex lives or to stimulate their flagging sexual energy.

Treatment

Treatment for All male Sexual Problems by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

MAINTAINING A HEALTHY PENIS 

Keeping your penis healthy gets you far greater erection strength and stamina, as well as general sexual satisfaction. Simply put, a healthy penis provides you with a healthy sex life!

As men grow older, the levels of male hormone, testosterone, gradually decline starting at the age of 30 and continue to do so at a staggering rate of 10 percent per decade. Since testosterone is a hormone that helps maintain sex drive, sperm production, pubic and body hair, muscle, and bone, the consequences slowly show as a man ages.

Most men who will basically experience one or all of these in varying degrees:

  • Hair loss
  • Bone loss
  • Sweating and flushing
  • Irritability
  • Fatigue
  • Loss of physical agility
  • Increased fat
  • Aches and pains
  • Sleeping problems
  • Depression
  • Decreased sexual drive and performance

Therefore, maintaining a healthy and vigorous penis is maybe one of the more important things all guys should be mindful of. Do your penis a favor by considering the following suggestions:

  • Eat a healthy, well-balanced diet. To ensure normal erectile function, you need to keep the continuous flow of blood to the penis by taking care of the arteries that supply it. Consume a high fiber diet, low in saturated fats and you can be sure to prevent or reduce the build up of fatty deposits that narrow and clog arteries. Stay away from animal fats, sugar, fried or junk foods.
  • Quit smoking. Smoking constricts blood vessels and leads to a build of plaque in the arteries that supply blood to the penis. This results in diminished erectile function, shrinkage of the penis, and impotence later in life.
  • Avoid liquor and dangerous drugs. Alcohol and narcotics puts you in great risk of impotence or erectile dysfunction.
  • Exercise. Exercising is good for your overall health. Try brisk walking, running, cycling, or swimming for at least 30 minutes a day, three times a week.
  • Take nutritional supplements. Certain vitamins and minerals are good for maintaining general penile health, such as Vitamin A, Vitamin B complex, Vitamin C, Vitamin E, Chromium, Zinc, and L-arginine. While certain herbs such as Ginkgo biloba, Ginseng, Damania, Sarsaparilla, Wild yam, Saw palmetto, Dong quai, Gotu kola, Hydrangea root, and Pygeum, are known to be particularly helpful for weak erections or impotence. Be sure to consult with your doctor first.
  • Stimulate your penis. Maintain healthy penis and prostate circulation by having regular erections and ejaculations. Natural penis exercises not only ensure good circulation but can also aid in penis enlargement, both in length and girth. This works best when coupled with the use of an enlargement device, penis enlargement pills, and semen volumizers.

Maintaining Penis Health

Did you know that what you ingest into your body would affect your whole body as well as your penis? A healthy penis is just as important than a healthy body.

Maintaining a healthy penis is equivalent to maintaining a healthy body. The foods you eat will not only affect your body, but it will affect the penis as well. For example, foods that are high cholesterol, such as fast foods and foods that are fried, are not healthy for your body. These types of foods will help your arteries clog. When your arteries are becoming clogged, it slows down the blood flow to a much slower rate. When the blood is not flowing correctly inside your body, it does not have time to make it to the penis. This causes impotence.  The penis will not be able to erect.

Did you know that impotence is a sign of not a healthy penis?

Premature ejaculation is another sign of a not so healthy penis. Clogged arteries will also cause you to ejaculate prematurely. Smoking and drinking alcohol is yet another unhealthy attribution to your body. When you smoke and/or drink your body is not up to its full potential, leaving it sluggish and slow. During a sexual encounter is it not always satisfying for the partner if you cannot handle a long session. Another helpful hint for keeping a healthy penis that has been practiced for many, many years are, protection and awareness. You should never engage in sexual intercourse without a condom. You definitely will be at high risk for a not so healthy penis if you do not wear a condom. Lack of a condom will most likely lead to a STD, especially if it is a casual encounter.

Practicing safe sex, a healthy diet and maintaining an exercise routine will not only help keep a healthy body, it will benefit in a healthy penis as well.

6 Tips for Maintaining  Healthier Penis

Just as you keep your body healthy; it is important to keep your penis healthy as well. Not only will it add to your sex life in general, but it gives you great erections and more stamina to have as much sex as you want to and still be able to enjoy it. The satisfaction you get from a healthy penis is also incredibly pleasurable and well worth the work you put into it.

When men age, their testosterone gradually decreases which can put a damper on your sexual desire. Starting at the age of 30, men start to suddenly feel less like having sex and more like just sitting around. It doesn’t just affect the sex life either. Lack of testosterone can hinder sperm production and the male hormones that keep you feeling energetic and young. Along with that you can experience hair loss, bone loss, fatigue, increased fat, sleeping problems, and depression.

You don’t have to let age get the best of you though. By changing your lifestyle and keeping your penis healthy you can effectively change your entire aging process by keeping up the testosterone level you have now and even increasing it. Some tips to follow start with simply eating healthier. You need a well balanced diet to ensure normal erectile function. This keeps a continuous blood flow throughout your body, especially if your diet includes a lot of fiber and hardly any saturated fats. This stops you from getting clogged arteries and having heart problems that slow down blood flow.

You may also want to quit smoking. Smoking constricts blood vessels and can lead to a plaque buildup in the arteries that stop blood flow to the penis as well. By smoking you may see an increase in erectile dysfunction, impotence, and even shrinking of the penis which is not pleasant for any man. Along with smoking, by quitting the alcohol and drugs you will help you to avoid the erectile dysfunction as well. Don’t think that you can get away without exercising as well. It is great for your overall health and energy levels to keep your sex life at maximum performance.

Lastly you want to maintain a healthy penis by taking nutritional supplements and providing your body with regular penis exercises. Both are natural and help to give you the fuller erections that you may be lacking as you get older. There are a few websites where you can find out how to combine creams, penis enlargement pills, and semen producers to get the circulation really flowing in your penis. When circulation flows well you are sure to have regular erections and more pleasurable and controlled ejaculations.

Healthy Penis

Men must take ownership of their penis’ health. Fortunately, there are many ways this can be accomplished:

A well-balanced diet that is rich in fiber and low in fat will go a long way in maintaining penis health. The avoidance of cigarettes and engaging in regular physical exercise are another. To preserve penis health, men must have regular ejaculations (let’s keep them in the privacy of the bedroom, shall we) because the penis needs oxygen to produce Prostaglandin E1, a substance that ensures good circulation.

Men are also encouraged to ejaculate often (again, not in a public place, please) and to take nutritional supplements – vitamins A, B-complex, C, E, chromium and zinc. And in case you weren’t aware, a frequently stimulated penis is a healthy penis.

And before we forget – we did mention exercise.

Try to remember that a penis does not have any muscle so if you were thinking of putting a 10-pound dumb bell on it to make it stronger, maybe it’s better if you just put on your gym shorts back and concentrate on your biceps instead.

Statistics show that on the average, men die 6 years younger than women die and have higher mortality rates, concerning other illness.

This is in conjunction with the fact that a majority of men still view sicknesses as a sign of weakness. Hence, their reluctance to see a doctor unless it is an emergency, a surgerical procedure, or it is too late.

If the man does not take care of his health, what help is there for his penis’s health?

In the country today, erectile dysfunction is a serious medical problem that affects an estimated 30 million American men. However, this and other male problems like impotence, premature ejaculation, penile injury, or fracture, Peyronie’s Disease, Balanitis, and Priapism, can easily be prevented or cured with regular doctor’s visits.

Just like any organ, such as the eyes, heart, or liver, the penis is a complicated piece of human “hydraulic” equipment. Besides, there are many long-term medical problems associated with its neglect.

What is a penis for?

  • First, the penis is used for urinating.
  • Second, the erect penis is used to provide pleasure for its owner and the partner.
  • Third, the penis is used for reproductive purpose. With a healthy penis, the human race lives on.

How does one know his member is healthy?

Anatomically the penis has three chambers, which is the erectile tissue, and the two larger ones of the chambers, called the Corpora Cavernosa. The smaller chamber found on the bottom, is called the Corpus Spongisum, from which urine and ejaculation is issued.

When you are aroused, your brain releases hormones, which send the blood to your penis, filing your Corpora Cavernosa to the maximum – which accounts for your erection.

As long as your penis is healthy, you can stay erect as long as you are aroused.

However, if you cannot have an erection, maintain, or control it, then something is wrong with this marvelous piece of equipment.

Here are some of the more common physical conditions of why you cannot have or sustain an erection:

Premature Ejaculation –

Refers to the inability of the man to delay ejaculation. This can cause the man to feel anxious and embarrassed, although it is perfectly normal.

Pelvic and Penis trauma-

This can result from several causes, such as the result of an accident from the use of pleasure toys, injuries sustained during a sports activity, or the foreskin tearing during intercourse.

Peyronie’s Disease-

And though the causes of this disease is yet unknown, when it strikes is a hard lump forms on the upper or lower part of the penis where the erectile issue is found. Without medical attention, this will grow into a hardened scar.

Balanitis

The head of the penis and the foreskin becomes inflamed. Redness, itchiness, and soreness are common symptoms. Some of the causes can be attributed to poor hygiene in uncircumcised men or a bacterial infection.

Remedies

Such as a salt-water bath, anti-fungal cream, or antibiotics are good solutions for this. As for prevention, washing daily and observing proper hygiene is best.

If you have diabetes

Heart problems, or other vascular diseases, this condition will weaken the ability of your heart to pump blood into the penis. Alternatively, the veins in the penis are too week, so the penis cannot sustain the erection.

In addition, strong medication for depression, high blood pressure and other medical illnesses can prevent the patient from achieving an erection. Consult your doctor about this problem, so they can reduce your medication or change it.

However, it is not all physical, for there are lifestyle indicators that can cause impotence.

Smoking- Many smokers have low sperm cell count, problems with erection and impotence.

Stress – When you are worried, you will find it hard to sleep, or relax. This will make it harder for you to achieve an erection, you are more likely to have premature ejaculation or be temporarily impotent.

Obesity – Being overweight, means fatty deposits end up in your arterial walls, which in turn restricts blood flow to your penis.

Alcohol- Excessive drinking done on a regular basis causes impotence and nerve damage. Alcoholism also disrupts hormone levels.

Lastly – if you need more convincing about having a healthy penis, think of the benefits associated with this.

Here are some of the benefits you will achieve with  stronger, healthier penis:

1.A satisfying and healthy sex life

2.Live longer, because medical evidence shows men who make love more often live happier and longer

3.When you are content, you become confident and this state flows into other areas of your life.

4.Lessen the possibility of impotence or erectile dysfunction (ED)

5.Have better control over ejaculation, adding more pleasurable hours when you make love.

A man after all, has only one penis; he should do all he can to ensure his penis stays fit.

Healthy Body – Healthy Penis

Too many men look at their penis as a separate entity instead of a functioning and necessary part of their body. Your penis if you wish it to perform on command must stay healthy.

Besides, having regular sex not only good for the health of your penis but also for the health of your body. You should also remember to keep the rest of your body in tip-top shape to ensure that your penis is getting all the blood flow, nutrients, and oxygen it needs.

In order to do this you should use this guideline for a healthy body and healthy penis.

Eating Healthy

You should eat five or more servings of fruits and vegetables per day and eat items with less saturated fat. Eating well-balanced meals can keep your weight where it should be and provide your body with the necessary vitamins and nutrients it needs to function properly including your penis.

Exercise

Exercise is an important part of maintaining proper weight for your height. Sex is one great exercise that burns more calories than most other exercise and is of course a lot more fun. Being overweight can cause all kinds of health problems and can affect your sexual activities. Obesity leads to diabetes, high blood pressure, heart disease, and stroke. In addition, if you are really overweight you may not be able to perform sexually, since you will more than likely not have enough energy to enjoy a sex session.

The doctors recommend that physical activity promote many healthy benefits such as gets the heart pumping blood and oxygen flowing throughout your body. In order for your penis to stay healthy, it requires blood and oxygen. However, instead of running a mile or two when it is freezing outside, jump in bed with your partner. A 20-minute sex session will also increase your heart rate, blood flow and give you a feeling of well-being.

Quit Smoking!

Smoking is associated with lung cancer and heart disease. You need your heart and lungs to function properly and provide your penis with the blood flow it needs to have those rock hard erections.

Manage your stress

Did you know that sex could also aid with stress related situations in some cases? Sex is also a great antidepressant. Next time you feel stressed or anxious, do not run to the medicine cabinet to pop a pill, jump in your partners arms.

Try a more natural way of reducing stress and depression than medication. Of course, sex will not eliminate all of the problems that you may encounter in your life but it will not hurt you and it could help you in more than ways than you can imagine.

Keep your body healthy so your penis will be healthy. Your body and your penis work hand in hand to maintain a healthy body. To be sure, that your penis is actually receiving adequate blood flow you can also begin a penis enlargement program, the exercises that can be used also help with other healthy issues besides the size of your penis.

Treatment 

Treatment for All Male Sexual Problems(Int & Ext) by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

PENIS HEALTH AND PENIS FITNESS PROGRAM.

The penis, although one of the most important organs in a man’s body are  most often completely neglected when fitness routines for other body parts are considered. The average male seldom considers it necessary to take special care of his penis, even in fact, some treat theirs with disdain.

For a man to admit that he applies a skin enhancing cream to his penis and testicles regularly, would take some courage, as he might feel that he is risking being the center of ridicule!

At Project ‘P’, we address the problem of poor penile fitness, by providing information about his penis, testicles and related organs, a scientifically devised system of exercises, and as much on line encouragement as the man needs.

No other such comprehensive exercise program exists to improve and strengthen your urinary / penile system to develop your penis to it’s full potential. The average man just accepts what nature has given him, while there is certainly so very much room for improvement.

As we grow older, we have come to expect weaker erections and eventually impotence. Although premature ejaculation and curvature of the penis may occur quite early in life, they may become more pronounced in later years.  Peyronie’s disease damage, caused by attempting sexual intercourse with  weak erections, as well as the build up of BPH material in the prostate gland, and other urinary problems, result from having an unfit penis system.

Prostate infection could eventually turn cancerous, This is the second largest cause of cancer deaths in England and Wales,

and the reported  occurrence of  prostate related problems is on the increase world-wide.

The major cause of these malfunctions is an unfit, weak penis system, with poor blood circulation, having little or no control over ejaculation timing, and an uninteresting sex life due to poor orgasm sensation. In general, the average penis is very poorly developed.

THE PROJECT “P” EXERCISES IMPROVE BLOOD CIRCULATION TO THE PENIS.

Other advantages:

An improved ejaculation force, having greater volume, and a heightened enjoyment of orgasm.

Great virility, more staying power and increased energy.

Improved sperm cell production and especially the very important male hormone “Testosterone”.

  • Improved function of the urinary nervous system, Prostate gland and Cowper’s glands.
  • Relief from pains associated with infection of the prostate gland as well as relief from constipation.

As you are aware, exercising any body part is always to your advantage, and the penis responds in exactly the same way to properly performed exercise. You may have spent many hours on sport or recreational activities or muscle building, but have you ever spent two minutes out of your entire lifetime to improve the function of your penis and related urinary system? The penis is very seldom handled in an energetic manner as it would be with thorough exercise.  Sexual  activity of any sort is not nearly enough to improve the fitness of your penile system.

REGULAR EXERCISE WILL IMPROVE THE FUNCTION OF THE PENIS.

Facts 

Do you know of any male who has ever spent time to improve, promote, or strengthen his penis and urinary system, or make it strong, fit and healthy, by means of faithfully performing a series of effective penis exercises. As exercise and physio-therapy improves the function and appearance of any part of the body, with no negative side effects, so will the natural exercises of Project ‘P’.

Should a muscle group be continuously and thoroughly exercised, it will expand, enlarge, and become more virile.  Exercise improves the blood circulation, providing the oxygen and nutrients which in turn makes for more efficient functioning of the body part.

Many men spend countless hours daily on physical exercise, in sporting and other  recreational activities and the time expended is never a problem. Why not spend fifteen or so minutes every day to keep your entire pleasure, reproductive and urinary system strong, fit and healthy. With exciting advantages for both you and your partner.

At first, the idea of a regular exercise system to improve your penis, testicles and related body parts seems beyond comprehension. Now, having read thus far in this introduction, you are ideally placed to take full advantage of the Project “P” program, which is 100% guaranteed and 100% risk free, you have nothing to lose and so very, very much to gain. Neglect of the penis is the major cause of poor development, later problems and becoming one of the negative statistics.

Penis size

Penis size is an important point of comparison with most men, since some believe there is a relationship between size and the level of sexual fulfillment given to their sexual partners. Our Project ‘P’ program has more than one specific exercise to grow your penis longer and thicker in the flaccid and erect position.

Very few men have an erect penis of 12 inches long,  the average length being between five and seven inches, and the size of the flaccid penis does not indicate the size of that  penis when erect. A large flaccid penis does not increase much in size when aroused, it simply becomes firmer, and stands away from the body at a different angle.

Should you have a problem with blood circulation, you may find that your penis does not extend to its full potential, and that you enjoy a less than satisfying sex life as a result.  Our Project ‘P’ system of exercises  focuses on this problem, and provides highly successful results.

Hormones

Without testosterone, normal sexual functioning is impaired.  Should this be your problem, it is easily and routinely treatable by a medical doctor. There is however, no completed study indicating whether, or to what degree testosterone influences penis size.

The correlation between blood testosterone levels and sexual activity is also a disputed area, since some studies indicate that increased testosterone levels influence sexual behavior, and others contest the amount of testosterone required to perform properly.

The Project ‘P’  exercises have proved to increase the volume of testosterone produced by the testicles, by improving their health, fitness, and robust virility.

Alcohol and other addictive substances

Some men might experience an increase in libido when large quantities of alcohol are consumed, or when certain addictive substances are used.  However, the downside of this is possible erectile dysfunction. Where drugs, including alcohol abuse, will not allow the penis to become fully erect, and the lessening of sensory perception will not allow ejaculation or orgasm. Chronic alcoholism and substance abuse may lead to impotence. Studies have shown that the liver is stimulated by these substances to produce an enzyme which destroys testosterone, and the body does not compensate for this loss.

We suggest  that a healthy lifestyle be followed if you wish to maximize your sex life.

Medication

Many drugs prescribed for a variety of health problems, from high blood pressure to anti-anxiety and anti-depression; drugs to treat ulcers; and many other medical situations,  which cause loss of libido, increase impotence and other body and sexual disturbances – which could include breast enlargement, decreased seminal emission, and so on…

An important factor to remember when taking this type of medication is to know that these side effects exist, this knowledge enabling you to discuss with your doctor should they adversely impact on your sex life. Should this occur, your doctor may consider substituting the drug with one that has less adverse side effects..

If substituting with another type of medication is not possible, it is important then to know why your sexual functioning is impaired,  to prevent you from doubting yourself.

Aphrodisiacs

Aphrodisiacs have been used since the beginning of time, and although some of them may help sexual functioning, some also have detrimental side effects.

Spanish fly, poppers etc, may help to some extent, but can carry a host of medical problems for the people using them.

Viagra, the wonder pill made by Pfizer, has changed the face of sexuality, yet it is interesting to note that Viagra does not offer a 100% success rate, and also has a range of undesirable side effects.

Project “P” is a natural exercise therapy, which we believe, and have proved, helps with sexual functioning in all cases, since it improves the natural ingredients important to sexual health in men

SAD BUT TRUE FACTS:

If men were to be honest enough to admit it, they all go through times of sexual dysfunction in their lives, and instead of seeing this in proper perspective, they often take the situation too much to heart, and allow it to disrupt their lives unnecessarily.

We believe that the Project “P” exercise program  is a great supplement. For years it has helped thousands of men have a better and more fulfilling sex life. However, should you have a medical problem, we strongly suggest that you contact your medical adviser.

Below we have listed some interesting points, but please note that this information is not meant as medical advice, or a substitute for medical advice, nor should it be used to treat any disease.

Impotence.

Impotence is the non-ability to achieve or sustain an erection, and most men will at some or other time experience this very frustrating problem. It can either be a once-in-a-lifetime problem, periodic or chronic occurrence.

When this happens it can cause anxiety, depression, and a variety of other problems, since it could lead to the man questioning his sexual prowess. Several diseases such as diabetes can cause impotence; yet, other factors such as worry, over-work, and fatigue can cause this highly frustrating experience.

Circulation of blood is of prime importance, since if the blood flow to the penis is not 100%, then problems may be experienced with achieving and maintaining an erection.

Nutrition also plays a large role in sexual activity, and that is where the belief originated regarding oysters and sex; the reason is simple, men need zinc for normal sexual functioning as zinc is an ingredient needed for testosterone manufacture and for sperm production.  A shortage of zinc can also contribute to mental problems, which could contribute to a loss of libido. Zinc is also required for proper prostate functioning.

One very important point to keep in mind is to discuss any sexual problem with your partner, this will clear the air, and will also help to lessen any psychological pressure that you may be feeling.

Age.

The male’s sexual peak is reached in early adulthood and then declines, but men can stay sexually active until a very advanced age, should they so choose.

Citing age as a contributing factor for erectile dysfunction is mostly used as an excuse to not have sex. But age, as such, does not mean that you should be sexually inactive.

Physical Damage.

Resorting to a penile implant can assist physical impairment in cases of urological malformation, spinal injury, diabetes etc. but should only be considered in cases of complete organic impotence, since the implant may destroy the natural mechanism for achieving an erection.

Conserve Our Wild Life.

Stop the slaughter of the tiger, the rhinoceros, certain buck and fish types all supposedly known for their aphrodisiac qualities. There is no artificial means of getting a tired, unfit penile system virile. Erections and virility are only possible with good blood circulation and a healthy, fit, strong penile system. Strong, healthy erections help to prevent cancer and can cure urinary, bladder and prostate infections!

Penis Survey!

ONLY 7% of men are satisfied with the size of their penis.

50% of normally functioning men encounter potency problems more than just occasionally

The average penis size when erect is only 6.0″, with a standard deviation of 1.1″.

Only 2 out of 10 men by the age of 50, DON’T have cancer cells developing in their prostates.

Only 15% of women ACTUALLY achieve an orgasm during intercourse (a number far too low).

Poor penis circulation is a universal problem leading to impotence, with less frequent erections, and less feeling.

The most common cancer worldwide is prostate, 38,000 men die each year from it.

  • In as little as 7 years:  from age 20 to27, men have an 80% reduction in the number of erections experienced.
  • Due to a feeble and unfit PC muscle 73% of men suffer from premature ejaculation.
  • Regardless of age or race, 33% of men are affected by Erectile Dysfunction.

The Project “P” program has been hailed as being a miracle by many of our clients some of whom suffer from Diabetes, high or low blood pressure, stress, medication or have undergone bypass surgery. All of which can cause impotence, a weak penis will allow the blood  to leak back, making the penis flaccid.

We believe that the Project “P” exercise program  is a great supplement. For years it has helped thousands of men have a better and more fulfilling sex life.

Penis-Enlargement Scams:

You’re more normal than you think

Considering penis enlargement? Male-enhancement pills, pumps, exercises and surgeries can be expensive and dangerous. Learn about better options.

Penis-enlargement products and procedures aren’t difficult to find. Men’s magazines, sports radio shows and Internet sites are filled with ads for pumps, pills, weights, exercises and surgeries — many of which claim to increase the length and girth of your penis.

There are plenty of opportunists trying to convince you that your penis is too small — and they are often promoting just the miracle solution to fix it. These solicitations are based on stereotypes about men’s insecurities.

If you are like the vast majority of men who wonder if their penis size is normal, the answer is — yes. While some men do fall for the hype and are looking for a way to enlarge their penis, it generally isn’t a good idea. No scientific research supports the use of any nonsurgical method to enlarge the penis — and no reputable medical society endorses penis-enlargement surgery performed for purely cosmetic reasons. Because many of these techniques can damage your penis and some may even cause impotence, think twice before trying any of them.

Penis size: What’s normal, what’s not?

Most likely, your size is within the normal range. Studies show the average penis measures between 3 and 4 inches when flaccid and between 5 and 7 inches when erect. A penis is considered abnormally small only if it measures less than 3 inches when erect (a condition called micropenis) — but even then, researchers have documented many cases in which men with micropenises have been fully capable of having satisfactory sex and fathering children.

Most men who think their penis is abnormally small actually have normal-sized penises. In recent studies, hundreds of men who sought the advice of their doctor because of concern about the size of their penis all had penises that measured in the normal range.

How partners view penis size

Advertisers would have you believe that your partner cares deeply about penis size. While some women say it matters, most women say size is unimportant. Advertisements would also have you believe that gay men are obsessed with penis size. But in most cases, penis size is a matter of personal preference for both you and your partner.

A penis that is too big may not be an advantage during sex. During intercourse, the tip of a long penis can strike a woman’s cervix and cause pain for a woman. And most of the sensitive nerves of the vagina are located close to the opening — where penis length isn’t an issue. If your partner suggests your penis is too small, discuss creative ways to deliver sexual satisfaction.

Unless your partner tells you otherwise, assume that you’re fine just the way you are. Understanding your partner’s physical and emotional needs and desires is much more likely to improve your sexual relationship than trying to change the size of your penis.

Be wary of penis enlargement techniques

Marketers offer many different types of nonsurgical penis enlargement, and often promote them with serious-looking advertisements that include endorsements from “scientific” researchers.

But if you look and read closely, you’ll see that claims of safety and effectiveness are groundless. No reputable scientific research validates any type of nonsurgical penis enlargement, so marketers rely on testimonials, skewed data and before-and-after photos that often aren’t authentic.

At the bottom of such advertisements, you’ll usually find a sentence such as “These statements have not been evaluated by the Food and Drug Administration (FDA).” Indeed, the FDA, the government agency that regulates medications and medical devices, has never approved any medications or devices for enlarging a penis.

Be wary of these common and ineffective penis enlargement techniques, some of which can result in serious damage:

Manual squeezing exercises (jelquing).

These exercises, which use a hand-over-hand motion to push blood from the base to the head of a semierect penis, are supposed to be performed on a regular basis. Although this technique may be safer than other methods, it can lead to scar formation, pain and disfigurement. There are no scientific studies that indicate this technique is effective at increasing penis size.

Stretching with weights.

This technique, which involves wearing weights on the flaccid penis, may cause permanent penile damage. There’s no scientific evidence that this technique increases penis size.

Vacuum pumps.

Because pumps draw blood into the penis and make it swell, they’re useful in the treatment of impotence (erectile dysfunction). This may create an illusion of a larger penis, but results are seldom permanent. Repeated use can damage elastic tissue in the penis, leading to less-firm erections.

Pills and lotions.

These usually contain vitamins, minerals, herbs or hormones such as testosterone that claim to enlarge the penis. None of these products has been shown to be effective.

Surgery is risky, costly & unlikely to produce satisfactory results

Studies have shown that the majority of men who undergo penis enlargement surgery aren’t satisfied with the results. Surgery may at best add an average of half an inch to the length of the flaccid penis. Surgery may not add any length to the erect penis.

Following various types of cosmetic penile enhancement surgery, some men have had to undergo additional operations to correct deformities caused by the original procedure. The ill effects include scarring, a shorter penis, hair on the base of the penis, a low-hanging penis, loss of sensitivity and abnormal fat lumps. Other complaints include impotence (erectile dysfunction), urinary incontinence and persistent pain.

Then there’s the cost: as much as $10,000 for a typical penis-enlargement surgery that doesn’t require additional corrective surgery. Because cosmetic surgery is seldom covered by insurance, you’ll likely have to bear the entire expense.

When surgery may be an option

There are procedures for reconstructing penises that have been amputated or damaged by circumcisions, animal bites, motor vehicle accidents and physical assaults, among other causes. A penis can be constructed in sex-change operations and to correct birth defects.

A few things that might help?

While there is no safe, effective way to enlarge your penis, there are a few things you can do if you’re concerned about your penis size:

  • Communicate with your partner. It may be hard to break old habits or to have an open dialogue about you and your partner’s sexual preferences. But you’ll be glad you did — and you may be surprised at the spark it puts back in your sex life.
  • Get in shape. Enhance your appearance in other ways. Regular exercise can make a big difference. Better physical conditioning may not only make you look better, it can also give you more strength and endurance during sex.
  • Lose the belly. The place that size might help the most is less belly — not more penis. If your lower abdomen hangs over your genitalia, you might look as if you have a shorter, smaller penis than you actually do. Fat can obscure some or much of the upper part of the penis. For this, the best treatment is to achieve a healthy weight.
  • Trim your pubic hair. A lot of pubic hair around the base of your penis can make your penis look shorter. Trimming may not only make your penis look bigger but may also increase sensitivity around the base of your penis.
  • Talk to your doctor or a counselor. Feeling unhappy about the size of your penis is a common problem. A certified counselor, psychologist, psychiatrist or your family doctor can help. Many men feel better with reassurance that they are “normal” or with advice about how to better satisfy their partner without resorting to cosmetic penis enlargement.

The bottom line

Many men think they have a small penis, and increasing the size of their penis will make them a better lover or make them more attractive. But chances are your penis is within the normal size range — and even if it is smaller than average, it may not matter as much as you thought. Consider other options before you resort to time-consuming, expensive or dangerous techniques that will be minimally effective at best. The most effective solution may be as easy as open communication with your partner, talking with a professional counselor or enhancing yourself in other ways.

Treatment

Treatment for Penis Enlarge Therapy (Internal & External Treatment)by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

TECHNIQUES FOR HARDER ERECTIONS 

These tips will help you achieve longer lasting & harder erections: Stick to a low-fat, high-fiber diet. High levels of cholesterol can actually clog the blood vessels in your penis. This also can cause impotence. Furthermore, you should include a little zinc in your diet. Foods containing zinc include lean beef, turkey, cereal, lamb, crabmeat and oysters. Also check out the vitamins and supplements that we recommend for a harder erection. Make sure you get plenty of exercise. When you’re out of shape, not only does this negatively affect your ability to have sex, it increases the likelihood of erection problems. Stop smoking. Besides the obvious health risks of smoking, studies show that smoking plays a major role in erectile & impotence problems among men. Finally, the best piece of advice that can be given (and one you probably won’t have any problem with) is this: If you want to have better erections- Have MORE erections! The muscle tissue in your penis needs oxygen to survive.

Where does it get that oxygen? From the red blood cells flowing in the blood. The more blood that circulates, the less chance of erectile failure. Since blood flows to the penis at a much greater rate when you have an erection, the best way to keep the muscle tissue in your penis properly oxygenated is by having more erections. There, now you have a legitimate excuse to masturbate.

Ancient Secret:

” Place your thumb on the top of the penis at the root and your index finger at the bottom of the penis at the root. Take a deep breath and while holding, squeeze and grip the shaft of your penis in a wave toward the tip of the penis. The thumb, the index finger and the pinky finger push, forcing blood into the penis head. Now hold this grip for as long as you’re able to hold your breath. Repeat this exercise 9 times. Each time you hold your breath, count to 9 and with each count, squeeze more toward the head of the penis.”

How Will It Work?

So will these exercises work for me?

Well, your penis is divided into three chambers which are made of a spongy tissue. This tissue absorbs blood as it rushes to the penis, creating an erection. If you can perform the right exercises, these three chambers will gradually expand and eventually be able to hold more blood. This creates a larger Penis! The key to growing the penis is to stretch and create tension to the erectile tissues, which makes up the majority of the penis in mass, being the corpus cavernosa. This stretch or expansion can take place with certain tools for the flaccid, semi-flaccid, or erect state. No matter who you are, it WILL work for you. Tension and force will make your erectile tissues grow because it has no choice but to respond. Even if gains are slow, you’ll make them.

It takes about a day before a new cell is permanently created and established inside your penis. However, just because permanent size gains are made, it does not mean that they are immediately noticeable to the human eye. You must be patient. It will take a few weeks before these accumulated permanent results are noticed.

When you first engage in penis enlargement your flaccid size will increase rapidly for about the first 2 inches. At this same stage you will gain roughly 1 inch in erect size. So, in the beginning you’ll gain 2 inches in the flaccid state and 1 inch in the erect state. This is what happens on average.

Introduction To Jelqing

JELQING (also known as “Milking”) is an “ancient” technique that has been performed for centuries by many tribes and cultures. It is considered THE most effective method of penis enlargement. These milking exercises force blood into the penis. Over the course of several months, the blood spaces in the penis became larger, which means that they can hold more blood. This in return makes your penis larger.

We have found that there are SEVERAL different variations of Jelqing that are practiced by men. The general notion of “milking the penis” is always the same, but the techniques seem to vary a bit. Our personal preference is TECHNIQUE ONE. We’ve had more success growth-wise with our clients with this particular technique. Read through all the different variations on Jelqing and decide which technique you think would work for you. You will want to use a lubricant for these exercises.

The results from Jelqing are PERMANENT. The penis will become enlarged in both the flaccid and erect states, but especially in its erect state. The exercises are beneficial, not harmful. They will actually improve the health and strength of the male organ as well as increase its size. IMPORTANT: Care must be taken that the exercise is NOT PERFORMED DURING HARD ERECTION. Vascular (vein) damage could result if the penis is forcibly milked in its fully erect state. You want your penis between half to 3/4 erect. Results cannot be obtained until a partial erection is present. After this exercise has been performed, it will be noticed that the penis (even in its flaccid state) appears both longer and thicker.

This is a fact. And from within one to several months of exercise, the penis will appear rather enormous; this is due to the impaction of blood in the penile tissues. Choose ONE of these jelqing exercise techniques to include in your workout.

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Jelqing Exercises

TECHNIQUE 1

This simple exercise, if practiced five days a week, will enable a man who possesses, for example, a six-inch erect penis, to add from between one to three inches to the length of his penis (measured at the top, from tip to pelvis) and it will grow in circumference proportionately. Little or no growth may be apparent for approximately one month. During the second or third month an increase of two or more inches will not be uncommon.

1 – When your penis becomes SEMI-ERECT, make the American” A-OK” sign with the thumb and forefinger of your left hand. With this hand, grip tightly around the base of your penis.

2 – Now starting from the base, pull the penis gently but firmly. Stretch downward and outward. You should still be in a semi-erect state. Make sure to touch the penis all the way from the base to the head. Note that the head of your penis expands with blood.

3 – Switch to the right hand and do the same thing, starting from the base and stretching downward to the head. Alternate both hands in a smooth rhythmic (”milking”) motion, touching upon every part of the penis except the very top part of the penis head.

Do 200-300 strokes/day at medium strength for the first week. (10 minutes)

Do 300-500 strokes/day at medium-full strength for the next week. (15 minutes)

Do 500 or more strokes/day from then on, and as strong as you can make them. (20 minutes)

If you find yourself getting an erection during this exercise, squeeze harder to discourage it or simply wait until it subsides. You can encourage circulation afterward by slapping your penis up and down 25 – 50 times. Perform this exercise 5 days a week. Remember to keep your penis only partially erect. If you feel ejaculation coming on, pause milking until the urge subsides. This is itself an exercise… one of self-control.

TECHNIQUE 2

1 – Apply lubrication to the flaccid penis from the hilt to the head.

2 – Using only the thumb and forefinger, stretch the penis downward and slightly outward. Be gentle, but firm.

3 – Alternate hands, one then the other, in a “milking action”.

4 – Keep performing gently until a certain amount of swelling develops, then perform the action a bit more firmly and forcibly.

5 – Repeat this action 100 times.

For the first ten days, take it relatively easy. Gradually though, you should be performing 200 repetitions. These exercises are the same for both circumcised and uncircumcised men. It will be noticed that the head (or glans) becomes extremely red and that it will swell considerably. This is normal and good, and is due to the forcing of blood to that area.

TECHNIQUE 3

This is the “Dry” version of Jelqing. Similar to Techniques 1 and 2, but without the lubrication.

In “dry” milking, you squeeze and pull the skin, but you don’t slide your fingers over the skin. As the penis becomes too large to cover in one stroke, work on the base and middle of the shaft separately. Some guys like to milk “dry” in the morning before getting out of bed (when testosterone levels are the highest.) If you find your penis is getting sore, take a day off.

TECHNIQUE 4

Apply lubrication to your penis, rubbing all over. With your penis in a 1/2 state of erection, rub a little more Vaseline into your palms. Take your left hand and make an “ok” symbol with your thumb and forefinger. Then take your thumb and forefinger and grip tightly around the base of your penis. Keeping a tight grip, slide your hand down to the head of your penis, pulling as you go (the head of your penis expands as you do this). Repeat with your right hand, and continue over and over, one hand then the other. Keep this movement going at a medium to fast pace. For the first week or so, only jelq 100-200 repetitions (about 10 minutes). After the first week, try to work up to 20 minutes each day. Remember to keep your penis only partially erect. If you feel ejaculation coming on, pause until the urge subsides.

TECHNIQUE 5

This is also know an the Tao technique. This works for men who want a bigger “mushroom” head on their penis. It’s essentially the same as Technique One, except performed slower and more gently. Use your fingers to push the blood up to your penis head and create some sustained pressure. Hold that position momentarily (approximately 10 seconds.). This will expand the capacity of your head to take in more blood, in the end creating a bell or mushroom shape. You can also squeeze the shaft to make the blood engorge in the head. Once it’s hard, you can release the squeeze. Repeat as many times as you wish (but don’t exceed 10 minutes).

Lubrication

When performing the jelqing exercise, you will need to apply a lubricant on your penis.

Do NOT use soap or shampoo! These can irritate the skin when applied so vigorously and for so long to the skin. It can also dry out the skin severely, causing it to crack and peel for a few days. Furthermore, it can sting if it gets into the hole (the urethral opening) at the end of your penis. Vaseline (Petrolium jelly) works, but.. be orewarned.. it’s greasy and makes a mess. Another downside is that Vaseline is so thick, it may not allow you to move your hand as fast as you’d like. Baby Oil also works, but it is also very messy and leaves stains. One of your best bets is using Vaseline Intensive Care. It cleans up fairly easily, is slippery, it lasts long, and lets you go as fast as you want when performing the exercises.

Hot Towel Warm-up

You should begin your daily workout with this procedure. This is not really an exercise, so much as a prerequisite. What the hot compress does is draws blood to the area of your penis, increasing the blood flow and making the skin slightly elastic. This also ensures a good grip for the exercises you will be performing. Soak a washcloth in warm-to-hot water, then wring out. Take the cloth and wrap it around the shaft of your penis (either flaccid or erect). Hold it there a minute, then repeat a couple of times. Dry off your penis well.

Growth & Circulation

 

After performing your daily stretching exercise, you should use this growth and circulation exercise. This technique gets the blood flowing in your penis and prepares you for the “semi-erect” state you willl need to be in for the next exercise in your workout… the Jelqing Exercise. Hold the penis and whip it around gently. Whip it no more than 30 times and make sure you protect your scrotum with the other hand, otherwise you may hurt yourself.

PC Introduction

In researching this manual, time and time again we came across resources mentioning the PC Muscle. Performing These exercises are most IMPORTANT for several reasons: they give you stronger erections, create intense (sometimes multiple) orgasms, help you control your ejaculations, help shorten the recovery time between orgasms, and even give you a healthy prostate. The PC muscle (or pubococcygeal muscle) is actually a group of pelvic muscles that form the basis for your sexual health. They run from your pubic bone in the front to your tailbone in the back. You can feel this muscle at your perineum, just behind your testicles and in front of your anus. In addition to controlling urination with other pelvic muscles, the PC muscle is what helps bring a man or woman to climax. For men, this is the muscle that involuntarily “pumps” when you ejaculate.

Strengthening and learning to control this muscle, you will find, is THE sex secret. These PC exercises involve doing a set of easy-to-learn pelvic-muscle exercises. This is a FOOLPROOF way for men to boost their partners’ and their own pleasure during lovemaking. Women have already been using their PC muscles for years to help them get sexually aroused easier, lubricate faster, and have more and better orgasms. First you must Locate Your PC Muscle. It’s actually easier for men to locate this muscle and do these Exercises than it is for women. Simply stop your urine midstream when you urinate. This not only teaches you how to find the PC muscle, but gets you started on your exercises. Stop and restart your urination 5 times during every trip to the bathroom. Using your ability to stop the flow of urine will help you control your ejaculations.

Ancient techniques refer to this process simply as “tightening the anus”. You can flex the PC muscle quickly and repeatedly, or clench tight and hold for as long as you can. This latter exercise is tougher than it sounds, yet this is the exercise that the sex gurus say will help you prolong your erections and increase the force with which you ejaculate.

PC Exercises

Once you’ve found your PC muscle, you can start doing the PC Exercises anytime, anywhere. You want to squeeze your PC on a daily basis. These are the PC Exercises: Perform quick PC CLAMPS. Squeeze and release, over and over. Start with sets of twenty, then build to 100 or more. Do at least 250 PC clamps every day, for the rest of your life. Your goal is to be capable of creating 1,000 clamps a day.

Practice LONG SQUEEZES by holding the PC muscle clamped tightly for thirty seconds, or as long as you can.

Try doing STAIR STEPS: tighten and loosen in increments. Tighten for a couple of seconds, loosen for a couple of seconds. Do it over and over again. PC FLUTTER: Tighten the PC muscle as slowly as you possibly can. Once you’ve finished the slow squeeze (to where you can’t squeeze anymore), let go. At some point it will “flutter,” and you’ll feel energy sparkling up your spine. Concentrate on deep, slow breathing while you do this. This is great for restoring energy when you’re running down! When you urinate and you want to let those last squirts shoot out, you use your PC muscle in the other direction. By doing this you’ll feel your anus open and the sensation is different. This is called the PUSH OUT PC. Most men can do Kegels anywhere, since they’re seldom aroused by the exercises.

Continued over a lifetime, the exercises can help men (and women) head off urinary incontinence as they get older. That, plus greater arousal, enhanced orgasms and longer-lasting sex, make these some of the simplest, most beneficial exercises a man or woman can do. Psychologists and sex experts have prescribed Kegel exercises to thousands of male patients, many of whom were troubled by erection problems. Most who did the exercises reported firmer erections than ever before. Others reported increased sexual sensation, more intense orgasms, and the ability to delay ejaculation. And most surprisingly, some of the men were eventually able to have multiple orgasms! That is, two or more climaxes during a single act of intercourse BEFORE ejaculating!

DLD Double Forced Jelq & Bend

By this time you are very comfortable with your Jelqing exercise. Being comfortable is good but to keep growing intensity must be added. We developed a special Jelqing style that brings you to the next level of intensity. DLD Forced Double Jelq & Bend takes the basics of the simple Jelq and adds a much needed intensity. The theory behind why the Jelq works is simple as explained in early literature. The more blood you can get into your penis the bigger your penis becomes and over time the capacity become greater and greater. Now taking this theory and improving on it is something we had always strived to do. With a normal Jelqing session we started to become too comfortable so we developed this method.

Instructions In practice

Step One

Start a normal Jelq at the extreme base.

Step Two

Jelq about an inch up, now taking the other hand start the next Jelq

while still trapping the first Jelqs blood with the other hand

Step Three

Follow through with this Jelq.

Step Four

Once you reach the bottom of the glans use that hand to deliberately push a slight bend forward against the hand supporting the base.

Instructions:

This is a strange movement at first but over a few sessions it will become second nature. With each passing day increase the intensity ever so slightly. The idea with this basic Jelq session is to prepare your penis for Phase two.

This completes 1 Set of Double Forced Jelq & Bend

This completes 1 Set of Double Forced Jelq & Bend

Sample: Normal jelq at extreme base

Sample: After this you do step four

Frequently Asked Questions

Below are a few of the most frequently asked questions about our manual:

When should I use these techniques?

Whenever you wish. A lot of men do their workout first thing in the morning, and others do it before they go to bed at night. The actual time of day will not affect the process.

Can I ejaculate right before, during, or after exercising?

When you ejaculate your body goes through several chemical and physical changes, first your blood testosterone levels begin to drop, second, all your connective tissues begin to tighten as well, it is best to wait at least several hours after completion of the exercises before ejaculating, just as it is also important not to ejaculate for at least several hours before exercising as well.

When I jelq I get a little, (or a lot) sore, is this normal?

Check the soreness and see what is causing it, you may just need to trim the pubic hair right at the base of your penis. Is it a sharp pain or just a dull discomfort? Are you doing the hot wraps?

A slight discomfort/soreness is normal and should pass as your penis and all supportive structures get used to the exercises. Try not to stop, a slight discomfort is normal, if the pain is sharp or is strong enough to keep you from exercising take a few days off from the exercises while continuing to do the hot wraps.

How can I keep from getting erect when jelqing or stretching?

DO NOT JELQ WHEN FULLY ERECT FOR ANY REASON!!!

When you are just starting out on the program your penis is accustomed to getting hard from the stimulation because it is always being used for the same thing, get hard, get stimulated, achieve orgasm and ejaculation. After a couple weeks to a few months your penis will be accustomed to the exercises and the erections should be more controllable. During these first few weeks if you get an erection take a few seconds or minutes to let it subside, you won’t hurt anything as all these first few weeks are for is so that Mr. Penis, (and you), can get accustomed to the exercises.

Can I do the exercises twice a day?

The ideal heal time for tissues in your body is 48 hours, (depending on the tissue type, muscle tissue is one of the the fastest, nerve tissue is the slowest at 1 to 2 mm a month). When you exercise more than once a day you are not giving Mr. Penis time to heal correctly often times at the sacrifice of growth.

I’m not circumcised, is there anything special I should do to do the exercises?

Not necessarily, there are mainly just two things you should be aware of. First, when jelqing be sure to stop just at the base of the head, second, if you choose you can use your free hand to retract the foreskin then jelq as you normally would.

How do I find my pc muscle?

An easy to find your pc muscle is: When urinating, stop the flow of urine without using your hands, and no, it’s not your anal sphincter or your abdominal muscles. After time you will get good at it and will be able to do it whenever you want, this is flexing your pc muscle. For starters stop the flow of urine as many times as you can every time you go. After a few days you will be able to do it whenever you want. Try and do as many Kegels as you can every day. Kegels are the exercise that work the pubococcygeal (pc) muscle.

Do I have to do the Hot Wraps?

The hot wrap should not be considered optional as they serve two main purposes. First they serve to loosen connective tissues so they can stretch more easily with less risk of injury.

Second the hot wraps serve to increase penile circulation which in turn increases the amount of nutrients that reach your penis.

When can I expect to see my first gains?

Most begin to see their first gains at around the second week with others seeing gains after their 2nd month, some see gains as soon as the first exercise session. You can expect to see flaccid gains before erect gains as your penis becomes more accustomed to the increased blood flow.

I don’t have enough time to do all the exercises at once, Can I spread them out over the day?

Yes. We know that sometimes it is hard to find the time. If you wish to split the exercises up during the day, then do so.

Why can’t I do the exercises 7 days a week ?

You must rest your penis for two days, This is essential for healing. YOU MUST ALLOW TIME TO HEAL. Many men spend a year or more trying to achieve enlargement, but never seem to grow. This is because the cells and tissues in your penis, after being stretched in exercise, must have enough adequate time to rejuvenate and build back up. This can only be accomplished through the rest time that you take off each week.

How long can I keep using these techniques?

You can use the program forever if you like. But practically speaking, your penis can only be increased SO much. You will see the most substantial growth within your first 6 months of the program (although some men may need a few months longer). However, after that time your penis may only grow a half inch a year, but there will be a slight size gain.

Note:

For this workout, we have included OUR recommended techniques for the exercises you have just read about. If you think you’d like to try one of the other techniques, go ahead and do so. But whichever techniques you decide to use, make sure you stick with them and give them a chance to work. If after a month you find that one of the exercises isn’t working for you (which is rare!), then try a different technique. Always refer to the instructions for ANY of the exercises whenever you need to.

Treatment

Treatment for Weak Erection by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects

 SPERMATORRHEA

Abnormally frequent involuntary emission of the semen without copulation, often while asleep. Spermatorrhea afflicts men who indulged too frequently in sex, particularly masturbation. It is characterized by loss of potency, “leaking” of bodily fluids, general mental and physical debilitation, and ultimately. Men’s anxiety about sex can lead to a spermatorrhea.        

If the functions which connect us with our species are a source of pleasure when properly governed, so they are also the causes of acutest agony when disordered, or even when we only imagine they are so. “It is a weakness of our sex,” justly remarks a well-known American surgeon, ” to be over-sensitive upon everything which pertains to the generative function. A man will be more alarmed by a trifling ailment there, than if told that he has tubercles in his lungs.”

Fully aware of this, and relying on the general ignorance on this subject, the most unblushing misrepresentations have been published by unscrupulous men for the sake of extorting money from terrified dupes. Nowhere do we see the lament-able effects of popular ignorance more sadly displayed than in the groundless alarms which so many young men suffer lest they are afflicted with the disease now very widely known even among unprofessional readers as spermatorrhoea. It is our object to do away with these fancied terrors, while at the same time we shall not hesitate to point out where real danger may be.

The long word itself means an involuntary loss of the secretion peculiar to the male. It may occur only in sleep, or else at stool, or when the passions are much excited, or when the parts are accidentally irritated. And at the outset we must correct an extremely prevalent error. We have often been consulted by young men who were badly frightened because they had once, or twice, or three times a week, or more rarely, involuntary losses during their sleep, usually associated with vivid, passionate dreams. They feared they were the subject of some terrible disorder; they believed they were losing their virility, and were fast becoming melancholy and debilitated. Their appetites were poor, their rest disturbed, their minds wandering.

Now all these symptoms were purely the results of a distempered fancy. There is no danger in such discharges when moderate. They are not a sign of weakness, but of strength. “They are natural to every healthy young man, and rarely lead to any bad results. They do not constitute the disease spermatorrhoea, and there is no necessity for a moment’s anxiety about them.

Spermatorrhoea itself is a very rare disease, although it is undoubtedly a very serious one when it does occur. The patient cannot recognize it for himself, and it is therefore useless and foolish for him to worry his mind about it. If he feels his health running down, and fears this may be the cause, let him frankly state his case to some physician in whom he has confidence, and not worry his own mind about it. It is no disgrace, and nothing to be ashamed of, as it arises nearly as often in perfectly continent as in unchaste men.

The loss of the secretion then takes place more frequently than we have mentioned, without dreams, and on very slight provocation. It is associated with all the symptoms of an enervated nervous system, extending to a loss of memory, of mental power, and even of epilepsy and insanity. The countenance is pale or sallow; the features drawn; the eyes dull; the spirits depressed. Exercise of the functions is impracticable, or nearly so. Profound melancholy, altered sexual feeling – often an aversion to society of either sex – and impotence, may also present themselves. But here, as before, we shall avoid any long and terrifying catalogue of symptoms. When a man feels one-half of the disturbances of system that spermatorrhoea brings, he should, as we have said, have medical advice, and the physician already is ac-quainted with the characters of the disease.

We said a patient cannot decide whether he has this complaint. Every one of its symptoms may be produced by other affections, and that physical sign which is so particularly terrifying to patients, and which when they see, they conclude at once that all is over with them, the discharge of a white glairy fluid, is most deceptive and uncertain. Many comparatively innocent causes may give rise to just such discharges. Altered conditions of the kidneys and bladder, local inflammations, and specific diseases may do so. Nothing but a careful examination under the microscope can decide whether or not such a discharge is the seminal secretion. And if it does exhibit those peculiar appearances – the spermatozoids – which distinguish this fluid, they may arise from accidental and innocent causes. Finally, if it is shown beyond a doubt that it is a clear case of spermatorrhoea, unless there are severe general symptoms of depression, there is still nothing at which to be frightened. Men have lived on for years in perfect health with daily losses of the kind. Professor Niemeyer, relates that he knew personally a conductor on a railroad, who, for at least ten years, lost a considerable quantity with every stool, without any observable bad effect on his general health. He was married, and his wife had several healthy children. The British surgeon, Mr. W.F. Teevan, expresses his opinion that a habitual escape of semen when straining at stool ” occurs to most men during some period of their lives without producing bad results.”

This illustrates how grossly those swindlers impose upon the public, who would make the ignorant believe that any loss of the kind is attended with disastrous effects. Our advice is, Do not fret about yourself, and keep your thoughts and actions pure, and you will not suffer.

But while we say all this, and say it most emphatically, our duty would be but half done did we not warn in equally clear language against the evils which lead to the real dis-ease. Though it is rare, it is, when present, most destructive to happiness and to health, and, what is more to our purpose, it is always preventable. We shall speak, therefore, of What brings it about?

Undoubtedly in most instances this is self-abuse. It is another of the bitter penalties which nature has attached to this unnatural crime. What is more, these cases are the most hopeless, simply because the victims cannot break the fatal chains which bind them. The tongues of men or angels, the solemn warning of the gospel itself, are unavailing. The only choice that is left is death not very remote, or a surgical operation which absolutely prevents them handling the parts. This last resort has succeeded when everything else has failed. But such is the state of mind of most victims that they cannot nerve themselves to submitting to it.

A second cause is excess in indulgence. This may be in the marital relation, but far more frequently it occurs in the unmarried who are more apt to indemnify themselves for long self-government by renouncing all restraint when opportunity offers. Not a few wretched old bachelors wreck themselves in this manner. This class, too, are particularly exposed to another cause which leads to the same result – secret diseases. The after-consequences of these when neglected or ill-treated, often enough produce a weakening of the part, and a loss of power to retain the secretion. So, too, the indulgence in impure imaginings, and allowing the passions to become frequently excited, surely bring about a similar debility with a like tendency.

All these are causes which imply a degraded mind and disgraceful habits. But it must be understood that this disorder may arise where no blame whatever attaches to the individual. The change in the urine which takes place when the substance termed oxalic acid is secreted in large quantities renders the fluid irritating, and may lead to sperma-torrhoea. So unquestionably may stone in the bladder, ulcers and worms in the lower bowel, and some local inflammations arising from colds. Prolonged diarrhoea, neglect of cleanliness, certain skin diseases, the inordinate use of coffee, alcohol, or tobacco, excessive mental application to the neglect of exercise, and a hereditary predisposition, may all or any of them lead to the same result, without the individual being the least in fault. The judicious physician always bears this in mind, and we mention it, so that no unfounded fear lest he should be suspected or convicted of debasing practices may restrain the young man who fears he is suffering from this much-dreaded complaint from candidly laying bare his anxieties to his medical counsellor.

And if it be these habits which are the source of his suffering, he should have no hesitation in making a frank statement, for the physician’s office is as inviolable as the confessional, and he knows too well that ignorance is at the source of this habit, to condemn or despise one who is or has been under its fell sway.

Causes

The main causes of spermatorrhea include:

  • The male generative organs, the testes, must remain somewhat cooler than body temperature. When they become overheated (by taking a hot tub bath), a release of sperm will be made in the night, since that supply of sperm has become damaged.
  • If you sleep too warm at night, due to an electric sleeping blanket set on high, the overheated testicles will eject sperm the next day.
  • Another cause is visual or thought sexual stimulation.
  • A poor diet is another cause. A low-protein diet, free from the use of eggs may also prove of benefit.
  • Excessive masturbation or sex can cause spermatorrhea.
  • It is also caused due to inefficient digestive system and general weakness.

If not treated in time, it becomes incurable. With the aggravation of the disease, the semen gets thinner and brightness on the face is lost. The genital becomes lax and the person fails to satisfy his partner sexually.

SYMPTOMS

Spermatorrhea itself is a symptom not a disease.

If the problem is caused due to excessive masturbation or sex, the following symptoms associated with long-term sexual exhaustion may appear:

  • Low back pain
  • Low back pain may radiate down into the leg
  • Pain in the testicles or perineum
  • Dizziness
  • Lassitude
  • Palpitations
  • Tinnitus
  • General weakness
  • Night sweat
  • Scrotal sweating
  • Warm and moist skin
  • Warm and moist palms and soles

How To Prevent Spermatorrhea 

The suggestions we have to offer here are rendered almost unnecessary by what we have said of its causes. Many of them – all of them, indeed, except the hereditary predisposition – are within the power of the individual to avoid, if he only knows enough to begin in time. The instructions we have previously given in detail about the general hygiene of the passions will apply to those who are threatened by weakness in consequence of excesses, either social or solitary. “When the water or adjacent irritations are to blame, these can promptly be remedied by any intelligent physician ; and when the habits of food or drink are injurious they must be amended.

Even when there is a natural weakness which leads to over frequent losses, very much can be accomplished by cold bathing, regular exercise, an unstimulating diet, and rigid purity. It is safe to say that this is one of those diseases which never occurs in a person who submits his life to thorough hygienic regulations; and it is, therefore, a disease which we hope soon to see almost unknown to the young men of our day.

Treatment

Treatment for Herbal Treatment for Spermatorrhea by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

Nocturnal Emission

A wet dream is an erotic dream that is so intense that a guy ejaculates (cums) in his sleep. Nocturnal emission is one of the ways the body gets rid of semen build up, so it usually doesn’t happen during periods of masturbation or sex play. Very often guys don’t remember the dream. If they don’t know what’s going on, they may think they’ve “wet the bed.”

Nocturnal Emissions occurs when whitish fluid called semen is released through the penis while a boy or a man is sleeping. Nocturnal emissions are most common during teenage and early adult years

It is associated with the fact that, males typically get an erection often during sleep and the semen released owing to the direct result of the stimulation caused by either erotic dreams, or memories of waking sexual activities but many men claim to have had nocturnal emissions without accompanying erotic dreams and another common theory is that wet dreams are the way the body disposes of “built-up” semen,

Although wet dreams are most common among teenage guys, many men also have nocturnal emissions as adults. Some guys never have wet dreams, but most do. Dreams or no dreams — both are normal.

And ladies needn’t feel left out — women and girls have wet dreams, too. Their vaginas become lubricated as they become sexually aroused in their dreams. But there is less evidence of wet dreams in women than in men because less liquid is produced or spilled on the bed sheets. Wet dreams are also more common in men, because a man’s penis gets more tactile stimulation (physical touch) during sleep than a woman’s clitoris.

A wet dream is the uncontrolled ejaculation of semen from the penis during sleep. This is caused by sexual arousal and orgasm from dreams and/or physical stimulation like rubbing against blankets, the bed or a full bladder.

This is completely normal for males going through puberty. When boys enter puberty, a lot of hormonal changes occur. These changes can result in spontaneous erections during sleep, during the day and wet dreams. These are simply a part of normal sexual development.

Most boys experience wet dreams between the ages of 12 to 18. Generally males have fewer wet dreams once they start masturbating, reach the end of puberty or become sexually active.

What’s Goin’ On?

So what happens from the time you rest your eyes to the time your sheets get sticky? Here’s how it works:

During sleep, from time to time, our bodies enter periods called REM, or rapid eye movement, which last from a few minutes to a half hour.

During these sleep periods, guys experience several erections, and girls experience vaginal lubrication.

If a dream during REM sleep is very arousing, the sensation of an erect penis pressed against a mattress can lead to erotic dreaming and ejaculation in guys. Girls can also have erotic dreams and get aroused to the point where they produce some liquid from their vaginas.

When It Gets Played Out

Having to change the sheets on a frequent basis can get annoying, and some guys may want to try to prevent wet dreams. In general, guys have nocturnal emissions less often if they are ejaculating while they are awake, either from masturbation or sex play with a partner. The same goes for girls who have wet dreams.

Of course, many girls and guys are perfectly content with their wet dreams. And that’s fine too. Remember, having wet dreams is natural, normal, and nothing to be embarrassed about. In fact, many people believe that nocturnal emissions actually help to relieve stress. And on top of all that, they feel pretty good!

How common is Nocturnal Emission?

The frequency of nocturnal emissions is highly variable. Some men have experienced large numbers of nocturnal emissions as teenagers, while some men have never experienced one in their lives

Usual rate of nocturnal emissions are once during a period of 15-30 days are considered physiological (normal) while that occurring twice a week or more and associated with symptoms such as dizziness, weakness and insomnia etc., are considered pathologic (abnormal)

PHYSICAL & PSYCHOLOGICAL INFLUENCES OF EXCESSIVE NOCTURNAL EMISSION:

  1. Hormonal disorders (lower testosterone or androgen)
  2. Abnormal sperm production or function (Most cases of male infertility are due to sperm abnormalities)
  3. Impaired shape and movement of sperm (structure (morphology) of the sperm are abnormal or the movement (motility) is impaired)
  • 4.  Low sperm concentration (A normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen)
  • 5.   No semen (The absence of ejaculate may occur in men)
  • 6.   Sexual issues (Difficulties with erection of the penis (erectile
  • dysfunction), premature ejaculation)
  • 7.   Constipation
  • 8.   Being underweight
  • 9.   Diminished confidence and self-esteem
  • 10. Guilt
  • 11. Emotional upsets

Should nocturnal emission be treated?

Excessive nocturnal emission needs immediate medical assistance because it may lead to Hormonal disorders and decreased testosterone level can be the cause for inability to achieve an erection.

Another major cause which of course tends to lead to “low sperm concentration” and a low sperm count is one cause of male infertility.

When to seek medical advice?

Talk with our doctor if nocturnal emissions occurring twice a week or more.

10 Things You Ought to Know About…WET DREAMS

  1. Wet dreams are normal, they are believed to happen when the body is not getting release from the hormonal build up of the teen years or sudden “dry spells” in sexually active individuals.
  2. Girls do get wet dreams, but they are far more common and much messier in guys.
  3. Masturbation can, but won’t always, put a stop to frequent wet dreams.
  4. Some experts theorize that wet dreams are one of the many sub conscious ways that the body handles stress – they seem to happen more frequently in teens and young adults because this age group is thought to be under extreme stress.
  5. Wet dreams are not drug induced.
  6. Wet dreams do not signal a sexual abnormality or mean you are sexually deviant.
  7. Wet dreams have nothing to do with being gay or straight, the type of wet dreams you have in no way represent your sexuality.
  8. Wet dreams about taboo subjects like; incest, animals, rape, sex with a superior or elder, public sex, group sex, and homosexuality are common and do not have anything to do with your waking sexual preferences (it doesn’t mean you secretly want to do these things).
  9. There is no reason to ever feel guilty about having a wet dream, they are subconscious and can not be easily controlled or manipulated..

10.Many people have wet dreams and don’t even know it is happening, for guys the morning mess is often the only evidence and for girls they can go unnoticed – for this reason they may be more common in girls than is currently believed (under reporting may be the real reason girls seem to have them less often).

Erections and wet dreams

When the penis becomes rigid and elevated, it is called an erection. Erections occur in males prior to birth, during childhood, adolescence and adulthood. Although erections occur during sexual excitement or fantasy, they may occur during sleep. Sometimes in adolescents an erection may occur spontaneously without any obvious reason.

The penis has three cylindrical bodies of tissue called the corpus cavernosum and corpus spongiosum that produce an erection when the tissues are filled with blood. These tissues are sponge like and consist of compartments that are interspersed with many blood vessels. When the blood vessels are dilated, the compartments fill with blood. The penis enlarges in length and width, becomes rigid and assumes a position that is elevated compared to its flaccid, soft or resting state. Thinking sexy thoughts produces nerve impulses from the brain that initiates the erection through a complicated series of nerve pathways.

Erections in adolescents may occur from lifting heavy loads and healthy adolescents usually have sleep related erections every night. Often these erections are associated with dreams or rapid eye movement (REM) sleep; teens may have as little as two erections or up to six erections each night. Sexual activity seems to have no significant effect on the number of nightly erections. It is usual for teen males to awaken with an erection in the morning. This is usually due to the stimulation of a full bladder. Some authors suggest that large amounts of seminal fluids may also cause erections in the sleeping or awakened adolescent.

Of course, the most common cause of erection in the adolescent male is sexual stimulation. According to Kinsey, a famous researcher of the human sexual response, a male’s first response to sexual stimulation is penile erection. Many adolescent males only need minimal sexual stimulation or sexual fantasy to achieve erection. After ejaculation, males lose their erection and there is a variable period of time before they can achieve another erection.

Erections that are prolonged due to disease may be painful. Termed priapism, this may be seen in males with sickle cell anemia. Males who cannot have erections may be impotent. Most teen males who cannot achieve erections do not have a disease process causing this problem. Rather, there may be a psychological barrier that is interfering with the capability to have an erection. Although it is unusual for male adolescents to require medication to achieve an erection, there may be circumstances where medication is indicated.

Virtually all males have experienced wet dreams or nocturnal emission. During puberty, sex hormones cause the testicles to produce sperm, and organs such as the prostate and seminal vesicles also produce other fluids that compose semen. Occasionally when these fluids build up in the body, a teen male will develop an erection during sleep followed by ejaculation or release of the semen. When this occurs during sleep, it is termed nocturnal emission. Some males may have romantic or sexy dreams when the emission occurs and others may not recall the dream. Although most males experience nocturnal emissions, some have them as frequently as a few times per week and some may have only one or two nocturnal emissions during their lifetime.

Nocturnal emissions will decrease or stop entirely when a male has ejaculation either through masturbation or sex with a partner. Wet dreams are a normal and expected experience of adolescence.

Treatment

Treatment for Nocturnal Emissions by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

DO YOU WANT A BIG PENIS?

Well, your penis is divided into three chambers which are made of a spongy tissue. This tissue absorbs blood as it rushes to the penis, creating an erection. If you can perform the right exercises, these three chambers will gradually expand and eventually be able to hold more blood. This creates a larger Penis!

The key to growing the penis is to stretch and create tension to the erectile tissues, which makes up the majority of the penis in mass, being the corpus cavernosa. This stretch or expansion can take place with certain tools for the flaccid, semi-flaccid, or erect state. No matter who you are, it WILL work for you. Tension and force will make your erectile tissues grow because it has no choice but to respond. Even if gains are slow, you’ll make them.

It takes about a day before a new cell is permanently created and established inside your penis. However, just because permanent size gains are made, it does not mean that they are immediately noticeable to the human eye. You must be patient. It will take a few weeks before these accumulated permanent results are noticed.

When you first engage in penis enlargement your flaccid size will increase rapidly for about the first 2 inches. At this same stage you will gain roughly 1 inch in erect size. So, in the beginning you’ll gain 2 inches in the flaccid state and 1 inch in the erect state. This is what happens on average.

Before You Start

Firstly, read through this manual carefully and make sure you understand each exercise. Once you’ve found the techniques that you’re comfortable using, stick with them. Here are a few tips before you get started.

MAKE SURE YOU MEASURE YOUR PENIS FIRST…

FLACCID: Get a ruler and place it over your penis. Then Push the ruler back into your abdomen as far as it will go. Hold your limp penis along the ruler and measure to the tip of the head.

ERECT: While standing, gently angle your erect penis until is is parallel to the floor. Press the ruler against your pubic bone (just above the base of the penis) and measure from top to tip. It may be easier to measure by standing with your knees locked and grabbing the penis from the bottom, just behind the head on either side. Press ruler against your pubic bone, and measure on top of penis as you pull it out as far as you can. Try moving your pelvis or changing the angle to see what variations can occur during this type of measurement. Once you’ve figured out how to measure to get the same result as your erect length, you will find that this measurement is easier and more convenient than measuring your actual erection.

GIRTH: With a piece of string or cloth measuring tape, measure the circumference of your erect penis at mid-shaft.

CUT YOUR PUBIC HAIR: Not only does this make your penis look bigger, but it helps when you’re doing some of these exercises. When stretching, pulling and “milking” your penis, you don’t want to be pulling your hairs out!

EAT HEALTHY AND TAKE VITAMINS: In order to eliminate any possibility of slow growth, make sure you’re getting an ample amount of nutrients. The proper levels of minerals, amino acids, and vitamins DO have an effect on the workout process. Also, drink lots of water! See our list of recommended vitamins & herbs.

MOST IMPORTANTLY, HAVE A GOOD STATE OF MIND: Your mentality has a lot to do with the growth of your penis. If you don’t believe that enlargement will work, it’s very likely that your subconscious will make it more difficult to physically grow the penis. A positive attitude is essential.

As we’ve said, these exercises demand COMPLETE 100% devotion. You MUST perform them 5 DAYS A WEEK. If at any time, though, you begin to feel discomfort or pain, take a little time off. You only want to enlarge your penis, not hurt it.

Remember, by applying tension, pulling, pressure, stretching, or expansion to a penis you are creating a force which will spit the cells in the penis. You want to be sure to split the cell and break it down just enough to ensure structural balance on a SAFE level as to allow for the normal healing processes. By forcing the division of too many cells, because of too much pressure, you are creating ugly healing which will create a distorted penis, possibly with no rate of gains. So again we stress… DON’T OVERDO IT!

If performed correctly and routinely, you will soon begin to see the results you hope for. Within the first few weeks or so, your penis will actually start looking LONGER AND THICKER. That should be all the encouragement you need to keep up with your daily exercises!

Lubrication

When performing the jelqing exercise, you will need to apply a lubricant on your penis.

Do NOT use soap or shampoo! These can irritate the skin when applied vigorously and for long periods. It can also dry out the skin severely, causing it to crack and peel for a few days. Furthermore, it can sting if it gets into the hole (the urethral opening) at the end of your penis.

Vaseline (Petrolium jelly) works, but.. be forewarned.. it’s greasy and makes a mess. Another downside is that Vaseline is so thick, it may not allow you to move your hand as fast as you’d like.

Baby Oil also works, but it is also very messy and leaves stains.

One of your best bets is using Vaseline Intensive Care. It cleans up fairly easily, is slippery, it lasts long, and lets you go as fast as you want when performing the exercises.

Safety while exercising

Be aware of when and when not to engage in penis enlargement. You should consult a urologist if you have a disease which may alter blood circulation, oxygenation, and regeneration of tissues which exists under the conditions of advanced diabetes, respiratory instability, and cirrhosis. As you’re doing your workout, here are some symptoms to be aware of:

Blisters are a result of too much pressure on the penis for a prolonged period of time. You want pressure, but don’t overdo it!

Red sores are a result of too much stretch. In order to avoid this, hold off on your exercises until the blisters have disappeared.

Nerve inflammation is caused by using excessive weight, too often, for a long period. This will distort the nerves within the penis and cause them too swell. If the swelling continues, then atrophy may occur. This could result in the inability to maintain an erection.

“Fuzzy skin” is a result of tissue abuse. When you touch this affected area you can actually feel its fuzziness because it’s directly external. This is the partially dead tissue covering your penis. This can happen when too much tension is applied. Red sores sometimes accompany fuzzy skin.

That being said, the exercises we’re about to discuss are all healthy natural ways to produce penis growth. Just use good sense when performing them. We offer a recommended Daily Workout which should be performed 5 days a week, but if at any time you begin to feel real pain or discomfort, ease up!

Hot Towel Warm-up

You should begin your daily workout with this procedure. This is not really an exercise, but a prerequisite. What the “hot towel warm-up” does, is draws blood to the area of your penis, increasing the blood flow and making the skin slightly elastic. This also ensures a good grip for the exercises you will be performing.

Soak a washcloth in warm-to-hot water, then wring out. Take the cloth and wrap it around the shaft of your penis (either flaccid or erect). Hold it there a minute, then repeat a couple of times. Dry off your penis well.

Stretching Exercises

After the Hot Towel warm-up, proceed to performing a stretching exercise. Squeezing and pulling your penis on a regular basis can produce incredible size gains, just as exercising muscles will make them larger. These exercises stretch your penis out, while also stretching the erectile tissue. These are the exercises for lengthening your penis in its flaccid and erect state. Choose ONE of these stretching exercise techniques to include in your workout.

TECHNIQUE ONE 

If you really want to enlarge your penis, this is the technique men swear by. This exercise is best performed when standing up

Make sure the penis is in its flaccid state for this exercise. You can not be erect. Also, do not lubricate the penis in any way.

  1. With the penis in its flaccid state, take one hand and grip firmly around the head of your penis. Be careful not to cut off too much circulation.
  2. Pull your penis out directly in front of yourself. Stretch it as much as you can without causing pain or discomfort. Hold it there for 1 minute.
  3. Relax for 10 seconds. “Twirl” your penis in a circular motion a few times. This gets the circulation flowing again.
  4. Repeat Step Two again 4 times, except pull your penis in a different direction each time… up, down, to the left, and to the right.
  5. After you’ve completed all 5 pulls (1 minute each), you may repeat the stretch (steps 1-4) as many times as you desire. We recommend repeating the stretch around 5-10 times.

Stretching the penis with your hand produces the same results as traditional penis weight systems. The best way to use your hand is by applying most of the pressure anywhere else except on the dorsal nerve, which is that thin nerve that runs along the top of the penis. There is nothing wrong with designing your own way of gripping your penis, as long as you know where and where not to apply the wrong pressures. Again, DON’T HOLD TOO TIGHT, otherwise you’ll cut off the circulation.

This exercise will ensure a longer penis within as little as 2 weeks, but within 3-4 months will really be noticeable.

TECHNIQUE TWO 

This technique is very similar to technique one. It’s been posted on web-forums several times by men who say they’ve added up to 2″ to their penis!

  1. While in its flaccid (limp) state, take one hand and grip around the head of your penis. Grip firmly, but not hard enough to feel discomfort or cut off too much circulation.
  2. Pull out directly in front of yourself with enough force to feel a good and painless stretch in your penis. Hold and count for at least 30 seconds to one minute and rest.
  3. Then continue doing this until you’ve logged in 5-20 minutes of stretching for one session. Take a 10-20 minute break after each session.

(You should print this info for easy reference!)

The Daily Workout Program

Hot Towel warm-up (5 minutes)

Stretching Exercise (25 to 30 minutes)

Growth and Circulation Exercise (1 minute)

Jelqing Exercise (10 to 20 minutes)

PC Exercises (5 minutes)

Massage and warm down (5 to 10 minutes)

HOT TOWEL WARM-UP (5 Minutes)

Soak a wash cloth in hot-warm water, wringing out the excess water. Wrap the cloth around the shaft of your penis (either flaccid or erect). Hold it there a minute, then repeat a couple of times. Dry off your penis well. This will ensure a good grip for the exercises you’re about to perform.

STRETCHING EXERCISE (25 to 30 minutes)

  1. With the penis in its flaccid state, take one hand and grip firmly around the head of your penis. Be careful not to cut off too much circulation.
  2. Pull your penis out directly in front of yourself. Stretch it as much as you can without causing pain or discomfort. Hold it there for 1 minute.
  3. Relax for 10 seconds. “Twirl” your penis in a circular motion a few times. This gets the circulation flowing again.
  4. Repeat Step Two again 4 times, except pull your penis in a different direction each time… up, down, to the left, and to the right.
  5. After you’ve completed all 5 pulls (1 minute each), you may repeat the stretch (steps 1-4) as many times as you desire. We recommend repeating the stretch around 5-10 times

GROWTH AND CIRCULATION EXERCISE (1 minute)

Take the penis and whip it around gently. Whip it no more than 30 times, making sure you cup your scrotum with the other hand, otherwise it will bounce around and get hurt.

JELQING (MILKING) EXERCISE (10 to 20 minutes)

  1. Using Massage Oil, Hemp Oil, or Vaseline for lubrication, slide your fingers over the skin of your penis and apply all over. A few drops of oil will last for several hundred strokes. Don’t use soap or you’ll be sore for days!
  2. With your thumb and forefinger, squeeze the base of the penis shaft. Pull downward. Stop at the head. Repeat, alternating hands. Make each stroke last about three seconds. This sensation should help you achieve an erection.
  3. When your penis becomes SEMI-ERECT, make the American “A-OK” sign with the thumb and forefinger of your left hand. With this hand, grip tightly around the base of your penis.
  4. Now starting from the base, pull the penis gently but firmly. Stretch downward and outward. You should still be in a semi-erect state. Make sure to touch the penis from the base the head. Note that the head of your penis expands with blood.
  5. Switch to the right hand and do the same thing, starting from the base and stretching downward to the head. Alternate both hands in a smooth rhythmic (“milking”) motion, touching upon every part of the penis except the very top part of the penis head.

Do 200-300 strokes/day at medium strength for the first week. (10 minutes)

Do 300-500 strokes/day at medium-full strength for the next week. (15 minutes)

Do 500 or more strokes/day from then on, and strong as you can make them. (20 minutes)

(If you find yourself getting an erection during this exercise, squeeze harder to discourage it or simply wait until it subsides. You can encourage circulation afterward by slapping your penis up and down 25 – 50 times. Do this exercise 5 days a week. Remember to keep your penis only partially erect. If you feel the urge to ejaculate, pause milking and wait for the urge to subside. Holding back is an exercise in restraint, which instills a sense of self-control.)

PC EXERCISE (5 minutes)

Refer to the directions as to how to find your PC muscle. Do different variations of these exercises each time you perform your workout. You can also do PC exercises throughout the day while you’re driving, watching t.v., whatever.

  1. Perform quick PC CLAMPS. Squeeze and release, over and over. Start with a set of twenty, then build to a hundred or more. Do at least 250 PC clamps every day, for the rest of your life. Your goal is to be capable of creating 1,000 clamps a day.
  2. Practice LONG SQUEEZES by holding the PC muscle clamped tightly for thirty seconds, or as long as you can.
  3. Try doing STAIR STEPS: tighten and loosen in increments. Tighten for a couple of seconds, loosen for a couple of seconds. Do it over and over again.
  4. PC FLUTTER: Tighten the PC muscle as slowly as you possibly can. Once you’ve finished the slow squeeze (to where you can’t squeeze anymore), let go. At some point it will “flutter,” and you’ll feel energy sparkling up your spine. Concentrate on deep, slow breathing while you do this. This is great for restoring energy when you’re running down!
  5. When you urinate and you want to let those last squirts shoot out, you use your PC muscle in the other direction. By doing this you’ll feel your anus open and the sensation is different. This is called the PUSH OUT PC.

MASSAGE AND WARM DOWN (5 to 10 minutes)

After your workout, gently massage your penis for several minutes. If you prefer, you can do this with an herbal enlargement cream. After massage, you can either apply another hot compress as you did at the beginning of your workout, or you can place your penis in a bowl of lukewarm water for another few minutes. Dry off well with a towel.

Well, that’s the workout. These are the exercises, the “secrets”, that are going to give you a longer, thicker, stronger penis… a firmer fatter erection… better orgasms….and lifelong sexual vigour! Do this Workout Program 5 DAYS A WEEK, and YOU WILL HAVE PERMANENT GROWTH!! IT REALLY WORKS! Please e-mail us with your progress. We love hearing from every guy who’s happy with his penis!!

Harder Erections

These tips will help you achieve longer lasting & harder erections:

Stick to a low-fat, high-fiber diet. High levels of cholesterol can actually clog the blood vessels in your penis. This also can cause impotence. Furthermore, you should include a little zinc in your diet. Foods containing zinc include lean beef, turkey, cereal, lamb, crabmeat and oysters. Also check out the vitamins and supplements that we recommend for a harder erection.

Make sure you get plenty of exercise. When you’re out of shape, not only does this negatively affect your ability to have sex, it increases the likelihood of erection problems.

Stop smoking. Besides the obvious health risks of smoking, studies show that smoking plays a major role in erectile & impotence problems among men.

Finally, the best piece of advice that can be given (and one you probably won’t have any problem with) is this: If you want to have better erections- Have MORE erections! The muscle tissue in your penis needs oxygen to survive. Where does it get that oxygen? From the red blood cells flowing in the blood. The more blood that circulates, the less chance of erectile failure. Since blood flows to the penis at a much greater rate when you have an erection, the best way to keep the muscle tissue in your penis properly oxygenated is by having more erections. There, now you have a legitimate excuse to masturbate.

 ANCIENT SECRET:

“Place your thumb on the top of the penis at the root and your index finger at the bottom of the penis at the root. Take a deep breath and while holding, squeeze and grip the shaft of your penis in a wave toward the tip of the penis. The thumb, the index finger and the pinky finger push, forcing blood into the penis head. Now hold this grip for as long as you’re able to hold your breath. Repeat this exercise 9 times. Each time you hold your breath, count to 9 and with each count, squeeze more toward the head of the penis.”

Control Premature Ejaculation

First of all, it should be noted that one man in 3 ejaculates quicker than he wants to, and that the vast majority of men sometimes ejaculate too quickly. So if this happens to you, you’re hardly alone.

The following are some tips and exercises that will assist you in learning to control this problem:

For starters, you might drink a glass of wine before having sex. Alcohol may relax you just enough to delay your ejaculation. Or there’s the old tried and true practice of masturbating a few hours before making love. If you “take care of your business” early, it will take you longer to ejaculate when the time comes to do it with your partner .

You can learn to tolerate long periods of sexual pleasure without ejaculating once you learn to recognize the feelings that precede your orgasm. There is an exercise you can try called The “One to Ten” Approach. Imagine that the scale of pleasure runs from 1 to 10: 1 you are just starting to feel aroused; 10 you have an orgasm and ejaculate. Therefore 9, the point just before your orgasm, is your point of no return. Try masturbating. When you reach your magic point 8, stop and let the urge to ejaculate subside. Then start masturbating again. Do this a few times. Masturbate, stop, masturbate. At the end of 15 minutes you can ejaculate (if you wish). Repeat this technique until you are able to enjoy your arousal without ejaculating for 15 minutes.

Another method that reduces the chance of premature ejaculation is one that we mention in your workout- Give Your PC Muscles a Squeeze. Review our discussion of Kegel (PC) Muscles if you’ve forgotten where these muscles are located. Strong PC muscles operate like a good set of brakes in your car- by contracting the muscles, you can control your arousal the same way you use your brakes to control speed. In the broadest terms of how to apply this muscle when making love, you prolong orgasms by a simulation of “stopping your urination in midstream”. Learn the powers of these muscles and how to use them. They will work wonders in the bedroom!

Finally, the oldest, simplest & best method for learning ejaculatory control is called the Locking Method. When having sex, if you feel yourself becoming too excited… simply withdraw your penis from the vagina and pull back so that only the head of your penis remains inside her. Then just remain motionless for 15 – 30 seconds. Wait for the urge to subside, then back to where you left off.

Curvature Straightening

Having a curve in your erection is caused from having a weak Corpora Cavernosa which allows the shaft to bend a certain direction because of the weaker cell walls. This problem can be easily dealt with using the Jelq.

This exercise strengthens your Corpora Cavernosa on both sides of your penis, and will start to form a straighter penis after several months of daily exercise.

Jelqing for a straighter penis 

Though this exercise is basically the same as you have read before, there is a little “twist” you must utilize. Begin jelqing just like you have before, grasping around the base of a partial erection, squeezing fairly tight and sliding it to your head, repeating with the other hand. Every 5 or 10 jelqs, milk your penis against the curve, bending it the opposite way as you milk down to your head, This will begin to not only strengthen your shaft, and also help strengthen the wall that’s curving, slowly training it to bend the opposite way.

As you milk down, really concentrate on your penis rebuilding with each stroke. Concentrate on visualizing your penis expanding and straightening every time you milk, taking deep breaths through your nose and exhaling through your mouth. With each breath you breathe in, visualize a ball of energy growing and and expanding in your stomach and chest. Once you cannot breath in any more, exhale and visualize the ball of energy flowing down and out through your penis as you continue to milk strongly. You will find that results will come much faster when you do this.

Vitamins & Herbs

Your regular enlargement workout program can be significantly enhanced by specific vitamins, herbs and supplements which you should add to your daily diet. Not only will they provide you with extraordinary energy, they can greatly enhance your sex drive and pump up your sensual passion.

It is best to purchase “A” grade supplements. You may pay a little more, but the results are noticeably better (and better for you) than cheap “bargain-brand” supplements. If you wish, you can shop online through one of our many affiliate vitamin and health stores. They all offer high-quality supplements and you can have them delivered right to your doorstep.

Vitamins to be taken daily for energy:

– 2,000 mg of vitamin C 2 or 3 times a day

– 30 mg of zinc

– 10,000 units (IU) of mixed carotenoids.

– 100 mg of vitamin A

– 200 mg of Magnesium

– 80 mg of coenzyme Q

– 100 i.u. of vitamin D

– 50 mg of thiamin

These vitamins are available at most of our affiliate stores in our Shopping Index, including the Internet’s #1 Vitamin Store, Drugstore.com

Additional Supplements for greater sexual performance:

– 525 mg of Calcium

– 200 mcg of Vitamin B12

– 150 mg of Vitamin E

– 25 mcg of Potassium

– 300 mcg of Biotin

– 200 meg of selenium

– 400 mcg of Folic Acid

Herbs to enhance sexual awareness:

– Damania Root

– Pumpkin Seed

– Buckwheat Protige

– Cranberry extract

These and other herbs for sexual enhancement are available online at the Erotix Products Pharmacy and many of our other featured affiliate stores in our Shopping Mall.

One more thing…

Drink lots of water! 150 – 200 ounces of pure bottled water every day is a wonderful healing nutrient, which aids in your enlargement workout. Not to mention adding that extra bit of boost needed to get you through your normal daily routines.

Frequently Asked Questions

Below are a few of the most frequently asked questions about our manual:

When should I use these techniques?

Whenever you wish. A lot of men do their workout first thing in the morning, and others do it before they go to bed at night. The actual time of day will not affect the process.

Can I ejaculate right before, during, or after exercising?

When you ejaculate your body goes through several chemical and physical changes, first your blood testosterone levels begin to drop, second, all your connective tissues begin to tighten as well, it is best to wait at least several hours after completion of the exercises before ejaculating, just as it is also important not to ejaculate for at least several hours before exercising as well.

 When I jelq I get a little, (or a lot) sore, is this normal?

Check the soreness and see what is causing it, you may just need to trim the pubic hair right at the base of your penis. Is it a sharp pain or just a dull discomfort? Are you doing the hot wraps?

A slight discomfort/soreness is normal and should pass as your penis and all supportive structures get used to the exercises. Try not to stop, a slight discomfort is normal, if the pain is sharp or is strong enough to keep you from exercising take a few days off from the exercises while continuing to do the hot wraps.

How can I keep from getting erect when jelqing or stretching?

DO NOT JELQ WHEN FULLY ERECT FOR ANY REASON!!!

When you are just starting out on the program your penis is accustomed to getting hard from the stimulation because it is always being used for the same thing, get hard, get stimulated, achieve orgasm and ejaculation. After a couple weeks to a few months your penis will be accustomed to the exercises and the erections should be more controllable. During these first few weeks if you get an erection take a few seconds or minutes to let it subside, you won’t hurt anything, as these first few weeks are for Mr. Penis, (and you), to get accustomed to the exercises.

Can I do the exercises twice a day?

The ideal heal time for tissues in your body is 48 hours, (depending on the tissue type, muscle tissue is one of the the fastest, nerve tissue is the slowest at 1 to 2 mm a month). When you exercise more than once a day you are not giving Mr. Penis time to heal correctly often times at the sacrifice of growth.

I’m not circumcised, is there anything special I should do to do the exercises?

Not necessarily, there are mainly just two things you should be aware of. First, when jelqing be sure to stop just at the base of the head, second, if you choose you can use your free hand to retract the foreskin then jelq as you normally would.

How do I find my pc muscle?

An easy to find your pc muscle is: When urinating, stop the flow of urine without using your hands, and no, it’s not your anal sphincter or your abdominal muscles. After time you will get good at it and will be able to do it whenever you want, this is flexing your pc muscle. For starters, stop the flow of urine as many times as you can every time you go. After a few days you will be able to do it whenever you want. Try and do as many Kegels as you can every day.

Kegels are the exercise that work the pubococcygeal (pc) muscle.

Do I have to do the Hot Wraps?

The hot wrap should not be considered optional as they serve two main purposes.

First they serve to loosen connective tissues so they can stretch more easily with less risk of injury.

Second the hot wraps serve to increase penile circulation which in turn increases the amount of nutrients that reach your penis.

When can I expect to see my first gains?

Most begin to see their first gains at around the second week with others seeing gains after their 2nd month, some see gains as soon as the first exercise session. You can expect to see flaccid gains before erect gains as your penis becomes more accustomed to the increased blood flow.

I don’t have enough time to do all the exercises at once, Can I spread them out over the day?

Yes. We know that sometimes it is hard to find the time. If you wish to split the exercises up during the day, then do so.

Why can’t I do the exercises 7 days a week ?

You must rest your penis for two days, This is essential for healing. YOU MUST ALLOW TIME TO HEAL. Many men spend a year or more trying to achieve enlargement, but never seem to grow. This is because the cells and tissues in your penis, after being stretched in exercise, must have enough adequate time to rejuvenate and build back up. This can only be accomplished through the rest time that you take off each week.

How long can I keep using these techniques?

You can use the program forever if you like. But practically speaking, your penis can only be increased SO much. You will see the most substantial growth within your first 6 months of the program (although some men may need a few months longer). However, after that time your penis may only grow a half inch a year, but there will be a slight size gain.

Treatment 

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THE IDEAL PENIS SIZE

Obviously, penises come in all kind of combinations of length versus girth. This leads us to the final and most important point: where do you fit on the scale of women’s preference? What does she think about your penis?

For the vast majority of women a man’s penis will fall in one of the following categories (applying the previous definitions of small, big etc. for length and girth):

ideal (perfect)

very satisfying but not ideal

satisfying

enjoyable

not satisfying

= too small in length and girth, or too big in length and girth or any odd combination of small and big

Penis Size Preference Chart (updated!)

The Penis Size preference Chart is a graph showing virtually all the possible combinations of penis length and penis girth in ¼ inch intervals. For each combination it lists the matching grade of women’s preference (A to E), stating its ability to satisfy the average woman.

To use the chart just locate your penis length and circumference (girth) along the axis. Where both meet you will find your penis grade.

Examples (extrapolated from the above chart)

At 5½ inches long by 7 inches around you will be enjoyable (too short but very thick) = D.

At 8 inches long by 5 inches around you are again enjoyable but not satisfying (big in length but on the small side for girth) = D.

At 7½ inches long by 6 inches around you are very satisfying but not ideal (big in length but just over average in girth) = B.

At 6 long by 5½ around you are on the borderline of being enjoyable and satisfying. Many girls might not be satisfied. It is a borderline C.

At 5 inches long by 4½ around you are classified E: not satisfying

At 11½ inches long by 9 around you will get an E from most women for being simply oversized!

Note: Let it be clear that the majority of men will fall in the lower-left D and C brackets. Grade-A penises are probably occurring in less than 10% of men.

Never lose out of sight that having an ideal penis alone is not what most women will look for. The vast majority will prefer a nice decent looking man with a grade B or C penis.

But let’s say someone has a borderline C graded penis as in the example above. Chances are the average girl is ok with this. She might even tell him that his penis is perfect. After all, there are many men with smaller penises than that, in length as well as in girth. But if she could choose between him and an exact clone of his (same character etc.) except with a grade B penis as in the above example, who do you really think she will choose? Deep in her heart, no normal girl will choose for the smaller guy. More about this later on.

Ugly Penis – Pretty Penis: What about penis “looks”?

The degrees in the above chart rate only the size aspect of a penis. Another rating could be established for the pure esthetical aspect, making things more complicated. A penis can be rated A for size but can be very ugly to look at for a woman. Or it can get a C for size and very pretty for the girl.

Women say the looks are determined by the looks of the whole package:

the proportions, i.e. the size of the testicles versus the penis

the way it hangs when flaccid and stands when erect

the curve of the penis

the penis shape

the color, texture and evenness of the skin

the penis’ muscularity (veins)

the way the testicles are attached to the penis

the way the whole thing is attached to your body

Seriously overweight guys tend to get automatically less points in this department. Uncircumcised penises are usually considered less attractive, especially when the foreskin extends past the end of the penis. In addition, many women claim that long thick pubic hair makes a penis less attractive and say that guys should trim it a bit. As a man it is hard to see how trimming could make a difference to the charisma of your genitals. Rather than trying to understand why, just consider that most men also prefer their woman nicely trimmed or even completely shaven around the vagina, so that probably explains their point of view.85 Penis Size “Facts”

After all this, you must be more than ready for the penis size “facts”. Note: When it says “men” or “women” then that is what it says, otherwise it would say “all men” or “all women”. So think about this before making a comment. There are exceptions to everything in life… Enjoy!

85 Penis Size “Facts

  1. If you are a woman and you don’t prefer bigger than average penises, then you are… an exception.
  2. Women prefer bigger penises more than men prefer bigger breasts.
  3. The average penis measures 6 to 7 inch long and 5 to 5 ½ inch in circumference (about 1 ¾ inch wide).
  4. When you think you have a small penis, you are generally right.
  5. Shorter and thinner than average flaccid penises are averagely shorter and thinner when erect than average erect penises. (Does that make any sense?)
  6. Penis size is not just a locker room issue.
  7. Women care about the size of flaccid penises.
  8. Women love touching and looking at big flaccid penises.
  9. Women love touching and looking at big erect penises.
  10. Women love giving oral sex to big penises, if they are able to of course.
  11. Big penises cause more vaginal pleasure for women.
  12. What about this: Twenty percent of all women stay with a man for his big penis…
  13. forty percent stay with a man for his money…
  14. forty percent stay with a man because of who he is…
  15. eighty percent would like their partner to have a bigger penis!
  16. eighty percent of women don’t orgasm from intercourse alone!
  17. eighty percent of men have an average or small penis!
  18. If your penis slips out often during intercourse, you probably have a small penis.
  19. Women find small penises frustrating.
  20. Women find small penises annoying.
  21. Women find small penises boring.
  22. Women find small penises embarrassing.
  23. Women look for bulge when meeting men.
  24. Women look up to men with big penises.
  25. Women find big penises impressive.
  26. Women consider men with big penises more masculine.
  27. Men with big penises are more self secure.
  28. Women prefer men who are self secure.
  29. Most women consider men with a big penis a sex object.
  30. Most men don’t mind to be considered a sex object by women.
  31. Women pretend they want a sensual and sensitive man no matter his size.
  32. Women know they want a macho and masculine man with big penis size.
  33. Women want to sleep at least once in their life with a man with a very big penis.
  34. Men with bigger penises date more women than men with smaller penises.
  35. Men with a big penis have more chance to have sex with two or more women at the same time.
  36. Women brag to other women if their partner has a big penis.
  37. Women have more patience when it comes to well hung guys.
  38. Men with a big penis get dumped less by their girlfriend than men with a small penis.
  39. Most women are sexually very active with different partners between the age of 17 and 21.
  40. Most women have had many more sexual partners than they are telling you.
  41. Consequently, the probability that a man’s new date has seen a bigger penis than his is very high.
  42. If a woman doesn’t make a comment about a man’s penis it means she is not impressed, …or worse.
  43. Women make favorable comments when they discover their new mate has a big penis.
  44. If you haven’t heard any great comments about your penis size when having sex the first time with a woman, you don’t have a big penis.
  45. If you have never heard a complaint about your penis being too small, it might be because the complaint was muted while pronounced.
  46. Asking a woman if she thinks your penis is big is useless.
  47. If a woman tells you your penis is nice, it means usually it is rather small.
  48. If a woman tells you your penis is big, it means usually it is plain average.
  49. If a woman tells you your penis is so huuuuge, it usually means it is just big.
  50. If a woman lowers your pants, utters a shriek, takes off her clothes and hugs your penis, it usually means you are too big.
  51. However, if a woman lowers your pants, utters a shriek, puts her clothes back on and leaves, it usually means you are too small.
  52. Women don’t tell you that you are average. They will tell you that you are big, the rest is small and very few are humongous.
  53. If your girlfriend’s previous lover was above average thick, she will not feel you inside if you are below average thick.
  54. If your girlfriend’s previous lover was way above average thick, she will not feel you inside if you are average thick.
  55. Most vaginas prefer thick penises.
  56. Most penises prefer tight vaginas.
  57. If your woman purposely squeezes her vagina very tight during intercourse, she wants to make you feel big.
  58. Women have to strain themselves to get off on a thinner than average penis.
  59. Men with a short penis have to work harder to give pleasure to a woman.
  60. Men with a long penis have to work less hard during intercourse.
  61. Men with a long penis have more fun during intercourse.
  62. Men with a long penis cause more fun during intercourse.
  63. Men with a long and thick penis cause the most fun during intercourse.
  64. Women consider a penis between 7 and 8 inch in length and between 6 and 6 1/2 inch girth ideal.
  65. Women whose partner is smaller than average, wish sometimes he would wear a big strap-on.
  66. A big strap-on causes less pleasure than a real penis of the same size.
  67. Women whose partner is larger than average never think of him wearing a strap-on.
  68. Men with small penises masturbate more often.
  69. Over-masturbating causes your penis to shrink by eventually depleting your sexual energy.
  70. Men with small penises are getting masturbated more often than getting laid.
  71.   Not using your penis by getting laid might cause it to shrink as well.
  72. Women who believe size is a non-issue tend to be more spiritual than sexual.
  73. Women who believe size is a non-issue care less about sex to begin with.
  74. Women who believe size is a non-issue only want to make love.
  75. Making love is spiritual…, having sex is physical attraction, size and technique.
  76. If a smaller endowed man has great technique, it might be because he doesn’t have much choice.
  77. In general, women prefer vaginal penetration above oral stimulation.
  78. Other reasons a woman can feel pain from penetration by a large penis is that she is not relaxed enough or that the guy has bad technique.
  79. The main reason some women feel pain from penetration by a large penis is that the guy rushes without waiting for the vagina to be expanded.
  80. Most women who always prefer receiving oral sex to penetration, do so because of either mental or physical causes.
  81.  Technique as smaller endowed men.
  82. Normal women want to make love on some days and have sex on the other ones.
  83. Women who believe size is a non-issue usually want flowers, candies and long walks under the moonlight instead of wild sex.
  84. Women who believe size is a non-issue tend to be more insecure and are looking for long-term relations.
  85.  If a woman publicly says that size doesn’t matter, it is often because she is with a small penis guy.

Awareness of penis girth

All ten objects are inserted a neutral six inches deep, one after the other, in random order.

Upon insertion of each object, the woman is asked:

  • to compare its girth to the previously inserted object (is it thicker or thinner)
  • to estimate its circumference. To indicate the circumference she will refer to a cone shaped object by holding it on the corresponding circumference between thumb and index finger.
  • Notate her response and compare it to the actual girth of the inserted object.

Awareness of penis length

Use only object E (which has a medium circumference of 5.5 inch).

Set the adjuster at maximum length (12 inches). Insert the object at different lengths.

Upon each penetration the woman is asked:

  • to compare its length to the previous penetration (is it longer or shorter)
  • to estimate the inserted length. To indicate this length she will use her hands by holding them apart at the corresponding distance.
  • Notate her response. Measure and notate the distance she indicates with her hands. Compare it to the actual penetration depth of the inserted object.

Vaginal sexual response due to penis width

  • Choose three objects with different girths.
  • For each object set the adjuster at six inches penetration depth. Use objects in random order.
  • Each object is inserted and then moved in an identical (“neutral”) back and forth motion to stimulate the vagina.
  • Notate the woman’s reactions and eventual comments. Notate the elapsed time at point of orgasm.
  • Vaginal sexual response due to penis length
  • Choose the object with her preferred girth.
  • Set the adjuster at four inches penetration depth.
  • The object is inserted and then moved in an identical (“neutral”) back and forth motion to stimulate the vagina. During each forward motion the object is completely inserted as far as the adjuster allows.
  • Notate the woman’s reactions and eventual comments. Notate the elapsed time at point of orgasm.
  • Repeat this procedure several times with the adjuster set at different penetration depths.

Notes:

Ideally such tests to study the vaginal sexual response of women should be done with the use of strategically placed devices (electrodes) that register the activity of the pubococcygeus (PC) muscles and uterine muscles. The problem however is that such devices wouldn’t stay in place during the test because of the thrusting motion.

The procedures laid out above are not definitive and can probably be improved. If you have any suggestions or comments about this test (or about any other penis size related things), use this page.

PENIS ENLARGEMENT TECHNIQUES

We have compiled a lot of information into this manual. Please read through it thoroughly in order to have a full understanding of each technique. Also, make sure you read carefully and fully understand each EXERCISE before you try them out. Perform these exercises safely, And don’t overdo it. Remember, it will not happen overnight. But if you do these exercises on a daily basis as instructed, then you will start to see changes in both the size and performance of your penis within the next 2 to 3 weeks! Use these techniques daily, be patient, and significant size gain will be accomplished in a few months. However, you can’t expect unbelievable results in just 1 or 2 weeks. This is the same concept as body building, you don’t go into the gym and expect to look like Arnold Schwarzenegger in just a few weeks. Give us a few months to see REAL results and you will be a believer.

After all, that’s why we have a full 6 months Money Back Guarantee to back up our claims! We are a very respected and trusted website, so you can be assured that our methods really do work. Please, remember, to check back often, as we are continually updating our manual to contain the latest information as it becomes available. Every day we receive e-mails from clients who have achieved amazing results from the techniques you’re about to discover. We hope to open our mailbox in a few short weeks, and read a great success story from YOU!

Legal Notice

Our Online Manual and all content within is NOT to be taken as medical advice. Our company is a research organization, and the material in this site should be viewed strictly as information. We shall not be held responsible for any injuries and/or health problems sustained either directly or indirectly as a result of the contents herein.

If you are seeking a MEDICAL solution with regards to penis enlargement, you should consult us. Before continuing on from this page, every customer legally agrees to assume all responsibility for their actions.

Recommended Daily Workout 

(You should print this info for easy reference!)

  • The Daily Workout Program
  • Hot Towel warm-up (5 minutes)
  • Stretching Exercise (25 to 30 minutes)
  • Growth and Circulation Exercise (1 minute)
  • Jelqing Exercise (10 to 20 minutes)
  • PC Exercises (5 minutes)
  • Massage and warm down (5 to 10 minutes)
  • HOT TOWEL WARM-UP (5 Minutes)
  • Soak a wash cloth in hot-warm water, wringing out the excess water.
  • Wrap the cloth around the shaft of your penis (either flaccid or erect).
  • Hold it there a minute, then repeat a couple of times. Dry off your penis well. This will ensure a good grip for the exercises you’re about to perform.
  • STRETCHING EXERCISE (25 to 30 minutes)
  • With the penis in its flaccid state, take one hand and grip firmly around the head of your penis. Be careful not to cut off too much circulation.
  • Pull your penis out directly in front of yourself. Stretch it as much as you can without causing pain or discomfort. Hold it there for 5 minutes. After each minute, pull it out slightly further each time.
  • Relax for one minute. “Twirl” your penis in a circular motion about 30 times. This gets the circulation flowing again.
  • Repeat Step Two again 4 times, except pull your penis in a different direction each time… up, down, to the left, and to the right. After each 5 minute pull, repeat Step 3.
  • After you’ve completed 5 pulls (5 minutes each), pull your penis out directly in front of you one more time. Give it a good 1-minute stretch and 10 slight “tugs” outward, not jerking too hard.

Growth & Circulation Exercise (1 minute)

Take the penis and whip it around gently. Whip it no more than 30 times, making sure you cup your scrotum with the other hand, otherwise it will bounce around and get hurt. JELQING (MILKING) EXERCISE (10 to 20 minutes)

  1. Using Massage Oil, Hemp Oil, or Vaseline for lubrication, slide your fingers over the skin of your penis and apply all over. A few drops of oil will last for several hundred strokes. Don’t use soap or you’ll be sore for days!
  2. With your thumb and forefinger, squeeze the base of the penis shaft. Pull downward. Stop at the head. Repeat, alternating hands. Make each stroke last about three seconds. This sensation should help you achieve an erection.
  3. When your penis becomes SEMI-ERECT, make the American” A-OK” sign with the thumb and forefinger of your left hand. With this hand, grip tightly around the base of your penis.
  4. Now starting from the base, pull the penis gently but firmly. Stretch downward and outward. You should still be in a semi-erect state. Make sure to touch the penis from the base the head. Note that the head of your penis expands with blood.
  5. Switch to the right hand and do the same thing, starting from the base and stretching downward to the head. Alternate both hands in a smooth rhythmic (”milking”) motion, touching upon every part of the penis except the very top part of the penis head.

Do 200-300 strokes/day at medium strength for the first week. (10 minutes)

Do 300-500 strokes/day at medium-full strength for the next week. (15 minutes)

Do 500 or more strokes/day from then on, and strong as you can make them. (20 minutes)

(If you find yourself getting an erection during this exercise, squeeze harder to discourage it or simply wait until it subsides. You can encourage circulation afterward by slapping your penis up and down 25 – 50 times. Do this exercise 5 days a week. Remember to keep your penis only partially erect. If you feel the urge to ejaculate, pause milking and wait for the urge to subside. Holding back is an exercise in restraint, which instills a sense of self-control.)

PC EXERCISE (5 minutes)

Refer to the directions as to how to find your PC muscle. Do different variations of these exercises each time you perform your workout. You can also do PC exercises throughout the day while you’re driving, watching t.v., whatever.

  1. Perform quick PC CLAMPS. Squeeze and release, over and over. Start with a set of twenty, then build to a hundred or more. Do at least 250 PC clamps every day, for the rest of your life. Your goal is to be capable of creating 1,000 clamps a day.
  2. Practice LONG SQUEEZES by holding the PC muscle clamped tightly for thirty seconds, or as long as you can.
  3. Try doing STAIR STEPS: tighten and loosen in increments. Tighten for a couple of seconds, loosen for a couple of seconds. Do it over and over again.
  4. PC FLUTTER: Tighten the PC muscle as slowly as you possibly ONLINE MANUAL…PenileSecrets.com

http://www.penilesecrets.com/members/recommended.html (3 of 4) can. Once you’ve finished the slow squeeze (to where you can’t squeeze anymore), let go. At some point it will “flutter,” and you’ll feel energy sparkling up your spine. Concentrate on deep, slow breathing while you do this. This is great for restoring energy when you’re running down!

  1. When you urinate and you want to let those last squirts shoot out, you use your PC muscle in the other direction. By doing this you’ll feel your anus open and the sensation is different. This is called the PUSH OUT PC.

MASSAGE AND WARM DOWN (5 to 10 minutes) After your workout, gently massage your penis for several minutes. If you prefer, you can do this with an herbal enlargement cream. After massage, you can either apply another hot compress as you did at the beginning of your workout, or you can place your penis in a bowl of lukewarm water for another few minutes. Dry off well with a towel.

Well, that’s the workout. These are the exercises, the “secrets”, that are going to give you a longer, thicker, stronger penis… a firmer fatter erection… better orgasms….and lifelong sexual vigour! Do this Workout Program 5 DAYS A WEEK, and YOU WILL HAVE PERMANENT GROWTH!! IT REALLY WORKS! Please e-mail us with your progress. We love hearing from every guy who’s happy with his penis!!

 Safety while exercising

Be aware of when and when not to engage in penis enlargement. You should consult a urologist if you have a disease which may alter blood circulation, oxygenation, and regeneration of tissues which exists under the conditions of advanced diabetes, respiratory instability, and cirrhosis. As you’re doing your workout, here are some symptoms to be aware of: Blisters are a result of too much pressure on the penis for a prolonged

period of time. You want pressure, but don’t overdo it! Red sores are a result of too much stretch. In order to avoid this, hold off on your exercises until the blisters have disappeared.

Nerve inflammation is caused by using too much weight, too often, for too long of a period. This will distort the nerves within the penis and cause them too swell. If the swelling continues, then atrophy might occur. This means you won’t be able to get an erection again.” Fuzzy skin” is a result of tissue abuse. When you touch this affected area you can actually feel its fuzziness because it’s directly external. This is the partially dead tissue covering your penis. This can happen when too much tension is applied. Red sores sometimes accompany fuzzy skin. That being said, the exercises we’re about to discuss are all healthy natural ways to produce penis growth. Just use good sense when performing them. We offer a recommended Daily Workout which should be performed 5 days a week, but if at any time you begin to feel real pain or discomfort, ease up!

Stretching Exercises 

After the Hot Towel warm-up, proceed to performing a stretching exercise. Squeezing and pulling your penis on a regular basis can produce incredible size gains, just as exercising muscles will make them larger. These exercises stretch your penis out, while also stretching the erectile tissue. These are the exercises for lengthening your penis in its flaccid and erect state. Choose ONE of these stretching exercise techniques to include in your workout.

TECHNIQUE ONE

If you really want to enlarge your penis, this is the technique men swear by. You can perform this either standing up or sitting down.

  1. With the penis in its flaccid state, take one hand and grip firmly around the head of your penis. Be careful not to cut off too much circulation.
  2. Pull your penis out directly in front of yourself. Stretch it as much as you can without causing pain or iscomfort. Hold it there for 5 minutes. After each minute, pull it out slightly further each time.
  3. Relax for one minute. “Twirl” your penis in a circular motion about 30 times. This gets the circulation flowing again.
  4. Repeat Step Two again 4 times, except pull your penis in a different direction each time… up, down, to the left, and to the right. After each 5 minute pull, repeat Step 3.
  5. After you’ve completed 5 pulls (5 minutes each), pull your penis out directly in front of you one more time. Give it a good 1-minute stretch and 10 slight “tugs” outward, not jerking too hard.

Stretching the penis with your hand produces the same results as traditional penis weight systems. The best way to use your hand is by applying most of the pressure anywhere else except on the dorsal nerve, which is that thin nerve that runs along the top of the penis. There is nothing wrong with designing your own way of gripping your penis, as long as you know where and where not to apply the wrong pressures. Again, DON’T HOLD TOO TIGHT, otherwise you’ll cut off the circulation. This exercise will ensure a longer penis within as little as 2 weeks, but within 3-4 months will really be noticeable.

TECHNIQUE TWO

This technique is very similar to technique one. It’s been posted on web-forums several times by men who say they’ve added up to 2″ to their penis!

  1. While in its flaccid (limp) state, take one hand and grip around the head of your penis. Grip firmly, but not hard enough to feel discomfort or cut off too much circulation.
  2. Pull out directly in front of yourself with enough force to feel a good and painless stretch in your penis. Hold and count for at least 30 seconds to one minute and rest.
  3. Then continue doing this until you’ve logged in 5-20 minutes of stretching for one session. Take a 10-20 minute break after each session.

TECHNIQUE THREE

This is one of the ancient sexual secrets. It involves stretching the penis in both flaccid & erect state. As is the case with most of these Ancient methods and healings, it is a little esoteric and describes some practices that may be unfamiliar to you. But for purposes of this manual, we will print the technique as it is described in the Taoist teachings: Inhale the air through your nose into the throat, then swallow and press it down to the stomach. When the air reaches your lower abdomen, press it into the penis itself. Take the 3 middle fingers of your left hand and press them to the Hui-Yin midpoint between the anus and the scrotum. This lodges the power in your penis. Resume normal breathing, still keeping the left fingers at the midpoint. With your right hand, begin exercising the penis by pulling it forward&backward, stretching it out in a smooth rhythmical motion 36 times. Use your thumb to rub the glans of the penis until it is erect. With your right hand, circle the penis firmly at its base. Still holding firmly, slide your hand forward an inch. This locks the air energy into the penis, pushing it toward the head. Pull the penis out to the right, then rotate with a stirring action 36 times clockwise and counterclockwise.

Then pull the penis out to the left and do the same. The energy of many of your body organs flows into the penis, which enhances its tone and function. Complete the exercise by gently beating the inner right thigh with your erect penis 36 times, then beat the inner left thigh 36 times.

TECHNIQUE FOUR   

This version of stretching appears in a bestselling book on male sexuality. It also involves stretching the penis in both its flaccid and erect state. This seems to be just a slightly modified version of the Ancient technique listed above (Technique Three).

  1. With your right hand, grip the penis and rhythmically pull it forward and away from your body 10 times (roughly 15 seconds each pull).
  2. Repeat to the right (10 times), to the left (10 times) and down (10 times).
  3. Rub the head of your penis with your thumb until you get an erection. Circle the penis at its base with your thumb and forefinger. Pull forward an inch (10 times) to force energy into the head.
  4. Pull the erect penis to the right and rotate in small circles while pulling outward (10 times). Repeat to the left (10 times).
  5. Gently slap your erect penis against inner thigh while pulling out on each side (10 times).

Workout Introduction

Now that we’ve explained each of the exercises, it’s time to apply them in a daily workout program. This, men, is the moment of truth! If you really want a LARGER PENIS, you MUST perform these exercises as explained. These are VERY POWERFUL methods that have been PROVEN! They’ve worked for us, they’ve worked for thousands of clients, and they’ve worked for hundreds of thousands of men throughout history! So believe us when we say.. THEY WILL WORK FOR YOU!! This is OUR suggested Workout Program. You MUST do this program for ONE HOUR EVERY DAY, 5 DAYS A WEEK. Be sure to take 2 days off a week (consecutively or not), as this is your” healing” time when your cells rebuild after they’ve been broken down. Do this, and you should start seeing results within the next 3 weeks. Once you witness this penis growth for yourself, you won’t want to stop this program, nor should you! Remember… Knowledge, Commitment, Growth. These exercises have been designed not only for penis enlargement, but also for a better self-esteem and personal satisfaction.

Frequently Asked Questions

Below are a few of the most frequently asked questions about our manual:

When should I use these techniques?

Whenever you wish. A lot of men do their workout first thing in the morning, and others do it before they go to bed at night. The actual time of day will not affect the process.

Can I ejaculate right before, during, or after exercising?

When you ejaculate your body goes through several chemical and physical changes, first your blood testosterone levels begin to drop, second, all your connective tissues begin to tighten as well, it is best to wait at least several hours after completion of the exercises before ejaculating, just as it is also important not to ejaculate for at least several hours before exercising as well.

When I jelq I get a little, (or a lot) sore, is this normal?

Check the soreness and see what is causing it, you may just need to trim the pubic hair right at the base of your penis. Is it a sharp pain or just a dull discomfort? Are you doing the hot wraps?

A slight discomfort/soreness is normal and should pass as your penis and all supportive structures get used to the exercises. Try not to stop, a slight discomfort is normal, if the pain is sharp or is strong enough to keep you from exercising take a few days off from the exercises while continuing to do the hot wraps.

How can I keep from getting erect when jelqing or stretching?

DO NOT JELQ WHEN FULLY ERECT FOR ANY REASON!!!

When you are just starting out on the program your penis is accustomed to getting hard from the stimulation because it is always being used for the same thing, get hard, get stimulated, achieve orgasm and ejaculation. After a couple weeks to a few months your penis will be accustomed to the exercises and the erections should be more controllable. During these first few weeks if you get an erection take a few seconds or minutes to let it subside, you won’t hurt anything as all these first few weeks are for is so that Mr. Penis, (and you), can get accustomed to the exercises.

Can I do the exercises twice a day?

The ideal heal time for tissues in your body is 48 hours, (depending on the tissue type, muscle tissue is one of the the fastest, nerve tissue is the slowest at 1 to 2 mm a month). When you exercise more than once a day you are not giving Mr. Penis time to heal correctly often times at the sacrifice of growth.

I’m not circumcised, is there anything special I should do to do the exercises?

Not necessarily, there are mainly just two things you should be aware of. First, when jelqing be sure to stop just at the base of the head, second, if you choose you can use your free hand to retract the foreskin then jelq as you normally would.

How do I find my pc muscle?

An easy to find your pc muscle is: When urinating, stop the flow of urine without using your hands, and no, it’s not your anal sphincter or your abdominal muscles. After time you will get good at it and will be able to do it whenever you want, this is flexing your pc muscle. For starters stop the flow of urine as many times as you can every time you go. After a few days you will be able to do it whenever you want. Try and do as many Kegels as you can every day. Kegels are the exercise that work the pubococcygeal (pc) muscle.

Do I have to do the Hot Wraps?

The hot wrap should not be considered optional as they serve two main purposes. First they serve to loosen connective tissues so they can stretch more easily with less risk of injury.

Second the hot wraps serve to increase penile circulation which in turn increases the amount of nutrients that reach your penis.

When can I expect to see my first gains?

Most begin to see their first gains at around the second week with others seeing gains after their 2nd month, some see gains as soon as the first exercise session. You can expect to see flaccid gains before erect gains as your penis becomes more accustomed to the increased blood flow.

I don’t have enough time to do all the exercises at once, Can I spread them out over the day?

Yes. We know that sometimes it is hard to find the time. If you wish to split the exercises up during the day, then do so.

Why can’t I do the exercises 7 days a week ?

You must rest your penis for two days, This is essential for healing. YOU MUST ALLOW TIME TO HEAL. Many men spend a year or more trying to achieve enlargement, but never seem to grow. This is because the cells and tissues in your penis, after being stretched in exercise, must have enough adequate time to rejuvenate and build back up. This can only be accomplished through the rest time that you take off each week.

How long can I keep using these techniques?

You can use the program forever if you like. But practically speaking, your penis can only be increased SO much. You will see the most substantial growth within your first 6 months of the program (although some men may need a few months longer). However, after that time your penis may only grow a half inch a year, but there will be a slight size gain.

Note:

For this workout, we have included OUR recommended techniques for the exercises you have just read about. If you think you’d like to try one of the other techniques, go ahead and do so. But whichever techniques you decide to use, make sure you stick with them and give them a chance to work. If after a month you find that one of the exercises isn’t working for you (which is rare!), then try a different technique. Always refer to the instructions for ANY of the exercises whenever you need to.

Treatment

Treatment for Penis Enlargement by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects

SMALL PENIS

The concern with penis size is common amidst men. Such anxiety can occur in childhood, adolescence, or adulthood. Boys often compare the size of their penis to the others. Jokes and jesting arise from such comparisons. However, the situation changes when sexual activity begins.

Many men, despite having a penis of normal size, find it small for a number of reasons:

  • The others’ penises are bigger.
  • This situation is quite common and often lacks medical basis. The patients complain about the length of their organ even with normal erection and vaginal penetration.
  • Obese patients complain about having a short penis.
  • This situation stems from the embedment of the penis into the fat on the pubis, which makes the organ looks small.
  • Tall stature and non-proportional penis.
  • Although there’s some correlation between the patient’s stature and his penis size, a wide range of lengths is found. Short men may have bigger penises than tall men, and vice-versa.
  • Penis flaccidity and erection.
  • By and large, patients are most concerned with the size of their penis in flaccid state, when usually they compare their penis size with other men’s. Many don’t know the length of their erect penis or how many additional inches are added. What many men forget is that size must be accompanied by an effective erection that ensures vaginal penetration.

What’s a normal penis?

Disregarding the anatomical aspects of normality, a flaccid penis is as long as 5 cm (1.97 inches) to 10 cm (3.94 inches). The size in flaccid state doesn’t determine the size during erection. The measure is taken from the point where the penis meets the body (not the skin) to the glans end. If we stretch it manually, the penis will gain from 2 cm (0.78 inches) to 5 cm (1.97 inches). Master and Johnson (1966) observed that an erect penis measures from 12.5 (4.92 inches) to 17.5 cm (6.89 inches). A newly born baby has an average length of 3.75 cm (1.47 inches).

What’s an abnormal penis?

There’s no universally accepted definition. A flaccid penis shorter than 4 cm (1.57 inches) or an erect penis shorter than 7.5 cm (2.95 inches) must be considered small. Nevertheless, we find patients close to these values who present a good erection and no complaints in their sexual relationship.

What are the causes of small penis?

Hormonal causes stemming from testicle or hypophysis dysfunction may interfere with the development of the penis as well as the entire male genitalia. Amidst these cases we may find disorders ranging from micropenis to ambiguous genitalia. The penis may remain small as a consequence of traumas, burns or acquired diseases (Peyronie’s disease). Usually, these causes are rare. Most frequently, the patient is not satisfied with his penis size, even if the physician finds no anomaly.

Conclusion

Unfortunately, many unethical professionals take advantage of the patients’ anxiety and doubts, indicating, without any criteria whatsoever, treatments whose main goal is to take the patient’s money rather than providing scientific guidance. Patients with doubts about their penis size must look for a qualified professional that will evaluate the situation, possibly entailing some multi-disciplinary advice from a sexologist or psychologist.

Size Matters:

4 Reasons Why A Short Penis Is Bad For You – & How To Make It Longer

  1. A short penis visually unexciting

Imagine you are dating the girl of your dream and this is the first night you are making out. You start fine with some nice foreplays and then it is time to reveal all. When you take it out, you can’t help but notice the disappointment in her eyes. What an anti -climax! A small penis is not only visually unexciting, it can be a turn off too.

  1. A short penis cannot reach her G spot

If you don’t already know, a girl’s most sensitive part (where she derive the most pleasure) is the G-spot. This is the sweet spot that is located deep under the roof of her love canal. Often stimulation of the G-spot can bring a woman to orgasm. A short penis can never do that in a million years. If you can’t really please your partner, you can be sure others will do the job for you.

  1. A short penis can cause a lack of sensation for you and your partner

The nerves of pleasure are all over the penis surface. If you have a short and small penis, then this means that the number of nerves will be proportionately smaller as well. Thus you will not fully enjoy the sexual sensations that a longer penis can give you. This will also affect your partner’s pleasure.

  1. A short penis can lead to a loss of self esteem

Believe or not, most men want their penises to be huge. Everyone wants to be “well hung”, like a horse. Why? Because a bigger member means more power, more ego, more everything. On the flip side, a small or short penis can lead to a loss of self esteem in a man as he may feel inadequate and not up to the mark.

The above are just 4 reasons why a small and short penis is no good for you – no can do!

But you don’t have to live with a small manhood if you are not satisfied with the status quo. There are ways to right the wrong that nature has done to you.

Remedies to get rid of a small or short penis

  1. You can start doing penis enlarging exercises (or Jelqing)

This is an ancient practice that involves pulling and stretching the penis to encourage penis growth. Although not scientifically proven, if done correctly, Jelqing can help you get a bigger and longer penis. There is ample evidence found on public forums where thousands of guys share their success stories (and some failures as expected).

  1. You can enlarge your penis size by using penis enlargement stretchers

This is a scientifically proven method endorsed by medical doctors. The penis stretching device works on the principle of traction used in orthopedic surgeries where limbs are repaired and lengthened. You simply wear the device over the length of your penis for a period of time and let it work. The stretching force will encourage penis tissue growth and therefore a permanently bigger penis.

So there you have it. There are ways to get rid of a small or short penis. Do something about that small penis and live the life you really want to live.

Small Penis Syndrome A Big Problem?

Does size matter? It does to men, according to this month’s BJU International, which contains a review of over sixty years worth of research into penile size and small penis syndrome. The researchers, Dr Kevan Wylie from Royal Hallamshire Hospital, UK, and Mr Ian Eardley from St James’ Hospital, UK, found that men can experience real anxiety – even if they are of average size. And while men often have greater confidence if they have a large penis, women don’t necessarily feel that bigger is better, citing looks and personality as more important than penis size.

Drawing together the results of 12 studies that measured the penises of more than 11,000 men, the researchers established that average erect penises ranged from 14-16cms (5.5 to 6.2 inches) in length and 12-13cm (4.7 to 5.1 inches) in girth. They noted that there was little evidence of racial differences influencing size, although one Korean study recorded smaller than average-sized penises. The researchers, however, questioned the accuracy of this study and suggested further investigation was required.

Dr Wylie says the review will provide doctors and other health professionals with an accurate summary of the many studies that have been carried out in the past into penile size and size-related syndrome. “It is very common for men to worry about the size of their penis and it is important that these concerns aren’t dismissed as this can heighten concerns and anxieties,” he explained. “It is helpful to normalize the situation and provide as much accurate information as possible, as many men either lack any information or have been misinformed.”

Key findings of the review included:

  • A survey taking in 50,000 heterosexual men and women found that while 85 percent of the women were satisfied with their partner’s penile size, only 55 percent of the men were satisfied.
  • Factors that make a male attractive to a woman were numerous, but penile size was not the most important factor for women. Several studies indicated that around 90 percent of women prefer a wide penis to a long one.
  • Somewhat counter-intuitively, small penis syndrome is much more common in men with average-sized penises than those men suffering from micropenis.
  • Men afflicted by small penis syndrome typically cite childhood comparisons and erotic imagery as the main contributing factors to their anxiety.
  • Interestingly, on average, homosexual men had larger penises than heterosexual men. The researchers suggest that exposure to male reproductive hormones in the womb may be one explanation for this disparity.

Techniques used by men to enhance the size of their penis were also covered in the review. The Topinama men of Brazil practice what is perhaps the most bizarre method, encouraging poisonous snakes to bite their penises to enlarge them.

The researchers said that evidence for the effectiveness of more popular (but mundane) enlargement methods – such as jelqing exercises and traction devices – was limited, but they noted that patients may experience psychological benefits from their use.

They authors are, however, very cautious when it comes to treating a psychological condition like small penis syndrome with gadgets or surgery. “There is poorly documented evidence to support the use of penile extenders, and while information is starting to emerge on the success of some surgical techniques, this is not backed up by data on patients’ satisfaction with such procedures,” stressed Dr Wylie.

In summary, the researchers said that small penis syndrome should be approached via a thorough urological, psychosexual, psychological and psychiatric assessment. “Conservative approaches to therapy, based on education and self-awareness, as well as short-term structured psychotherapies, are often successful,” they concluded.

Treatment

Treatment for Small Penis   by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

WHAT IS THE AVERAGE PENIS SIZE?

Average Penis Length

With penis size having great physiological and physiological importance, it is often important to note the average size of the penis. Penis length is typically measured while a subject is standing with the penile shaft pointing downwards. Several academic and clinical studies have been conducted in order to establish this data. Studies by the Journal of Urology and the International Journal of Impotence Research have noted that the average erect length ranges between 5 to 5.4 inches.

Average Penis Girth 

Girth typically refers to the circumference or width of the penis. The average penis circumference ranges between 4.75 to 5.00 inches. Although this is the average length, many men range between 4.25 inches in circumference to 5 inches.

Does Race Affect Penis Size?

There are a variety of myths concerning the size of the penis and its correlation to race. Popular culture has promoted the notion that males of African descent may have larger genitalia while those of Asian descent are smaller in length. These are all common misconceptions, as penis size is generally dispersed and variable amongst the population. There have been no scientific studies that have shown a correlation between race and penis size. These popular notions have been blamed for “penis envy” within the media; however, researchers continue to study the preferences of women with respects to penis size.

Preferred Penis Size  

Studies have been conducted by a series of research firms pertaining to women’s preferences in relation to penis size. Although length does play a role in the satisfaction of women, a study by a Women’s Health group noted that girth was a more important factor. Out of the 400 women surveyed through a random sampling method, majority of these women emphasized the importance of girth, particularly during sexual intercourse and for sexual stimulation.

Facts about penis size

Even in this supposedly enlightened century, men fret about penis size. Though the vast majority of guys have more than enough bulk to perform well as lovers, there is a widespread masculine obsession that ‘more would be better’.

We get a constant flow of emails and letters from males who are worried that they are ‘too small’. Vast sums of money can be made by exploiting this obsession, but other than surgery, there is little that is clinically proven to increase penis size.

Any woman reading this article may find it puzzling that so many men are concerned about the length of their penis and wish they had ‘just a couple of inches more’. But that’s the way that a lot of men are.

Size matters

To the average man, his penis is, consciously or unconsciously, one of the most important things in the whole world. At an early age he discovers it and immediately becomes fascinated by it.

And so he goes on through life, always a tiny bit sensitive about the size of his organ, always convinced that it would be nicer if it were just that little bit longer.

No matter how often it’s written that penile size doesn’t matter, and that women aren’t attracted to a man because of the length of his organ, the average male continues to think the same way.

The average female cannot understand this obsession with penile measurement. So if you’re a woman, never belittle a man’s penis in bed, even as a joke, or say anything to indicate that you think it’s small. The guy may take you seriously, and if he does, he’ll be deeply hurt.

We have known men who have gone on to have problems with impotence (erectile dysfunction) after someone made an unthinking remark about their dimensions. But almost all of these men had a perfectly normal male organ. Each one just thought he was very small compared with other men.

A question of perspective

The trouble is that every man sees his own penis in a foreshortened view. The angle at which you look down inevitably makes your penis seem shorter than it is.

But when you glance at another man’s organ, there’s no such foreshortening effect, so very often it’ll look as though the other guy is slightly better endowed.

A lifetime of comparison of this sort (and virtually every male does a quick mental check on each naked man he sees) can easily make you feel a bit inadequate. But it’s important to realise the facts about penis length.

Average penis length

A non-erect penis usually measures between 8.5cm and 10.5cm (3-4 inches) from tip to base.

The average figure is about 9.5cm (3.75 inches), but this kind of precise measurement is rather valueless. Many factors can cause a temporary shrinkage of two inches or more, for instance cold weather or going swimming, so you needn’t worry if you happen to fall short of the average figure.

Of course, it’s true that some men have big penises and some have smaller ones, just as some men have small feet and some have big feet, but the measurement is not – repeat not – an index of virility.

Most people think that a tall man will usually have a large penis, but this is not true. The distinguished American researchers Masters and Johnson measured the penile lengths of more than 300 men.

  • The largest organ was 14 cm (5.5 inches) in the flaccid state. It belonged to a slim man who was 5′ 7″ tall (170 cm).
  • The smallest penis measured 6cm (2.25 inches). It belonged to a fairly heavily built man of 5′ 11″ (180cm).

It’s also worth pointing out that there is no correlation between penile size and race.

Average size of erections

We’ve talked about the length of the penis in its ordinary non-erect state, but how long should it be when it’s erect?

Interestingly, most penises are very much the same size when erect.

  • The man whose non-erect penis is smallish will usually achieve about a 100 per cent increase in length during sexual excitement.
  • The man whose non-erect penis is on the largish size will probably manage about a 75 per cent increase.
  • This means the great majority of penises measure between 15cm and 18cm (6-7 inches) when erect, with the average figure being about 16.5cm (6.5 inches).

So you can see that even if a man has got a ‘small’ penis, he’s got a built-in compensating factor that will bring him up to about the same size as the guy who appears to be ‘better equipped’ in the shower room.

Sex and women

Virtually every man forgets that it doesn’t matter how long or how short your penis is, because the vagina will accommodate itself to any length.

  • The vagina of a woman who hasn’t had a child is only 7.5cm (3 inches) long when she’s not sexually excited. The figures for women who have had babies are only slightly different.
  • Even when aroused, a woman’s vagina usually extends only to a length of about 10cm (4 inches).

This means any man’s penis will fill her vagina completely, unless you happen to be one of those rare guys with an erect penile length of less than four inches.

You’re probably now wondering how the average man with an erection of six inches manages to insert his penis into the vagina at all.

The vagina has the most remarkable capacity for lengthening if something is introduced into it gradually.

So the exceptional man whose erect penis is eight inches long can still make love to any woman, providing he excites her properly and introduces his organ very slowly. If he does this, her vagina will lengthen by 150 or 200 per cent to accommodate him.

What if I’m not happy about my penis size?

If you’re really worried that your penis is the wrong size, go and see your doctor.

If you’re not happy about consulting your GP on such an intimate matter, you could see one of the medics who spend their entire day checking men’s penises. You can find these doctors at:

  • private ‘well-man’ clinics, but take care: a few of these are run by quacks
  • NHS urology clinics
  • NHS sexual medicine clinics
  • NHS genitourinary medicine (GUM) clinics
  • NHS family planning clinics, although these tend to be oriented towards women and don’t have much time to deal with males.
  • Brook advisory clinics (for the under 25s).

What treatments are there to increase penis size?

Many companies claim they know how to enlarge your penis – for a price.

We have been to several medical conferences this year at which leading experts have spoken about penis size and penis enlargement.

Their opinions on the various methods that are so widely advertised to the public can be summed up as follows.

  • Pills or patches for increasing penis size: a complete waste of time.
  • Penile enlargement surgery: of uncertain value and sometimes dangerous.
  • Penile enlargement exercises: probably pretty futile.
  • Penile suction devices: probably of little use.

Several European experts say that the relatively new stretcher or extender devices may sometimes be of value in giving a man a little extra length.

PENIS SIZE SURVEYS

Every man wants to know if they are average or not? hopefully they are not below averages other wise what do they do? The problem is unfortunately there is no definitive answer to this question. Many researches have been done and the average penis size as ranged from 6 inches to 6.5 inches, the question is which study to believe. Durex have been running a online study for many years now and you can see their results by visiting their site..

The study which should be the most accurate is the report done by The Alfred C. Kinsey Institute for sex. The largest sample of 10,000 men were measured and then the results compiled. The results showed the average was 6-6.5 inches in length. Average girth is 5-5.5 inches See graph below:

The size of your penis doesn’t have a relationship with anything else. For example a person with big feet does NOT necessarily have a 9 inch penis. Whether you are above or below the average ask yourself does it really matter? If you feel comfortable with the way your penis looks then it is not an issue. If not then you could do what I did and set about enlarging your penis. See links on the left.

THE MEASURE OF THE MAN    

What is Average?

The quick answer is that the average length is somewhat under 6″

& the circumference is just under 5″.

Or to be more exact, the average length seems to be between 5.65″ and 5.87″. The average circumference between 4.67″ and 4.97″. Both depending on how you interpret the data.

If you really want to go into detail, just keep reading.

Here is the only survey that I’ve found that was anything like scientific, so probably gives as accurate an average as you are going to get.

Conducted research into the average length and circumference of the erect penis during Spring Break in Cancun and found that the average penis length is 5.877 inches, with the majority ranging between 5.5 inches and 6.3 inches.

The average girth is 4.972 inches, with the majority ranging between 4.7 inches and 5.1 inches.

From March 11 to 17, a total 401 males over the age of 18 were measured, one at a time, by qualified medical staff (protected by gloves) in private tents at the Dady Rock nightclub in Cancun, Mexico. Of the 401 men, 300 were able to gain an erection for measurement — a success rate of only 75%.

Measurement methodology

The following criteria were enforced by a doctor and a team of four nurses, who attended each of the seven nights of the penis size research. Measuring of length was from the point at the base of the erect penis where the top of the penile shaft meets the pubic area to the tip of the glans (“head”). For uncircumcised men, the foreskin was retracted. Measuring of girth was at mid-shaft around the circumference of the penis when the penis was erect. Failure to gain an effective erection for measurement disqualified the volunteer from being included in the data for the calculation of average erect penis length and girth.

Environment

The majority of participants were U.S. college men, but it was not limited to this group. Volunteers were asked to enter a private area, where they would gain an erection and then call for the two nurses to measure their erect penis. (Male fantasy overload.) To ensure the accuracy of the data, each erect penis was measured by two of the nurses. A doctor supervised the nurses and all activity.

Volunteers tended to be groups of friends, which helped ensure a wide range of penis sizes (big and small) and provide a more accurate average figure.

Sample size 

The sample included 401 male volunteers, of which only 300 were “effective” male volunteers (75 percent), because 101 volunteers (25 percent) could not gain an erection for measurement. At 300 effective measurements, the study was twice the size of any previous study that used medical staff to measure penis size. This method is more accurate and reliable than studies in which volunteers undertake self-measurement/reporting.

Erect penis length

The average erect penis length was 5.877 inches (14.928 cm). Standard deviation was 0.825 inches (2.096 cm) with 54 percent of the effective sample measuring between 5.5 inches (14 cm) and 6.3 inches (16 cm).

Length % of men
3.50″ to 3.75″ 0.2 %
3.75″ to 4.00″ 0.3 %
4.00″ to 4.25″ 0.2 %
4.25″ to 4.50″  0.7 %
4.50″ to 4.75″ 0.8 %
 4.75″ to 5.00″ 2.0 %
5.00″ to 5.25″ 9.0 %
5.25″ to 5.50″ 10.8 %
5.50″ to 5.75″ 24.3 %
5.75″ to 6.00″ 23.9 %
6.00″ to 6.25″ 9.3 %
6.25″ to 6.50″ 6.7 %
6.50″ to 6.75″ 4.4 %
6.75″ to 7.00″ 2.9 %
7.00″ to 7.25″ 1.0 %
7.25″ to 7.50″ 1.0 %
7.50″ to 7.75″ 0.9 %
7.75″ to 8.00″ 0.8 %
8.00″ to 8.25″ 0.3 %
8.25″ to 8.50″ 0.3 %
8.50″ to 8.75″ 0.1 %
8.75″ to 9.00″ 0.1 %

Erect Penis Girth

The average erect penis girth was 4.972 inches (12.63 cm). Standard deviation was 0.508 inches (1.29 cm) or with 53.33 percent of the effective sample measuring between 4.525 inches (11.5 cm) and 5.118 inches (13 cm).

The Geeks out there will notice that this is nowhere near a normal distribution, which makes the mean and standard deviations a bit difficult to interpret. More here.

Even these results might be an exaggeration because:

1) Even in groups, you are more likely to attract customers who feel they have something worth showing.

2) It’s possible that the more cock-sure ones, would find it easier to get an erection.

Circumference % of men
Under 3.00″ 0.2 %
3.00″ to 3.25″ 0.3 %
3.25″ to 3.50″ 0.2 %
3.50″ to 3.75″  0.7 %
3.75″ to 4.00 0.8 %
 4.00″ to 4.25″ 2.0 %
4.25″ to 4.50″ 9.0 %
4.50″ to 4.75″ 10.8 %
4.75″ to 5.00″ 24.3 %
5.00″ to 5.25″ 23.9 %
5.25″ to 5.50″ 9.3 %
5.50″ to 5.75″ 6.7 %
5.75″ to 6.00″ 4.4 %
6.00″ to 6.25″ 2.9 %
6.25″ to 6.50″ 1.0 %
6.50″ to 6.75″ 1.0 %

Treatment 

Treatment for Penis Size   by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

MICROPENIS

Micropenis is a clinical term used to describe a very small penis. In an ideal world (where we didn’t assume that being too far from a norm is automatically cause for concern) being born with a very small penis would not be considered a medical problem unless the penis was causing pain, or not functioning the way a newborn penis should. However, because we do associate health at birth with a variety of norms, infants born with very small penises can be labeled as in need of medical attention.

People born with micropenises that either received no treatment, or received treatment that had no effect, can go through puberty and move into adulthood and still have a micropenis. The generally accepted definition of a micropenis is a penis that is “more than 2.5 standard deviations” below the average penis length for the age of the individual. This is just a statistical term that means a certain length away from average, based on the average penis size in the population.

Despite the fact that researchers disagree on what constitutes and average penis size, a micropenis is considered in newborns to be around 3 /4 of an inch (1.9 centimeters) in length, and in adults to be less than 2.8 inches (7 centimeters) in length when flaccid and stretched.

Why do some people have Micropenises?

Micropenises are the result of a difference in fetal development. Most often the cause of a micropenis is chromosomal and hormonal, and results from some problem in either the making of, or body’s response to, androgen. Research on fetal development suggests that there are two stages of penile development in fetuses. The first happens early in fetal development is when androgen triggers the development of the penis and scrotum from its undifferentiated state. The second, which happens later on in fetal development, occurs when androgen influences the further growth of the penis. It is thought that a micropenis is the result of the first stage happening but not the second (so the penis looks like most penises, but it is much smaller).

Because the term micropenis is really just a descriptive one, there could be many reasons someone is born with a micropenis. As many as a third of people born with a micropenis don’t fit into an easily identifiable category to explain the cause of it.

Many adult men who think they have a micropenis would not fit the clinical diagnosis. If you are concerned that you may have a micropenis the easiest first step would be to talk with your doctor.

Can you have sex with a Micropenis?

You can absolutely have sex with a micropenis. For adult men who have true micropenises this may be a huge concern. The first thing to point out is that if you want, you can have great sex without a penis at all. So regardless of size, sex is still out there.

In terms of the sexual functioning and response of the micropenis itself, reports vary. Certainly many men who have micropenises report having satisfying sexual intercourse as well. There haven’t been many studies, but one reported that 75% of men with micropenises reported satisfying sexual intercourse. Yet another recent study which examined the nighttime erections of men with micropensises found them to be different from men without micropenises. Again, I would suggest that sexual satisfaction and functioning are not categories to be left to “researchers” alone, and how you feel about it is more important than what laboratory research can tell us.

Is there treatment for a Micropenis?

Given the society we live in, where a man’s worth is measured by the size of everything from his car to his income to his penis, it’s not surprising that many men think a small penis is, by definition, a broken penis. But this isn’t the case. If you are an adult with a micropenis the “treatment” may be more about accepting that your body is okay, and can give you the same amount of pleasure as other bodies than any more significant intervention.

Definition of Micro penis- A very small penis 

Micropenis, also known as microphallus, is a penis that is 2.5 standard deviations below the mean (average) for the age and race of the child. This definition translates to a stretched penis length of less than 1.9cm (3/4 inch) long at birth and can be described as a micropenis. Statistically, micropenis occurs in 0.6% of the population.

Lack of development of sexual organs and penis size     

There are many reasons why the penis may not develop. Very early in the development of the human male or female fetus differences in the genitalia cannot be detected, even though the sex chromosomes XX (in most females) and XY (in most males) have put down the basic building blocks. It is hormones produced by the gonads determined by the sex chromosomes that then determine which organs develop and which ones disappear. The same tissue that forms the clitoris in the female forms into a penis in males, the tissue that makes the scrotum in the male makes the labia in the female. Because of the complexity of fetal development things can and do go wrong. Therefore it should be no surprise that things can go wrong in the development of the sex organs.

Getting the best advice about Micropenis

As a parent, advice and treatment options should be discussed with a specialist medical team made up of pediatricians, urologists, endocrinologists, geneticists and radiologists very soon after the birth of the child. Tests will need to be carried out to see if the gender of the baby can be determined. Treatment and management options need to be discussed that result in the best possible outcome for the child. The family need to be supported and informed. Changes in the way micropenis is treated by the medical expert’s means that it is worth getting more that one opinion to make sure all avenues have been explored if the treatment is complex or has lasting implications for the infant.

Causes of micropenis- Very small penis

The central role here is chromosomes and hormones as the deciding factors of the male or femaleness of the fetus and baby. Micropenis occurs when these systems fail to work properly. There are many different possible causes and problems with penis growth can start the after 14 weeks of fetal growth.

Micropenis is often due to inadequate testosterone in 2nd and 3rd trimester of fetal growth. There may be a genetic cause. Although there is no gene per se that causes micro penis, there are a number of associated syndromes. An example is androgen insensitivity, where the fetus started as a male but was insensitive to testosterone (the male hormone), or syndromes caused by chromosomal abnormalities such as Klinefelter’s Syndrome, Turner’s Syndrome or Down’s Syndrome.The medical team can investigate the many possible causes and carry out tests that will inform future management and treatment.

Cultural & social issues of maleness & the penis 

The range of things that can go wrong in the external genitalia and the way the penis may look and function, is an area bound up with images of maleness (or femaleness). The penis is so central to sexuality and sexual satisfaction that it has even influenced medical treatment. Since the mid 1950s and until quite recently, a child with a micropenis would be surgically realigned to a female and hormones given to enhance that change.

Many would argue that the decision was underpinned by the idea that was essentially, culturally and socially led, that a man must have a ‘normal’ penis size to be a man. Size really did seem to matter.

The medical establishment has responded to the changing attitudes on gender and sex, social and cultural issues, increased genetic information and medical advances, research and from information from relevant pressure and support groups. Treatment options are no longer as straight forward as they used to be. Society does expect male or female. If a child waits until it is old enough to make a decision there is obviously the potential for confusion, upset, teasing and bullying. A great deal of thoughtful and emotional support will be required

What are the symptoms of Micropenis?

While each child may experience symptoms differently, the most common finding with micropenis is an infant penis size that is less than 1.9 centimeters when stretched gently. In some cases, low sperm count, resulting in infertile

How is Micropenis Diagnosed?

Diagnosis is usually made by physical examination. Your child may then be referred to several specialists including a pediatric urologist (a physician who specializes in the in disorders and care of the urinary tract and the male genital tract) and a pediatric endocrinologist (a physician who specializes in hormones).

Research & Micro Penis 

Although research in this complex area is relatively lacking, there have been a few long term studies that have found that most boys raised as boys have strong male identity. Most end up as sexually active and enjoy sex and satisfy their partners. More comprehensive research is needed to give a clearer picture of people’s lives who have micropenis, or who have had treatment decided for them, been assigned gender with or without surgery.

Treatment

Treatment for Micropenis by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

AZOOSPERMIA

Azoospermia is one of the most severe forms of male factor infertility. It is a condition in which a man has no sperm in his ejaculate. In order to transport sperm outside of the body, it mixes with ejaculate (semen) at certain places throughout the male reproductive system. Sometimes, due to blockages or sperm production problems, sperm does not mix with ejaculate, and therefore cannot leave the body. This is why so many men with azoospermia find it difficult to have children.

There are actually two types of azoospermia:

Obstructive Azoospermia: Obstructive azoospermia accounts for 40% of all cases of azoospermia. It occurs when a blockage in your duct system prevents your sperm from mixing with your semen. These obstructions may be present in your vas deferens or epididymis.

Non-Obstructive Azoospermia: Non-obstructive azoospermia accounts for 60% of all cases of azoospermia. It occurs when there is a problem with the actual production of sperm within your body. It is often the result of hormonal imbalances

How sperms develop:

When boy becomes of 14 years of age then L.H. & F.S.H. hormone secretion from pituitary increases. The rise in these hormones leads to proliferation of sperm forming cells (Germ Cells) in the testis. These germ cells start multiplying under the effect of above-mentioned pituitary hormones along with assistance of other hormones as testosterones, Growth hormones, Androstenidione, insulin like growth factor-I, Thyroids hormone, paracrine hormone & growth factors. Under the control of above-mentioned hormones germs cells divide & transformed into primary spermatocytes. Then further maturation of primary spermatocytes to spermatids & then finally into mature spermatozoa (i.e. normal sperms) occurs under the control of above-mentioned hormones. After few weeks of progressive maturation inside the testis these sperms become normally motile & develop the capacity to fertilize the ovum. This total sperm cycle, from first stage to final stage of normal mature sperms is of three months. Thus to produce normal sperms testis should have normal sperm producing germ cells & normal regulating hormones. Any major hindrance in the development of these spermatozoa will lead to absent sperm production resulting into nil sperm..

Causes of Azoospermia: 

The various causes of Azoospermia are as follows :

Hormone Disorder:

The various endocrine (Hormone) disorder leading to azoospermia are as follows:

  1.  Hormone deficiency of pituitary gland as L.H., F.S.H., Prolactin, thyroids hormone, hypothalmic deficiency of GnRH, Pituitary gland failure, Hypopituitarism, Idiopathic hypopituitarism, Kallman syndrome, Isolated hypogonadotropic hypogonadism, Drugs, toxins, Idiopathic hypogonadotropic hypogonadism & due to many more causes.
  2. Obstruction in the outflow of semen (Sperms) from testis to outside through urethral opening. Many times the production of sperms in testis is absolutely normal but these sperm are unable to come out due to obstruction in the out flow tract leading to absent sperms in the semen. The various causes of obstruction are absent vas deferens, absent seminal vesicle, posttraumatic, post surgical ligation of vas deferens. After some infections, as chlamydial, gonococcal urethritis. It may also be due to post tubercular epididimo-orchitis. The sperm may also not come out of testis if the are imotile due to any of the following causes as imotile cilia syndrome, kartagener syndrome cystic fibrosis & many other rare diseases.
  3. Absence of germ cells in testis also called sertoli cell only syndrome. In this there are no germs cells i.e. sperm forming cells in the testis. For you knowledge, I wish to inform you that in testis germ cell come to testis from neural cord area of the body during neural cord area of the body during development of fetus. So in some fetuses this migration of sperm cells do not occurs leading to testis only having testosterone forming & sertoli cells. Thus this condition is called sertoli sell only syndrome it is a developmental defect.
  4. Maturation Arrest (. Spermatid arrest): of primary spermatocytes to secondary spermatocyte, spermatids or to mature spermatozoa. Due to may local, systemic, hormonal growth factor deficiency or due to idiopathic factor. The various paracrine hormones and growth factors are essential for normal development i.e. maturation of one germ cells to multiplication of ultimately production of multiple mature, normal & motile sperms. Many other factor as infection, varicocele, drugs, chemotherapy may also lead to maturation arrest. The other causes may by developmentally defective germs cells & spermatocyte. So that they did not have inherent capacity of developing into a mature & motile sperms.
  5. Testicular disorders (primary leydig cell dysfunction), Chromosomal (Klinefelter syndrome and variants, XX male gonadal dysgenesis), Defects in androgen biosynthesis, Orchitis (mumps, HIV, other viral, ),Myotonia dystrophica, Toxins (alcohol, opiates, fungicides, insecticides, heavy metals, cotton seed oil), Drugs (cytotoxic drugs, ketoconazole, cimetidine, spironolactone)
  6. Varicocele (Grade 3 or more severe): A varicocele is a varicose vein in the cord that connects to the testicle. (A varicose vein is one that is abnormally enlarged and twisted.)  Varicocele decreases sperm productions by elevating temperature of the testis, may produce higher levels of nitric oxide chemical in the testis which blocks sperm production, varicocele damages sperms directly & lastly varicocele decrease the oxygen supply to testis.
  7. Drugs (e.g. spironolactone, alcohol, ketoconazole, cyclophosphamide, estrogen administration, sulfasalazine)
  8. Presence of Antisperm antibody. These Antisperm antibodies bind with sperms & either make them less motile, totally immotile or even dead which is called necrospermia
  9. Trauma
  10. Environmental toxins
  11. Viral orchits
  12. Granulomatous disease as tuberculosis, sarcoidosis of the testis
  13. Defects associated with systemic diseases, Liver diseases, Renal failure, Sickle cell disease, Celiac disease
  14. Neurological disease as myotonic dystrophy
  15. Development and structural defects, Germinal cell aplasia, sertoli cell only  syndrome, Cypt-orchidism
  16. Androgen resistance
  17. Mycoplasma infection
  18. Cystic fibrosis patients often have missing or obstructed vas deferens (the tubes that carry sperm) and hence a low sperm count.
  19. Klinefelter syndrome patients carry two X and one Y chromosomes (the norm is one X and one Y), which leads to the destruction of the lining of the sperm forming germ cell in the testis.
  20. Environmental Assaults: Over exposure to environmental assaults (toxins, chemicals, infections) can cause nil sperm either by direct suppression of sperm production or on the hormone. Some chemicals that affect sperm production men are: Oxygen-Free Radicals, Estrogen emulation pesticidal chemicals (DDT, aldrin, dieldrin, PCPs, dioxins, and furans), plastic softening chemicals like Phthalates, hydrocarbons (ethylbenzene, benzene, toluene, and xylene)
  21. Exposure to Heavy Metals: Chronic exposure to heavy metals such as lead, cadmium, or arsenic may affect sperm production and may cause nil sperms in otherwise healthy men. Trace amounts of these metals in semen seem to inhibit the function of enzymes contained in the sperms, the membrane that covers the head of the sperm.
  22. Radiation Treatment: Over-exposure to radiation & xrays affect any rapidly dividing cell, so cells that produce sperm are quite sensitive to radiation damage. Cells exposed to significant levels of radiation may take up to two years to resume normal sperm production, and, in severe circumstances, may never recover.
  23. Misuse of substances: There are a number of banned substances that can have potentially lethal effects on sperm production. Taking anabolic steroids, for example, to increase performance in sports such as weight lifting, can dramatically alter both the motility and the health of the spermatozoa. Other banned substances, such as cocaine, marijuana and heroin can reduce sperm production & may make a man infertile.
  24. HGH Deficiency

Diagnosis of Cause of Nil Sperm Count

For correct diagnosis of cause of nil sperm count, we need detail history & physical examinations then certain relevant investigations are required.

History & Physical Examinations: First step in proper treatment is accurate diagnosis of cause of nil sperm count. So we first try to find out cause. We take detailed history, thorough drug history, and general physical examination, examination of testis, epididymis & testicular veins & sperm carrying duct examinations. These examinations give idea about whether testis is normally developed or not & how is its function. After that depending on likelihood of particular, cause relevant tests are done. All testing facilities are available at our centre. Thus you may consult us at our centre & at same time you may get all tests done. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.

Investigation & Diagnosis: For completes diagnosis of causes of azoospermia (nil sperms) one or more of the following tests may be required as:

1) Complete male hormone profile: This profile includes all the male hormone tests which affect testicular development, growth & other genital organ development as well as genital functions. L.H., F.S.H., Testosterone, prolactins, thyroids test,

2) Antisperm antibody

3) USG or Doppler study of scrotum & testis

4) Semen culture sensitivity

5) Semen fructose

6) Fine Needle Testicular Biopsy of the testis to look for evidence of spermatogenesis & testicular structure.

8) Human Sperm-Zona Pellucida Binding Ratio

9) Human Sperm-Zona Pellucida Pentration test

10) Genetic Studies

11) FNAC Testis

12) Egg penetration test

13) Molecular genetic studies done in some special cases

14) Chromosome analysis i.e. Karyotype (chromosome analysis)

15) Assessment of androgen receptor

16) Combined Pituitary hormone tests is performed when needed

17) Immunobead test

18) MRI head, Hemogram, test for systemic diseases.

19) Olfactory test is done to find out kallman’s syndrome

Treatment of Azoospermia:

After the finding out cause of azoospermia treatment is started depending on the cause found.

The various treatments are as follows:

Correction of the Cause: First of all we try to find out the primary cause of nil sperms by above mentioned investigations. Then we correct the basic defect i.e. correction of hormone disorder & other defects. We also give following treatment for permanent cure of low sperm count & motility disorder.

1) Correction of Hormone deficiencies: Once the hormone disorder is found then it is corrected by any of the below medicines. Usually sperm count normalizes in three month time with proper hormone treatment.

2) Gonadotropin Therapy: Gonadotropins are most potent natural stimulators of sperm production in the testis. Once we start gonadotropin therapy, these gonadotropins stimulates the sperm producing cells in testis. Under the stimulating influence of gonadotropins dormant sperm forming cells which were not producing any sperms, they start dividing & produce multiple immature sperm cells with in three to four weeks. These are further matured in next two to three month into mature sperms under the influence of gonadotropin treatment. Thus in more than 90% cases sperm production can be normalized in three to four months time if it is started in properly selected cases of nil sperms. Gonadotropin therapy is most successful of all the available treatment for nil sperms till now. In many cases of nil sperm count, when all other treatment has failed even in those cases gonadotropin therapy is effective. Thus treatment of nil sperms with gonadotropin results in pregnancy soon.

3) Repronex.

4) Bravelle

5) Ovidrel

6) Gonadotropin-releasing hormone (Gn-RH) analogs

7) Growth hormone therapy in many cases where somatropin deficiency is found

8) In cases of Antisperm antibody induced cases treatment is sperm washing followed by intrauterine insemination, steroid use or intra-cytoplasmic injection of sperms (ICSI).

8) Growth Factor, Mineral & Micronutrient Therapy

9) Free Radial Scavengers: These are drug to reduce the free damaging oxidative radical in the testis. For your information every minute lot of oxidant radicals are generated inside the testis which damages sperm forming cells. These special antioxidant drugs scavenge these damaging oxidative free radicals thus leading to production of normal sperms by the testis. In many study these free radical scavengers have been found to be very-very effective in normalizing sperm count.

 10) Coenzyme ubique: These drugs improve the nutritional status of the testis. Thus sperm forming cells get enough nutrient which helps in fast generation of sperms in good number with good motility & fertilizing capacity.

11)  Carnititine supplimentation increases the production of sperm, with normalization of sperm count in three months.

13) Bromocriptine. This medication is for men who has elevated levels of prolactin, then this hormone rise decreases the sperm production

14) Correction of thyroid hormone

15) Correction of congenital adrenal hyperplasia

17) Zinc

19) Antibiotics

23) Hgh

26) AIH

27) Certain Newer Drugs has been found very effective

28) Surgery: Depending on the surgery may be a treatment option for nil sperm count due to blockade of the tract from testis to the tip of penis (i.e. obstructive azoospermia). Surgery is also the treatment of choice for significant varicocele. Similarly surgery may be one of the treatment options for many endocrine tumours. Surgical reconstruction When obstruction in transport of sperm from testis to outside is diagnosed, it is treated by surgical reconstruction. All this surgical treatment facility is provided by our expert micro surgeon. In this obstruction segment is bypassed by surgical anastomosis.

29) But there are many cases of azoospermia in which inspite of best treatment sperm production either does not improves or is impossible. In these cases we do fine needle testicular biopsy in which sometimes we may get some normal sperms or even spermatids. These spermatocytes or sperms are then injected in ovum leading to formation embryo. These embryos are ten transferred into uterus leading to achievement of pregnancy.

30) But in some cases inspite of all efforts no sperm can not be produced. In such cases we advise artificial insemination by semen from donor. In this normal semen is taken from sperm i.e. semen bank. This is one of the very successful method of treatment with minimal cost involvement.

31) Test tube baby is also delivered with our efforts by use of intra-cytoplasmic sperm injection (ICSI), then transfer of embryo to uterus of mother.

32) Semen Bank: Facility for good quality sperm is semen bank in also available. At our center we have facility for all the testing & treatment facility required for low sperm count to achieve pregnancy.

33) Assisted reproductive technology (ART)

ART has revolutionized the treatment of infertility. Each year thousands of babies are born in India as a result of ART. Medical advances have enabled many couples to have their own biological child.

The most common forms of ART include:

  1. In vitro fertilization (IVF). This is the very effective ART technique. IVF involves retrieving mature eggs from a woman, fertilizing them with a sperm from sperm bank in a dish in a laboratory and implanting the embryos in the uterus three to five days after fertilization.
  2. Surgical sperm aspiration. This technique involves removing sperm from part of the male reproductive tract such as the epididymis, vas deferens or testicle. This allows retrieval of sperm if blockage is present.
  3. Intracytoplasmic sperm injection (ICSI). This technique consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure.

34) Varicocele ligation

A varicocele is an abnormal tortuosity and dilation of veins of within the scrotum. It can be surgically treated – which might help fertility in some cases.

At our center we have facility for all the testing & treatment facility required for nil sperm count to achieve pregnancy.

Response of Treatment: By above treatment many patients are cured in three to four months times. But if we  diagnose that this problem is not curable in such cases we tell the patient that your problem is incurable & suggest them other available options as test tube baby, ICSI, AIH etc..

Treatment

Treatment for Azoospermia by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

OLIGOSPERMIA (Low Sperm Count) 

When sperm count is less i.e. decreased in number or amount than normal is called oligospermia i.e. low sperm count.

When ever there is less sperm count then chances of spontaneous pregnancy decreases (i.e. difficulty in conceiving i.e. wife does not becomes pregnant). This is one of the common causes of male factor infertility. This is also one of the most common semen abnormalities in men.

How Sperms Develop:

When boy becomes of 14 years of age then L.H. & F.S.H. hormone secretion from pituitary increases. The rise in these hormones leads to proliferation of sperm forming cells (Germ Cells) in the testis. These germ cells start multiplying under the effect of above-mentioned pituitary sex hormones along with assistance of other hormones as testosterones, Growth hormones, Androstenidione, insulin like growth factor-I, Thyroids hormone, paracrine hormone & growth factors. Under the control of above-mentioned hormones germs cells divide & transformed into primary spermatocytes. Then further maturation of primary spermatocytes to spermatids & then finally into mature spermatozoa (i.e. normal sperms) occurs under the control of above-mentioned hormones. After few weeks of progressive maturation inside the testis these sperms become normally motile & develop the capacity to fertilize the ovum. This total sperm cycle from first stage to final stage of normal mature sperms is of three months. Any hindrance in the development of these spermatozoa will lead to less count of sperm & decreased motility, immotile or even dead sperms.

Causes of Low Sperm Count:

The various causes of low sperm count are as follows:

1) Deficiency of central sperm producing hormones:

Hypothalamic – pituitary deficiency: Idiopathic GnRH deficiency, Kallman syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome, Hypothalamic deficiency, pituitary hypoplasia, Trauma, post surgical, postiradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, hemochromatosis) Autoimmune hypophysitis, Drugs (drug-induced hyperprolactinemia, sex steroids use) 

Untreated endocrinopathies, Glucocorticoid excess, Hypopituitarism, Isolated gonadotropin deficiency (non acquired): Pituitary, Hypothalamic, Associated with multiple pituitary hormone deficiencies: Idiopathic pan hypo pituitarism (hypothalamic defects), Pituitary dysgenesis, Space-occupying lesions (craniopharyngioma, Rathke pouch cysts, hypothalamic tumors, pituitary adenomas), , Laurence-Moon-Beidl syndrome Prader-Willi syndrome , Frohlich syndrome, Hypergonadotropic hypogonadism : Klinefelter syndrome, Noonan syndrome,  Viral orchitis, Cytotxic drugs, Testicular irradiation.

2) Testicular disorders (primary leydig cell dysfunction i.e. Hypoganadism), Chromosomal (Klinefelter syndrome and variants, XX male gonadal dysgenesis), Defects in androgen biosynthesis, Orchitis (mumps, HIV, other viral, ),Myotonia dystrophica, Toxins (alcohol, opiates, fungicides, insecticides, heavy metals, cotton seed oil), Drugs (cytotoxic drugs, ketoconazole, cimetidine, spironolactone),

3) Partial obstruction in outflow tract from testis to penile pening in epididymis or of vas deferens (cystic fibrosis, diethlstibesterol exposure) also called obstructive oligospermia.

4) Varicocele:  varicocele is dilatation of scrotal vein in the scrotum that leads to rise in temperature of testis and raise testicular temperature, resulting in less sperm production & death of whatever sperms are produced.

5) Drugs (e.g. spironolactone, ketoconazole, cyclophosphamide, estrogen administration, sulfasalazine)

6) Autoimmunity i.e. presence of Antisperm antibody. These Antisperm antibodies bind with spems & either make them less motile, totally imotile or even dead which is called necrospermia.

7) Undescended testicle (cryptorchidism). Undescended testis is a condition when one or both testicles fail to descend from the abdomen into the lower part of scrotum during fetal development. Undescended testicles can lead to less sperm production. Because the testicles temperature increase due to the higher internal body temperature compared to the temperature in the scrotum, sperm production may be affected.

8) Mosaic Klinefelter’s syndrome. In this disorder of the sex chromosomes, of the man is abnormal. This causes abnormal development of the testicles, resulting in low sperm production. Testosterone production may be low or normal.

9) Viral orchits as mumps or other viral infections.

10) Infections as tuberculosis, sarcoidosis involving testis or surrounding structures as epididymis.

11) Chronic systemic diseases as Liver diseases, Renal failure, Sickle cell disease, Celiac disease

12) Neurological disease as myotonic dystrophy

13) Development and structural defects as mild degree of Germinal cell hypo-plasia

14) Partial Androgen resistance

15) Mycoplasmal infection

16) Partial Immotile cilia syndrome

17) Partial Spermatogenic arrest due to interruption of the complex process of germ cell  diffrentation from spermatid level to the formation of mature spermatozoa results in decreased sperm count i.e. oligospermia. Its diagnosis is made by testicular biopsy. This is found in upto 30% of all cases of low sperm count patients.18) Heat Exposure to testis: as febrile illness or exposure to hot ambience induces a fall in sperm count which is usually reversible.

19) Infection – as bacterial epididimo-orchitis, even in prostatis spermatogenic defect have been noted.

20) Hyper-thermia due to cryptorchidism

21) Chromosomal abnormality: has been found in many cases of low sperm count

22) Alcohol use, Cocaine or heavy marijuana use or Tobacco smoking may lower sperm count

23) Anti-sperm antibodies.  In some people there occurs development of some abnormal blood proteins called anti-sperm antibodies which binds with sperm and make them either immotile or dead or decrease their count.

24) Infections. Infection of urogenital tract may affect sperm production. Repeated bouts of infections are one of the common causes associated with male infertility.

25) Klinefelter’s syndrome. In this disorder of the sex chromosomes, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production. Testosterone production also may be lower.

26) Trauma to testis

27) Environmental toxins: as Pesticides and other chemicals in food or as ayurvedic medicines.

28) Genetic Factors: as idiopathic partial hypo-gonadotropic hypogonadism

Diagnosis of Cause of Low Sperm Count  

For correct diagnosis of cause of low sperm count, we need detail history & physical examinations then certain relevant investigations are required.

History & Physical Examinations: First step in proper treatment is accurate diagnosis of cause of low sperm count. So we first try to find out cause. We take detailed history, thorough drug history and general physical examination, examination of testis, epididymis, testicular veins & sperm carrying duct examinations. These examinations give idea about whether testis is normally developed or not & how is its function. After that depending on likelihood of particular, cause relevant tests are done. All testing facilities are available at our centre. Thus you may consult us at our centre & at same time you may get all tests done. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.

Investigation & Diagnosis:

For completes diagnosis of causes of decreased sperm count & one or more of the following tests may be required as

1) Complete male hormone profile: This profile includes all the male hormone tests which control testicular development, functions including normal sperm Productions. The tests include L.H., F.S.H., Testosterones, prolactins, thyroids test, & other relevant hormone tests depending on history & examinations.

2) Antisperm antibody  

3) USG or Doppler study of scrotum & testis

4) Semen culture sensitivity

5) Semen fructose

6) Immunobead test

7) Sperm Function Tests

8) Human Sperm-Zona Pellucida Binding Ratio

9) Human Sperm-Zona Pellucida Pentration test

10) Genetic Studies

11) FNAC Testis

12) Egg penetration test

13) Molecular genetic studies done in some special cases

14) Chromosome analysis i.e. Karyotype

15) Assessment of androgen receptor

16) Combined Pituitary hormone tests is performed when needed

17) MRI head if pituitary hormone defect suspected

18) Hemogram test for systemic diseases.

19) Sperm Function Tests

The hamster egg penetration assay (HEPA) and the hemizona assay (HZA) are sperm function tests which can help assess the ability of sperm to penetrate the egg. These tests will not definitively tell whether a pregnancy will occur, but an abnormal test result helps predict reduced fertilizing capability. These tests are performed only rarely today.

20) Semen Fructose

Treatment: Once the cause of low sperm count are found then with in three months of treatment sperm count & motility becomes normal in more than 90% cases.

The various treatments

Correction of the Cause: First of all we try to find out the primary cause of infertility by above mentioned investigations. Then we correct the basic defect i.e. correction of hormone disorder & other defects. We also give following treatment for permanent cure of low sperm count & motility disorder.

1) Correction of Hormone deficiencies: Once the hormone disorder is found then it is corrected by any of the below medicines. Usually sperm count normalizes in three month time with proper hormone treatment.

2) Gonadotropin Therapy: Gonadotropins are most potent natural stimulators of sperm production in the testis. Once we start gonadotropin therapy, these gonadotropins stimulates the sperm producing cells in testis. Under the stimulating influence of gonadotropins dormant sperm forming cells which were not producing any sperms, they start dividing & produce multiple immature sperm cells with in three to four weeks. These are further matured in next two to three month into mature sperms under the influence of gonadotropin treatment. Thus in more than 90% cases sperm production can be normalized in three to four months time if it is started in properly selected cases of low sperm count. Gonadotropin therapy is most successful of all the available treatment for low sperm count till now. In many cases of low sperm count, when all other treatment has failed even in those cases gonadotropin therapy is effective. Thus treatment of low sperm count with gonadotropin therapy results in pregnancy soon.

3) Repronex.

4) Bravelle

5) Ovidrel

6) Gonadotropin-releasing hormone (Gn-RH) analogs

7) Growth hormone therapy in many cases where somatrop deficiency is found.

8) Growth Factor, Mineral & Micronutrient Therapy

9) Free Radial Scavangers: These are drug to reduce the free damaging oxidative radical in the testis. For your information every minute lot of oxidant radicals are generated inside the testis which damages sperm forming cells. These special antioxidant drugs scavange these damaging oxidative free radicals thus leading to production of normal sperms by the testis. In many study these free radical scavengers have been found to be very-very effective in normalizing sperm count.

10) Coenzyme ubique: These drugs improve the nutritional status of the testis. Thus testis as well as sperm forming cells get enough nutrient which helps in fast generation of sperms in good number with good motility & fertilizing capacity.

11)  carnititine supplimentation increases the production of sperm, with normalization of sperm count in three months.

12) Fertyl: This drug is taken orally and it causes the pituitary gland to release more FSH and LH, which then stimulates the testis to produce more sperms.

 13) Bromocriptine. This medication is for men who has elevated levels of prolactin, then this hormone rise decreases the sperm production

14) Correction of thyroid hormone

15) Correction of congenital adrenal hyperplasia

16) Vitamins

17) Zinc

18) Methy-Predinisolone

19) Antibiotics

20) Antiestrogens

21) Tamoxifen

22) Clomiphene

23) Hgh

24) Antimicrobials

25) Anti-inflammatory

26) AIH

27) ART

28) Certain Newer Drugs has been found very effective

29) Treatment of antisperm antibody is achieved by steroid therapy, intrauterine insemination intra-cytoplasmic sperm injection (ICSI)

30) Surgery: Depending on the cause, surgery may be a treatment option for low sperm count due to partial blockade of the tract from testis to the tip of pennis. Surgery is also the treatment of choice for significant varicocele. Similarly surgery may be one of the treatment options for many endocrine tumours.

31)  Intra-uterine insemination: In certain patients motile sperms are selected by various methods & then transferred directly in uterine cavity leading to improved pregnancy rate.

32)  Test tube baby is also delivered with our efforts by use of intra-cytoplasmic sperm injection (ICSI), then transfer of embryo to uterus of mother.

33) Treatment of general sexual problems. Addressing imppotence or premature ejaculation can improve fertility. Treatment for these problems often is with medication or behavioral approaches.

33) Semen Bank: Facility for good quality sperm is semen bank in also available. At our center we have facility for all the testing & treatment facility required for low sperm count to achieve pregnancy.

34) Assisted reproductive technology (ART)

ART has revolutionized the treatment of infertility. Each year thousands of babies are born in India as a result of ART. Medical advances have enabled many couples to have their own biological child.

The most common forms of ART include:

  1. In vitro fertilization (IVF). This is the very effective ART technique. IVF involves retrieving mature eggs from a woman, fertilizing them with a man’s sperm in a dish in a laboratory and implanting the embryos in the uterus three to five days after fertilization. IVF often is recommended as a first-line therapy. It’s also widely used for unexplained infertility, male factor infertility.
  2. Electric stimulus brings about ejaculation to obtain semen.
  3. Surgical sperm aspiration. This technique involves removing sperm from part of the male reproductive tract such as the epididymis, vas deferens or testicle. This allows retrieval of sperm if blockage is present.
  4. Intracytoplasmic sperm injection (ICSI). This technique consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure. ICSI has been especially helpful in couples who have previously failed to achieve conception with standard techniques. For men with low sperm concentrations, ICSI dramatically improves the likelihood of fertilization.

35) Varicocele ligation

A varicocele is an abnormal tortuosity and dilation of veins of within the scrotum. It can be surgically treated – which might help fertility in some cases.

Response of treatment: When we start treatment, maturation of spermatocyte to mature spermatozoa start occurring in three to 4 weeks time and achievement of normal sperm count in three months. Thus cure rate is achieved in more than 95% of patients in three months time.

Side effects: This treatment is harmless because we prescribe well proven drugs which are prescribed in scientific literature. These medicines have to be purchased from medical store by patient himself.

For consultation & treatment (by appointment / or online) click How to Consult Us

Treatment

Treatment for Oligospermia by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

NECROSPERMIA

When semen has less of mature normal sperms & more of dead sperms this condition is abnormal. When ever there is less of normal sperm then chances of spontaneous pregnancy decreases (i.e. difficulty in conceiving i.e. wife does not becomes pregnant). This is one of the common causes of male factor infertility. This is also one of the most common semen abnormalities in men.

How sperms develop: When boy becomes of 14 years of age then L.H. & F.S.H. hormone secretion from pituitary increases. The rise in these hormones leads to proliferation of sperm forming cells (Germ Cells) in the testis. These germ cells start multiplying under the effect of above-mentioned pituitary  hormones along with assistance of other hormones as testosterones, Growth hormones, Androstenidione, insulin like growth factor-I, Thyroids hormone, paracrine hormone & growth factors. Under the control of above-mentioned hormones germs cells divide & transformed into primary spermatocytes. Then further maturation of primary spermatocytes to spermatids & then finally into mature spermatozoa (i.e. normal sperms) occurs under the control of above-mentioned hormones. After few weeks of progressive maturation inside the testis these sperms become normally motile & develop the capacity to fertilize the ovum. This total sperm cycle from first stage to final stage of normal mature sperms is of three months. Any hindrance in the development of these spermatozoa will lead to dead sperms, less count of sperm & decreased motility, immotile or even dead sperms

Causes of dead sperm:

The various causes of dead sperms are as follows:

1) Deficiency of central sperm producing hormones: 

Hypothalamic – pituitary deficiency: Idiopathic GnRH deficiency, Kallman syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome, Hypothalamic deficiency, pituitary hypoplasia, Trauma, post surgical, postiradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, hemochromatosis) Autoimmune hypophysitis, Drugs (drug-induced hyperprolactinemia,  steroids use)

Untreated endocrinopathies, Glucocorticoid excess, Hypopituitarism, Isolated gonadotropin deficiency (non acquired): Pituitary, Hypothalamic, Associated with multiple pituitary hormone deficiencies: Idiopathic pan hypo pituitarism (hypothalamic defects), Pituitary dysgenesis, Space-occupying lesions(craniopharyngioma, Rathke pouch cysts, hypothalamic tumors, pituitary adenomas), , Laurence-Moon-Beidl syndrome Prader-Willi syndrome , Frohlich syndrome, Hypergonadotropic hypogonadism : Klinefelter syndrome, Noonan syndrome,  Viral orchitis, Cytotxic drugs, Testicular irradiation.

2) Testicular disorders (primary leydig cell dysfunction i.e. Hypoganadism), Chromosomal (Klinefelter syndrome and variants, XX male gonadal dysgenesis), Defects in androgen biosynthesis, Orchitis (mumps, HIV, other viral, ),Myotonia dystrophica, Toxins (alcohol, opiates, fungicides, insecticides, heavy metals, cotton seed oil), Drugs (cytotoxic drugs, ketoconazole, cimetidine, spironolactone)

3) Varicocele:  varicocele is dilatation of scrotal vein in the scrotum that leads to rise in temperature of testis and raise testicular temperature, resulting in less sperm production & death of whatever sperms are produced.

4) Drugs (e.g. spironolactone, ketoconazole, cyclophosphamide, estrogen administration, sulfasalazine)

5) Autoimmunity i.e. presence of Antisperm antibody. These Antisperm antibodies bind with sperms & either make them less motile, totally immotile or even dead which is called necrospermia.

6) Undescended testicle (cryptorchidism). Undescended testis is a condition when one or both testicles fail to descend from the abdomen into the lower part of scrotum during fetal development. Undescended testicles can lead to less sperm production. Because the testicles temperature increase due to the higher internal body temperature compared to the temperature in the scrotum, sperm production may be affected.

7) Mosaic Klinefelter’s syndrome. In this disorder of the chromosomes, of the man is abnormal. This causes abnormal development of the testicles, resulting in low sperm production. Testosterone production may be low or normal.

8) Viral Orchits as mumps or other viral infections.

9) Infections as tuberculosis, sarcoidosis involving testis or surrounding structures as epididymis.

10) Chronic systemic diseases as Liver diseases, Renal failure, Sickle cell disease, Celiac disease

11) Neurological disease as myotonic dystrophy

12) Development and structural defects as mild degree of Germinal cell hypo-plasia

13) Partial Androgen resistance 

14) Mycoplasmal infection 

15) Partial Immotile cilia syndrome

16) Partial Spermatogenic arrest due to interruption of the complex process of germ cell  differentiation from spermatid level to the formation of mature spermatozoa results in decreased sperm count i.e. oligospermia. Its diagnosis is made by testicular biopsy. This is found in upto 30% of all cases of dead sperm patients.

17) Heat Exposure to testis: as febrile illness or exposure to hot ambience induces a abnormality in spermatogenesis.

19) Infection – as bacterial epididimo-orchitis, even in prostatis spermatogenic defect have been noted.

20) Hyper-thermiadue to cryptorchidism

21) Chromosomal abnormality: has been found in many cases of low sperm count

22) Alcohol use,Cocaine or heavy marijuana use or Tobacco smoking may lower sperm count

23) Anti-sperm antibodies.  In some people there occurs development of some abnormal blood proteins called anti-sperm antibodies, which binds with sperm and make them either immotile or dead or decrease their count.

24) Infections. Infection of uro-genital tract may affect sperm production. Repeated bouts of infections are one of the common causes associated with male infertility.

25) Klinefelter’s syndrome. In this disorder of the  chromosomes, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production. Testosterone production also may be lower.

26) Trauma to testis

27) Environmental toxins: as Pesticides and other chemicals in food or as ayurvedic medicines.

 28) Genetic Factors: as idiopathic partial hypo-gonadotropic hypogonadism

Diagnosis of Cause of Dead Sperms

For correct diagnosis of cause of more of Dead sperm, we need detail history & physical examinations then certain relevant investigations are required.

History & Physical Examinations: First step in proper treatment is accurate diagnosis of cause of dead sperms. So we first try to find out cause. We take detailed history, thorough drug history and general physical examination, examination of testis, epididymis, testicular veins & sperm carrying duct examinations. These examinations give idea about whether testis is normally developed or not & how is its function. After that depending on likelihood of particular, cause relevant tests are done. All testing facilities are available at our centre. Thus you may consult us at our centre & at same time you may get all tests done. The time taken in getting all the reports ready is 36 hours.

Investigation & Diagnosis: For completes diagnosis of causes of dead sperms one or more of the following tests may be required as

Complete male hormone profile: This profile includes all the male hormone tests which control testicular development, functions including normal sperm Productions. The tests include L.H., F.S.H., Testosterones, prolactins, thyroids test, & other relevant hormone tests depending on history & examinations.

2) Antisperm antibody  

3) USG or Doppler study of scrotum & testis

4) Semen culture sensitivity

5) Semen fructose

6) Immunobead test

7) Sperm Function Tests

8) Human Sperm-Zona Pellucida Binding Ratio

9) Human Sperm-Zona Pellucida Pentration test

10) Genetic Studies

11) FNAC Testis

12) Egg penetration test

13) Molecular genetic studies done in some special cases

14) Chromosome analysis i.e. Karyotype

15) Assessment of androgen receptor

16) Combined Pituitary hormone tests is performed when needed

17) MRI head if pituitary hormone defect suspected

18) Hemogram test for systemic diseases.

19) Sperm Function Tests

The hamster egg penetration assay (HEPA) and the hemizona assay (HZA) are sperm function tests which can help assess the ability of sperm to penetrate the egg. These tests will not definitively tell whether a pregnancy will occur, but an abnormal test result helps predict reduced fertilizing capability. These tests are performed only rarely today.

20) Semen Fructose

21) Sperm Coiling Test to find out whether the particular sperm is live or dead

Treatment

Once the cause of low sperm count are found then with in three months of treatment sperm count & motility becomes normal in more than 90% cases.

The various treatments are as follows:

Correction of the Cause: First of all we try to find out the primary cause of infertility by above mentioned investigations. Then we correct the basic defect i.e. correction of hormone disorder & other defects. We also give following treatment for permanent cure of low sperm count & motility disorder.

1) Correction of Hormone deficiencies: Once the hormone disorder is found then it is corrected by any of the below medicines. Usually dead sperms problem is cured in three month time with proper hormone treatment.

2) Gonadotropin Therapy: Gonadotropins are most potent natural stimulators of sperm production in the testis. Once we start gonadotropin therapy, these gonadotropins stimulates the sperm producing cells in testis. Under the stimulating influence of gonadotropins dormant sperm forming cells which were not producing normal sperms, they start dividing & producing normal sperms. Thus in more than 90% cases sperm production can be normalized in three to four months time if it is started in properlyselected cases of low sperm count. Gonadotropin therapy is most successful of all the available treatment for dead sperms till now. In many cases of dead sperms, when all other treatment has failed even in those cases gonadotropin therapy is effective. Thus treatment of dead sperms with gonadotropin therapy results in pregnancy soon.

3) Repronex.

4) Bravelle

5) Ovidrel

6) Gonadotropin-releasing hormone (Gn-RH) analogs

7) Growth hormone therapy in many cases where somatotropin deficiency is found.

8) Growth Factor, Mineral & Micronutrient Therapy

9) Free Radial Scavangers: These are drug to reduce the free damaging oxidative radical in the testis. For your information every minute lot of oxidant radicals are generated inside the testis which damages sperm forming cells. These special antioxidant drugs scavange these damaging oxidative free radicals thus leading to production of normal sperms by the testis. In many study these free radical scavengers have been found to be very-very effective in curing dead sperms.

10) Coenzyme ubique: These drugs improve the nutritional status of the testis. Thus testis as well as sperm forming cells get enough nutrient which helps in fast generation of normal sperms in good number with good motility & fertilizing capacity.

11)  Carnititine supplementation increases the production of sperm, with normalization of normal sperms in semen in three months.

12) Fertyl: This drug is taken orally and it causes the pituitary gland to release more FSH and LH, which then stimulates the testis to produce more normal sperms.

 13) Bromocriptine. This medication is for men who have elevated levels of prolactin.

14) Correction of thyroid hormone

15) Correction of congenital adrenal hyperplasia

16)    Vitamins

17)     Zinc

18)     Methy-Predinisolone

19)    Antibiotics

20)    Antiestrogens

21)    Tamoxifen

22)    Clomiphene

23)    Hgh

24)    Antimicrobials

25)    Anti-inflammatory

26)    AIH

27)    ART

28)    Certain Newer Drugs has been found very effective

30) Surgery:  Surgery is also the treatment of choice for significant varicocele. Similarly surgery may be one of the treatment options for many endocrine tumours.

32)  Test tube baby is also delivered with our efforts by use of intra-cytoplasmic sperm injection (ICSI) after separating out live sperms out of dead ones then transfer of embryo to uterus of mother.

33) Semen Bank: Facility for good quality sperm is semen bank in also available. At our center we have facility for all the testing & treatment facility required for low sperm count to achieve pregnancy.

The most common forms of ART include:

  1. In vitro fertilization (IVF). This is the very effective ART technique. IVF involves retrieving mature eggs from a woman, fertilizing them with a man’s sperm in a dish in a laboratory and implanting the embryos in the uterus three to five days after fertilization. IVF often is recommended as a first-line therapy. It’s also widely used for unexplained infertility, male factor infertility.
  2.  Electric stimulus brings about ejaculation to obtain semen.
  3.  Surgical sperm aspiration.This technique involves removing sperm from part of the male reproductive tract such as the epididymis, vas deferens or testicle. This allows retrieval of sperm if blockage is present.
  4.  Intracytoplasmic sperm injection (ICSI). This technique consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure. ICSI has been especially helpful in couples who have previously failed to achieve conception with standard techniques. For men with low sperm concentrations, ICSI dramatically improves the likelihood of fertilization.

34) Varicocele ligation: A varicocele is an abnormal tortuosity and dilation of veins of within the scrotum. It can be surgically treated – which might help fertility in some cases.

Response of treatment: When we start treatment, maturation of spermatocyte to mature spermatozoa start occurring in three to 4 weeks time and achievement of normal sperm count with normal sperms is achieved in three months. Thus cure rate is achieved in more than 95% of patients in three months time.

Side effects: This treatment is harmless because we prescribe well proven drugs which are prescribed in scientific literature. These medicines have to be purchased from medical store by patient himself.

Treatment

Treatment for Necrospermia by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

PENILE INJURIES

Several types of injuries can affect the penis. Catching the penis in a pants zipper is common, but the resulting cut usually heals quickly. Cuts and irritations heal quickly without treatment but may need antibiotics if they become infected. Injuries to the urethra (the opening at the end of the penis) may require other specific treatment, usually provided by a urologist (a doctor who specializes in the diagnosis and treatment of genitourinary  disorders).

Fracture of the Penis

can occur from excessive bending of an erect penis. Pain and swelling from damage to the structures that control the erection and difficulty with intercourse or urination follow. Fractures of the penis usually occur during vigorous sexual intercourse. Emergency surgery is usually necessary to repair such a fracture to prevent abnormal curvature of the penis or permanent erectile dysfunction (impotence). The penis can also be partially or fully severed. Reattachment of a severed penis is sometimes possible, but full sensation and function are rarely recovered.

The location of the scrotum makes it susceptible to injury. Blunt forces (for example, a kick or crushing blow) cause most injuries. However, occasionally gunshot or stab wounds penetrate the scrotum or testes. Rarely, the scrotum is torn off the testes. Testicular injury causes sudden, severe pain, usually with nausea and vomiting. Ultrasound may show whether the testes have ruptured. Ice packs, a jockstrap, and drugs for pain and nausea usually effectively treat internal bleeding in or around the testes. Ruptured testes require surgical repair. When the scrotum is torn off, the testes can die or lose their capacity for hormone or sperm production. Surgery to bury them under the skin of the thigh or abdomen may save the testes.

What is a penis fracture?

Although the penis has no bone, there are ligaments in the penis. When these ligaments are torn, a penile fracture occurs.

What is penile injury? 

Injury or trauma to the penis can be accidental or deliberate.

Deliberate penile injury is a particularly violent event that is usually self-induced, or inflicted by a jealous partner or their former lover. Despite the publicity surrounding a case of penile amputation in the USA, deliberate penile injury is rare in Western cultures, but seen more often in the Far East. Common injuries are:

  • penile amputation
  • penile fracture.

Fracture of the penis 

Fracture occurs when an abnormal force is applied to the erect penis. The ‘fracture’ is actually a tear in the tunica albuginea, the thick fibrous coat surrounding the corpora cavernosum tissue that produces an erection. It is an uncommon injury, usually but not always the result of damage to the penis during sexual intercourse. Most cases (75 per cent) occur on one side, 25 per cent affect both sides and in 10 per cent the tear extends into the urethra.

What are the symptoms of penile fracture?

  • A ‘cracking’ noise.
  • Pain.
  • Bruising.
  • Immediate loss of erection.
  • Bleeding from the urethra may occur if the urethra is damaged.

What causes a penis fracture?

In most cases, a penile fracture occurs during intercourse.  The penis is most vulnerable when fully erect.  This is when it is stretched to the limit, so to speak.  If the penis hits something hard, like the body of your wife or girlfriend landing on top of you after you have slipped out of her, this can result in a broken penis.Image result for penile fracture

What do I do about a penis fracture?

You go to the hospital, plain and simple.  This is a medical emergency and failure to treat a penile fracture can result in a number of complications, among them is permanent erectile dysfunction.  In order to avoid any complications, go to the emergency room.

When does this occur & how? 

Obviously, sexual activity can play a role.  Upon penetration, if the vaginal introitus is missed and the penis suddenly hits the thigh or introitus, a rapid rise in pressure can cause disruption of this capsule and fracture of the penis.  Frequently, a loud noise is made at the time of the fracture, as if a bone was cracking.

On occasion, sudden bending of an erect penis in young males awakening in the morning can also lead to a fracture as can an array of trauma accidents. Still, all told, it is a relatively rare occurrence.

Surgery is obviously indicated and usually involves circumscribing the penis, reflecting the skin of the shaft of the penis, evacuating the clots and debris and suturing closed the traumatic injury to the capsule of the corpora cavernosum.

Erectile dysfunction is certainly a major complication of this injury and should be discussed with your patient prior to surgery. After full healing in 6-8 weeks, use of PDE5 drugs (Viagra, Cialis and Levitra) to help prevent against this problem should be used.

How do I avoid a penile fracture?

The only way to avoid a penile fracture  is to be extremely careful during intercourse.  As most cases of a penile fracture, the incident occurs when the woman is on top of the man.  You can avoid this position if you want to avoid a penile fracture.  Or you can just be a little careful when you have sexual intercourse in this fashion, although this is a pleasurable position for most women.

If, however, you find that you can only enjoy sexual intercourse with your wife or girlfriend on top because you are too tired to maintain sexual stamina in other positions, perhaps it is time for male enhancement pills.

Injured Penis: The Fracture

It’s perhaps the greatest irony of a man’s sexual life: The harder the penis is, the more vulnerable it is to injury.

Fractures to the penis, although uncommon, do occur when an abnormal force is applied to the erect penis. The ‘fracture’ is actually a tear in the tunica albuginea, the thick fibrous coat surrounding the corpora cavernosum tissue that produces an erection. It is not a common injury to the penis during sexual intercourse, but it can happen. Penile fracture can only occur with an erection.

Most cases (75 per cent) occur only on one side, but sometimes the injury affects both sides. Also, a small portion of the injured penis population tear extends into the urethra.

Penile fractures can also happen during masturbation. Although, most injuries that result from masturbation come from forcibly hiding an erection without care and fracturing it.Image result for penile fracture

There is one common scenario/position that results in many penis fractures. In this scenario, the female partner is on top during intercourse, as the penis thrusts in and out it becomes dislodged from the vagina and when attempting to reinsert it, the partner comes down hard on the penis, striking the female pelvic bone, and creating a sudden bending of the penis. A sure sign is a loud snap and excruciating pain following the injury, as well as the rapid development of a hematoma or bruise. These injuries are not difficult to diagnose, and symptoms will depend upon the severity of the fracture.

Men with penile fractures will be in excruciating pain and notice black-and-blue marks in close proximity to the injured area on the penis. When the diagnosis is equivocal (a large bruise, but no obvious distortion or destruction) the penis is evaluated with corporal cavernosography. This is the procedure where urologists or radiologists place a fine needle into the corporal body of the penis and inject contrast material in order to examine the shape of the corporal bodies and to test for leakage. If there is a question of urethral injury, a retrograde urethrogram is also performed in which contrast material is instilled down the urethra via a small tube or catheter to test for leakage. Urethral injury is usually evident with blood in the urine.

Historically, conservative therapy was considered the treatment of choice for penile fractures. Conservative therapy consisted of cold compresses, pressure dressings, penile splinting, anti-inflammatory medications, fibrinolytics, and suprapubic urinary diversion with delayed repair of urethral injuries.

However, this concept has fallen into disfavor due to the high complication rates (29-53%) of non-operative therapy. Complication rates of conservative management included missed urethral injury, penile abscess, nodule formation at the site of rupture, permanent penile curvature, painful erection, painful coitus, erectile dysfunction, corporourethral fistula, arteriovenous fistula, and fibrotic plaque formation. Also, another problem with conservative management is that fibrosis of the lining of the corporal body can create a bend and poor healing, similar to the effects of maltreated broken arm. Additionally, complications from expanding blood clots, such as a blood clot accumulation or a hematoma, or an infection of the hematoma can occur as well.

Because of the risk of major complications stemming from penis fractures, surgery is the best treatment for the serious injury. These days, primary goals of surgical repair are to expedite the relief of painful symptoms, prevent erectile dysfunction, allow normal voiding, and minimize potential complications from delay in diagnosis. The faster the torn tissues can be re-approximated, the sooner the healing process can begin. The men with penile fractures caused from sexual intercourse are typically young, sexually active, and highly motivated to resume sexual activity as soon as the healing process is complete. This means that surgery is often the best choice and the best treatment

Treatment

Treatment for Fracture of the Penis by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

BALANITIS

Balanitis is an inflammation of the head and foreskin of the penis. Balanitis generally affects uncircumcised males. These are men who have a foreskin, which is the “hood” of soft skin that partially covers the head of the penis. In balanitis, the head and foreskin become red and inflamed. (In circumcised men, who lack a foreskin, these symptoms only affect the tip of the penis.) The condition often occurs due to the fungus Candida albicans, the same organism that causes vaginal yeast infections in women. Balanitis (which is also referred to as balanoposthitis) can be caused by a variety of other fungal or bacterial infections, or may occur due to a sensitivity reaction to common chemical agents.

Image result for causes of balanitis

Uncircumcised men are more at risk for balanitis due to the presence of the foreskin. The snug fit of the foreskin around the top of the penis tends to create a damp, warm environment that encourages the growth of microorganisms. Most of the organisms associated with balanitis are already present on the penis, but in very small numbers. However, if the area between the head and foreskin is not cleansed thoroughly on a regular basis, these organisms can multiply and lead to infection.

Diabetes can increase the risk of developing the condition.

What is Balanitis?

Balanitis is the inflammation of the glands located in the head and foreskin of the penis. It is common in uncircumcised men. Men with diabetes are more prone to developing balanitis.

Balanitis is not sexually transmitted. It is the result of an overgrowth of organisms which are normally present on the skin of the glands.

What causes Balanitis?

The most common causes are:

  • Irritants: neglected hygiene and tight foreskin (particularly in young boys) lead to irritation by smegma (a cheesy substance secreted under the foreskin).
  • Seborrhoeic dermatitis: an inflammatory rash of uncertain cause that is commonly seen on the scalp, behind the ears and in the skin folds.
  • Thrush (candida): although this infection is probably over-diagnosed by doctor and patient.
  • Contact allergy: latex and additives used in rubber manufacture (eg condoms) and constituents of skincare products (used by the patient or partner).
  • balanitis xerotica obliterans (BXO, also termed lichen sclerosis): this condition primarily affects the foreskin, leading to loss of skin colouration, scarring and tightness of the foreskin, and phimosis (inability to pull the foreskin back behind the glans), which may require circumcision. Involvement of the opening of the urethra (urine tube) can lead to irritation and burning. Surgery might be needed to prevent a stricture (narrowing) in the urethra. Steroid creams may help the irritation but patients require long-term follow-up to prevent recurrence.
  • balanitis circinata: a skin manifestation of Reiter’s syndrome, in which the patient also has arthritis (often of the knees), urethritis (inflammation of the urine tube in the penis) and conjunctivitis (red eyes).
  • generalised skin conditions: these can also affect the penis, including: lichen planus, psoriasis, erythema multiforme, erythema fixum (particularly caused by tetracycline antibiotics), erythroplasia of Queyrat (a rare, pre-cancerous skin condition).
  • diabetes.

Predisposing factors include:

    • Moisture (sweat), which permits the microorganisms to thrive. Nonspecific balanitis nearly always affects uncircumcised men, as the tissue under the foreskin may fail to dry out properly.
    • Infrequent washing and/or failure to dry the glans after washing
    • Conversely, over-frequent washing, especially with standard alkaline soap, or drying vigorously with a harsh towel
    • Diabetes mellitus, which especially increases the likelihood of Candida albicans infection
    • Sexual partner suffering from vaginal thrush (in which case it’s the partner’s yeasts that cause the irritation rather than a sexually transmitted infection)Image result for factors of balanitis
    • Chemical irritants, e.g., lubricating jelly, medicated creams
    • Minor trauma – this may include friction during sexual intercourse
    • Obesity

Balanitis in young boys is usually associated with a tight foreskin that cannot be pulled back behind the glans (phimosis).

Phimosis leads to deficient hygiene and persistent contact of urine and smegma with the skin of the glans. Straightforward cases usually respond to antibiotic ointments but recurrent cases require investigation to exclude urinary tract infection.

Occasionally, irritation and swelling of the glans can be due to paraphimosis (‘Spanish collar’), caused when a tight foreskin is retracted down the shaft behind the glans.

The tightness around the shaft slows the venous drainage of the end of the penis, and the glans swells, which tightens the paraphimosis further, making the foreskin virtually impossible to retract.

Ultimately, the restriction can interfere with the blood supply to the glans and urgent medical treatment is required. Often the foreskin can be returned to its normal position under sedation, but, if not, circumcision is required.

 Diagnosis

Balanitis is usually diagnosed based on a brief physical examination. This may be conducted by your regular health care provider or by a urologist, the type of doctor who specializes in such disorders. The doctor may take a sample of the discharge (if any) to determine the nature of the possible infection. A urine test may be recommended to evaluate glucose (sugar) levels in the urine. Balanitis treatment is typically covered by medical insurance.

What investigations are needed?

  • Skin swabs for bacterial or fungal culture might be taken to confirm infection, particularly in cases that do not respond to a first-line antibiotic.
  • A urine sample might be sent for microscopy and culture if urinary tract infection (UTI) is suspected.
  • Patch testing might be required to confirm allergies.
  • A dermatologist or urologist might perform a biopsy if BXO or erythroplasia of Queyrat are suspected.
  • The urine or blood should be checked for diabetes.

Symptoms

The incubation period varies from 3 days to 1 week. The first signs of involvement may be small red erosions on the glans or undersurface of the prepuce, with concomitant development of much preputial exudation; the purulent discharge may be accompanied by phimosis. If the disease is unchecked, confluent ulcerations will develop along with considerable edema of the penis.

Redness of foreskin or penis

Other rashes on the head of the penisImage result for balanitis symptoms

Foul-smelling discharge

Painful penis and foreskin

Tenderness

Discharge from the penis

Impotence

Swelling

Difficulty with passing urine

Inability to retract the foreskin

Chronic inflammation or infection can:

  • Scar and narrow the opening of the penis (urethral stricture)
  • Make it difficult and painful to retract the foreskin to expose the tip of the penis (a condition called phimosis)
  • Make it difficult to reposition the foreskin over the head of the penis (a condition called paraphimosis); swelling can affect the blood supply to the tip of the penis

When to Contact a Medical Professional

Notify your health care provider if you are experiencing any signs of balanitis including swelling of the foreskin or pain.

Prevention

Good hygiene can prevent most cases of balanitis. During bathing, the foreskin should be retracted to adequately clean and dry the area beneath it.

Can it be Treated Successfully?

Yes if we can identify what is causing the problem.

  • Check for infection by taking swabs and examine the skin. Treatment (such as hydrocortisone) may be given if needed. Partners may also be advised to attend if the balanitis is thought to be due to sexual activity.
  • Care should be taken with hygiene. Hands should be washed before and after urinating.
  • Avoid scented soaps and cosmeticsImage result for balanitis treatment
  • Avoid biological powders/softeners for washing underwear.
  • Use condoms without spermicidal lubricants. Non-oxynol-9 is usually the major culprit. Sensitol is better. Check with your local clinic sexual health adviser on the more suitable brands available.

Why Balanitis Occurs

Balanitis is not sexually transmitted. It results from an overgrowth of organisms which are normally present on the skin of the glans. The condition most commonly occurs in men who have a foreskin (i.e. have not been circumcised). The environment under the foreskin is warm and moist, and these conditions often favour the growth of the organisms that cause balanitis.

These organisms are especially likely to multiply and cause inflammation if moisture is allowed to persist under the foreskin for a while. This may occur if you have not washed for a couple of days, or sometimes after sexual activity (vaginal, oral or anal – with or without a condom).

One common organism associated with balanitis is a yeast known as Candida albicans.  Balanitis may occur because of excessive growth of Candida, due to moisture and warmth under the foreskin.

Protective Effect of Circumcision

Herzog and Alvarez demonstrated that uncircumcised boys had approximately twice the risk of developing balanitis or irritation (irritation is itself a form of balanitis). A later study by Fergusson et al. confirmed this finding.

The protective effect may be greater in adulthood. In a cross-sectional study of 398 patients, Fakjian reported that balanitis occurred more than five times as often in uncircumcised men than in circumcised men. Another study by Mallon et al. provided supportive evidence for this.

Mycobacterium smegmatis has been implicated in the formation of Zoon’s balanitis

 Dissenting views

One study, suggested that circumcised boys were at greater risk of developing balanitis, though his study was limited by the small number of uncircumcised males in his sample (only 36 of the 468 in total were uncircumcised).

Table 1: Summary of comparative findings (studies with available data)

Blantitis circumcised% Blantitis, Uncircumcised% Relative risk for circumcised notes
2.3 12.5 0.2 398 adykts
2.9 5.9 0.5 545 children, 4months 12years
1.1 3.6 0.3 545 children, 4months 12years
7.6 14.4 0.5 1,265 children, 0-8 years
0.002 0 136,086 infants, < 1 month of age

Management of Balanitis

The aim of treatment is to keep the glans and foreskin clean and dry to make it difficult for organisms to grow under the foreskin. Medication (e.g. cream or ointment) is

rarely necessary, and is usually less effective than good hygiene measures.

Once a day, ideally when you have a shower, slide your foreskin back towards your body until the glans is completely uncovered (Figures 1a and 1b). Do not use any force. If there is any resistance or discomfort, check with a doctor.

Wash the end of your penis and foreskin thoroughly using warm water only. Alternatively, sorbolene and glycerine cream (available from chemists and supermarkets) may be used as a substitute for soap.

After washing, dry the end of the penis and foreskin thoroughly. If convenient, sit with the glans exposed to the air for 10 minutes. More thorough drying can be achieved by using a fan or hair dryer (Figure 2).

After drying, replace the foreskin (Figures 3a & 3b).

When you urinate, slide the foreskin back so that urine does not wet the foreskin (Figures 4a & 4b). After urination, dry the end of the penis and replace the foreskin.

If you are prone to develop balanitis a few hours after sex, wash the penis as described above shortly after having sex. Make sure the glans is completely dry before replacing the foreskin.

These measures should lead to a rapid improvement in symptoms and help prevent further episodes of balanitis.

If you experience repeated attacks of balanitis despite adequate foreskin hygiene, consult your doctor

Treatment

Treatment for Balanitis by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

BALANITIS XEROTICA OBLITERANS   

Balanitis xerotica obliterans is a chronic, sclerotic dermatitis involving the genital skin of men. When it occurs at sites other than the penis, it is called lichen sclerosus et atrophicus. Clinically, patients with balanitis xerotica obliterans develop discrete, angular, white, atrophic macules and patches on the glans, prepuce, and foreskin of the penis, with only rare involvement of the shaft. The prepuce is often thickened, and fissures and erosions appear over the glans. Because the atrophic sclerotic lesions can be quite sensitive to trauma, bullae, shallow erosions, and bleeding are sometimes observed. Phimosis, the inability to retract the foreskin over the corona of the penis, and paraphimosis, the inability to extend the foreskin over the glans, are potential sequelae. Balanitis xerotica obliterans is found most commonly in patients aged between 15 to 50 years who are uncircumcised or who had circumcisions later in life. It tends to progress slowly and insidiously for an extended period and can be accompanied by pruritus, tenderness, painful erections, dysesthesia, dysuria, and a reduction in the force of urine flow.

These symptoms can be quite troubling for a patient and often prompt his visit for medical attention. Despite considerable clinical transformation and damage, however, some patients can remain asymptomatic.

Although the cause of balanitis xerotica obliterans is unknown, autoimmune, hormonal, keratin, collagenase, elastase, and genetic factors are all implicated. Balanitis xerotica obliterans is diagnosed definitively by histologic evaluation of a cutaneous biopsy. Affected tissues display variable hyperkeratosis, parakeratosis, epidermal atrophy, liquefaction, degeneration of the basal layer, flattening of the rete pegs, homogenization of collagen in the dermis, and a sparse dermal mononuclear cell infiltrate.

Given the clinical appearance of balanitis xerotica obliterans, the differential diagnosis includes genital herpes, syphilis, fixed drug eruption, vitiligo, Reiter syndrome, squamous cell carcinoma, and erythroplasia of Queyrat. (Table 1)

Genital herpes simplex virus (HSV) infection is a sexually transmitted disease classically described as grouped vesicles on an erythematous base associated with HSV type 2.[2] Vesicles generally range from 2 to 4 mm and are distributed over the glans, prepuce, and shaft. Because the vesicles are fragile, patients infrequently come to their primary care provider with intact lesions; more commonly, the lesions consist of shallow erosions. Primary genital herpes is associated with a severe cutaneous eruption and fever and symptoms of headache, malaise, myalgias, and arthralgias. Recurrent genital herpes infections are generally less severe and might not produce systemic symptoms. A suspected diagnosis of genital herpes infection can be confirmed by the evaluation of a tissue scraping from the base of an erosion, a positive Tzanck smear with multinucleated giant cells, or a positive rapid fluorescent antibody test specific for herpes simplex.

Syphilis is a sexually transmitted disease caused by the spirochete, Treponema pallidum. Primary syphilis usually appears at the corona of the penis as a painless chancre consisting of a central ulcer with raised edges. These early lesions generally regress after several weeks. The resolving primary chancre looks like an atrophic macule or patch, mimicking balanitis xerotica obliterans. Syphilis is diagnosed by identifying the spirochete with dark-field microscopy or by serologic studies. Nonspecific serologic tests that use a nontreponemal antigen are the rapid protein reagin test and the VDRL test. As false-positive results occur (most commonly in collagen vascular disease), a specific treponemal antigen test (FTA-Abs) will confirm the diagnosis of syphilis.

A fixed drug eruption is a recurrent allergic reaction to an ingested substance. Both skin and mucous membranes can be involved. In order of frequency, the genitalia, face, and torso are most commonly involved. A bulla on an erythematous base or a painful erosion can be found during physical examination of active lesions.

As the acute phase of the fixed drug eruption resolves, discrete postinflammatory hyperpigmented macules are typically observed. Fixed drug eruption of the male genitalia is usually confined to the glans. Diagnosis is based on a careful history, in which the lesion reappears in the same location and is associated with ingestion of a drug. The more common medications implicated in fixed drug eruption are phenolphthalein (a laxative agent that has been removed from the US market), barbiturates, sulfonamides, tetracycline, ampicillin, and nonsteroidal anti-inflammatory medications.

Vitiligo is depigmentation of the skin resulting from the loss of melanocytes. Genital lesions tend to be located on the penile shaft and are not sclerotic, atrophic, or symptomatic. Diagnosis is often made on the basis of finding other hypopigmented lesions. Balanitis xerotica obliterans can also have extragenital involvement, however, and a complete history and physical examination are essential to find all areas of involvement. For patients with lighter skin tones, a Wood lamp (ultraviolet light) can be used to augment depigmented patches. Additionally, biopsy shows the absence of melanocytes without dermal sclerosis or loss of the rete pegs.

Reiter disease, found almost exclusively in men, is classically associated with the triad of arthritis, urethritis, and conjunctivitis. Cutaneous manifestations include circinate balanitis (sharply marginated erosions that can involve the glans, foreskin, shaft, and scrotum) and keratoderma blennorrhagicum (psoriatic-like pustular plaques often noted on the palms and soles). Systemic findings, such as fever and malaise, are common. Diagnosis of Reiter disease is predicated on a seronegative asymmetric arthropathy lasting more than 1 month and one or more of the following: urethritis, cervicitis, dysentery, inflammatory eye disease, or mucocutaneous disease. A complete history and physical examination are of paramount importance, as biopsy findings of Reiter disease are often indistinguishable from psoriasis. The development of Reiter disease is strongly associated with urogenital infections caused by a variety of agents in patients who are positive for human leukocyte antigen B27.

Squamous cell carcinoma of the penis and erythroplasia of Queyrat (squamous cell carcinoma in situ of the glans or prepuce) both must be kept in the forefront of any differential diagnosis of penile lesions because of the serious nature of the disease. Characteristically, squamous cell carcinoma appears as a velvety, red, sharply demarcated plaque. The clinical signs can be quite variable, however, and range from white macules to brown verrucous plaques.

Human papillomavirus has been implicated in invasive squamous cell carcinoma and, to an even greater degree, in squamous cell carcinoma in-situ.[6] Specifically, Papillomavirus type 16 is most closely associated with malignant transformation, and research suggests a role for human papillomavirus in the pathogenesis of squamous cell carcinoma. Definitive diagnosis is made by histologic evaluation of a cutaneous biopsy.

Causes

The etiology of male genital LS is unknown but is thought to be multifactorial. Several contributing factors are possible, as follows:

  • Circumcision after age 13 years/uncircumcised state

¨        This may very well be due to the effect known as the isomorphic, or Koebner, phenomenon. The large majority of inflammatory dermatoses of the male genitalia, including LS, occur in uncircumcised or late-circumcised men.

¨        The presence of a foreskin may promote chronic irritation or serve to maintain a friendly environment for an as-yet unidentified infectious agent. Such chronic irritation and subsequent inflammation may initiate the changes noted in LS.

  • Hormonal factors

¨        Hormonal influences in the development of LS have long been postulated, mainly in female vulvar LS.

¨        Most studies have concentrated on the role of testosterone in the pathogenesis of vulvar LS. Childhood vulvar LS frequently resolves with the onset of menarche and the related pubertal increase in testosterone production in genital skin; additionally, adults with LS have been found to have decreased serum levels of free testosterone, androstenedione, and dihydrotestosterone compared with control subjects.

¨        The underlying defect may be a problem with the function of the enzyme 5-alpha reductase.

  • Autoimmune Disease

¨        Various autoantibodies (including antinuclear, thyroid antimicrosomal, antigastric parietal cell, anti-adrenal cortex, antismooth muscle, and antimitochondrial antibodies) have been detected in patients with LS.

¨        Vitiligo, thyroid disease, diabetes, and alopecia areata have also been commonly reported in association with LS.

  • Genetic Factors

¨        LS (not necessarily genital LS) has been reported in families, including twins (identical and nonidentical), sisters, mothers and daughters, and a brother and sister.

¨        Note, however, that no consistent pattern of genetic inheritance has been identified.

  • Presence of human papillomaviruses

¨        The presence of human papillomaviruses (HPV) has been reported in some cases of childhood penile LS. Whether the LS is directly attributable to HPV infection, or if LS merely promotes HPV infection is unclear.

¨        Patients with penile LS alone have not been demonstrated to have a higher incidence of HPV infection.

  • Other: In a study of 18 patients9 with combined buccal mucosa grafting and genital skin flap reconstruction of extensive anterior urethral strictures, 16.7% of stricture cases were caused by BXO.

Complications

  • As the disease progresses, urinary retention may be sufficient to lead to retrograde damage to the posterior urethra, bladder, and kidneys.
  • As previously noted, painful erections in some cases of male genital LS may limit sexual function.
  • Malignancies have been reported to occur in penile lesions (rare). Common signs and symptoms of penile malignancy include nodule or tumor growth, ulceration, blistering, hematuria, erythema, pain, purulent discharge, bleeding, lymphadenopathy, and failure to respond to treatment for presumptive inflammatory or infectious balanitis. For this reason, close follow-up care is indicated in order to quickly diagnose any malignant changes.

Treatment

Treatment for Balanitis Xerotica Obliterans Problems by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

CIRCUMCISION

Removal of the foreskin, a flap of skin that covers the tip of the penis.

Parts of the Body Involved

  • Penis

Reasons for Procedure

In the US, the procedure is mostly done for cultural and/or religious reasons. It is usually performed on babies within the first few days of life. It may be done on older boys or men if there is a medical reason.

Certain health benefits are thought to be associated with circumcision. Many health professionals believe these benefits are slim. Circumcision may be associated with decreased risks of:

  • Urinary tract infection
  • Foreskin infection
  • Phimosis (tightening of the foreskin, which can be severe enough to close off the opening to the penis)
  • Penile cancer
  • Certain sexually transmitted diseases

Risk Factors for Complications During the Procedure

  • Infants with bleeding disorders
  • Infants with a family history of bleeding disorders
  • Infants whose mothers were taking blood thinners during pregnancy
  • Infants with penile deformities whose foreskin may be needed to repair the deformity
  • Premature infants
  • Infants with infections or serious jaundice at the time of the circumcision

What to Expect Prior to Procedure

  • The doctor will carefully examine the baby to make sure he is in good health and that the penis appears normal
  • Blood and/or urine tests may be performed
  • An anesthetic cream may be applied to the penis 60 to 90 minutes before the procedure to begin numbing the area
  • During the Procedure an injected anesthetic is also sometimes used
  • No medications or IV fluids are necessary during circumcision
  • A pacifier that has been dipped in a sugar solution may help keep the baby calm during the procedure Anesthesia
  • Research shows that the best method is a penile ring block.

Description of the Procedure

The baby is carefully restrained on an infant board or by a chosen individual. The anesthesia is injected. The penis is cleaned with an antiseptic solution.

The doctor pulls the foreskin away from the body of the penis while sweeping away any areas where tissue still adheres to the penis. Pressure is applied on blood vessels. The excess, unwanted foreskin is cut away. Rarely, stitches may be used to sew the remaining bit of foreskin into place on the skin of the penis.

The foreskin can be removed by a number of ways. Some use a simple scalpel to remove the foreskin. Others may use one of several devices to ensure an even circumcision and clamp blood vessels. These devices include the Gomco clamp, Plastibell device, or Mogen clamp. The Plastibell device is left in place instead of a bandage. It falls off on its own within 5 to 8 days. Petroleum jelly or antibiotic ointment is smeared generously on the penis and a bandage is sometimes applied.

After Procedure

No special medications are necessary after circumcision.

How Long Will It Take?

The procedure lasts 15 to 30 minutes.

Causes for circumcision

  • Neglect and Ignorance
  • Narrow or tight foreskin
  • Prevent easy infection
  • Tender skin and painful intercourse
  • Balanitis
  • Phimosis
  • Paraphimosis

Will It Hurt?

With appropriate anesthesia, the baby should feel only minimal pain.

Possible Complications

  • Infection
  • Bleeding
  • Anesthetic reactions
  • Unsatisfactory cosmetic outcome, due to removal of too little or too much foreskin, or uneven appearance
  • Meatitis and meatal stenosis (irritation or narrowing of the opening of the urethra)
  • Penile skin bridges
  • Decreased penile sensation
  • Loss of excessive penile skin
  • Buried penis
  • Need for further surgery
  • Scarring
  • Loss of sensation on the glans-penis
  • Loss of the sensitive terminal nerves in the foreskin
  • Causes early Impotence

Average Hospital Stay

There is no hospital stay associated with circumcision.

Postoperative Care

  • Change the bandage and clean the circumcised area at every diaper change
  • Apply petroleum jelly or an antibiotic ointment to prevent the diaper or the bandage from sticking to the penis

Outcome

There may be significant swelling of the penis and/or a clear scab over the area of circumcision. The penis should be healing well within 7-10 days of the circumcision. If a Plastibell device was left in place, it should fall off on its own within 10 days.

Call Your Doctor If Any of the Following Occurs

  • A bloodstain larger than the area of a quarter on the baby’s diaper
  • The Plastibell device has not fallen off within 10 days
  • The penis or the area of the incision appears red, swollen, hot to the touch, or is oozing a yellowish discharge
  • The baby develops a fever or appears to be in pain
  • The baby does not have a wet diaper within about 6 to 8 hours of the procedure
  • The head of the penis appears blue or black

Advantages of a fully Functional Foreskin.

At birth, every boy has the skin of his penis extending to cover the end of it, protecting his penis from abrasion and chemical attack. As the boy grows; this skin, although originally attached all the way ’round to the glans of his penis, comes free, so that by the time he is five or six years old, he is able to roll the skin back to expose the whole of his glans.  Never force this to happen!  The glans and neck area of his penis is very sensitive, as is the interior surface of his prepuce, (foreskin), with millions of touch sensitive nerves distributed throughout the whole foreskin.

Should the opening of the foreskin of an older boy be too small for the glans to be pulled back for cleaning, introduce him to our specific exercise for stretching the foreskin.  With the advent of antibiotic medicines, any medical reason for circumcision falls away. This topic is more fully discussed in our Member’s Area

Circumcision performed on the newborn baby boy traumatically interrupts the natural separation of the foreskin from the glans that normally occurs anywhere between birth and age 18. The raw, exposed glans penis heals in a process that measurably thickens the surface and results in desensitization of the head (glans) of the penis.

Even though the medical indications for circumcision have fallen away, except in cases where the flow of urine is totally restricted, circumcisions are still being carried out as a matter of course.  We, along with a growing number of concerned parents and others interested,  recommend that circumcision should be avoided except in life threatening situations.

Although there has been a call for further research study into the location and function of sensory receptors in the male genitalia, consultation of any uncircumcised male over the age of two years will confirm that life is a lot more fun with a foreskin than without!  In America, studies are in progress, evaluating the psychological effects of circumcision.

In order to decide whether a child’s foreskin should be ablated, the anatomy and function of the structure should be clearly understood. The supposed danger of conserving the child’s  foreskin must be balanced against the hazards of the operation, including the mortality rate and negative after effects, which must be known and considered, and which may include Hemorrhage (bleeding) – Serious hemorrhage occurs in about 2% of infants during the circumcision procedure, resulting in shock and sometimes death. While death is a rare complication of circumcision, it does occur.

Boys with unrecognized bleeding disorders are at risk for serious hemorrhage.  Not the least is the unsightly scar tissue and  mutilated aspect of the circumcised penis resulting from emergency  measures that are needed from time to time. None of the above, can in any way describe the screams of agony and anger of the child!

As the protective, mechanical and sensory roles of the foreskin become recognized and better understood, a growing number of circumcised men are becoming interested in the possibility of restoring their foreskin through a non-surgical process of skin expansion and skin development by means of simple self-applied methods.

Read more about the foreskin.

The foreskin has twelve known functions.

  1. To cover and bond with the synechia so as to permit the development of the mucosal surface of the glanspenis and inner foreskin.
  2. To protect the infant’s glans from feces and urine ammonia in diapers.
  3. To protect the glans from friction and abrasion for a lifetime.
  4. To keep the glans moisturized and soft with emollient oils.
  5. To lubricate the glans
  6. To coat the glans with a waxy protective substance.
  7. To provide sufficient skin to cover the erection by unfolding and stretching.
  8. To provide an aid to masturbation and foreplay.
  9. To serve as an aid to penetration.
  10. To reduce friction and chafing during intercourse.
  11. To serve as erogenous tissue because of its rich supply of erogenous receptors.
  12. To contact and stimulate the G-spot of the female partner.

Effects of penile reduction surgery (circumcision) on sexual intercourse

Although still pleasurable for the man, intercourse without the participation of the prepuce lacks the gliding mechanism. The only source of stimulation is the glans rubbing against the wall of the vagina. The sensations from the specialised receptors of the frenar band, frenulum and inner foreskin layer are missing.

“With intravaginal containment of the normal penis, the male’s mobile sheath is placed within the woman’s vaginal sheath. It is impossible to imagine a better mechanical arrangement for non-abrasive stimulation of the male and female genitalia than this slick ‘sheath within a sheath.’ Circumcision destroys this one sheath within a sheath . . . I would hazard a guess, that dyspareunia [painful intercourse] is more common in the women whose husband is circumcised . . . one would be foolish to discount the circumcised male’s immobile penile skin sheath as an ancillary item contributing to vaginal, abrasive discomfort . . . The male with a penis already moderately obtunded by circumcision may be less apt to use a condom, which he feels may further decrease his genital sensitivity . . . because most American males lack a facile prepuce, the period of foreplay and dalliance may be abbreviated in the rush to the intra-vaginal method of penile stimulation. Both these factors conceivably could be of significance in increasing the rate of venereal disease, including AIDS . .

The narrow or right foreskin

Do you suffer from Intertrigo?

Intertrigo is an inflammation of large skin surfaces that are in close contact. A common site is the groin, especially in babies, the elderly and the obese. The condition is also common in hot climates.

Symptoms 

  • An inflamed, unpleasant smelly skin area.

Causes

  • The skin becomes excessively moist due to sweating or incontinence (involuntary passing of urine)
  • Friction between the damp surfaces leads to infection.

Treatment in the home 

Bath often, dry yourself carefully and afterwards apply talc powder or our magnificent non-medicinal texture cream.

In certain cases, Intertrigo is caused by diabetes.

Prevention 

  • In general, bath often and dry yourself carefully.
  • If you are obese, try to reduce your mass.
  • If you suffer from incontinence, try our treatment and the texture cream should cure or prevent incontinence or infection, but good hygiene and regular care or exercise is required to prevent recurrence.
  • As always, further consult your urologist or physician if you have any sexual infections or diseases.
  • A strengthened Glans skin prevents painful intercourse and easy infection!

A Safe and Natural Alternative to Surgery and Medication.

Having experienced endless problems with a too short frenulum, narrow foreskin and over sensitivity of the glans penis that caused painful intercourse for many years a Urologist was visited to discuss circumcision. Circumcision was not recommended for a male over the age of 48, the suggestion was to snip the frenulum.

The frenulum was cut and there was good improvement, however the tight, narrow foreskin and over sensitivity remained.

The exercises and a good texture cream were applied to the glans penis and foreskin, the idea was to end sensitivity and strengthen the glans and prepuce skin. The final results were astonishing to say the least, the fore skin opened and the glans skin strengthened, the penis enlarged overall in length and thickness, the erection strength and flow of urine improved tremendously and premature ejaculation came to an abrupt halt.

GENITAL HERPES

Genital herpes is usually a sexually transmitted infection. Many people who are infected with this virus never have symptoms, but can still pass on the infection to others. If symptoms occur, they can range from a mild soreness to painful blisters on the genitals (vulva or penis) and surrounding area. A first episode of symptoms can last 2-3 weeks, but may be shorter. Recurrent episodes of symptoms then develop in some cases from time to time, but are usually less severe than the first episode. Antiviral medication can ease symptoms when they develop. Some people who have frequent recurrences of symptoms take antiviral medication each day to prevent symptoms from developing.

What is genital herpes?

Genital herpes is an infection of the genitals (penis in men, vulva and vagina in women) and surrounding area of skin. It is caused by the herpes simplex virus. The buttocks and anus may also be affected. There are two types of herpes simplex virus:

  • Type 1 herpes simplex virus is the usual cause of cold sores around the mouth. It also causes up to half of cases of genital herpes.
  • Type 2 herpes simplex virus usually only causes genital herpes. It can sometimes cause cold sores.

How do herpes simplex infections occur?

The herpes simplex virus is passed on by skin-to-skin contact. The virus can pass through the moist skin that lines the mouth, genitals, anus (and sometimes the eye). The skin of the rest of the body is less susceptible to herpes infection. Therefore, herpes simplex infection of other parts of the body is rare if the skin is not damaged or cut.

The first time you are infected is called the primary infection. This may, or may not, cause symptoms. Following a primary infection, the virus is not cleared from the body but lies inactive (dormant) in a nearby nerve. In some people the virus ‘activates’ from time to time, and travels down the nerve to the nearby skin. This causes recurrent symptoms of genital herpes if the primary infection was in the genitals, or recurrent cold sores if the primary infection was around the mouth.

The rest of this leaflet deals just with genital herpes. There is a separate leaflet that deals with herpes simplex infection around the mouth (‘cold sores’).

Genital Herpes Causes

Genital herpes is caused by the herpes simplex virus (HSV). There are two types: HSV-1 and HSV-2. Most genital herpes infections are caused by HSV-2. HSV-1 is the usual cause of what most people call “fever blisters” in and around the mouth and can be transmitted from person to person through kissing. Less often, HSV-1 can cause genital herpes infections through oral sexual contact. The genital sores caused by either virus look the same.

  • Genital herpes is spread by direct contact with an infected person. Sexual intercourse and oral sex are the most common methods of spreading genital herpes. Any type of skin-to-skin contact, however, is capable of spreading herpes.

Note: People with herpes may spread the disease even if they do not realize they have an infection. Furthermore, there is strong evidence that people with herpes can transmit infection even while their disease appears to be inactive and no sores can be seen.

  • Many people remember having an episode of genital herpes when it occurs. But as many as 90% of those infected fail to recognize the symptoms or have no symptoms at all. It is not clear whether these people never had an initial herpes outbreak or whether they never noticed a mild infection. They are contagious and may have additional outbreaks, nonetheless.

What are the symptoms of genital herpes?

  • A first episode of symptoms

At first you may feel generally unwell with a mild fever, and aches and pains. Groups of small, painful blisters then appear around your genitals and/or anus. They tend to erupt in crops over 1-2 weeks. The blisters turn to shallow, sore ulcers. The glands in your groin may swell and feel like lumps at the top of your legs. It is common to have pain when you pass urine, especially in women. A vaginal discharge may occur in women. The ulcers and blisters last up to 10-14 days, and then gradually heal and go without scarring.

Sometimes less typical symptoms occur. For example, you may just have a small raw area, one or two small ulcers, or just an area of irritation with nothing to see. Sometimes symptoms last just a few days.

  • Recurring episodes of symptoms

After the first episode, further episodes of symptoms occur in some cases from time to time. These are called ‘recurrences’. It is not clear why the dormant virus ‘erupts’ from time to time. Recurrences tend to be less severe and shorter than the first episode. It is more usual to have 3-5 days of symptoms with a recurrence, unlike the 2-3 weeks of symptoms that may occur during the first episode. A tingling or itch in your genital area for 12-24 hours may indicate a recurrence is starting. The time period between recurrences is variable.

Recurrences tend to become less frequent over time. In people who have recurrences, their frequency can vary greatly. Some people have six or more a year. For others it is less frequent than this. Many people do not have recurrences at all after a first episode of symptoms.

  • It is common not to get symptoms

Most people (about 4 in 5 infected people) never develop any symptoms when they are infected with the virus. (Or, they only have a short bout of very mild symptoms which is not recognized as genital herpes. For example, just a slight area of itch or a small red area which soon goes.) The virus stays inactive (dormant) in the root of a nerve that supplies the genitals, but never causes recurrent episodes of symptoms. However, even people who do not get symptoms may, on occasions, have virus in their genital area and therefore be infectious to their sexual partners.

Note: sometimes a first episode of symptoms appears months or years after being first infected. This is why a first episode of symptoms can occur during a current faithful sexual relationship. You may have been infected months or years ago from a previous sexual partner who did not realize that they were infected.

It is not clear why some infected people develop symptoms, some don’t, and some have a first episode of symptoms months or years after first being infected. It may be something to do with the way the immune system reacts to the virus in different people.

How Long Until Symptoms Appear?

Someone who has been exposed to genital herpes will notice genital itching and/or pain about 2 to 20 days after being infected with the virus. The sores usually appear within days afterward.

Who gets genital herpes?

Many people in the UK are infected with the herpes simplex virus in the genital area. However, about 4 in 5 infected people never have any symptoms, or only have one short bout of very mild symptoms which is not recognized as genital herpes. So, many people are not aware that they are infected.

However, if you are infected, you can still pass the virus on to others even if you have not had symptoms (see below). It is estimated that in at least half of people who develop genital herpes, the virus came from a a sexual partner who did not know that they were infected with the virus.

What are the possible complications of genital herpes?

In a small number of cases the infection spreads to other areas of skin on the body. Occasionally, the blisters become infected by bacteria (other germs) to cause a spreading skin infection.

In some cases, people have the wrong idea about herpes simplex. Usually, this will be due to wrong ideas about the infection, thinking it is far worse than it really is. Good counselling is thought to help in these cases.

Note: genital herpes does not damage the uterus (womb) or cause infertility. Nor does it cause cancer of the cervix.

Do I need any tests?

Yes. A blister can be swabbed by a doctor or nurse to obtain a small sample to send to the laboratory. This can confirm the infection is due to the herpes simplex virus. Tests to look for other infections may also be done at the same time.

Exams & Tests

Many doctors will start treatment based only on the appearance of the sores, if the sores seem typical of herpes. Doctors may also take a swab of the sore and send the swab to the laboratory to see if the virus is present. This test generally takes a few days.

What is the treatment for genital herpes?

Treatment for Genital Hherpes by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

HYPOSPADIAS

Hypospadias: A birth defect of the penis involving the urethra (the transport tube leading from the bladder to discharge urine outside the body). The urethra normally travels in the male through the full length of the penis so that the stream of urine comes from the urethral opening at the tip of the penis. However, in hypospadias the urethra does not go all the way through the penis but, instead, opens on the underside of the shaft of the penis or below the penis.

Hypospadias is relatively common, affecting approximately 1 in every 500 newborn boys. Hypospadias can occur as an isolated birth defect in an otherwise normal child or it can be part of a multiple malformation syndrome. There is no association between the mother’s use of loratadine (Claritin) in early pregnancy and the occurrence of hypospadias in her son.

In mild type (first-degree) hypospadias, the urethral opening is below the tip but still nearby (on what is called the glans). In moderate (second-degree) hypospadias, the urethra opens closer to the body on the underside of the shaft of the penis. In severe (third-degree) hypospadias, the urethal opening is below the penis on the skin and this is called a perineal hypospadias.

In a child with hypospadias, the urine comes from an opening that is on the underside of the penis or below the penis. With moderate-to-severe degrees of hypospadias, the boy will therefore usually sit to urinate. Some cases of first-degree hypospadias are so mild as to not require treatment.

If the hypospadias needs to be repaired, this is done by surgery. The aim is to repair and reconstruct the urethra. Depending on the degree of the hypospadias, the surgery can range from relatively simple to very challenging.

The opposite of hypospadias is epispadias, a less common birth defect in which the urethra opens prematurely on the upperside of the penis or above it.

What is Hypospadias?

Hypospadias refers to a urethral meatus (“pee-hole”) which is located along the underside, rather than at the tip of the penis. In minor, or distal hypospadias, the meatus may be located on the underside of the penis, in the glans. In more pronounced hypospadias, the urethra may be open from mid-shaft out to the glans, or the urethra may even be entirely absent, with the urine exiting the bladder behind the penis.

Distal Hypospadias

Penoscrotal Hypospadias 

Types of Hypospadias

There are different types of hypospadias.

  • The opening of the urethra (where the urine comes from) is not at the end of the penis but is somewhere else along the penis (see the diagram below).
  • The foreskin may be all at the back of the penis (“dorsal hood”) and may have none on the undersurface.
  • The penis may not be straight (has a bend in it and this is called a “chordee”)

There is not a Straight Stream of Urine  

What problems can hypospadias cause?

Problems are likely to occur if hypospadias is left untreated. The further back the opening of the urethra is, the more severe the problems are likely to be.

  • Passing urine is different to normal. A baby in nappies will have no problem. However, when older the urine stream may not be able to be directed forward into a urinal. When going to the toilet the urine is likely to ‘spray’ backwards. Sitting on a toilet may be needed to pass urine without mess.
  • Chordee which causes bending of the penis. This is more noticeable when the penis is erect. Sexual intercourse may be difficult or impossible in severe cases.
  • Psychological problems about being ‘different’ to normal are common.

How Common is Hypospadias & what Causes it?

About 1 in 400 boys are born with some degree of hypospadias. It seems to be getting more common.

The reason why the penis does not develop properly is not clear. The development of the penis whilst the baby is growing in the womb is partly dependent on the male sex hormones such as testosterone. The effects of testosterone on the growing penis may be blocked in some way. One study found that vegetarian mothers were five times more likely to have a son with hypospadias than meat eaters. The reason for this is not known. One theory is that chemicals such as fertilisers, pesticides, etc, that are more commonly eaten by vegetarians may have something to do with it.

Symptoms

In hypospadias, the opening of the urethra is located on the underside of the penis instead of at the tip. The severity of the condition varies. In most cases, the opening of the urethra is near the head of the penis. Less often, the opening is at midshaft or at the base of the penis. Rarely, the opening is in or beneath the scrotum.

Other signs and symptoms of may include:

    • Downward curve in the penis (chordee)
    • Hooded appearance of the penis because only the top half of the penis is covered by foreskin
    •  Abnormal spraying during urination

Are any Tests Needed?

The diagnosis is usually obvious from examining the penis. No other tests are routine.

A small number of people with severe hypospadias (when the urethral opening is at the base of the scrotum) may have other abnormalities of the genitals. The appearance of severe hypospadias may be part of a rare ‘intersex’ syndrome. Therefore, tests of the chromosomes and scans of the genitals may be made to determine if it is part of a wider syndrome. Note: these syndromes are rare and most boys with hypospadias are truly ‘male’ and have no other abnormalities.

How will Hypospadias affect my Child?

Hypospadias is essentially a cosmetic difference. A person with hypospadias may have to urinate sitting, rather than standing. He may also be prone to urinary tract infections.

More important is the emotional impact of having a penis that “looks different.” This is why your doctor may advocate surgery for your child’s hypospadias. Our discussions with men who have had hypospadias surgery lead us to believe that the physical damage and emotional trauma of genital surgery are frequently far worse than the hypospadias itself.

Hypospadias does not in itself cause infertility. Infertility may be present in the more extreme forms of hypospadias, where the testes are irregular and cannot produce viable sperm. Hypospadias surgery cannot make an infertile male fertile.

A hypospadic penis is entirely capable of pleasurable sexual sensation and orgasm. Plastic surgery on the genitals damages erotic sensation; it cannot improve it. There are some conditions however, which may require surgery to save your child from pain or illness, such as chordee which bends the penis causing painful erections, exposed mucous membrane, or adhesions.

Did I Cause it?

Hypospadias is not caused by any parental negligence. Because genital difference is so stigmatized in our culture, there are no good statistics, but hypospadias is quite common, probably occurring in one of two or three hundred births.

Does my Son Need Surgery?

Although surgeons usually counsel early surgery to repair the hypospadias, we have found that surgery is frequently very harmful, both physically and psychologically. Surgeons, of course, are trained in surgery; they are not experts in child psychological development or human sexuality.

Surgical Complications

Many complications can occur with hypospadias surgery. Unfortunately, it is usually performed on children before puberty, and few doctors do extensive follow up on their hypospadias patients. A young man who finds that his sexual function was irreversibly damaged by surgery during childhood is often

Natural vs. Surgically Constructed Urethra

The urethra, the tube which carries urine and semen out of the penis, is made of mucosal tissue, like the inside of your nose or mouth. This mucosal tissue is designed to resist both the irritating effect of urine, and the growth of bacteria, which would otherwise flourish in such a warm, wet, protected environment.

When surgeons use a flap of skin to construct or extend the urethra, the skin tube that results is poorly equipped to resist irritation from urine, or infection by bacteria. Further, the surgically created urethra is not as smooth as a real urethra, and may grow hair.

Urinary Tract Infections, Fistulae

Urine may collect in a surgically constructed urethra. Pressure during urination can force urine to escape into the body of the penis. These factors can result in pain and a life-long tendency toward urinary tract infections, which may involve the bladder and kidneys, and become quite serious. The surgical scar can break down, forming fistulae, or holes, in the urethra, resulting in pain and more surgery.

Hair in the Urethra

The penis heals poorly after surgery, because of its midline, distal location. Surgeons often resort to cortisone to promote healing. Unfortunately, cortisone can cause hair to grow in the skin which was used to build the urethra. This hair exacerbates the urinary tract infections that can plague boys and men who have had hypospadias surgery.

Scarring

Poor healing also leads to extensive scarring. The penis is an unfortunate part of the body on which to have thick, inflexible scars. More important than the appearance is the fact that scar tissue has little sensation, and is very stiff. Instead of a penis capable of exquisitely pleasurable sensation, many men who have had hypospadias surgery report that they have little or no sensation, or even that the stiff scar tissue causes them pain upon erection.

Local Infection, Sloughing

Skin which is transplanted to the penis from another part of the body, or penile or scrotal skin which is wrapped around to form a urethra, is at risk of infection or sloughing away. The result is often more pain, emotional trauma, and repeated invasive genital surgeries for the unfortunate boy.

Emotional Trauma

We have found that genital surgery performed on infants and children who are too young to understand the implications for their sexual future can be emotionally traumatic. The hidden message is that the child’s genitals, although not causing him any physical discomfort, made adults so uncomfortable that they had to be surgically “fixed” before he was old enough to have a say in the matter.

Counseling is Essential

We believe that your child will be best helped by minimizing genital surgery. No surgery should be performed unless it is absolutely necessary for his comfort and safety. Whatever you decide, we urge you to obtain help from a professional therapist with training in sexuality. Education and counseling for the whole family, including parents and siblings, will help you to help your son deal with his difference.

After puberty, when your son is sexually mature, and able to make responsible decisions for himself, he may wish to consider hypospadias repair surgery. He will be able to weigh for himself the inevitable trade-off of sexual feeling for a possible improvement in appearance. Furthermore, the surgical prospects are improved when working with a mature, full grown organ, after the dramatic size and shape changes of puberty are complete.

Understanding the Normal Penis & Urethra

The urethra is the tube that urine flows through out of the bladder. It passes through the penis. The opening of the urethra (meatus or ‘pee-hole’) is normally at the end of the penis, partly covered by the foreskin.

What is the Penis Like in Hypospadias?

The main problem is that the urethra opens on the underside of the penis instead of at the end of the penis. The opening can be anywhere from just below the normal position (mild) to as far back as the base of the scrotum (severe).

Hypospadias may also Include the following.

  • A hooded appearance of the foreskin. This is because the foreskin does not develop on the underside of the penis.
  • Tightening of the tissues on the underside of the penis (called ‘chordee’). This pulls the penis down and it cannot fully straighten. The further back the urethral opening is the more severe the chordee tends to be. Mild hypospadias may not have any chordee.

Treatment

Treatment for Hypospadias by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

PARAPHIMOSIS

Paraphimosis occurs when the fold of skin that covers the head (glans) of an uncircumcised penis (i.e., the foreskin) has been retracted and narrows below the glans, constricting the lymphatic drainage and causing the glans to swell. If not corrected, blood flow in the penis becomes impeded by the increasingly constricting band of foreskin, which causes further swelling of the glans. Because lack of oxygen from the reduced blood flow can cause tissue death (necrosis), paraphimosis is considered a medical emergency and requires immediate treatment.

What is paraphimosis?

Paraphimosis (say: “para-fim-oh-sus”) is a serious condition that can happen only in men and boys who haven’t been circumcised. Paraphimosis means the foreskin is stuck behind the head of the penis and can’t be pulled back down into a normal position.

What Causes Paraphimosis?

Uncircumcised men sometimes pull the foreskin back during sex, when they go to the bathroom or when they clean their penises. Doctors and nurses might pull the foreskin back when they examine the penis or put in a catheter.

Causes

Causes include the following:

  • Bacterial infection (e.g., balanoposthitis)
  • Catheterization (i.e., if the foreskin is not returned to its original position after a urethral catheter is inserted, the glans may become swollen, which can initiate paraphimosis)
  • Poor hygiene
  • Swelling-producing injury
  • Vigorous sexual intercourse

Sometimes you, a doctor or a nurse might forget to pull the foreskin back down. If the foreskin is left behind the head of the penis too long, your penis might swell so much that the foreskin is trapped behind it.

What can I do to Avoid Getting Paraphimosis?

  • After having sex, going to the bathroom or cleaning yourself, be sure to pull the foreskin back down to its natural position.
  • Never leave the foreskin behind the head of your penis for any longer than you need to.
  • If a catheter is put into your bladder, check afterward to be sure that the foreskin is covering the head of your penis.

What Happens if I Get Paraphimosis?

Paraphimosis usually causes pain in your penis, but not always. You might get an infection in your penis. You might not be able to go to the bathroom at all. If you can’t pull your foreskin over the head of your penis, you need to call your doctor right away.

The first thing your doctor will do is treat the swelling. This can be done by pressing your penis with a hand or by wrapping your penis in a tight bandage. After the swelling has gone away, your doctor should be able to pull the foreskin back down. If the foreskin remains stuck, your doctor might need to make a small cut in the trapped foreskin to loosen it.

Signs & Symptoms

Symptoms include the following:

  • Band of retracted foreskin tissue beneath the glans
  • Black tissue on the glans (indicates necrosis)
  • Inability to urinate (urinary retention)
  • Penile pain
  • Redness (erythema)
  • Swollen glans (the shaft of the penis is not swollen)
  • Tenderness

When the foreskin is retracted it usually slips back over the glans, or head of the penis, if the penis is not erect. Sometimes the foreskin remains retracted, restricting the flow of blood out from the glans. This causes swelling, and the ring of tissue that keeps the foreskin from slipping back over the glans tightens even more. If the foreskin is left in a retracted position long enough, the painful swelling known as paraphimosis can result.

Complications

Tissue death caused by loss of blood supply (gangrene) and spontaneous detachment of diseased tissue (autoamputation) of the glans are possible complications of paraphimosis.

Care

Sometimes the foreskin can be worked back into place manually. However, the doctor may need to make a slit in the foreskin to relieve the pressure. Removal of the foreskin (circumcision) is often recommended.

WHAT YOU SHOULD DO

  • If the doctor slits the foreskin, keep the dressing clean and dry and leave it in place until you return to the doctor.
  • Apply ice packs to the penis to reduce swelling.
  • You may take over-the-counter pain medicines such as aspirin, acetaminophen, or ibuprofen. You doctor may prescribe additional medication.
  • Do not try to pull back the foreskin until after your follow-up visit.
  • Avoid sexual intercourse for 7 to 10 days.
  • In uncircumcised babies, the foreskin is normally tight. It usually doesn’t start to loosen enough to be pulled back until the baby is at least 18 months old. Until then, leave the foreskin alone. Later, you may gently pull back the foreskin during bathing.

Call Your Doctor If…

  • The pain gets worse.
  • The foreskin stays swollen for 24 hours, or the swelling gets worse.
  • You have increasing redness, swelling, or drainage from the area. These are signs of infection.

Seek Care Immediately If…

  • You are unable to urinate.
  • You develop severe pain.
  • You have bleeding from the area that will not stop with gentle pressure.
  • You have a high temperature.

 Incidence & Prevalence

In the United States, paraphimosis occurs in about 1% of males over age 16. It can occur at any age but is most common during adolescence. Paraphimosis occurs in the elderly who need frequent catheterizations and those who have a history of poor hygiene or bacterial infections.

Risk Factors

Uncircumcised males are at risk. Piercing the penis increases the risk if the penile ring interferes with foreskin retraction or replacement over the glans, and if infection results from the piercing.

How to Bring it Back

What is Going on in the Body? 

You can probably bring your foreskin back yourself. The procedure is very like getting a tight ring off your finger. The essence of getting the glans back through the foreskin is not stretching the foreskin, but compressing the glans. Gently squeezing it and pushing it with your thumbs will press the blood back down the penis and make it smaller. It can then be pushed back through the narrowest part of your foreskin. A drop or two of something slippery like cooking oil or sexual lubricant on the glans may help.

If the patient is a child, the person reducing the paraphimosis by this method needs to know that the process will hurt, but only momentarily.

One good way to reduce the swelling is by covering the penis in ordinary (granulated) sugar. This draws the fluid out of the penis by osmosis (the old high school water-through-a-membrane trick).

If this fails, it is important to see a doctor. S/he can draw off the fluid with a hypodermic needle or, as a last resort, cut through the tight band.

Recently another method has been recommended, the “Dundeetechnique”. This involves pricking the swollen prepuce about 20 times (under anaesthetic) and letting the fluid escape.

The doctor may then recommend circumcision or try to order it, maybe telling you tales of necrosis, gangrene and autoamputation (“You penis will fall off!”) to scare you into it. Circumcision will remove any chance of this happening again. But if the doctor has put a slit in your foreskin, that is probably enough and it won’t happen again. Otherwise, it’s up to you whether you think you can trust yourself to act in time next time – as you did this time. You’re hardly likely not to notice that your foreskin is retracted. It also depends how much you value your foreskin.

The commonest cause of paraphimosis is iatrogenic (doctor-caused), when a catheter (drainage tube) is put in your penis and your foreskin is not brought forward again – probably because the doctor or nurse is unfamiliar with the normal foreskin. The catheter pushing out from inside and the foreskin constricting from outside combine to produce the paraphimosis. The catheter needs to be removed before the paraphimosis is reduced. No catheter, no paraphimosis, and no need for circumcision. The catheter can be put back, the foreskin pulled forwards and paraphimosis will not occur again.

Treatment

Treatment for Paraphimosis by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

PENILE & TESTICULAR CANCER

Penile Cancer is a disease in which malignant (cancer) cells form in the tissues of the penis.

The penis is a rod-shaped male reproductive organ that passes sperm and urine from the body. It contains two types of erectile tissue (spongy tissue with blood vessels that fill with blood to make an erection):

1         Corpora cavernosa: The two columns of erectile tissue that form most of the penis.

2         Corpus spongiosum: The single column of erectile tissue that forms a small portion of the penis. The corpus spongiosum surrounds the urethra (the tube through which urine and sperm pass from the body).

The erectile tissue is wrapped in connective tissue and covered with skin. The glans (head of the penis) is covered with loose skin called the foreskin.

Human papillomavirus infection may increase the risk of developing penile cancer.

Anything that increases your chance of getting a disease is called a risk factor.

Circumcision may help prevent infection with the human papillomavirus (HPV). A circumcision is an operation in which the doctor removes part or all of the foreskin from the penis. Many boys are circumcised shortly after birth. Men who were not circumcised at birth may have a higher risk of developing penile cancer.

Other risk factors for penile cancer include the following:

  • Being age 60 or older.
  • Having phimosis (a condition in which the foreskin of the penis cannot be pulled back over the glans).
  • Having poor personal hygiene.
  • Having many sexual partners.
  • Using tobacco products.

Penile Cancer

The penis contains several types of tissue, including skin, nerves, smooth muscle, and blood vessels. Running through the inside of the penis is a thin tube called the urethra. Urine and semen come out through the urethra. The head of the penis is called the glans. At birth, the glans is covered by a piece of skin called the foreskin, or prepuce. The foreskin is often removed in infant boys in an operation called circumcision.

Inside the penis are 3 chambers that contain a soft, spongy network of blood vessels. Two of these cylinder-shaped chambers, known as the corpora cavernosa, lie on either side of the upper part of the penis. The third lies below them and is known as the corpus spongiosum. This chamber widens at its end to form the glans. The corpus spongiosum surrounds the urethra, a tube that carries urine from the bladder through the penis. The opening at the end of the urethra is called the meatus.

When a man gets an erection, nerves signal to his body to store blood in the vessels inside the corpora cavernosa and corpus spongiosum. As the blood fills the chamber, the spongy tissue expands, causing the penis to elongate and stiffen. After ejaculation, the blood flows back into the body, and it becomes soft again.

Semen consists of fluid produced by 2 small sacs near the bladder and prostate (the seminal vesicles) and by the prostate gland. It contains sperm cells that were made in the testicles. This fluid is produced and stored in the seminal vesicles. During ejaculation, semen from the seminal vesicles passes into the urethra and out the tip of the penis.

Cancers of the Penis

Each of the tissues in the penis contains several types of cells. Different types of penile cancer (cancer of the penis) can develop in each kind of cell. The differences are important because they determine the seriousness of the cancer and the type of treatment needed.

Epidermoid carcinoma: Penile cancer develops in the skin of the penis. About 95% of penile cancers develop from flat skin cells called squamous cells. Penile tumors tend to grow slowly. If they are found at an early stage, these tumors can usually be cured. Squamous cell penile cancers can develop anywhere on the penis but most develop on the foreskin (in men who have not been circumcised) or on the glans.

Verrucous carcinoma is an uncommon form of squamous cell cancer that can occur on the male or female genitals, skin, mouth, larynx, and anus. Verrucous carcinoma of the genitals is sometimes also called a Buschke-Lowenstein tumor. It looks a lot like a benign (noncancerous) genital wart (see the section “Benign and Precancerous Conditions” for more information). These low-grade cancers can spread deeply into surrounding tissue, but they rarely spread to other parts of the body.

Adenocarcinoma, a very rare type of penile cancer, can develop from sweat glands in the skin of the penis. Paget disease of the penis is a condition in which adenocarcinoma cells are found in the penile skin. The cancer cells at first spread within the skin, but they may eventually invade underneath the skin and spread to lymph nodes. Paget disease can affect skin anywhere in the body but most often affects skin of the perianal area (tissues of or around the anus), vulva, and the breasts. (This condition should not be confused with Paget disease of the bone, an entirely different disease also named after Dr. James Paget.)

The earliest stage of squamous cell cancer of the penis (or any other organ) is called squamous cell carcinoma in situ (CIS). Penile CIS is contained entirely within the skin of the penis and has not yet spread to deeper tissues of the penis. Depending on the exact location of a CIS of the penis, doctors may give additional names to the disease. CIS of the glans is sometimes called erythroplasia of Queyrat. The same condition when found on the shaft of the penis (or skin of other parts of the body) is called Bowen disease.

Melanomas: About 2% of penile cancers develop from pigment-producing skin cells called melanocytes. Cancers of these cells are called melanoma. These cancers are more dangerous because they grow and spread more rapidly. Melanomas usually develop from sun-exposed areas of skin. Although sun exposure is an important risk factor for melanoma, a few of these cancers can develop on the penis or other areas not likely to become sunburned.

Basal cell penile cancer: Basal cell cancers represent less than 2% of penile cancers. They are slow-growing tumors that rarely spread to other parts of the body.

Sarcomas: The remaining 1% of penile cancers are sarcomas, cancers that develop from the blood vessels, smooth muscle, and other connective tissue cells of the penis.

Benign & Precancerous Conditions

Sometimes abnormal benign (not cancerous) growths develop on the penis. Some of these benign growths may eventually evolve into invasive cancer if they are not treated. These precancerous conditions can resemble warts or irritated patches of skin. Like penile cancer, they usually develop on the glans or on the foreskin, but they can also occur along the shaft of the penis.

Condylomas are wart-like growths that resemble tiny cauliflowers. Some are so small that they are apparent only when the skin is viewed under a magnifying lens. Others may be as large as an inch or more in diameter.

Squamous cell cancer of the penis usually forms slowly over many years, and it is usually preceded by precancerous changes that may last for several years. The medical term for this precancerous condition is penile intraepithelial neoplasia, or dysplasia. “Intraepithelial” means that the precancerous cells are confined to the epithelium (surface layer of the penile skin).

Testicular Cancer

Definition

Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis. The testicles produce male sex hormones and sperm for reproduction.

Compared with other types of cancer, testicular cancer is rare. But testicular cancer is the most common cancer in American males between the ages of 15 and 34. The cause of testicular cancer is unknown.

Testicular cancer is highly treatable, even when cancer has spread beyond the testicle.  Depending on the type and stage of testicular cancer, you may receive one of several treatments, or a combination. Regular testicular self-examinations can help identify growths early, when the chance for successful treatment of testicular cancer is highest.

Symptoms

  • Testicular cancer can result in a number of signs and symptoms. These may include:
  • A lump or enlargement in either testicle
  • A feeling of heaviness in the scrotum
  • A dull ache in the abdomen or groin
  • A sudden collection of fluid in the scrotum
  • Pain or discomfort in a testicle or the scrotum
  • Enlargement or tenderness of the breasts
  • Unexplained fatigue or a general feeling of not being well

Cancer usually affects only one testicle.

Causes

Nearly all testicular cancers begin in the germ cells — the cells in the testicles that produce immature sperm. What causes germ cells to become abnormal and develop into cancer isn’t known.

Risk Factors

Researchers don’t know what causes testicular cancer. Risk factors may include:

  • An undescended testicle (cryptorchidism). The testes form in the abdominal area during fetal development and usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than are other men are. The risk remains, even if the testicle has been surgically relocated to the scrotum. Still, the majority of men who develop testicular cancer don’t have a history of undescended testicles.
  • Abnormal testicle development. Conditions that cause testicles to develop abnormally, such as Klinefelter’s syndrome, may increase your risk of testicular cancer.
  • Family history. If other family members have had testicular cancer, you may have an increased risk.
  • Age. Testicular cancer affects teens and younger men, particularly those between ages 15 and 34. However, it can occur at any age.
  • Race. Testicular cancer is more common in white men than in black men. The reason for racial differences in the incidence of testicular cancer is unknown.

Prevention

Testicular self-examination

There’s no sure way to prevent testicular cancer. However, regularly self-examination may improve your chances of finding a tumor at its earliest stage. Beginning in your midteenage years, and continuing throughout your life, examine your testicles at least once a month.

A good time to examine your testicles is after a warm bath or shower. The heat from the water relaxes your scrotum, making it easier for you to find anything unusual.

To do this examination, follow these steps:

  • Stand in front of a mirror. Look for any swelling on the skin of the scrotum.
  • Examine each testicle with both hands. Place the index and middle fingers under the testicle while placing your thumbs on the top.
  • Gently roll the testicle between the thumbs and the fingers. Remember that the testicles are usually smooth, oval shaped and somewhat firm. It’s normal for one testicle to be slightly larger than the other. Also, the cord leading upward from the top of the testicle (epididymis) is a normal part of the scrotum. By regularly performing this exam, you will become more familiar with your testicles and aware of any changes that might be of concern.
  • If you find a lump, call your doctor as soon as possible. Testicular cancer is highly treatable, especially when identified early.
  • Your doctor should also examine your testicles whenever you have a physical. If you have an undescended testicle, be sure to tell your doctor, who may refer you to a urologist for treatment or a more specialized exam.

Treatment

Treatment for Penile & Testicular Cancer by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

PHIMOSIS

Phimosis is a medical condition in which the foreskin of the penis of an uncircumcised male cannot be fully retracted. Phimosis is usually referred as male problem, but can also happen to women: women suffer from clitoral phimosis (in this article we will discus phimosis in men only). Phimosis can occur at any age, but the highest incidence is seen in infancy and adolescence ( approximately 1% of males older than 16 years suffers from phimosis)

The term  phimosis denotes both physiological stage of development (it is not referred as disease), and a pathological condition, when phimosis can cause problems for a person. In most but not all infants phimosis is physiological rather than pathological, whereas phimosis in older children and adults is more often pathological than physiological.

In the literature the true definition of phimosis has been confused. Essentially, there are two entities, and they are based on age and pathophysiology: congenital or primary phimosis, and acquired or secondary phimosis (or secondary phimosis of a lichenoid or fibrous type).

Both terms denote the inability to retract the distal prepuce over the glans penis; however once the foreskin

can be retracted so that the glans penis partially appears, a phimosis is no longer present.

Phimosis is not a disease- phimosis is a condition. 

Primary or congenital phimosis is the condition when subject had phimosis ever since he can remember. Treatment in this case usually includes gentle stretching, since there is a reason to believe that gentle stretching will mobilise the elastic capacity of the skin tissue.

Secondary phimosis of a lichenoid or fibrous type is a phimosis, when subject can remember developing phimotic ring. In these cases such types of phimosis are prone to degeneration and are generally difficult to stretch. In some cases steroids may help, but recurrent problems require surgery.

There is one more term we have to define: paraphimosis. Paraphimosis is the entrapment of a retracted foreskin behind the coronal sulcus, and the condition occurs in the incorrectly circumcised or uncircumcised penis.

While primary and secondary phimosis denotes aggravated o impossible retraction of foreskin over the glans penis, typical of paraphimosis is edema, tenderness, and erythema of the glans or of the distal foreskin

Primary or congenital phimosis occurs on young children: infants and it is normal to have it into the  teenage years. Primary or congenital phimosis is physiologic, but does not cause any side problems, such as urinary obstruction, hematuria, or preputial pain. It is possible child suffers from congenital phimosis because of history of recent catheterization or of parents forcibly retracting the foreskin in an attempt to clean the glans.

Secondary or acquired phimosis also has several possibe causes: it most often occurs because of a history of poor hygiene, chronic balanoposthitis, but forceful retraction of a primary phimosis is also possible. Secondary or acquired phimosis is often followed by hematuria or preputial pain. Acquired phimosis is typical for both children and adults.

Secondary or acquired phimosis, caused by poor hygiene and/or chronic balanoposthitis can eventually lead to paraphimosis.

Typical of paraphimosis is pain and edema of the uncircumcised or improperly circumcised penis. Even vigorous sexual activity has been reported to predispose one to paraphimosis.

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Foreskin Contraction (phimosis)

How the Foreskin Develops in the First Couple of Years

The foreskin of a newborn boy is always closely contracted around the penis head (glans). Only a small passage allows the urine to pass through. In the first months the foreskin is stuck to the glans and cannot be pulled back and one should not attempt to do so.

During the first couple of years, the foreskin will become gradually looser and in many boys it can in time be pulled back without trouble. Half of all three-year-olds can pull back their foreskin.

It is not advisable to try pulling the foreskin back using force, since this may cause small cuts in the foreskin with scars which could finally cause a regular foreskin contraction.

Who Can Help?

A health visitor or GP will be able to give advice. If the foreskin is very contracted and stays so, causing recurrent infections and problems when urinating, then it may be necessary to operate.

Which Problems may follow Foreskin Contraction?

Foreskin contraction – also called phimosis – can last throughout life and not cause any trouble at all. It is a voluntary decision whether to have an operation or not. If any problems do arise they happen after puberty. The contraction may occur for the first time as an adult and usually requires an operation (circumcision).

  • There might be trouble urinating.
  • Infections may occur under the foreskin.
  • When infections are recurrent under the foreskin, a GP or health visitor should be consulted.
  • In many cases an infection can be avoided by cleaning regularly under the foreskin with lukewarm water.
  • At erection, a contracted foreskin may cause trouble by hurting when an attempt is made to pull the foreskin back. It may not go back over the glans before the penis is limp again.
  • Men may be able to have intercourse with a contracted foreskin but would probably manage better without this condition.
  • Very rarely, a malignant growth can occur in a long-standing foreskin contraction.

How is a Contracted Foreskin Treated?

Many boys can be treated with a cream that contains a weak corticosteroid.

  • A GP can provide this treatment. The tip of the penis should be treated with the cream two to three times a day for two to three weeks at a time.
  • The foreskin must be pulled as far back as possible without using force before the cream is put on.
  • If this treatment does not work, an operation can help.

The operation for phimosis is usually done under general anaesthesia without any serious problems. The doctors may try to retain the foreskin in the operation where often a small cut is enough to loosen it up sufficiently for it to be pulled back without trouble.

An actual circumcision where the foreskin is removed completely is more often required in adults where the foreskin is thickened and scarred.

Check your Symptoms

We want to make sure that you are definitely suffering from a tight foreskin and that the Homecure Program is going to be suitable for you.

Please compare yourself to the symptoms below to confirm that you suffer from tight foreskin/phimosis and to assess the severity of your symptoms:

Unable to completely pull back foreskin when flaccid and/or erect

Pain when pulling back or attempting to pull back foreskin when flaccid and/or erect

Foreskin dry, red, slightly swollen and/or tender

Foreskin is infected

If your symptoms are simliar or identical to those mentioned above not including the red then you will be able to cure yourself using the Homecure Program. The Homecure Program contains everything you need to know in order to cure yourself quickly, painlessly and discreetly from home. It is explained in great detail with annetations and photographs where appropriate. As customer satisfaction is our highest priority all customers receive free support via email for any questions that may arise and you are also protected by our 100% moneyback guarantee in the unlikely event you do not see results

What You Should Know?

If the foreskin of the penis is so tight that it can’t be pulled back, the condition is known as phimosis (fim-O-sis). It is seen most frequently in children.

Care

If the boy is unable to urinate, seek medical attention at once. The doctor may need to thread a tube (catheter) into the tip of the penis, through the urinary canal (urethra), and into the bladder to drain the urine. If the boy can urinate, he may not need treatment right away. The usual remedy is circumcision to remove the foreskin.

What You Should Do?

  • Do NOT use force to pull the foreskin back. This can cause scarring and make the condition worse. Clean under the foreskin regularly if possible.
  • In uncircumcised babies, the foreskin is normally tight. It usually doesn’t start to loosen enough to be pulled back until the baby is at least 18 months old. Until then, leave the foreskin alone. Later, you may gently pull back the foreskin during bathing.

Call Your Doctor If…

  • There is redness, swelling, or drainage from the foreskin. These are signs of infection.
  • The boy has pain when urinating.
  • The boy gets a high temperature.

Seek Care Immediately If…

  • The boy has not urinated in 24 hours.

Treatment of Phimosis

Some men accept the chronic irritation and the red, swollen foreskin. They sometimes complain of phimosis and visit the doctor only when there is pain or an odorous discharge.

Antibiotics may control the infection. Hot soaks may help separate the foreskin from the glans. If they fail, a small incision is made to release it. Circumcision is generally advised when the inflammation clears.

For some pliant, unscarred foreskins, a preputial stretch may be used. This can even be done under local anesthesia with, for example, EMLA cream. Some surgeons may perform a preputioplasty, with the aim of increasing the diameter of the preputial ring but without excising the prepuce (foreskin).

Circumcision is typically performed under general anesthesia. The foreskin is pulled back as far as it will go. It is slit along its upper surface and then all around so that it can be removed. The raw edges of the inner and outer layers are stitched, and a dressing is applied. The patient usually goes home the same day.

Immediately after circumcision, the patient may find that the appearance of the penis has changed considerably. Until healing is complete, there will be some pain but this can be controlled by painkillers. Urination may be painful and the urine should be kept away from the incision.

For some days, walking or any movement is discouraged that may cause penile contact with clothes or thighs while the previously very sensitive glans loses some of its sensitivity through constant exposure to air. At the end of that time, however, there should be no pain, the stitches should be healing, and interest in sex will have been re-established. While healing is taking place, there is very little risk of the stitches splitting or pulling out because of an erection. The good blood supply to the area also means the chance of infection is rare.

Although it is in generally- a common condition- not too many people have heard about the condition called phimosis. What exactly is phimosis? Well, it is defined as the inability of the prepuce, also called -the foreskin, to be retracted behind the glans penis. Of course- we are talking about uncircumcised males. What’s also interesting-a great majority of all males are born with congenital phimosis but this represents a benign condition that resolves in the great percentage of infants in their early childhood. It is also extremely important to point out that the phimosis in most infants is physiological rather than pathological, whereas phimosis in older children and adults is more often pathological than physiological. Although, it is mostly a condition that affects the males, women can also suffer from a similar condition called the clitoral phimosis. The most common symptoms are:

  • inability to retract foreskin
  • straining during urination
  • thin stream of urine
  • recurrent urinary infections

Good thing is that uncomplicated pathologic phimosis is usually acceptable to conservative medical treatment but patients should know that every failure of medical treatment is a secure indication for surgical intervention, usually in the traditional form of a circumcision or preputioplasty.

Relevant Anatomy

Everyone should know that the foreskin or prepuce is an integral, normal part of the penis. It normally forms an anatomical covering over the glans. It is interesting that the sensory receptors of the ridged band of the preputial mucosa may form part of the afferent limb of the ejaculatory reflex and that’s why it is important that all of these structures are fully functional. Like it was been told- the development of the prepuce is incomplete in the newborn male child. Separation from the glans and foreskin retractability occurs at a variable age.

Incidence of the Condition

Important thing to point out is that a commonly incidence statistic for pathological phimosis is 1% of uncircumcised males. Others have described incidences in adolescents and adults as high as 50%. Several researches done in the past have showed that only 4% of infants had a fully retractable foreskin at birth but that 90% did by age 3 years. This means that this condition could be, in certain occasions and age, considered to be physiological. Beside this, primary type- experts are saying that adult phimosis may also occur secondary to poor hygiene or an underlying medical condition.

Types of Phimosis & Possible Treatments

 
  1. Infantile or Congenital Phimosis

Like it was already mentioned- this infantile phimosis has been widely recognized by the general practitioners for most of the last century. It is extremely important to point out that this foreskin cannot be easily retracted. There are several approaches to this type of phimosis and the most famous one where foreskin is being repeatedly retracted to free it from the glans. If this isn’t being done- later in life, a boy could experience pathological phimosis and urinary problems. Poor hygiene was thought to predispose to pathological phimosis. Oppositely to this approach- there are some experts that claim that forceful retraction that results in inflammation may actually contribute to pathological phimosis at an older age.

Another approach is presented in some physicians is based on routine neonatal circumcision. How come? Well, the fact is that circumcision really does prevent phimosis, although by some incidence statistics, at least 10 to 20 infants must be circumcised to prevent each case of potential phimosis. Although, so far, this infantile phimosis is mentioned only as physiological, the thing is that this isn’t the only case because not all infantile phimosis is simply physiological. Possible causes of these, pathological congenital phimosis, are:

¨        balanitis (inflammation of the glans penis)

¨        preputial stenosis or narrowness that prevents retraction

¨        a condition called- Frenulum breve

There are several management approaches to infant phimosis and some of the most common are topical steroid ointments and several other surgical techniques.

  1. Acquired Phimosis

Reasonably- not all phimosis are the same! They can vary in severity, with some men able to retract their foreskin partially, condition called relative phimosis, and some completely unable to retract foreskin, condition called full phimosis. Of course- this first type- relative phimosis is more common, with estimates of its frequency at approximately 8% of uncircumcised men.  Exact medical graduation is next:

¨        Grade I – Fully retractable prepuce with stenotic ring in the shaft

¨        Grade II – Partial retractability with partial exposure of the glans

¨        Grade III – Partial retractability with exposure of the meatus only

¨        Grade IV – No retractability

Potential Complications of Acquired Phimosis

It is reasonable that acquired phimosis, if left untreated, can lead to several complications! Chronic complications of acquired (pathological phimosis) include: discomfort or pain during urination or sexual intercourse. How come? Well, it is simple- the urinary stream can be impeded, resulting in dribbling and wetness after urination. During sexual intercourse, or even during simple erection, patient could experience strong pain because of over-extension of the foreskin! Pain may occur when a partially retractable foreskin retracts during intercourse and chokes the glans penis. Although nothing of this is proven –the fact is that there is some evidence that phimosis may be a risk factor for penile cancer. Of course, all patients should know that the worst acute complication is paraphimosis. Paraphimosis is one acute condition characterized by the glans swollenness and strong pain. During this condition the foreskin is immobilized by the swelling in a partially retracted position. The contraction may occur for the first time as an adult and usually requires an operation (circumcision).

Review of possible complications:

  • There might be trouble urinating
  • Problems and pain during intercourse
  • Infections may occur under the foreskin
  • Frequent and recurrent infections under the foreskin which can be avoided by cleaning regularly under the foreskin with lukewarm water
  • At erection, a contracted foreskin may cause trouble by hurting when an attempt is made to pull the foreskin back
  • Although very rarely, there is a chance that a malignant growth can occur in a long-standing foreskin contraction.

Circumcision – Health Benefits 

Urinary Tract Infections

One of the most beneficial things about the circumcision is the fact that it has been promoted as a means of reducing the risk of urinary tract infections, which are more common in uncircumcised males younger than 6 months. Several researches have proven

that the risk in circumcised kids is approximately 1 in 1000, while the risk in uncircumcised kids is about 1 in 100.

Sexually Transmitted Diseases

Another very serious indication for circumcision is prevention of STDs. Although not too many people know about this- the fact is that a large number of case-control studies concerning the relationship between the foreskin and HIV infection have confirmed the present but not definite link. Another fact is that the United States has one of the highest rates of STDs, HIV infection, and male circumcision. Strange!

Penile Cancer

Timing of circumcision could also be amazingly important! Although it may sound impossible- the fact is that infant circumcision seems to decrease the risk of penile cancer, while the same thing but only -done later does not. Good thing is that penile cancer is a rare disease in the United States, with an incidence of 1.5 per 100,000 people. Direct proof of this the fact that the lowest incidence has been reported in Muslims and Jews and we all know that both of these groups have high rates of neonatal circumcision.

Diabetes Mellitus

Experts are claiming that this condition may be a presenting symptom of early diabetes mellitus. Where is the connection between these two conditions? Well, it is simple- when the residual urine of a patient with diabetes mellitus becomes trapped under the foreskin, the combination of a moist environment and glucose in the urine may lead to a proliferation of bacteria which can then progress to phimosis.

Circumcision & Sex

Experts today know that the presence of the foreskin actually enhances the sexual experience for men because it constantly moves over the head of the penis causing more friction and pleasure. Therefore, it is logical to assume that men will also lose much sensitivity to the glans if circumcised. Not only that- it is also proven that circumcised men will have to deal with discomfort and dry glans. The foreskin has many needed functions: protective, erogenous, sensory, and sexual physiologic.

Treatment

Treatment for Phimosis by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

PIMPLE-LIKE BUMPS ON PENIS AND TESTICLES

Everyone is familiar with pimples, condition that effects the oil glands of the skin. We are not worried if pimple occurs on our nose or cheeks, but what if pimple pops up on penis or testicle? Is that still normal? What to do then? Call a doctor or wait until the pimple subsides?

What are Pimples?

Pimple is actually a result of a blockage of the skin’s pore and it can happen anywhere on the body: face, back, legs, even genitals and elsewhere. Pimples is a common and frequent condition that effects the oil glands of the skin. Oil glands are found in every hair follicle and when they become clogged or inflamed, they can lead to pimples breakouts.

Are Pimples on Penis & Testicles Normal?

Yes and no. Some types of so-called pimples (bumps,…) are normal and represent very common condition, but in some cases those bumps can be dangerous and demand prompt medical attention.

Pimples on penis or testicles typically occur in teenage years, but it is also possible men will experience pimples at some time later in their life. Statistics claim that eight out of ten men will experience pimples on penis and/ or testicles at some time in their life. Most of the time penis and testicle pimples go away as person grows, or if they occur later in life, they subside in a matter of week or two. But

the fact is that if they don’t, it is not wise to sit at home miserable, hoping they will go away.

If you notice any new lumps or bumps,

Ask your doctor to check, or go to a genitourinary medicine clinic. I know it can be suffering, not to mention the psychological effect pimples on genitals can cause.

What Spots are Normal on Penis?

So called (and looking like) pimples are normal. They are pearly penile papules, small in size (approximately 1-2 mm) and they look just like pimples, but are not pimples. They are actually tinny glands, and you shouldn’t pick on them. They occur around the margin of the penis head, and can be seen when foreskin is pulled back. They usually develop in teenage years, but may occur up to the age of 40. They are visible in some men, while in others are less noticeable. Around 10% of men is affected by pearly penile papules.

After masturbation or sexual intercourse hard swelling might appear near the foreskin, in the shaft of the head of the penis. This swelling is called lymphocele, and is caused by temporary blockage of the lymphatic channels at the area described. This condition is also normal and goes away on its own without any after-effects.

What Spots on Penis are not Normal?

Ulcers

Ulcers. If ulcer develops, you must immediately visit your doctor. Ulcers appear as craters on the skin and represent a full-thickness loss of skin (epidermis). Typically of ulcer is crust, clear liquid (serum) or pus in the crater. Ulcers may occur due to genital herpes, infection, virus or may even be form of skin cancer.

Papules

Papules are small lumps (less than than 1 cm), raised above the skin surface. Most penile papules do not have a serious cause (pearly penile papules for example), but some are infectious and may lead to more serious conditions.

Types of Papules:

Molluscum contagiosum is form of papules, which is very common, but must be supervised by doctor. They are pinkish-white round lumps, each about 1–5 mm in diameter, and are caused by a virus.

Hair follicles are a normal and are usually found on the underside of penile shaft. They may be visible or only felt as small lumps in the skin. They are recognized by having a hair arising from them.Pearly penile papules (described above as very normal condition)

Fordyce spots are small (1-5mm) bright red or purple papules that can appear on the penis or testicles. They usually affect younger men, and appear in crops. They are painless and not itchy, but are embarrassing because of their appearance.

Genital warts are very common and are caused by a virus. In case of genital warts seek medical help.

Plaques

Plaques are raised, flat-topped lesions, greater than 1cm in diameter. Usually they do not have a serious cause, but some are infectious and others may develop into more serious conditions, such as Erythroplasia of Queyrat, lichen sclerosis and balanitis xerotica obliterans, which may lead to the development of penile cancer

Erythroplasia of Queyrat appears as a sharply demarcated bright red plaque with a velvety surface. Disease is not infectious, but needs prompt medical attention since it represents an early manifestation of penile cancer. Treatment usually involves excision of the affected area.

Lichen sclerosis looks like white plaques on the glans, foreskin or shaft of the penis. The severe form of lichen sclerosis is balanitis xerotica obliterans, and it occurs on the opening of the foreskin, which becomes white and firm. Both conditions may lead to penile cancer, but rarely. Medical care is necessary.

What Spots are Normal on Testicles?

Chicken-skin: it is normal that the skin on testicles looks similar to the skin of plucked chicken.

Sebaceous cysts: they are swollen, blocked grease glands that look like yellowish pimples. They occur  in dozens or more. If they become infected, they can be treated.

Angiokeratoma of Fordyce: tiny, bright-red blood-blisters; can be itchy, but are otherwise harmless.

What Spots are not Normal on Testicles?

Genital Warts

Varicoceles, which are caused by the swelling of veins; are more noticeable when standing. Approximately 15% men have this condition, and usually occurs on left side.

Lump(s) in the testicles, which usually isn’t visible, but can be felt through the skin. In most cases these lumps are armless cysts, but they may develop into testis cancer. Consult your doctor if you find a lump in your testicle.

In Conclusion

Men are understandably concerned when they notice spots on the penis. So, what is best to do in this case?

First of all- do not make the situation worse! For that reason do not try to squeeze anything! Squeezing might cause an additional inflammation, which can spread the bacteria that caused pimple, which leads to spreading pimples and possible scarring. Clean your skin several times daily with pH neutral soap, but do not exaggerate, since this could lead to other problems. If you suffer from swelling, apply ice pack, which should reduce swelling, redness and pain.

However, if you feel your condition isn’t just pimples, it is highly recommended to see doctor or dermatologist as soon as possible

Red Spots on the penis 

Men are understandably concerned when they notice spots on the penis. They are frequently worried they may have a sexually transmitted disease or some form of cancer. They may equally be worried about the appearance of their penis and what their sexual partner might think of it.

Are They Common?

Spots on the penis are very common and most do not have a serious cause. However, some do and it is important to seek prompt medical advice if you are concerned.

This article describes some of the causes of spots on the penis, but reading it and examining your own penis is no substitute for examination by a doctor!

What Should I Do?

Unless you think you have a sexually transmitted disease (STD), the first place to seek advice about spots on the penis is from your GP.

If you are too embarrassed to discuss it with your family doctor, or think you might have an STD, you can seek confidential advice from your local genito-urinary medicine (GUM) clinic. You don’t need a referral letter from your GP, but it is advisable to first telephone the clinic for more information.

In the UK, they are usually listed in the telephone directory under ‘Health Service’ or ‘Hospitals’.

Types of Spots

Spots on the penis can be divided into groups according to their appearance.

Ulcers: ulcers appear as craters on the skin and represent a full-thickness loss of skin (epidermis). There is frequently a crust, clear liquid (serum) or pus in the crater.

Papules: papules are small (less than 1cm diameter) lesions (lumps) raised above the skin surface.

Plaques: plaques are raised, flat-topped lesions, greater than 1cm in diameter.

Ulcers

Single penile ulcers frequently have a serious cause and it’s important to seek prompt medical advice.

Possible causes:

  • primary syphilis: a single, round, painless ulcer on the penis or scrotum is characteristic of the first attack of (or primary) syphilis. It is caused by a spirochaete (spiral-shaped) bacterium called Treponema pallidum. The diagnosis must be confirmed by laboratory tests. It is an infectious STD.
  • chancroid, granuloma inguinale, lymphogranuloma venereum: these are tropical diseases that cause a single, painless, foul-smelling ulcer. The diagnosis must be confirmed by laboratory tests. They should be suspected in men with a history of sexual contact in tropical areas. They are all infectious STDs.
  • penile cancer (squamous cell carcinoma): may appear as a painless, irregular genital ulcer. Early diagnosis and treatment is essential and may be life-saving.

Multiple penile ulcers are more common and may have a less serious cause. However, seeking prompt medical attention is still important. They can be divided into two groups: acute – present for less than two weeks – and chronic – present for more than two weeks.

Acute

  • Herpes simplex: this is the commonest cause of genital ulceration. It is caused by Herpesvirus hominis type two, or sometimes type one – the virus usually associated with oral herpes or cold sores. Herpes is characterised by recurrent bouts of genital vesicles, like small blisters, which rapidly break down to form small, painful ulcers. It is highly infectious and usually sexually transmitted. The first episode is usually associated with an acute feverish illness, which may be quite severe. The diagnosis must be confirmed by laboratory tests. Acute episodes can be effectively treated with antiviral medicines, such as aciclovir, although recurrences are common. Stress or other feverish illnesses may precipitate such recurrences.
  • Secondary syphilis: multiple irregular, shallow, painless grey ulcers, sometimes described as ‘serpiginous’, like a snail track on the penis, are characteristic of secondary syphilis. It is caused by a spirochaete bacterium called Treponema pallidum. A flu-like illness and a blotchy, red rash usually accompany it over the body. As with primary syphilis, the diagnosis must be confirmed by laboratory tests. It is an infectious STD.
  • Apthous ulcers: these are small, shallow, painful ulcers that most commonly appear in the mouth, but can also affect the penis. Typically, they have a grey centre surrounded by a bright red halo. They occur in crops and resolve without treatment. They can easily be confused with herpes simplex ulcers, so laboratory tests are necessary to reliably distinguish the two. They are not infectious and their cause is unknown.

Chronic

Pemphigus: this usually affects other parts of the body, frequently starting in the mouth, but may be restricted to the penis. It appears as fragile, thin-walled blisters that break down to form ulcers. These are often painful and may itch. There are a variety of different forms; the most severe type may affect the whole body and is life threatening. It is caused by a breakdown in the adhesion between different layers of the skin. Prompt diagnosis and treatment is essential.

  • Behçet’s disease: an inflammatory disorder affecting the skin, joints, nerves, eyes and other body systems.Symptoms may include large, deep and painful ulcers on the penis and scrotum, but is always accompanied by mouth ulcers. It is a potentially serious condition and prompt diagnosis and treatment is essential. It is not infectious.
  • Reiter’s syndrome: an inflammatory condition that occurs with generalised arthritis. About a quarter of affected men have small, ulcerated plaques around the glans and foreskin. It can also affect muscles, the eyes and nails. It is caused by an abnormal immune response to a gut or genital infection. It may follow a prolonged, relapsing course, but can be treated. Reiter’s syndrome is not itself infectious, but the germs that might cause it are. Some of them can be sexually transmitted.

Papules

Most penile papules do not have a serious cause, but some are infectious and may lead to more serious conditions. An early penile cancer may also appear as a papule before ulcerating. It is important to seek prompt medical advice about penile papules.

  • Molluscum contagiosum: a common, benign, infectious viral disease affecting the skin and mucous membranes. It is a common skin condition in childhood when it is transmitted through ordinary peer contact. In adults it may be sexually transmitted and this is probably the commonest cause of penile molluscum in adult men. It appears as multiple, small, dome-shaped papules, often with a central depression or plug. A curd-like discharge can be squeezed from them. It may disappear without treatment, but freezing or cautery will usually get rid of it. Molluscum contagiosum is a marker for ‘unsafe’ sexual practices in adulthood and those affected should be screened for HIV
  • Hair follicles and sebaceous (sweat) glands: these are a normal part of the skin’s anatomy and are commonly found on the penile shaft, particularly on the ventral surface (underside). They may be visible as small nodules or might only be felt as small lumps in the skin. They will have a hair arising from them that reveals their true nature. They are quite normal.
  • Pearly penile papules: multiple, small (about 1-3mm) papules running around the circumference of the crown of the glans penis. They typically develop in men aged 20 to 40, and around 10 per cent of all men are affected. They may be mistaken for warts, are not infectious and require no treatment.
  • Fordyce spots: small (1-5mm) bright red or purple papules that can appear on the glans, shaft or scrotum and usually affect younger men. They may occur as a solitary lesion, but frequently appear in crops of 50 to 100. They are painless and not itchy, but may cause embarrassment because of their appearance, or a fear that they might be sexually transmitted. They are abnormally dilated blood vessels, covered by thickened skin. They may bleed if injured or even during intercourse. They are not infectious and their cause is unknown. Although a number of approaches have been tried, there is no simple, reliable treatment to remove them. Troublesome bleeding spots can be sealed with a device that uses a small electric current (electrocautery).
  • Psoriasis: most commonly affects other parts of the body, particularly the knees, elbows and scalp, but occasionally first appears on the penis, usually on the glans or inner surface of the foreskin. Psoriasis appears as thickened red papules or plaques with a well-defined edge. In uncircumcised men, and at other sites, it has a scaly surface. It rarely causes irritation. It is caused by an abnormality of skin production and can be inherited. It is unsightly, but rarely serious. There are a number of effective treatments available, such as steroid creams and calcipotriol cream (Dovonex).
  • Warts: a number of different types of wart may appear on the penis. Genital warts are caused by human papilloma virus (HPV) and are infectious. They may be single or multiple, skin-coloured, pink or brown, with a moist surface. HPV infection is associated with the development of cervical and anal cancer, so it is important that sexual partners are screened for evidence of infection. They can be treated in a variety of ways, from skin paints to cautery, but are sometimes very difficult to eradicate.

Plaques

Penile plaques do not usually have a serious cause, but some are infectious and others may develop into more serious conditions: Erythroplasia of Queyrat, lichen sclerosis and balanitis xerotica obliterans may lead to the development of penile cancer.Make sure you seek prompt medical advice about penile plaques.

  • Balanitis and posthitis: balanitis is an inflammatory condition of the glans penis. Posthitis is an inflammatory condition of the foreskin. Symptoms include local irritation, burning and a red rash. Sometimes the skin appears to be peeling off as if scalded. Bacteria and yeasts such as candida can cause it. It is more common in older men and those with diabetes. Balanitis is infectious and may be sexually transmitted. It can be treated with appropriate antimicrobial creams.
  • Erythroplasia of Queyrat: appears as a sharply demarcated bright red plaque with a velvety surface. It is usually painless, and not itchy. It is an early manifestation of penile cancer and needs prompt diagnosis and treatment. Excision of the affected area is usually curative. It is not infectious.
  • Zoon’s plasma cell balanitis: Zoon’s balanitis appears as a bright red, shiny-surfaced plaque on the glans or inner surface of the foreskin. It is usually painless but may be accompanied by itching. The cause is unknown. It may respond to application of steroid cream, but frequently recurs. Circumcision is curative, but not essential. It is a harmless condition but can be confused with the much more serious condition of Erythroplasia of Queyrat. It is not infectious.
  • Lichen sclerosis and balanitis xerotica obliterans: lichen sclerosis appears as white plaques on the glans, foreskin or shaft of the penis. It usually has no symptoms, although burning and irritation have been reported. Balanitis xerotica obliterans is a severe form of lichen sclerosis affecting the foreskin of uncircumcised men. The opening or edge of the foreskin is firm and has a white scarred appearance. It is quite inelastic and will not pucker open as it is retracted. This may interfere with passing urine or sex. Both conditions may, rarely, lead to penile cancer and circumcision may be necessary. They are not infectious.
  • Psoriasis: See Above, Under Papules.

Eczema: most commonly affects other parts of the body, but occasionally it may first appear on the penis. In such cases, it may be a skin reaction to an irritant that is better be described as dermatitis. Eczema appears as diffuse red plaques with a poorly defined edge and finely scaled surface. It frequently causes quite severe irritation. It can be caused by infection or local reaction to skin injury from chemicals or radiation. There are a number of effective treatments available, such as steroid creams. It is not infectious.

Treatment

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PRIAPISM

Priapism is a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction.

Definition

Priapism is a condition characterized by a sustained, persistent, frequently painful erection. It’s not associated with sexual stimulation or desire.

In normal sexual functioning, an erection occurs when your penis fills with blood, and it subsides upon orgasm as excess blood leaves your penis. But with priapism, this blood doesn’t drain from the penile shaft upon orgasm.

Priapism can occur at any age, although it’s most prevalent in boys between ages 5 and 10 years old, and men from ages 20 to 50 years. An uncommon condition, priapism is usually an emergency that needs immediate medical attention. Delaying treatment can result in permanent scarring of your penis, interfering with the ability to achieve a normal erection. However, when treated promptly, priapism has no lasting negative effects.

The word “priapism” is derived from Latin mythology, and specifically from Priapus, the name of a male fertility god.

It can occur in all age groups, including newborns. However, it usually affects men between the ages of 5 to 10 years and 20 to 50 years.

There are two categories of priapism: low-flow and high-flow.

Low flow: This type of priapism is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but also affects men with sickle-cell disease, leukemia (cancer of the blood) or malaria.

High flow: High flow priapism is more rare than low-flow and usually less painful. It is the result of a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus), which prevents blood in the penis from circulating normally.

What Causes Priapism?

Causes

The cause of priapism is a malfunctioning of the blood vessels and nerves, in which blood becomes trapped in, and thus cannot drain from the tissues of the penis that are associated with erections.

Use or misuse of certain drugs may lead to priapism. Most people can use these medications with an extremely low risk of priapism. However, in certain people, signs and symptoms can begin within weeks to months after starting these medications. These drugs include:

Oral medications used to manage erectile dysfunction, such as sildenafil (Viagra) and vardenafil (Levitra)

Drugs injected directly into the penis to treat erectile dysfunction, such as papaverine

Antidepressants, such as trazodone (Desyrel)

Anti-anxiety medications, such as diazepam (Valium)

Blood thinners, such as heparin and warfarin (Coumadin)

Blood pressure lowering medications    

Other Causes of Priapism Include

Trauma or injury to your genitals, groin or spinal cord

Blood clots

Leukemia

Inflammation of the tube through which urine flows out of your body (urethra)

A tumor located in your pelvis

Abuse of alcohol, cocaine or marijuana

Sickle cell anemia, an inherited disease characterized by a deficiency in healthy red blood cells, and which can interfere with blood flowing out of an erect penis

Fabry’s disease, a metabolic disorder in which fats are not properly broken down in your digestive system

Carbon monoxide poisoning

Black widow spider bites

In Some Cases, Doctors are Unable to Find a Specific Cause for Priapism.

Doctors divide priapism into two subtypes:

Ischemic (or low-flow) priapism. In this type, blood flow out of the penis is impaired or obstructed, often in otherwise healthy people. This form accounts for about 90 percent of cases of priapism.

Nonischemic (or high-flow) priapism. This less common type tends to be less painful or pain-free. It’s most often associated with a ruptured artery due to trauma and injury to the penis or to the area between the scrotum and the anus (perineum).

Symptoms

Priapism causes abnormally persistent erections. The signs and symptoms may include:

An erection lasting at least four to six hours

An erection not associated with sexual desire, or that continues even after sexual stimulation or orgasm ends

A painful erection

A firm penile shaft, but a soft tip of the penis

Some cases of priapism can cause “stuttering” — intermittent symptoms lasting for several minutes to as long as three hours, and then resolving on their own. In people with stuttering priapism, painful erections can occur repeatedly.

How is Priapism Diagnosed?

If you experience priapism, it is important that you seek medical care immediately. Tell your doctor:

The length of time you have had the erection

How long your erection usually lasts

Any medication or drugs, legal or illegal, which you have used. Be honest with your doctor, illegal drug use is particularly relevant since both marijuana and cocaine have been linked to priapism.

Whether or not priapism followed trauma to that area of the body.

Your doctor will review your medical history and perform a thorough physical examination to determine the cause of priapism. This will include checking the rectum and the abdomen for evidence of unusual growths or abnormalities that may indicate the presence of cancer.

After the physical exam is complete, the doctor will take a blood-gas measurement of the blood from the penis. During this test, a small needle is placed in the penis, some of the blood is drawn and then it is sent to a lab for analysis. This provides a clue as to how long the condition has been present and how much damage has occurred.

Tests & Diagnosis

Your doctor will begin the diagnostic process by taking a medical history, asking questions such as:

How long have you had an erection?

How does this compare with how long your erections normally last?

Have you had previous episodes of lengthy erections?

Have you recently experienced an injury or trauma to the groin or nearby areas of the body?

Are you feeling pain? Ischemic priapism is a painful condition, while nonischemic priapism is more likely not to cause pain.

What medications or drugs are you taking — prescription, over-the-counter or illegal?

Do you consume alcohol?

Next, your doctor will conduct a physical examination, looking for evidence of trauma or inflammation of the urethra. Your doctor will examine your abdomen, perineum and genitals, and check for signs of tumors that could be related to priapism.

Your doctor may also recommend or perform the following tests to help make the diagnosis:

Blood gas measurement

In this test, a tiny needle is inserted into your penis to remove a small sample of blood, which is sent to the laboratory. The lab analysis can provide information that may help your doctor determine the extent of any damage to your penis, how long priapism has existed, and whether it’s ischemic or nonischemic.

Blood tests. These tests, providing a complete blood count and platelet count, can help detect acute infections that might be causing symptoms, or blood abnormalities such as sickle cell disease.

Ultrasound. You may undergo a color duplex ultrasonography, which is a non-radiation medical imaging procedure using sound waves. Or, your doctor may have you undergo a penile angiogram, which involves injecting dye into the vessels of your penis to improve the quality of imaging. This test can be used to evaluate blood flow within your penis. Ultrasound can differentiate between ischemic and nonischemic priapism, as well as detect any other abnormalities in your penis that could suggest another medical condition.

Risk factors

Boys and men with sickle cell anemia have an increased risk of developing priapism. Trauma — in the area of the genitals, perineum and pelvis — is another risk factor.

Complications

When erections continue for an extended time (more than four hours), the blood trapped within the penis starts to thicken due to loss of oxygen. This can injure the penile tissue, which can lead to lasting problems in achieving erections. With ischemic priapism, for example, the incidence of erectile dysfunction can be as high as 50 percent when the condition has persisted for four or more hours.

Prevention

If you’ve experienced one or more episodes of priapism, you may be able to avoid further incidents by staying away from triggering factors such as certain medications, drugs or alcohol.

As a preventive measure, doctors sometimes prescribe the drugs pseudoephedrine and terbutaline (Brethine) for people who have had episodes of stuttering priapism. You can take these medications orally or self-inject them in the earliest stages of an abnormal erection. A number of other medications may be effective in preventing priapism, including hormonal drugs and the muscle relaxant baclofen (Lioresal).

Proper treatment of sickle cell disease, including the use of the drug hydroxyurea (Hydrea), may help prevent priapism.

Progression

Low flow priapism begins with the development of a painful persistent erection, with stimulation or sexual desire. The penis will remain erect and at sigificant risk of permanent damage, unless the patient seeks medical aid to restore normal blood flow to the penis. With adequate therapy, the patient will retain his erectile function. If therapy remains inadequate or is provided too late, the patient may suffer permanent damage and long-term impotence.

Probable Outcomes

The prognosis of low-flow priapism depends largely on the time taken to restore normal blood flow to the penis. If treatment is initiated early and is successful, the patient will retain normal erectile function and appearance. If treatment is delayed or unsuccessful, the patient may suffer irreversible penile damage and loss of erectile function.

The prognosis of high-flow priapism is generally good, for the blood supply to the penis is not compromised, only deranged. The penis is not at risk of major damage, and thus many physicians prefer to treat this condition is a “wait-and-see” manner, with the condition settling by itself in many cases.

Predisposing Factors

The most common cause of priapism are drus used in the treatment of erectile dysfunction or impotence. Those drugs which are directly injected into the penis place the patient at most risk of this condition. About 25% of cases are associated with co-existing medical conditions such as:

  1. Advanced cancer,
  2. Leukaemia and
  3. Sickle cell anaemia and other haemoglobin disorders

4.Treatment for erectile dysfunction (particularly penile injections)

  1. Use of anti-coagulant and some psychiatric medications
  2. Fabry’s disease

Other cases may be related to recent trauma, but the majority of patients have not predisposing factors, occurring spontaneously

Treatment

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THE ANATOMY OF THE PENIS

What Makes up the Anatomy of the Penis?

The male penis is a complex structure of tissues that fill up with blood when the penis is sexually aroused. Besides sexual functions, the penis is also an important part of the “drainage system” of the male body.

What is the anatomy of the penis like? You must heard or read of the corpa cavernosa, of testes & testicles and even od vas deferens . But what do they do?

Find out in this article for on the penis anatomy for a fascinating journey

Penis Anatomy and Glossary

To understand how penis enlargement works, it is helpful to know how the penis is made up, how it works and so on.

There are two main chambers to the penis that make up the corpora cavernosa. These chambers get filled with blood during arousal, and the tissues become engorged. The expansion of these chambers puts pressure on the tunica albuginea and the blood is trapped in the corpora cavernosa, hence the penis becomes erect. This is how erection happens.

The corpus spongiosum also fills with blood, but to a lesser extent compared to the corpora cavernosa. This is to protect the fine tissues of the urethra, and to permit ejaculation.

The capacity of the corpora cavernosa is crucial in determining the size of an erect penis. The erect penis can only become as large as the chambers itself. Most penis enlargement methods (other than surgery) hope to increase the capacity of these chambers so as to allow more blood into the penis during an erection.

Corona:

The ‘crown,’ a ridge of flesh demarcating where the head of the penis and the shaft join.

Corpa Cavernosa:

The corpora cavernosa are the two spongy bodies of erectile tissue on either side of the penis. These become engorged with blood from arteries in the penis during arousal, thus causing an erection.

Corpus Spongiosum: 

  • The spongy tissue surrounding the urethra. This tissue expands to protect the urethra when filled with blood but not as much as the corpora cavernosa.

Cowper’s Glands:

The Cowper’s glands secrete a small amount of pre-ejaculate fluid prior to orgasm. The functon of this fluid it to neutralize the acidity within the urethra itself.

Dorsal Side:

  •  The top or upper side of the penis.

Ejaculatory Ducts: 

  • The path through the seminal glands which semen travels during an orgasm.

Epididymis:   

The ‘holding pen’ where sperm produced by the seminiferous tubules mature. The sperm are held here until ejaculation or nocturnal emissions (wet dreams) happens.

Foreskin, Prepuce:

A roll of skin which covers the head of the penis in uncircumsized men.

Frenulum, Frenum:

A thin strip of flesh on the underside of the penis that connects the shaft to the head.

Glans:  

The glans is the head of the penis. The glans in uncircumcised men is usually covered by the foreskin. The glans is highly sensitive, as is the corona, the ridge of flesh that connects the glans to the shaft of the penis.

Head: Also known as the glans, this is the bulbous tip of the penis.

Meatus:  

The opening at the tip of the penis to allow the passage of both urine and semen.

Perineum: 

The area between the scrotum and anus.

Prostate Gland:   

This gland produces a fluid that makes up the semen. The prostate gland also shuts the urethral duct to the bladder in order to prevent urine from mixing with the semen and disturbing the pH balance required by sperm.

Pubococcygeus Muscle:

Also known as the PC or pelvic floor muscle. Necessary to control urination and ejaculation.

Raphe: 

Visible ridge running from the meatus to the perineum across the scrotum. Is formed during fetus development and gender assignation.

Scrotum: 

The scrotum is a sac that hangs behind and below the penis. Commonly called the balls. It contains the testes, the male sexual glands. The scrotum’s main role is to maintain the testes at approximately 34 C . This is the temperature in which the testes can most effectively produce sperm.

Semen:   

The fluid produced during ejaculation. Made up of 2-5% sperm. The main bulk of semen is seminal plasma, with large concentrations of Zinc, and amines that protect the sperm from the acidic environment of the vagina.

Seminal Vesicles:

The seminal vesicles produce semen, a fluid that activates and protects the sperm after it has left the penis during ejaculation.

Shaft:

The main length of the penis made up of the corpora cavernosa, corpus spongisum, urethra, cavernosal artery and dorsal vein and artery.

Smegma:      

A substance with the texture of cheese made up from oils secreted by glands on each side of the frenulum, combined with skin cells, and moisture. This usually only occurs in uncircumcised men.

Testes, testicles

The male sexual glands, the two testes within the scrotum produce sperm and testosterone. Within each testis is a kilometer of ducts called the seminiferous tubules, the organs which generate sperm. Each testicle produces nearly 150 million sperm every 24 hours.

Urethra:  

Passageway of the penis, carrying urine from the bladder and semen from the testes to the tip of the penis.

Vas Deferens:

The ducts leading from the epididymis to the seminal vesicles. These are the ducts that are cut during the procedure known as vasectomy.

Human Penis Size

The general rule with respects to male penis size is that it is usually proportional to the size of the body. Results typically vary across study, usually a result of participant bias. Studies have shown that the average penis size ranges between 5 to 5.5 inches erect.

Variations of Penis Size

While there have been studies on the size of the penis at erect length, there have been very few pertaining to flaccid size. This typically varies amongst men however the most recent study noted a flaccid length of approximately 3 inches.

Penile Stimulation

The most important components of the physical erogenous stimulation of the penis during foreplay and intercourse are the sensations from the foreskin, frenulum/frenar band, and glans. These structures each have their own feeling, and each contributes in its own way to the man’s total experience of lovemaking. It must be emphasized that emotional excitement is an extremely important component of sexual enjoyment, and intensifies the man’s perception of any physical sensations from his penis.

The foreskin has an inner and outer layer. The outer foreskin layer contains nerve endings which respond to gentle touching during the early stages of sexual arousal. This helps to trigger an erection. The nerves of the inner and outer foreskin contribute to the experience of penile stimulation, up to and including orgasm. These receptors are stimulated by stretching, or when the foreskin rolls over the surface of the glans during intercourse or masturbation. (see `the gliding mechanism,’ below).

The foreskin contains sensory receptors called Meissner corpuscles. We believe that these nerves, similar to nerve endings in the fingertips, are there to provide pleasure, as well as fine sensory perception. This seems to help a man to enjoy sex longer without ejaculating prematurely, because he can more easily tell when he is approaching the threshold of orgasm.

Stimulation of the frenulum and ridged band results in intense pleasurable feelings during arousal. The ridged band consists of a number of “ridges”, described by Dr. John Taylor in his recent article. Sensations from these structures during intercourse or masturbation are thought to be the primary trigger of orgasm in the intact male. Dr. George Denniston writes:

The ridged bands, which are like horseshoes only in that they curve forward underneath toward the point where the frenulum attaches, can be found in several pictures in John’s paper. There are some 20 concentric ridged bands which rub over the corona. Each ridge has Meissner’s corpuscles, which respond to pressure, and they produce the sexual pleasure which no individual has a right to take away from another individual.

We believe that stimulation of the glans is most significant in the later stages of sexual intercourse, when penetration is deepest and emotions are running at their highest. Sensations from the glans contribute to the quality of the sensual experience. They are also apparently capable of triggering orgasm on their own, as would be the case in a circumcised man.

Circumcised adult penis

The Circumcised Penis: Erect State

Following circumcision, the foreskin of the penis has been cut away. The surface of the glans has developed a thick, dry layer of keratin (toughened skin), which makes it less sensitive to unwanted stimulation, but also less sensitive to the more subtle qualities of lovemaking.

All circumcised men have an annular scar on the shaft of the penis. The location of the scar varies, from near the head to far down the shaft. For some men, so much skin has been removed that erection becomes difficult and even painful. This was one of the most common complaints reported by circumcised men in a recent poll.

The Gliding Mechanism

During intercourse the loose skin of the intact penis slides up and down the shaft of the penis, stimulating the glans and the sensitive erogenous receptors of the foreskin itself. On the outstroke the glans is partially or completely engulfed by the foreskin. This is known as the `gliding mechanism.’

The gliding mechanism is Nature’s intended mechanism of intercourse. As such, it contributes greatly to sexual pleasure. Also, since more of the loose skin of the penis remains inside the vagina, the woman’s natural lubrication is not drawn out to evaporate to a great extent, which makes sex easier without using artificial lubricants.

The prepuce is a highly innervated and vascularized genital structure. It is entirely lined with the peripenic muscle sheet. Specialized ecoptic sebaceous glans on the inner preputial surface produce natural emollients and lubricants necessary for normal sexual function. The primary orgasmic triggers are found in the preputial orifice and frenulum. When unfolded, the prepuce is large enough to cover the length and circumference of the erect penis and acts as a natural sheath through which the shaft glides during coitus. Only the presence and functions of the prepuce allow for physiologically normal coitus to occur as designed by nature.

PUS IN SEMEN 

Pus cells in semen may be due to infection into genito-urinary tract due to any of the following causes:

1.) Chlamydia infection

Chlamydia is a  common infection of genitourinary tract all over world. It’s a bacterial infection. The infection with bacteria decreases sperm count motility & fertilizing capacity of sperms. Complication of this can be epididymitis, and inflammation in the scrotum that may leave the man sterile.

Chlamydia is the most common diagnosed STI and the number of new cases keeps rising. Young men and women aged 16 to 24 are most at risk although people of all ages can be affected.

Chlamydia is a sexually transmitted infection caused by a bacterium.

Chlamydia can be transmitted through oral and anal sex. It’s such a widespread disease that it is often known as the silent epidemic.

Chlamydia is the most commonly reported infectious disease and although curable is considered one of the most dangerous sexually transmitted diseases among men because of the far-reaching complications it can cause.

The reason chlamydia is so widespread and dangerous is because it often goes unrecognised and therefore is left untreated. Around 50% of men with chlamydia have no symptoms of the disease once infected. If left untreated it can cause infertility.

It is for this reason that regular testing is encouraged among sexually active men, particularly those under the age of 24. Statistics show that the most vulnerable and highest reported number of cases are men between the ages of 16 and 24.

Who is at risk?

Everyone who is sexually active, or who have been sexually active but has not been screened for chlamydia. Also, if you’ve had multiple sexual partners and fail to use contraception (condoms and dams) 100% of the time.

Chlamydia Prevention

You can get and spread chlamydia through unprotected oral and anal sex. This means you should approach sexual relationships or encounters responsibly, limit the number of sex partners, always use condoms or dams, and if you think you are or may be infected, avoid any sexual contact until you have been given the all-clear by your doctor or local GU/STI clinic. You also need to make sure your partner is treated to avoid the risk of re-infection.

Where can Chlamydia develop?

Chlamydia in men can initially develop in several areas of the body:

Urethra

Throat

Mouth

Rectum

Chlamydia Symptoms

Not everyone will experience every symptom outlined below, but some of you may experience one or more of the following (symptoms of chlamydia in men):

Pain, burning or stinging during urination

Pain or tenderness in the testicles

Clear, or slightly coloured discharge from the urethra

Unusual itching, particularly around the opening of the end of the penis

In rare instances, chlamydia can infect the area in and around the rectum, producing inflammation and the production of a clear, sticky discharge from the rectum and, through not always, pain when going to the toilet.

Complications of Chlamydia Infections in Men

Sterility

Fertility problems

Epididymitis – this is inflammation of the epididymis, the tube that carries sperm from the testicle. It can occur in one or both tubes and can result in extensive, very painful swelling

Reiter’s Syndrome, an autoimmune condition where the joints are affected by arthritis

Chlamydia Test

It is a very straightforward test which can be carried out either by your GP or at a GU/STI clinic. A swab from the urethra or throat should be sufficient to identify whether you are infected or a simple urine sample.

2) Gonorrhea (Gonococcal Urethritis)

Also called the “clap” or “drip,” gonorrhea is a contagious disease transmitted most often through sexual contact with an infected person. Gonorrhea may also be spread by contact with infected bodily fluids, so that a mother could pass on the infection to her newborn during childbirth. Both men and women can get gonorrhea. The infection is easily spread and occurs most often in people who have many sex partners.

What Causes Gonorrhea?

Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in mucus membranes of the body. Gonorrhea bacteria can grow in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb) and fallopian tubes (egg canals) in women, and in the urethra (the tube that carries urine from the bladder to outside the body) in women and men. The bacteria can also grow in the mouth, throat, and anus.

How Common is Gonorrhea?

Gonorrhea is a very common infectious disease. In the U.S. each year, about 700,000 people are infected with gonorrhea, and about 75% of all reported gonorrhea is found in younger persons aged 15 to 29. The highest rates of infection are usually found in 15- to 19-year-old women and 20- to 24-year-old men.

How do I Know if I Have Gonorrhea?

Not all people infected with gonorrhea have symptoms, so knowing when to seek treatment can be tricky. When symptoms do occur, they are often within 2-10 days after exposure, but can take up to 30 days and include the following:

Gonorrhea Symptoms in Women

  • Greenish yellow or whitish discharge from the vagina
  • Lower abdominal or pelvic pain
  • Burning when urinating
  • Conjunctivitis (red, itchy eyes)
  • Bleeding between periods
  • Spotting after intercourse
  • Swelling of the vulva (vulvitis)
  • Burning in the throat (due to oral sex)
  • Swollen glands in the throat (due to oral sex)
  • In some women symptoms are so mild that they escape unnoticed.

Many women with gonorrhea discharge think they have a yeast infection and self-treat with yeast infection medications purchased over-the-counter. Because vaginal discharge can be a sign of a number of different problems, it is best to always seek the advice of a doctor to ensure proper diagnosis and treatment.

Gonorrhea Symptoms in Men

  • Greenish yellow or whitish discharge from the penis
  • Burning when urinating
  • Burning in the throat (due to oral sex)
  • Painful or swollen testicles
  • Swollen glands in the throat (due to oral sex)
  • In men, symptoms usually appear 2-14 days after infection.

How is Gonorrhea Diagnosed?

Your doctor will use a swab to take a sample of fluid from the urethra in men or from the cervix in women. The specimen will then be sent to a laboratory to be analyzed. You also may be given a throat or anal culture to see if the infection is in your throat or anus. There are other tests which check a urine sample for the presence of the bacteria. You may need to wait for several days for your tests to come back from the lab.

Gonorrhea and chlamydia, another common sexually transmitted disease, often occur together, so you may be tested and treated for both.

How is Gonorrhea Treated?

To cure the infection, your doctor will give you either an oral or injectable antibiotic. Your partner should also be treated at the same time to prevent reinfection and further spread of the disease.

It is important to take all of your antibiotics even if you feel better. Also, never take someone else’s medication to treat your illness. By doing so, you may make the infection more difficult to treat. In addition,

Tell anyone you have had sex with recently that you are infected. This is important because gonorrhea may have no symptoms. Women, especially, may not have symptoms and may not seek testing or treatment unless alerted by their sex partners.

Don’t have sex until you have completed taking all of your medicine.

Always use condoms when having sex.

What Happens If I Don’t Get My Gonorrhea Treated?

Untreated gonorrhea can cause serious and permanent problems in both women and men.

In women, if left untreated, the infection can cause pelvic inflammatory disease, which may damage the fallopian tubes (the tubes connecting the ovaries to the uterus) or even lead to infertility, and untreated gonorrhea infection could increase the risk of ectopic pregnancy (when the fertilized egg implants and develops outside the uterus), a dangerous condition for both the mother and baby.

In men, gonorrhea can cause epididymitis, a painful condition of the testicles that can sometimes lead to infertility if left untreated. Without prompt treatment, gonorrhea can also affect the prostate and can lead to scarring inside the urethra, making urination difficult.

Gonorrhea can spread to the blood or joints. This condition can be life-threatening. Also, people with gonorrhea can more easily contract HIV, the virus that causes AIDS. People with HIV infection and gonorrhea are more likely than people with HIV infection alone to transmit HIV to someone else.

How Does Gonorrhea Affect Pregnancy & Childbirth?

Gonorrhea in a pregnant woman can cause premature delivery or spontaneous abortion. The infected mother may give the infection to her infant as the baby passes through the birth canal during delivery. This can cause blindness, joint infection, or a life-threatening blood infection in the baby. Treatment of gonorrhea as soon as it is detected in pregnant women will lessen the risk of these complications. Pregnant women should consult a doctor for appropriate medications.

How Can I Prevent Infection?

To reduce your risk of infection:

Use condoms correctly every time you have sex.

Limit the number of sex partners, and do not go back and forth between partners.

Practice sexual abstinence, or limit sexual contact to one uninfected partner.

If you think you are infected, avoid sexual contact and see a doctor.

Any genital symptoms such as discharge or burning during urination or an unusual sore or rash should be a signal to stop having sex and to consult a doctor immediately. If you are told you have gonorrhea or any other STD and receive treatment, you should notify all of your recent sex partners so that they can see a doctor and be treated.

3) Non-Specific urethritis or NSU (Non-gonococcal Urethritis)

It is caused by any of the following causative agent Chlamydia trachomatis, Ureaplasma urelyticum, Mycoplasma genitalium ,Candioda species, Anaerobes, Trichomonas vaginalis,, Unidentified / idiopathic. Some times it may be Persistent/recurrent non-gonococcal urethritis or Prolonged urethritis.

What is NGU?

Nongonococcal urethritis (NGU) is sometimes called nonspecific urethritis (NSU). It is an infection of the urethra (the tube leading from the urinary bladder to outside the body). The symptoms of NGU are similar to gonorrhea, but the usual treatments for gonorrhea will not work.

What causes NGU?

NGU is caused by a bacterium called Chlamydia trachomatis. There are several other bacteria—including Ureaplasma urealyticum, Mycoplasma and Trichomonas—that can cause symptoms resembling those of NGU.

How does NGU spread?

NGU is a sexually transmitted disease (STD). It is passed from one person to another by unprotected sexual contact. It can be spread through vaginal sex, oral sex or anal sex.

What are the symptoms of NGU?

It usually takes one to three weeks after the infection occurs before a man develops any symptoms of NGU. The first symptom is usually a leakage of milky fluid (discharge) from the tip of the penis. The amount of discharge may vary from a little to quite a lot. There also may be mild burning of the penis during urination. If the symptoms are ignored, the discharge may decrease although the infection is still present. Sometimes there are no symptoms. If left untreated, the infection may move up around the testicles, causing pain, swelling and sterility. The infection also may spread to other parts of the body, causing severe illness.

How can I know if I have NGU?

If you think you have NGU, or any STD, contact your health care provider. He or she will examine you and perform tests, if necessary, to determine if you have an STD. A sample of fluid is taken from the penis and tested for the germs that cause gonorrhea and chlamydia. Notably, 20% of men with gonorrhea are co-infected with Chlamydia. Testing for HIV and other STDS should also be done in confirmed cases of NGU.

What should I do after being treated?

Make sure you take all of the medicine you have been given. Do not stop taking the medicine, even if your symptoms go away. Do not share your medicine with others.

Do not have sex until you have taken all of the medicine and you are sure that the discharge is gone.

Men can check themselves for discharge by gently squeezing the penis. The best time to do this is when you get up in the morning before you urinate. Clear fluid from the penis is normal. A discharge that looks like milk or pus means that you still have an infection. Don’t check for discharge more than once a day. Squeezing the penis more often may cause irritation and discharge even when there is not an infection.

Avoid reinfection by always using condoms for vaginal, oral and anal sex.

Contact all of the people with whom you have had sex during the last three months and advise them to get treated. Remember that there are other causes of NGU besides chlamydia. Even if your partner has a negative chlamydia test, he or she may still have given you the infection.

If the discharge doesn’t go away, or if it goes away and then comes back, return to your health care provider for further treatment.

Syphilis

What is syphilis? 

Syphilis is a sexually transmitted disease (STD) or sexually transmitted infection (STI) that, when left untreated, can progress to a late stage that causes serious health problems. The infection alternates with periods of being active and inactive (latent). When the infection is active, symptoms occur. But when the infection is latent, no symptoms appear even though you still have syphilis.

Anyone who comes into close physical contact with a person who has syphilis can develop syphilis. You don’t have to have sexual intercourse to get syphilis-exposure can result from close contact with an infected person’s genitals, mouth, or rectum.

What causes syphilis?

Syphilis is caused by a type of bacterium (Treponema pallidum) that usually enters the body through the mucous membranes. An infected person can pass the disease to others (is contagious) whenever a sore or a rash is present.

What are the symptoms?

Symptoms of syphilis may not be noticed or may mimic those of many other diseases. This may cause an infected person to delay seeking medical care and can make diagnosis difficult.

The four stages of syphilis have different symptoms.

Primary stage: During this stage of syphilis, a painless open sore called a chancre (pronounced “shanker”) develops. Because syphilis is usually passed from person to person through sexual activities, chancres are often found in the genital area, anus, or mouth, but they may also be found wherever the bacteria entered the body.

Secondary stage: A skin rash and other symptoms occur during the secondary stage, which begins 4 to 10 weeks after the initial infection. Secondary syphilis is highly contagious through direct contact with the mucous membranes or other surfaces affected by the skin rash.

Latent stage: This stage is often called the hidden stage of syphilis because usually no symptoms are present. The latent stage is defined as the year after a person becomes infected. A person in early latent stage may be contagious. Many times, latent-stage syphilis is detected in a mother only after she gives birth to a child infected with syphilis (congenital syphilis).

Late (tertiary) stage: If syphilis is not detected and treated in the early stages, problems can develop because of damage caused by having the syphilis bacteria in the body for so many years. These may include heart disorders, mental disorders, blindness, other problems associated with the nervous system, and even death.

How is syphilis diagnosed?

The first steps in diagnosing syphilis are discussing the history of your symptoms and sexual activities with a health professional and having a physical exam. The diagnosis of syphilis is usually confirmed with one of several blood tests.

How is it treated?

If detected and treated, syphilis can be cured with antibiotics. If not treated, syphilis may linger and may progress to the late stage where more serious health problems, such as blindness, heart disorders, mental disorders, nervous system problems, and even death, can occur.

What does the presence of  pus cells in the semen signify ?

Whether pus cells are present or not. While a few white blood cells in the semen is normal, many pus cells suggests the presence of seminal infection. Unfortunately, many labs cannot differentiate between sperm precursor cells ( which are normally found in the semen) and pus cells. This often means that men are overtreated with antibiotics for a “sperm  infection” which does not really exist

Some labs use a computer to do the semen analysis. This is called CASA, or computer assisted semen analysis. While it may appear to be more reliable (because the test has been done “objectively” by a computer), there are still many controversies about its real value, since many of the technical details have not been standardised, and vary from lab to lab.

Anti-Sperm Antibody

In some male’s, antibody production starts against its own sperms. These antisperm antibodies may then enter the testis & seminal fluid and ‘attack’ the sperms & sperm forming cells. These antisperm antibodies stick the sperms with each other and thus tend to seriously reduce sperm motility, thereby causing infertility. By the use of various treatments, the amount of antibodies may be reduced and fertility restored.

Antisperm antibodies have been found to be present in up to 40% of couples with unexplained infertility, and in 10% of unexplained male infertility. Infertility in a couple can occur if the woman’s cervical mucus provides a hostile environment by producing antibodies to her partner’s sperm. More often, the problem is due to the male partner producing antibodies against his own sperm. Unilateral or bilateral obstruction of the genital tract (either congenital or acquired), epididymitis and varicocele are also sometimes associated with an autoimmune response against spermatozoa.

What are Antisperm Antibodies?

Antisperm antibodies are one immune factor which could be involved in infertility. Antisperm antibodies are cells that fight against normal, healthy sperm. If you have antisperm antibodies, instead of seeing sperm as natural cells, your immune system fights against your sperm and destroys them. This prevents you from producing any viable sperm. Though still to be proven, there is evidence that antibodies against sperm can result in male infertility.

How Do Antisperm Antibodies Affect Fertility?

Antisperm antibodies can really impair the function of healthy sperm. These antibodies attach to your sperm, reducing motility and making it more difficult for sperm to pass through cervical mucus. Antisperm antibodies can also force sperm to clump together, making it difficult for your sperm to fertilize an egg.

Testing for Antisperm Antibodies

There are a variety of tests that can detect the presence of antisperm antibodies in the body:

Blood Tests: In women, blood tests are commonly used to detect the antibody.

Post-Coital Test: The post-coital test can detect the presence of antisperm antibodies in a woman’s cervical mucus.

Sperm Testing: In men, sperm testing is the best way to analyze for antisperm antibodies. The immunobead assay and the mixed agglutination reaction test are both used.

Treating Antisperm Antibodies?

There are a variety of treatments available to help couples struggling with antisperm antibodies to conceive.

Corticosteroids: Corticosteroids help to decrease the production of antisperm antibodies. Unfortunately, corticosteroids are associated with side effects, including hipbone damage.

Intrauterine Insemination(IUI): IUI can help couples to overcome antisperm antibodies as it allows sperm to bypass the cervical mucus. Fertility drugs can also be used.

In-Vitro Fertilization(IVF): IVF is the most successful treatment for couples with antisperm antibodies. This allows the sperm to be directly injected into the egg, without havng to travel throguh the uterus and fallopian tubes.

Less Semen Formation 

Low Semen Levels

A reduced amount of ejaculated semen (less than 0.5 milliliters per sample) may be caused by a

1) Obstruction in the tube carrying the sperm from testis to outside i.e. structural abnormality in the tubes transporting the sperm.

2) Retrograde ejaculation: In which patient gets orgasm at normal time but semen in place of coming out through penile opening goes into bladder.

(3) Absent Ejaculation or Orgasm: There are certain conditions in which patient does not get orgasm even after prolonged sexual activity. the cause of this can be primary, Psychogenic or due to certain medication, neurological diseases, surgeries etc. Treatment needs diagnosis of cause & then treatment.

4)  Hormone deficiency of pituitary gland as L.H., F.S.H., Prolactin, thyroids hormone, hypothalmic deficiency of GnRH, Pituitary gland failure, Hypopituitarism, Idiopathic hypopituitarism, Kallman syndrome, Isolated hypogonadotropic hypogonadism, Drugs, toxins, Idiopathic hypogonadotropic hypogonadism & due to many more causes.

5) Testicular disorders (primary leydig cell dysfunction), Chromosomal (Klinefelter syndrome and variants, XX male gonadal dysgenesis), Defects in androgen biosynthesis, Orchitis (mumps, HIV, other viral, ),Myotonia dystrophica, Toxins (alcohol, opiates, fungicides, insecticides, heavy metals, cotton seed oil), Drugs (cytotoxic drugs, ketoconazole, cimetidine, spironolactone)

Absent Ejaculation

Absent Ejaculation Orgasm

Absent ejaculation in which patient does not gets orgasm & semen discharge even after prolong sexual activity

Delayed ejaculation: In this disorder orgasm & semen discharge occurs after abnormally prolonged sexual activity.

Retrograde ejaculation: In which patient gets orgasm at normal time but semen in place of coming out through penile opening goes into bladder.

Absent Ejaculation or Orgasm: There are certain conditions in which patient does not get orgasm even after prolonged sexual activity. the cause of this can be primary, Psychogenic or due to certain medication, neurological diseases, surgeries etc. Treatment needs diagnosis of cause & then treatment.

Great Semen Health

Great male semen health is important.First of all the thing to work out is the health of your sperm as it is now. This means semen analysis.

Just so you know what you are in for here it is explained for you. The following is according to the World Health Organization (WHO ) on semen samples brought in for fertility testing.

APPEARANCE. What it looks like. A brownish tinge may indicate the presence of blood, while a yellowish color could be a sign of pus cells.

VOLUME. How much there is. After two days abstinence, there should be more than 2 ml of semen specimen.

VISCOSITY. Fluidity of the sample i.e., water has a low viscosity. Semen should have a fairly watery consistency at the time of testing (about one hour after ejaculation ).

LIQUEFACTION. Ejaculated semen coagulates on contact with air, and liquefies after a short time. This liquefaction should be complete at the time of testing (about one hour after ejaculation).

AGGLUTINATION. The semen sample is examined under a microscope. Presence of motile sperm stuck together is known as agglutination and may indicate antibodies.

MOTILITY. Percentage of sperm moving and how well they are moving. Motility is graded as follows:

* Grade A — % of sperm actively, progressively motile (they move forward quickly) * Grade B — % of sperm slowly, progressively motile (they move forward slowly) * Grade C — % of sperm non-progressively motile (they move but they stay in the same place) * Grade D — % of sperm non-motile

  1. Alkalinity or acidity of the sample (pH 7.0 is neutral). While semen pH increases over time, it should not be less than 7.2 at one hour.

SPERM COUNT. Total number of sperm (spermatozoa) present, usually recorded in millions of sperm per ml. Normal count is generally greater than 20 million sperm per ml of semen.

WHITE CELL COUNT (pus), may be normally present in semen in small numbers, (i.e., less than one million per ml). Larger numbers may indicate infection, but not always.

VITALITY. Percentage of sperm which are alive (not the same as % of motile sperm). Motile sperm are obviously alive, whereas non-motile sperm may or may not be alive. At one hour, more than 50% of the sperm should be alive.

MORPHOLOGY. Examines individual stained spermatozoa samples under a microscope and determines what percentage is normal. A normal morphology level should be greater than 14%.

A semen analysis is the first step in semen health. Know where are are and then you will have a far better idea of what you have to do to get the semen health you want.

Treatment

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Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.

THE PENIS

Click on a problem to go down the page to the answer. If your problem isn’t here, try the other problem pages on the menu above.

1 A bent penis

2 Is my penis normal?

3 Penis size! It isn’t big enough

4 The hidden penis – retracted inside the body

5 Son’s penis is not normal

6 Hypospadias

7 Newly wed husband with hypospadias

8 White or yellow spots on the penis skin

9 More on hypospadias

10 My penis is not sensitive

11 Too hairy!

12 What’s this veiny lump on my penis?

13 A penis problem that terrifies me

14 My disappearing penis

15 My swelling penis!

16 Even more on hypospadias

17 I never knew my foreskin went back!

18 My penis makes me feel bad

19 I have a small penis at 16  

20 Vein like swelling on my penis

21 My shrinking penis!

22 What’s this ridge on the underside of my penis

23 My frenulum has torn!

24 My foreskin won’t go back over my glans!

25 Those tiny white spots again!

26 What’s this bump on my penis?

27 My penis bends – help!

28 Is this wrinkly skin normal?

29 A hypospadic penis with two holes

30 What’s this lump on my penis?

31 My penis is too damn’ small!

32 The doctor forced my foreskin back!

33 My penis hole is getting bigger

34 Penis snapped in an accident

35 No balls?

36 Penile pain on erection

37 Penis disappears into my body

38 One ball bigger than the other

39 My twisting testicle 

40 Foreskin won’t budge

41 My retracting penis

42 My bendy erection point downwards

43 Semen color

44 Ring of dark skin on penis?

45 Why does my husband masturbate?

46 Has masturbation like this ruined my penis?

47 No way I can get to orgasm except by this weird method

48 Frenulum Breve

49 My penis is losing its sensitivity

50 Can’t stay hard like I used to!

51 Rash on my penis – too embarrassed to get help!

52 Just pulled my foreskin back and penis head is too sensitive!

53 I didn’t develop normally in puberty

54 What’s wrong with my penis?

55 Smegma?

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1. A Bent Penis

Q: I think I have Peyronie’s disease. My penis bends to the left like the ones I have seen on websites about the disease. But on the sites it says that the condition arises because of an injury during intercourse. But I am a virgin, and my penis has been like this for as long as I can remember so I don’t think it can be the result of anything that happened to it. My pee comes out of the tip and for the most part my penis looks like a normal penis, but will this get worse over time, and will I be able to make love to a woman?

Ans: If you have continuing pain in your penis you may have Peyronie’s. It is possible to injure the penis even when you are unaware that you have done so. Even a small injury to the internal cavities of the penis can cause scar tissue and plaque formation, which causes one side of the penis to be less flexible on erection and makes it bend when erect. But the other possibility is that you have just been born with a penis that has one side bigger than the other. You don’t tell me how bad the bend is, and I am wondering if it is less significant than you imagine. Lots of penises bend up or down, one way or the other, and many are not symmetrical. (You can see that on this website’s page with photos of erection angles.) If your penis does not have more bend than is normal, and you are worrying about it because of some concerns about sex or masculinity, I think you may find that when you come to make love the shape of your penis will be much less important for your partner than you imagine. Many women actually like an upwardly curving penis as it can provide more stimulation of the G spot in the vagina.

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2. Is my Penis Normal?

Q: I have been worried for 30 years. Of course, I don’t dare look at other men’s parts in the changing rooms, but mine looks as though it has sewing stitches along it (they are very faint now that I am 40, but when I was 20 they were very clear). Is this normal, please?

Ans: Are you looking at the median raphe, which is the the join where the penile skin comes together during a baby boy’s development in the womb? Sometimes this can be very prominent, a dark color, and zigzag its way up the penis. Sometimes it is hardly noticeable. I think you can stop worrying, though!

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3. Penis Size! It isn’t Big Enough

Q: Hi, I’m 22 years old. I live in California and I have a girlfriend. We haven’t really done anything that involves my penis, this is because I’m embarrassed about my size. I need help in getting my penis bigger. I don’t want surgery, I just want to exercise it to make it become larger and thicker.

Ans: You are going to have to get over the hurdle of showing it to someone, sometime. And if you’re in a relationship where you love each other, then it won’t be a problem. Besides, she may be worried about the size of her breasts, or something! Why don’t you introduce her to the idea gradually – tell her that you feel you are a bit on the small side, and that you will need gentle encouragement and support? Honesty is always the best policy. And on a wider front, there is no doubt that guys are very concerned about penis size. Do they need to be? Good question. There is loads of information at Penis Myths and Facts about penis size, and the various options for enlarging your organ.

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4. The hidden penis – retracted inside the body

Q: I am wondering what the problem is when someone’s penis doesn’t stick out like normal. When I am with a woman it gets erect, but under normal circumstances, though, it is not visible.

Ans: This is called a “retractile penis”.  Many men have a hidden penis that shows nothing or maybe just a bit of the glans when they are not sexually excited. This retraction into the body is just one of the aspects of human variation. Most of these men would show a normal – by which I mean 5 inches or more – sized erection. They are mostly quite unhappy about not having a prominent penis, as you can see if you visit the message forums and web sites devoted to penis size. For pictures of the condition, see: Images of Size

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5. Son’s penis is not normal

Q: My son is 8 years old. He was born with a large penis which is now probably 3″ erect. I noticed one morning when he was using the bathroom and had a morning erection, his penis’s curvature is down instead of the normal up position. It would not have caught my attention but is very pronounced like an L. I do not want him to have problems in the future and would appreciate any insight in this issue.

Ans: First off, don’t panic. It’s likely you can get whatever is wrong put right. This sounds a bit like chordee, which is usually associated with hypospadias. If you have read about hypospadias you may know that chordee is a tight band of tissue on the underside of the penis which is associated with a congenital malformation of the penis. Chordee will pull the end of the penis down. You can easily check if your son has hypospadias by seeing if his urethral opening is in the normal place. If it is a slit or a hole which is displaced backwards down the shaft (i.e. it opens on the underside of the glans, on the coronal ridge or on the shaft itself) he probably has. If so, you need to get the advice of a pediatric urologist and think about joining the support groups listed on Hypospadias Association

However, I think I am right in saying that chordee can develop without hypospadias on rare occasions, although even here, you still need the advice of a pediatric urologist. However, my first step would be to see the family doctor and ask advice. NB IF HE IS UNCIRCUMCISED, AND DOES HAVE A PROBLEM, THEN DO NOT LET ANYONE CIRCUMCISE HIM AS THE SKIN MAY BE NEED FOR REPAIR! THIS IS VERY IMPORTANT! You MUST also see an expert – as you will see from the messages in hypospadias support groups for parents, going to a medic who has no experience can result in devastating damage! If you can, try going to a teaching hospital as the expertise is often much higher. Please don’t leave the problem unresolved – the psychological effects of this condition can be very severe, as you might guess.

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6. Hypospadias

Q: Hi. I am 17 years old and have hypospadias. It is bad. I can’t piss standing up straight and my penis is only about 4″ erect. This condition has made my life hell.

Ans: I know how you feel. I have counseled many men with a similar problem. And yes, it is true that it can affect life in many ways. You have certainly been given a short straw in life. The question is, can you get to an emotional place where you feel better about yourself? The first thing is that life seems hopeless right now, and that isn’t surprising. You feel very different from the guys around you, and perhaps you are imagining that you can never do the things they are doing. OK, so you have a penis that is different. Does that stop you finding some way to achieve happiness? You may think so. But there are men in the world who have this condition and are in very loving relationships. I know, because I have met many of them. Do you believe that if they can do it, you can too? Somewhere inside, can you see that it might be possible to live with the hypospadias, even if it doesn’t seem so right now?

Please go to the Yahoo support groups for hypospadias (the links are here: Hypospadias Association), and read the messages. You can read a lot of experiences from men with this kind of problem, and you will find that they understand your pain. They may not all have a penis like yours, but they all understand the pain. Are you able to speak to your doctor? Or Dad, or another male relative? Whether you can or not, please have a look at the Yahoo forum: think of it as a band of brothers! Have you considered the possibility of surgical correction, or at least seeing if it would be possible?

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7. Newly wed husband with hypospadias

Q: I have just been on your very interesting and informative website. I am a relatively newlywed and I believe my husband has hypospadias. I had never heard of this condition, and didn’t even know what it was until I started researching the internet. He has a regular hole in the tip but it is “sealed off”. The pee hole is on the underside and he has half a foreskin. He has bouts of kidney stone attacks and always has a dribble (leak). I would appreciate any information you could offer. Please allow me to be frank about my feelings. In fact, when I first saw him, I was a bit shocked. It wasn’t until I started searching the web that I found out what it was. Before we were married, we talked about things and he assured me that he was circumcised. Yes, he has half a foreskin…that is the only way I can describe it. On top there is loose skin, sort of a hood but underneath there is none. It is like a sort of split on the corona, then below that is the “pee hole.” OK, now about his feelings. I don’t think he has maybe never seen another man’s parts because he thinks his is the way other men’s penises look. Does that make sense? (My ex-husband looked very different.) To be perfectly honest, he got very defensive when I asked if he would like to read about hypospadias. Our sex life sucks, plus he has impotence problems, but I would never cheat. He is only 31. Can his impotence be a result of the urethral tube not being long enough? I am really searching for answers here. Even in the most “down and dirty” situations, he never gets very hard. He has a 9 year old daughter, though, so I know it works. I would greatly appreciate your advice and insight. Thank you so much for your help.

Ans: I don’t think his impotence has anything to so with his penis structure. I feel it is much more likely to be psychological. And that might imply the need to see a sexual therapist or a psychotherapist….and I guess from what you say, it isn’t going to be easy to persuade him to try that idea. It is possible, but a bit unlikely, that he doesn’t know he is different; however, if you look at the messages in the Yahoo hypospadias forum (link to be found on this page: Hypospadias Association), you will see some guys in their 30s and 40s writing about not having known they were different until quite recently, so it is possible. But I do know that until you get him talking about it, nothing is going to change. Yet if he feels defensive or threatened by his problems – the hypospadias, or his impotence, or his kidney problems, or the urine leaking – he may be very unwilling to engage in a dialogue. You can imagine how much psychological stuff must be whizzing around in his mind and, of course, it’s rubbing off onto you as well. Personally, I think he could benefit from seeing a urologist to find out if his penis can be surgically corrected. This may produce improvements in leaking and kidney problems, his impotence, and therefore also his state of mind. You have a lot on your plate, and so does he. I would start by trying to gently encourage communication. Or even make it clear to him that you expect him to talk about these issues, since they affect you !

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8. White or yellow spots on the penis skin

(which you can read about by clicking here)

Q: Hi, I’m 15 (male) and, well, here’s the problem. Okay, it all seems well and good that these tiny little white, yellow or creamy colored spots on the shaft of the penis or the coronal rim are just harmless sweat glands (they are harmless, right?). What did you call ’em, Fordyce spots, right? “They cannot be controlled, massaged, oiled, or wished away, or anything else.” So what the hell am I to do if I’ve got these for the rest of my life? Have there been any cases where they’ve disappeared? Cos y’know, I’m a popular lad an’ still a virgin, so it won’t be good if my first sexual encounter ends with a scream of terror from my girlfriend followed by a slow embarrassing life at school, which is probably then followed by suicide… You say they are responsive to testosterone in the body…right? Well, since I’m 15 my hormones are goin’ mental and I do masturbate (which I don’t usually admit) regularly, as in, every day or so… (by the way, is that healthy, it can’t be, can it?) Anyways, I guess you know how troubled I am about this, so PLEASE could you email me back, thank you VERY, VERY much…

Ans: Your email made me smile….sounds like you have a good sense of humor, which might be a good thing in the circumstances! On the subject, though, you have to learn to live with these “spots”. (And yes, they are harmless!) You don’t want to hear this, I know, but here’s how it is: all men have them, you are not alone, and I get loads of emails from men and boys with exactly your query. So I do know how troubling they can be. OK, now, all these other guys have these spots (although I admit some men have more spots than others), but it hasn’t stopped them having good sexual relationships, right? And it won’t stop you, either! And, when the time is right for your first sexual experience, you will find it doesn’t matter at all. For one thing, remember that the skin of the labia – the lips around the vaginal opening – can develop these spots as well, so your girl may have exactly the same “problem”.

For another thing, she will probably be too concerned with the size of her breasts, or their shape, or the size of her labia, or whether she can please you – or something – that the last thing she will be thinking about is the spots on your penis! During sex, everyone is wrapped up in their own concerns, and seems to think that these problems will be just as significant to their partner – but the funny thing is that this is almost never the case!

I can reassure you that with age and experience, this will not seem like the big deal it does now. Believe me, I am not discounting your worries right now, but the fact is that you can’t do anything about these spots. Also, here’s another thought: you sound like a guy who can get along with people, so remember that when the right girl finds you (or vice versa) she won’t want you just for your dick – she’ll want to be with you for the sake of YOU. That’s how women see sex – as a part of love, so to her it will be closeness, touching, kissing and loving intimacy that is most important, not the size and appearance of your penis.

By the way, are you worried about anything else? I ask because sometimes people project their sexual worries onto things that they can see, like these little blemishes on the skin.

As for the masturbation, I would say enjoy it – it’s quite normal and very healthy (as long as it doesn’t become an obsession!).

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9. More on hypospadias

Q: I ran across your website out of curiosity. I am 34 years old and have hypospadias. At one time, I too felt that I was abnormal. When I was growing up I had to explain things to other boys on more than one occasion. I didn’t feel like it was that big a deal and they must have agreed since I was never made fun of. My sex life started to blossom in my college years and a glorious time it was. Contrary to girls who had slept with me telling other girls that I was deformed or abnormal, they would brag to their friends about how big I was. My penis is 8 1/2 inches long, when erect, it has a strong curve downward (like a banana), and the head is huge since it is more or less separated on the bottom. My pee hole is located on the shaft very close to the head. Every girl I have ever slept with can’t seem to get enough. Maybe that’s because of the curve, head size, or both. Guys with this “problem” can hit areas inside of a vagina that very few others can. Think about it – if you are doing it doggie style you have got full pressure on a girl’s G-spot! Face it, if you are capable of getting the ladies to take their clothes off and have sex, what your dick looks like will never matter one bit – it’s what you do with it that counts! Any woman will tell you this – and they mean it. I’m not trying to come off as being a “stud”. I’m trying to point out that this condition shouldn’t be thought of as a deformity, it is a part of you that makes you unique. It is something that a lover gets from you that she may NEVER get again if she lets you go!

Ans: Many guys with hypospadias have actually got short-changed in the size dept as well. You are right in all the comments you make, but any guy who has the condition in the form you have it will know (well, maybe he will, let’s hope so!) the truth of what you say. For someone who is struggling with hypospadias AND a small penis size, well, I don’t think things are so easy. I am glad you have had such a great experience….you’re a lucky guy.

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10. My penis is not sensitive

Q: I’ll try to get right to the chase. I am a 23 year old gay male. My partner and I have noticed that I am not as sensitive on my penis as other men, because it takes me a long, long time to reach an orgasm. The only part of my penis shaft seems to be sensitive is a small part on the underside where the glans and shaft meet. My partner is sensitive everywhere, and can have an orgasm very quickly. Is there any treatment or surgery which might help?

Ans: No. Men who have a penis sensitivity problem are often “cut off” from their feelings, by which I mean that something is blocking their experience of sexual enjoyment. It’s not likely to be a physical problem, so I think the answer may lie in the area of sexual therapy to deal with emotional issues around sex.

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11. Too hairy!

Q: I’ve a problem that I never heard about before (and I’ve searched in various sites and forums) – I have too much pubic hair in my genital area. You might say that is very common, but it has spread to my penis and is growing in size and length. This is causing me various problems like pain, discomfort, bumps on penis caused by inner growth of hair follicles and so on.

Ans: An answer from a public discussion forum: “I have excessive hair growth on the shaft of my penis. One good thing is that I have blond pubic hair and it is not as noticeable. But the solution is simple. I just shave myself (carefully) every couple of days with a disposable razor while taking a shower. I must admit it is a real turn on to see the results.”

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12. What’s this veiny lump on my penis?

Q: Hi there. I’m very worried about my penis because there’s a lump on the top of it that looks like a shoe lace. It’s only about 2 inches long and half the size of a shoelace. It feels hard, it’s just under the skin and when I move the entire skin around my shaft it stays in the same position. I can move it with my finger. It also seems to get thicker and harder when my erection gets bigger. I’m only seventeen. What do you think it is?

Ans: I think it is a vein, and perhaps it has hardened by rough masturbation/sex. But to know for sure, you really need to have a quick check up at the doctor’s to make sure that it is nothing more serious.

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13. A penis problem that terrifies me

Q: Hi. I noticed a couple of months ago, that I had a cyst-like pimple at the base of my shaft, right above the testicles. When my penis is relaxed, it is soft, but when my penis is erect, the cyst gets harder and I can actually feel its roundness (it feels like a tiny pellet). It looks as though I can squash it, but it is fairly hard, I wouldn’t try anyway. It causes absolutely no pain at all, it hasn’t grown so far, but I know I didn’t always have this and I’m terrified at what it is…can you help me?

Ans: The only way to be a 100% sure is to go and get a check at the docs. The sooner you go and get confirmation it is harmless, the sooner you can stop worrying!

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14. My disappearing penis

Q: I have a problem. I am not a overly huge man, indeed I am about normal weight, but when I am not erect I have a problem with my penis going back into my body. I have been circumcised. This has just started four months ago, and at 25 years old it is very uncomfortable and irritating. Is there anything I can do to stop this from happening?

Ans: This is not uncommon, but what is a bit unusual is that it has started at 25. Most men whose penis does this would recognize it as a thing that has always happened to them. There seems to be no simple explanation of the retractile penis, which is what it is called, or why it happens. I think it is probably a genetic thing; you’re just born with a penis like this. However, I do know that a nervous disposition, with a high-ish anxiety level seems to make it more likely, so it probably has something to do with the muscle fibers in the skin of the penis contracting under the influence of adrenalin. Also, I have the impression from my work with guys who have this sort of penis that a decline in testosterone makes it happens more often, so, if you’re experiencing a decline in sex drive or difficulty in getting erections, you might like to go and get a hormonal check-up.

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15. My swelling penis!

Q: I am miserable! A few days ago, I noticed that my foreskin and shaft has become thicker. Now, I’m a teenager, and this happened in the span of a few hours, after masturbation. I do not know if that was the trigger or not. There’s no pain or discomfort, either flaccid or erect, but I’m worried about a sudden change in the skin – slight swelling, if you will. I can’t tell whether it is inflammation of some kind, or irritation from a pubic hair I found caught underneath the foreskin when I was cleaning in the shower. I have not seen a doctor yet as I wanted to see whether it would return to normal by itself. Your advice would be greatly appreciated.

Ans: Could be a bit of edema or water retention in the tissues, especially if you were a bit rough during masturbation. I suggest if it hasn’t gone down after a few days, you have a word with your doctor, just for reassurance, because although it doesn’t sound serious, you won’t want to take any chances with your most precious bodily part!

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16. Even more on hypospadias

Q: Thanks for putting up the info on hypospadias. (That’s to be found here.) I’m a guy in my early 20s and have mild hypospadias and chordee. Unfortunately, it has caused me so much psychological and emotional suffering that it’s as if I had been born crippled. The problem is cosmetic, but when you’re talking about something like the penis, it doesn’t matter whether it’s cosmetic or functional…any abnormalities are significant, and a large part about being male and having a penis IS cosmetic. I cannot have sex without it constantly being a worry for me what will be thought of my large opening and bent penis, and I simply don’t have a feeling of comfort with myself that I know most men have when it comes to sex. What I would do to have been born with a normal penis like some I’ve seen. In any case, the reason I’m writing is to share my views/advice on 2 things I think anyone with this problem, or any parents who have a son with this problem should read:

1. If a son has any kind of penis abnormality, it is FAR better to have the problem fixed while the boy is young (6-12 months) rather than wait and “have him choose”. Any surgery at that age most likely won’t even be remembered by the child (do we remember being born?) and the psychological effect of having even the slightest abnormalities when older will most likely psychologically devastate him as they have done to me.

2. Be sure to find a doctor who has extensive, extensive, experience in reconstructive urology and don’t just go to your local doctor. VERY FEW urologists know how to do hypospadias repairs properly and successfully. I had 2 operations on my penis when I was an adolescent, and not only were they emotionally painful because of my age, but they were done by an urologist who wasn’t even close to being an expert in the matter. My parents didn’t even take the time to get 2 or 3 opinions! Now I have to see someone to have the damage repaired. I live in a large metropolis and I’ve seen 3 uros here: 2 of them referred me to a world-renowned expert in reconstructive urology and both said that there is no-one in my city of several million who is qualified to do the surgery. Good thing I got 2 second-opinions, since the first guy didn’t even know of this specialist, and was willing to do surgery that he admitted wouldn’t result in much success. I wish my parents had done the right thing when I was younger, and maybe I wouldn’t be in this predicament.

Ans: In the Yahoo hypospadias groups you can get support, and share your experiences. It’s well worthwhile joining, as you’ll soon begin to see yourself as less out of the ordinary and more normal. Links to join can be found on this page.

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17. I never knew my foreskin went back!

Q: I am 23 years old and had never heard about retracting the foreskin till just recently. When I did try, it kinda hurt, so I stretched the opening, and that helped. But anyways my question is: After I push the foreskin back, is the glans supposed to feel so weird? It’s such a different, weird sensation, and it’s hard to describe…..

Ans: Hi. I would say you probably have a tight opening at the end of the foreskin, and if you can stretch it, that would make things easier for you. My guess would be that the glans feels weird because it isn’t used to being exposed. After all, if it has been protected by the soft warm skin inside your foreskin, it will be much more delicate than if it had been exposed for masturbation or sex, or even just rubbing on clothes, for several years. I think it will feel better as time goes by, but if it still feels weird after a few weeks, then just visit your doctor for a check up. if you have a tight foreskin, you can read about the condition on this very website or Penis Myths and Facts

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18. My penis makes me feel bad

Q: Just wondering, most places I have looked to see about these white spots on the penis say that they are normal and are just glands underneath the skin, something like that. I even asked my doctor. Point is, healthy or not, they produce a horrible insecurity that I have not been able to overcome in the last 5-6 years of my life. Do you know you know of anything that can be done to reduce or eliminate them?

Ans: Interesting question. Guys often project other worries about sex or their penises onto the small things they can see like these white spots. I wonder if there is something deeper bothering you, like you’re ashamed of your body, your penis, or frightened to show it to others, or terrified of getting into sexual situations? If so, then I think a bit of counseling may be called for. And remember, a sensitive partner would probably help your confidence enormously, whether you are gay or straight. What’s more, your insecurities are not going to keep you away from sex for ever! Your time will come, but maybe you can speed up its arrival by seeing a counselor.

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19. I have a small penis at 16

Q: Hey, I’m 16 years old, 4″ inch erect, 4″ girth. And I wanted to know if this was a problem, and at what age does it stop growing? Thanks for responding.

Ans: OK, I know this is a sensitive subject. I have dealt with a lot of men and especially those with penis problems in my work as a counselor, so I know how sensitive this issue can be for teenagers and adults. I think you probably realize you are below “average” for your age. However, an average means of course that some will be bigger, and some smaller. So that isn’t really helpful – some men will always be below average, some above, and you can’t do a lot about it. It’s like the size of, say, your feet: controlled by mother nature, and your inheritance. So, that raises the question, is it “normal”, and will it get bigger? I don’t know the answer, but maybe I can offer you some thoughts.

First of all, have you developed pubic hair, a deeper voice, and hair on your body (armpits, etc). Are you masturbating and ejaculating? Do you have a higher sex drive than at 11 or 12? I ask these questions because first and foremost if the problem is that you haven’t started puberty, you need to get help or advice from a doctor. And I think the same is true if you started puberty late, or you feel it isn’t going as it should. By the way, I don’t think you can use penis size as a measure of that – I think things like testicle growth and body hair, and sex drive and masturbation are more likely to be signs of pubertal development. So, start by asking yourself if there may be a hormonal problem, and, if you think there may be, get the advice of a doctor.

On the other hand, if you feel happy that your puberty generally is going well, this leads to the question of penis size. I think it fair to say that penis growth stops at about 17. Two sources of information that may be helpful to you is the size page on this very website, and Jackinworld. These will tell you lots of things about development in the teen years, and maybe give you an idea how you are doing.

Suppose, having said all that, that your penis is now as big as it ever will be? I guess that’s what you’re thinking about. But this size of penis, however it makes its owner feel, is actually quite common. 0.5 per cent of men have a penis of four inches long when erect, which makes about 500,000 men in America alone. (By the way, there would be 2,500,000 men with a penis 4 and a half inches erect or less). The fact is, many of these guys have happy relationships with women who love them for more than just their dick size. They love things like their man’s personality, loving nature, the fact that he a great dad to their kids – whatever.

I want to be realistic about this because it is true SOME women think penis size is important – but then some women think having a husband with an income of over 100,000 dollars a year is important. Do you see what I am getting at? Women love different aspects of a man, and that is why penis size is mostly a male issue, not a female one.

So, is having a four inch penis a problem? The simple answer is that it’s only a problem if it’s affecting your ability to interact in some way with people. Since you’ve said that you’re basically shy of getting into a sexual situation because of your penis, therefore I would say it is a problem! However, the other way of looking at the issue is not from your point of view, but from the likely point of view of a woman. First let me say that I think you do need to accept that there are some women out there for whom things like penis size is important. This is inevitable, and whatever you think of this point of view, it is simply the case that some women believe it to be important to them. So in some cases, there will be women whom you meet for whom it may be an issue. But you need to remember that anyone who is taking the view that a physical characteristic like penis size outweighs the importance of a man’s other qualities, like his caring nature, his sense of humor, and so on, is probably a superficial person anyway.

So, the question is, if you have these doubts, how can you get into a situation where you trust a woman enough to “reveal all”! The answer is that you will know when you meet someone special, who really cares for you, and the whole process will unfold naturally. And I think there is something else you can do as well which will give you power and control over your fears. Honesty is always the best policy in relationships, and when you trust someone enough to want to get sexual with them, you can make gentle hints about how you find it difficult to get intimate because you have been blessed with a penis on the smaller side. Her response to this will give you a good idea of how supportive she will be, and on the basis of that you can decide whether to go further or call the whole thing off. This may sound negative, but it is a lot better than getting hurt by a negative reaction after you have taken your clothes off! If you are thinking that it would be impossible to say such a thing, then I ask you to think about the fact that all of this relates to sexual intimacy, which is an expression of emotion between 2 people that deserves open and honest communication. People make themselves vulnerable when they get sexual, and this can be scary, but some of the fear can be discharged by talking openly with your partner. I hope this helps. If you want a one line answer, though, here it is: penis size matters to some people, some of the time, and not at all to others.

Whether it matters to you or not will probably depend in many ways on how careful you are in picking your sexual partners, even if this means waiting a bit longer for the right moment! BTW, i know this may seem even more ridiculous, but is your Dad the kind of guy you could confide your fears in? He is a man, after all, and he will know where you are coming from. (Don’t worry if this idea seems to have come from another planet. I suspect most guys couldn’t bring themselves to do this! However, I do think you might be surprised by the reaction if you broached the subject…..but you know best whether this is a good idea or not).

From the tone of your message I would say you are an intelligent guy, so you may now be thinking I might be right but somehow you can’t apply all this information to yourself. If you are having a problem believing things will be OK for you, have a look at the small penis forums for advice and support. You can find some information here: Penis Myths . You will find support from guys who are successfully living with what nature has given them.

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20. Vein like swelling on my penis

Q: Hi. I have something going on with my penis. It is strange and difficult to describe. I guess the best way to describe it is that there appears to be a vein that gets “full” of something. It doesn’t look like blood and appears to be white in color (under the skin). It is hard but not solid. It is located under the head of my penis. I am circumcised, by the way. Sometimes it extends almost a quarter of the way around the head of my penis. The end of it (the part that is most usually there) is “loose” and can be moved as though it is like a tail. Usually it is there after sex or in the morning after I wake up. But sometimes it goes away and sometimes it doesn’t. I first noticed it after sex in the shower and I was cleaning myself and noticed that what I thought was a vein, was not subsiding and I thought that it would go down when my penis went down. But it was still there the next day. A few days later, we had sex again and when we were finished it was gone. Now it comes and goes and there is no link between having sex and not having sex. There’s no pain involved either. Just the curiosity and a little apprehension about the situation. Do you have any idea what this is? I am hesitant to try to see a doctor because I don’t know if it will be there when I get to see him. You know it’s just like when you take the car to a mechanic for a knock in the engine and then the car doesn’t make the sound for the mechanic. So, if you have any ideas, I would appreciate any information you can give me.

Ans: I think it may be an edema (or oedema) caused by the friction of sex. However I cannot offer you a medical opinion. If it were an edema, this would be a swelling caused by the accumulation of tissue fluid – a bit like a blister. Harmless, but a nuisance. However, you need to see a doctor, as I guess you know, just to get it checked out.

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21. My shrinking penis!

Q: As I have become older (now 38), my penis has shown a marked decrease in length and a little in circumference. I have also gained a lot of weight and developed a “pot belly”. Is this the cause or is there some other common ailment?

Ans: There are actually two causes: one, the fatty tissue spreading over your pubic region does make your penis look smaller, without doubt. The root of the penis extends back towards you anus and is fixed, so it follows that if you grow outward with fatty tissue in your pubic region, your penis will look smaller. If you lose weight, obviously it will return to its old appearance. Second, if your sex drive has decreased, there may be a hormonal aspect to your penis shrinking. You can read about that here: http://www.the-penis.com

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22. What’s this ridge on the underside of my penis?

Q: I think your website is really great, and showed me that my penis is reasonably normal. It curves slightly upward when erect, which I used to worry about, until I saw on your site that it is normal for a penis to do this. However, there is something else about it which bothers me. On the underside of my penis, there is a small ridge. At the bottom, it is in two parts, and joins together about an inch up. Then it goes right up to the end, and finishes in a little point, just under the glans. It is soft, and appears to be just skin. It shows up much more when my penis is erect. I used to think this was normal, until I read a gay pornographic magazine (I’m bisexual), and realized that none of the men in the magazine had this feature. Nor have I seen any other pictures of a penis which had this feature. This ridge doesn’t hurt or feel of anything and my penis works as normal, but I’m curious to know what it is. I’d be grateful for any advice.

Ans: You are wrong about this – it is quite normal, and all men have it. It is called the “raphe”, and it is seen on every penis to a greater or lesser degree. There is a picture of this on the problem page of The Penis.com – so go and have a look – you will find an explanation of it as well.

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23. My frenulum has torn!

Q: Hi there! My name is … hmm … Anonymous .. or you can call me Joker! I have a problem of course! I’m from Bulgaria! That’s not the problem! The problem is with my penis. One day I was masturbating and at the end at the orgasm I pulled the skin too hard. (Forgot to tell you .. I am a virgin and I am a guy.) And that skinny thing between the head and the foreskin tore, but not entirely and some blood came out! One day it opened again, and more blood came, though it soon stopped. So, my questions are: What’s supposed to happen when you lose your virginity (I mean is this skin supposed to break?) Should there be any blood coming out? And, more to the point, what the hell should I do now? Is this going to ruin my first experience of sex? Do these things usually break when you lose virginity?

Ans: This skin, which attaches the foreskin to the base of the glans, looks like a little piece of string. It’s called the frenulum. It’s a common myth that a boy has to tear his frenulum when he has sex for the first time. But it isn’t true! I really don’t know where the idea comes from, unless it has something to do with the idea that men have to bleed a bit, like a woman when her hymen is torn. Anyway, it isn’t true. Having said all of that, when a guy has a short frenulum, it can tear when he masturbates or has sex, and it is unfortunately often uncomfortable thereafter. The best thing to do if this has happened to you, and it doesn’t heal up quickly and stay healed, is to go and see a urologist, who may be able to do a simple surgical repair that prevents it tearing again.

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24. My foreskin won’t go back over my glans!

Q: My “friend” has a question for you. He is uncircumcised and when the penis is soft he can fully retract the foreskin. When he gets an erection the foreskin gets very tight around the penis and becomes unretractable. The most he can do is maybe get a tiny peek at the head, which is too wide for the foreskin to roll back. If the foreskin is retracted before he gets an erection it rolls back over the head as he gets bigger. I would like to know if this is normal and if it is not what can we do fix the problem Thanks.

Ans: Have a look at the answer to this problem on the problem page of this site and see if that answers your question. Basically, you can stretch the foreskin or have a circumcision.

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25. Those tiny white spots again!

Q: I have some tiny white growths like the tip of a paint brush around the ridge of the head of the penis. It’s difficult to describe but maybe you’ve seen or heard of this.

Ans: If you look at the problem page of Penis Myths, you will see there is lots of information about these white spots – they are called Fordyce spots and they are completely normal and harmless.

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26. What’s this bump on my penis?

Q: I’ve noticed something today that I’ve had for at least a year or two and paid little attention to. On my penis shaft, just below the head, there is a small, hard, round, and movable bump. It isn’t visible on the surface, and is much more noticeable during an erection when it is easily felt. I can move the outer skin without moving the bump, but if I put any pressure on it I can move the bump around a bit. It doesn’t cause any pain, and I haven’t noticed any change in it since I first noticed it a couple years back. This seems very different from all the “outer bumps” mentioned on health sites I’ve seen.

Ans: I can’t offer medical advice, but it sounds a bit like a sebaceous cyst (blockage of a sweat gland and subsequent swelling). A minor thing, easily removed by a doctor, and completely harmless. But, just to be safe, please get a medical opinion.

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27. My penis bends – help!

Q: I just can’t pucker up the guts to tell ANYONE not even the doctor, about my problem, after all I’m only 15! The thing is my penis bends to the left very much when erect, and the foreskin is too tight to pull back over the head. I think that it is so tight that it may have caused my penis to grow in a bend during puberty. Is there anything I can do? It bends starting from around half way up and bends about 30 degrees to the left!

Ans: Right, first things first. So, you are 15. By not seeing a doctor, you are denying yourself the right to  something you have every right to have – happiness and better health. The fact that you are 15 and the problem concerns your penis is really irrelevant. You are a man who needs help in this matter and you have every right to get it! The fact that you are 15 does not stop you you having all the rights and expectations of any other man whatever his age. Indeed, it probably gives you more rights because at that age you need the support and guidance of older men who know what you are going through as you grow up. This means you can expect older men like the doctor to help you, and hopefully you need not be scared of telling them your problems!

I think you now have to summon your courage and go see a male doctor. Let me explain my thinking. First it sounds like you have a phimosis, and you can’t retract your foreskin. If this is so, you need to get it sorted, as it will make sex uncomfortable later in life. Plus, if your foreskin does get retracted and then won’t move forward again, you have a bigger problem (try to make sure this doesn’t happen when you are masturbating, by the way). You don’t necessarily have to have a circumcision or a full circumcision to cure this – you can read about the options on this very website. Take some time to do that, so you know what you are dealing with. Second, you are understandably troubled by all this stuff and need some practical support. If you can’t speak to your dad, then your doctor, bound by confidentiality rules, and having seen it all before in his career, is the obvious choice. But you might be surprised if you did try speaking to your dad about this, by his willingness to help. Don’t forget he is a man, and he knows about the penis! If you can’t do that – is it even remotely possible you could talk to your mother about it? Third, the phimosis may have some bearing on your penis shape. It might be that the restriction of the skin is causing some of the bend – although the bend isn’t out of line with what a lot of men have got, by the way, although I know that may not be much comfort – and if this is so, then the sooner you get the phimosis attended to, the better. Fourth, the longer you leave this problem, the more it may affect you. BUT if you start getting it sorted out now, in 12 months (or six or three, or whatever) you might be completely free of it, and happier about everything!

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28. Is this wrinkly skin normal?

Q: Hi. I am uncircumcised and I was wondering if I had a problem. What happens is that a lot of the time my foreskin will not completely cover the head of my penis so it makes the skin on my penis look wrinkly. This usually happens after an erection. It almost always eventually goes back to completely covering the head of my penis without looking wrinkly, but it bothers me when it does. I was just wondering if it is normal for the uncircumcised penis to look wrinkly sometimes. Thanks.

Ans: Yes, everything you describe is completely normal…I would say that the majority of uncircumcised penises behave like yours, rather than having a foreskin which completely covers the glans. No need to worry!

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29. A hypospadic penis with two holes

Q: I am writing because I have not come across the condition I have found in my boyfriend. My boyfriend lives in Scotland and I am a New York lady. Well, I have not encountered too many foreskins but when I pulled back his foreskin to perform oral sex I noticed another hole where the foreskin and shaft met, about 1/4 to 1/2 inch away from the top of the penis (which has a hole as well). I asked him and he said the hole on top was where he urinated and the hole on the underside was where he ejaculated. He then showed me how semen comes out of the hole on the underside and I almost fainted! At 31, I feel I am experienced enough to know that this is not the norm! We went to the doctor’s and we were told it was a birth defect and he can be referred. Have you ever heard of this condition and what can be done to fix it? I am concerned about both infection on his behalf with such an exposed hole (the hole is about 1 cm) and fertility: will it affect his fertility? His semen is much stickier than any other I have ever encountered, very different in fact.

Ans: I think he has hypospadias. You will find this condition described on this website. It is a birth defect. Usually this means a hole in the wrong place, but one form of it can be that a man has two holes, one of which is in the correct place, one of which is in the wrong place. However, if he has a normal foreskin which goes all around his penis, rather than just a hood over the top, that would be quite unusual for hypospadias, as the foreskin is usually abnormal as well. Still, anything is possible, and the only way to find out would be to see a urologist (dick doctor). The other thing that comes to mind is that he may have had his penis pierced – yes, hard to believe, I know, but some men do have rings through their penises in exactly the way you describe – the piercing is known as a Prince Albert. I doubt this is the case with him, though, as the hole is so large. His semen and fertility will be no different in any way because of this condition.

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30. What’s this lump on my penis?

Q: I am concerned about a hard lump on the shaft of my penis, it is situated where the largest vein on the penis ends. It is slightly smaller than a lentil and has been present for months now, I am unsure if there has been any change in its size. It swells with blood upon erection and has no surface expression. I have been to the doctors twice and both times he has told me it is a varicosity, and not cancer. I am very concerned that he isn’t considering the possibility of cancer because it is so rare.

Ans: OK, so if you are concerned, go and see a dermatologist (skin specialist). Then you would know for certain.

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31. My penis is too damn’ small!

Q: I am frustrated with the size of my penis. It’s only 5 and 1/2 inches when hard. I am embarrassed to take my clothes off in front of a girl and my self-esteem is real low!

Ans: You have a normal sized penis. Here’s some information on penis size: Penis Facts

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32. The doctor forced my foreskin back!

Q: Hi, please help me to answer some of my queries. I’m an Asian, have a penis size of 6 inches, age 19. When I was young, I had an minor accident causing my penis to swell. When I consulted a doctor, he forced my foreskin to retract back. This was really painful. After that I recovered, and didn’t notice anything different until one day, I saw all of my friends’ penises were different from mine. When they are not stimulated, their foreskins will remain more or less over the glans; when they are erect, their foreskins are fully retracted, revealing their glans. But with mine, excited or not, I have to use my hand to pull my foreskin back to reveal my glans. When I manually pull back the foreskin, it looks exactly like the others, and this is not painful to do. Most books say that if it doesn’t cause pain when pulling back the foreskin, everything is normal, but I still feel that mine is different from others. Will this cause problems when I have sex in future? Is it normal and acceptable? Can you please give me some advice whether I need to go for circumcision or whether it is alright without the operation.

Ans: There is nothing unusual about this at all. Many men have to pull their foreskin back manually and many find that it will not stay back. If you can move it back, and there is no pain, you are fine, and sex will be very good. The doctor was however very wrong to force it back. This can really hurt and and cause discomfort in the future, as it tears the adhesions between the glans and the foreskin. These can then heal with scar tissue on the glans which may make it very sensitive. A boy’s foreskin should be left to separate naturally from his glans, and if it remains attached at puberty, then is the time to get the help of a doctor.

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33. My penis hole is getting bigger

Q: I am 19 years old. My penis’s hole seems to be slowly tearing towards the back half of the shaft, into a slit-like shape. It is now about twice the length it should be (about a centimeter). I have always (or at least for the past few years) had trouble urinating straight or in a single, thin stream, but as of late I have had sensitivity in this area. For the past few months, my penis has hurt when rubbed across the top of the head sideways across the hole (slit). It has also hurt of late when penetrating my girl friend, wearing boxers, or when my penis is in the wrong position in briefs. Is this a huge problem? Should I worry or not worry about it? It there a way that I can cure the problems…the slit and/or the sensitivity? Please give me a few more options other than seeing a doctor. I do plan to see a doctor in the next month, but do not wish to see my family doctor about this embarrassing problem. Please give me any advice to help this problem.

Ans: I haven’t come across this before. Did you have a slit or a hole to start with, and where was it located? On the face of it I would say that you MIGHT have a mild form of hypospadias. This means that a boy is born with the opening of his penis located below the head of the penis. Sometimes the opening is a slit, sometimes a hole. If it is a slit, and the overlying tissue is weak, I have heard of cases where the slit has lengthened in later life. But I am not a doctor, and can’t see your penis, and therefore am a bit stuck. You might like to read the hypospadias page of my website, and then follow the links to the hypospadias support groups, where you can see photos: that will tell you if you have the condition.

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34. Penis snapped in an accident

Q: When I was 16 I hit my penis against the bed when I had an erection and felt a snap. Now I am 18 and I only get semi hard, and there is a curve in my penis. I believe the upper side has scar tissue in it and the underside is trying to grow while the top won’t so that the curve gets greater every year. Also since that time my penis goes straight out in front rather than upright when erect. Is there any surgery or procedure I could have which would solve the problem?

Ans: What you say does fit with the scar tissue problem. The only way to deal with it is to see a urologist (dick doctor) who can advise you what to do next. You can get a referral through your family doctor. The penis can rupture, for although it has no bone inside it, the fibrous tissue of the erectile chambers can snap during sex, often when the man misses the woman’s vagina as he thrusts. It is a painful event, and can lead to scar tissue forming inside the penis cavities – which is what seems to have happened to you. Another possibility is that you are developing peyronies disease. In any case, you need the help of a doctor to diagnose and fix the problem.

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35. No balls?

Q: I have recently had sex with a male around 20 years of age, and I noticed that his balls were extremely small and extremely tight, it was almost as if he didn’t have any or there was no sack. Is that normal at all?

Ans: Well, it isn’t common, but it isn’t unusual either. Some men have a very tight scrotum, and their balls can appear very small because they are held tight up against the body wall. Sometimes balls can be very small, too. See this reference for more information.

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36. Penile pain on erection

Q: For about the last 5-7 days, I’ve experienced a degree of pain when I achieve an erection. This is a moderately dull-to-sharp sort of “muscular” pain – slightly akin to the type of pain one might associate with a bruise, although there is no visible bruise on my penis. The painful area is only on the left side, near the top of the shaft, and a little in the center of the head. I have absolutely no pain when not erect. I am sexually active with a monogamous partner, and I also masturbate fairly frequently. (Incidentally, masturbation/ejaculation does not worsen the pain.) What do you think this is, and what should I do about it?

Ans: I think it is a bruise inside the erectile chamber of the penis (caused by rough or vigorous sex or masturbation) and that it will ease with time, but to be sure, see a doctor. From the emails I get, I would say that such internal penis injuries are very slow to heal. Another (remote) possibility is that this is a problem in your back and the nerves to your penis are being stimulated in such a way that you feel the pain there. I don’t think this is likely, but it can happen. Read about penile pain here.

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37. Penis disappears into my body

Q: I am 24 years old. For the past couple of months my penis has been retracting into itself like a turtle’s head does. It is very uncomfortable and has never happened before. It seems to happen more when I am running, or driving. What should I do?

Ans: I don’t think you can do anything. The retractile penis, as it is known, is fairly common, and unfortunately it is uncomfortable. Most guys do find that it gets worse as they get older – I’m not at all sure why, though I have often wondered if it is to do with declining testosterone levels. If you had any pain or discomfort that hadn’t been there before, you’d obviously want to get it checked out by a doctor.

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38. One ball bigger than the other

Q: Hello. I’ve read your articles and I think that they are great and good advice too. I looked at your article on testicle size and it only helped me a bit. I’m 18 years old (19 in a few days) and one of my testicles is really big and the other is really small. Sometimes it shows through my trousers, it’s so damn big! This has been bugging me for a number of years now, but I’m too scared to go to the doctor. I read somewhere that if you had a testicle this size it can lead to cancer – is this true?

Ans: No. But the fact that it is so much bigger than the other is unusual. It would clearly be wise to see a doctor and check it out.

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39. My twisting testicle

Q: I am 14. I have a problem with my left testicle. About 1 month ago I was watching TV and I went to take a shower. When I took my clothes off I realized that my left testicle was twisted around. It did it again exactly 10 days after that. The first time it spontaneously turned back around in about 20 min. The second time it was more like 35 min. Before the second time I could ejaculate multiple times. Now only one big ball of semen comes out. I think I am ruined for life. Do you think that it was damaged? I think I am only going to have one that works now. Please answer back….I am nervous.

Ans: OK, well if you have had no pain or swelling, or discomfort, you will not have had any damage, so don’t worry about that. I think you would be wise to see a doctor, just to get his advice. Not that I believe there is anything wrong, because testicles do turn around like this in the scrotum. As long as they go back, there is no problem. But there is a medical emergency when a testicle spins around and refuses to go back – this needs urgent medical attention at the ER. The pain and swelling would leave you in no doubt if this had happened to you.

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40. Foreskin won’t budge

Q: I have an average penis and no problem with erection, but I can’t pull my foreskin behind my glans – I can’t even stretch it by hand. It just doesn’t work. What can I do to get loose foreskin to have sex without pain? Is it also possible that my always fast ejaculation is related to this problem?

Ans: If sex is uncomfortable, as it can be if the foreskin doesn’t slide easily, then I suspect that you may have developed a habit of ejaculating quickly so as to shorten he time during which you feel uncomfortable. You can read all about the ways to deal with a tight foreskin on problem page 1 of this website.

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41. My retracting penis

Q: Having read all the information available on line, I still have the same question. I understand the withdrawal back inside the body of either the penis or testicles is called retraction. My question is can this condition be eliminated? Is it caused by nervous reaction or something based on body temperature, outside temperature or what? In a normal, non-aroused state my penis is 3 to 3-1/2 inches long. That’s when it has not retracted. When retracted it can be from about 1-1/2 to 2 inches long with the skin pushed back and wrinkled and usually part way over the head, which has been circumcised. This condition does attract the attention of sexual partners or anyone else who might observe and can be very embarrassing. Any cure?

Ans: No cure, sorry. But surely if your penis is erect when it needs to be, you don’t have a problem?

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42. My bendy erection point downwards

Q: Hello, I am not sure as to how I should start, but I will give it a try. What I would like to ask is if I am right that I have a problem of sorts. I am a virgin, non-circumcised, and it seems that whenever I have an erection my penis is not fully erect. It feels really hard when I do touch it but it is bent downwards not upwards. I am not sure what causes this problem and I am not sure as to what I should so.

Ans: But this is normal…..some penises do bend downwards when erect, and so long as it is hard enough to go inside a vagina, you have no problem. Some penises bend upwards, some downwards, some to the left and some to the right. it is all part of the variation in the penis. unless your penis looks deformed or abnormal, then you are probably just one of those guys with a bendy penis. See Penis Myths for more information.

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43. Semen color

Q: Hi. Crazy question: sometimes my semen is very yellow and sometimes it is white. If you can explain this I would be very happy. Thank you.

Ans: It isn’t a crazy question. It comes up a lot, actually. Many guys say the color of their semen changes from day to day. They often wonder why it has a greenish tinge or yellowish color. I’m not quite sure what the cause is but it is certainly a common thing. I think maybe it is remnants of urine which discolor the semen. You could test this by drinking a lot of water till your pee is colorless, then see if your semen is yellow or white! Anyhow it definitely is not anything to worry about! If, however, you ever get any blood in your semen, then you need to pop along to the doctor pronto.

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44. Ring of dark skin on penis

Q: Hello, I’m 18 years old. I am writing you because I have an embarrassing aesthetic problem with my penis. I have become aware of a ring of dark skin about an inch away from the head. I understand that this kind of scar can arise from circumcision but I’m not sure that mine has. Anyhow, how can it be a scar if it’s not scar tissue? I think it may have arisen from the way I hold my penis when I masturbate. I continue to give this theory credence because I do not believe that this scar has always been here and I was circumcised at birth. This is a very embarrassing problem for me and I would like to get an anonymous diagnosis before I go and pull my pants down for the family doctor. What is this and how do I get rid of it?

Oh, and I get erections a LOT. How can I calm it down – when I see my girl, my pants go ‘flying upwards’…..is there no way to calm it down besides yelling “down boy!” and looking like a fool – LOL! No, seriously?

Ans: The word scar is not really accurate, it isn’t so much a scar as the dividing line between the skin of the shaft and the remains of your foreskin (which is a different type of skin) – depending on how far back they cut it off, then the ring of different color will be higher or lower up the shaft.

I get loads of queries along the lines of “How do I stop getting so many erections?” Well, sorry, you can’t! Just be glad you’re so masculine. (I know it can be an embarrassing problem, but you have more testosterone in your body now than you ever will again in the rest of your life, so the erections are quite normal – almost everyone has them at that age!)

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45. Why does my husband masturbate?

Q: Hi, I am a woman, writing in hopes that you can honestly answer a question for me or at least clear up some confusion. I am not sure how many letters you receive from women, but I was interested in a topic that was related to your site. Here is my situation….. My boyfriend and I have been together for about a year and a half and for the most part we share a healthy sexual relationship. However, recently I have become more frustrated with the fact that he still masturbates 1-2 times a week. He tells me it is perfectly normal and has nothing to do with our relationship or how he feels about me. I am still really uneasy about the whole thing and I feel pretty insecure when I know he has done it. Sometimes he will even do it the day after we have had intercourse, that seems unnecessary to me, am I wrong? Also I would like to have sex more than we do, which is usually 2-3 times a week. I would rather we just had intercourse rather than him masturbate. However, he will often complain that he just doesn’t want to engage in it as often as I do, that makes no sense to me because he is still masturbating in place of us having intercourse. I am so confused and frustrated. Can you please let me know if this is normal or do I have something to be concerned about. On the average, how many times a week do men with partners masturbate? Will this decrease as he gets older? I forgot to add that my boyfriend is 24 and I am 22. Please respond to my letter, I really need some feedback.

Ans: Several women have asked this question. It doesn’t mean he doesn’t respect or love you. Masturbation for men, even when they have a partner, is really normal. I would say every man does it. This seems to be the consensus of all my reading and research. OK, if so, then why? Well, because I think that despite female consciousness raising and greater sexual freedom, it is generally true that men have a higher sex drive than women, and sometimes it is nice to just engage in a quick method of relief and release that is simple, rewarding and feels good. The significance of masturbation is very different for men than it is for women: though men like to be in a relationship, there is a form of sex (wanking) which is just like snacking because you’re hungry, as opposed to sharing a feast with a loved one. I am sorry if this doesn’t convey an adequate explanation of why he’s doing it. But you also need to understand it is no reflection on you. And finally why don’t you offer to masturbate him, without necessarily expecting more sexual intimacy? He might like this, though I have to say, knowing something about men, I would be surprised if he accepted your offer, or, even if he did, this stopped him masturbating on his own. In short, don’t feel it’s a reflection on you; it isn’t, it’s how men behave!

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46. Has masturbation like this ruined my sex life?

Q: A question on my problem, which I didn’t find on your site. When I started to masturbate at 13 years of age, I would rub my penis against the sheet rather than using my hand. If at home in bed at the time, at the moment of orgasm I would stop myself ejaculating by pushing very hard downwards against the sheet & mattress, and no sperm would come out (& mother wouldn’t know as there wouldn’t be any tell tale stains on the sheets). Where did the sperm go? I ask because I feel almost no pleasure during sex, whether masturbating or with a partner. I remember that after I stopped myself ejaculating, the next time I masturbated I had far fewer pleasurable sensations. Since then I feel almost no pleasure at all during sex, just a little at orgasm & ejaculation, but the main experience is the release of tension.

I have always had a strong sex drive though slowing now compared with what it was. I have seen a sex therapist, he didn’t seem to believe me (about stopping the ejaculation) as he said there was nowhere else for the sperm to go. He recommended trying sex toys to masturbate into, which I did try but no difference. He saw the problem as purely psychological. I wonder if he is correct because I still have sexual hang-ups due to my strict religious upbringing and uptight, domineering mother. I have finally accepted that I am bisexual, and have told my wife, siblings & a couple of friends. I have a reasonably healthy sex life with my wife, but there could be so much more pleasure. I recall reading years ago about a penis with broken nerve connections or something like that and the guy no longer felt anything during sex. Could something like this have happened to me?

Ans: It is very unlikely you have suffered any damage. During masturbation, I think that you probably forced the semen back into the bladder, a condition known as retrograde ejaculation, and not uncommon. (BTW that sex therapist must have been quite ignorant if that possibility did not occur to him. If he didn’t know of it, I find that extraordinary). Anyway, I suspect that IF this is what happened – then your body needs retraining to ensure you get a lot more pleasure from sex. The other possibility is that you would get more pleasure from sex with men, you don’t say if you’ve tried this or not. I think the best idea is a good sex therapist, and a partner committed to helping you. I am sorry I can’t be more specific, but I don’t think you’re going to be able to deal with this without professional help.

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47. No way to get an orgasm except like this

Q: Hi. I am 18 years old and a virgin. When masturbating I can’t ejaculate and have an orgasm without lying on my back tensing up all my muscles in my body up (up to the stage where I get cramps in my legs). If I don’t do this, I can masturbate for ages until I lose interest and lose my erection. Will this happen with a girl? I’m worried that I’ll go soft before getting an orgasm ‘coz I won’t be able to use this tensing my muscles trick.

Ans: One of the problems with learning to masturbate in a particular way is that it can become a habit, and in the worst cases, impossible to ejaculate in any other way. You need to retrain yourself so that you can experience different ways of bringing yourself to orgasm. The help of a willing partner would be useful, so when you get to be with a girl, make sure you choose one who will be understanding and sympathetic if you lose your erection. Personally I doubt you’ll have a problem anyway, in the excitement of exploring sex with a woman for the first time.

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48. Frenulum Breve

Q: I think I might have Frenulum Breve, the frenulum is joined at the tip of the penis and meets the hole, I’ve heard that it normally joins the shaft lower down. When I masturbate and the penis gets really erect the frenulum digs into the head and this is usually the time when the penis begins to go soft. Does this sound like Frenulum Breve?

Ans: Could be FB. Why don’t you go see a urologist and explain it all to him, he can then decide what to do. You can read about frenulum breve on the links listed on this page: The Penis.com Problems

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49. My penis is losing its sensitivity

Q: I’m 24, and masturbate 2-3 times a week. I’ve noticed that my penis isn’t as sensitive as a couple of years ago. I can get hard and ejaculate, it just takes a little longer. Everything else seems normal. Will not masturbating for a while increase the sensitivity? How about another lubricant?

Ans: All good questions, which I get over and over again. One day someone will do some research on why men’s penises become less sensitive. Many men report their penis seems less sensitive than it used to, but don’t know why. I can only think it might have something to do with the penis head getting rougher and less sensitive due to years of underwear rubbing on it (if you are circumcised). As for a cure, you probably need to experiment. More lubrication like baby oil may make masturbation a smoother experience, while for other men, less lubrication – to increase the friction they experience during masturbation – seems to work better. You could also try different lubricants, leaving longer between masturbation so you get more urgency, and increasing the strength of your PC muscles to increase the force of your orgasm. (Read about that here.)

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50. Can’t stay hard like I used to!

Q: I am a 45 years old male. My problem is that I can get erect but right after I ejaculate I go soft instead of staying rock hard like I used to. How can I maintain it?

Ans: This is a symptom of age, and lowering testosterone levels. You could try Viagra. And read about the symptoms here.

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51. Rash on my penis – too embarrassed to get help!

Q: OK….I’m really embarrassed cause I’m only 15…and my problem is my penis, for like 2 or 3 days now I’ve got a rash on the head of my penis and it has like kinda bumps on it and white spots! I’m like freaked out cause I don’t want to go to a doc or show my folks. Do you have any idea what my problem is or the cause of it? Can I heal/get it better w/o doctors or parents involved? Please Help ME….Thank You!

Ans: Whoa, hold on! You may only be 15, but so what? You’re a man, or rapidly becoming one….so why do you think having a man’s problems is embarrassing? And going to the doctor is not really embarrassing at all – it is a sign of maturity – you have a problem, you solve it, in this case by getting the advice of a professional in the field. Anyway, he will have seen it all before, and seeing your dick isn’t going to be a problem for him. What you have may be a fungal infection like athlete’s foot or jock itch, but you need the appropriate diagnosis and treatment from a doctor. If you leave it, it will only get worse, so summon up your courage right now, and go to the doc – tell your folks you have a rash or something, on your genitals, or if that’s a bit embarrassing, on your crotch…they will understand, I hope, and not ask any more questions. Alternatively, have a quiet word with your dad – he is a man, after all, and may well have experienced this himself! And, of course, he does know you have a penis – after all, he has one himself!

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52. Just pulled my foreskin back & penis head is SO sensitive!

Q: Hi there, I am 22 yr old male. Still a virgin. I have been masturbating almost once every day or more for the past 5 years. I didn’t know until recently that the foreskin can go down and expose the head completely. I guess my foreskin was tight. But now it goes back okay but not completely and is fatter at the middle (because it doesn’t go all the way back). Well, that’s the background. The problem is 1) when my penis is not erect I can take the foreskin all the way back to its limit but when erect it just stops after the base of head. 2) I have seen in porno videos that while having sex they actually lick the head. I tried touching it and it is very, very sensitive. When I try to rub it between my hands it really is so uncomfortable that I lose my erection. It is not like pain but it is so sensitive that I can’t stand the feeling. And I just lose the erection. I like my foreskin going back and forth over the head but I think if I tried to have sex or had a partner lick my penis head, I would not be able to stand it and would just lose my erection. Even so, my gut reaction says that this is normal as I have just started doing it. But I just wanted to run it past you.

Ans: One of the big complaints of circumcised men is that they lose sensitivity in the penis head because it has rubbed against clothing and so on for so long. I think many of them wish they were uncircumcised. But of course, as you point out, one big disadvantage of being uncircumcised is the extra sensitivity of the glans! By the way everything you describe is completely normal, including the fact that your foreskin goes back a different amount when your penis is erect than when soft. So don’t worry about that. So, what about the sensitivity? Well, the natural movement of the penis in a vagina is to slide back and forth inside the foreskin as you thrust in and out – a sensation which you mimic in masturbation. If you have a partner who wants to masturbate you, she (or he) can do the same thing as you. You will probably find that when you have oral sex, you will want to pull the foreskin back, and that the sensations in your partner’s mouth when he or she licks the head of your penis will be very good indeed. If you want to reduce your sensitivity a bit, you could try walking around for a few hours a day with your penis foreskin pulled back (if it will stay back on its own) inside your underwear. Of course you may find that this merely gives you an erection, but you could work at it. All in all, however, I wouldn’t worry, I think everything you describe is normal.

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53. I didn’t develop normally in puberty

Q: I’m 17 and a half and haven’t developed. It’s not just my penis – about five inches long when erect but thin – but it’s like I started puberty at 13 and have slowly being going through it for 4 years. My dick has not grown at all. I do have some hair but not much and I have a little showing on my legs and under my arms but that’s it. I have a bit of a moustache but never shave. And my girlfriend doesn’t know that I feel I can’t have sex because I’m in a child’s body, although I think I disguise my despair well. I don’t know what to do.

Ans: There are two ways of looking at this. First, you might be on the low edge of the normal range of normal male development. Second, you might have a problem that could benefit from medical treatment. Let’s think about it.

You do have some sexual development. Your penis, although it is in the lower size range, is not “abnormally” small. Even if it isn’t thick, it will still be the same size as many men’s – you can check this out on the stats on the size page of my website. (Though I know if you feel its size is part of a larger picture of developmental problems, this may be no comfort.) Your facial hair, although not dense, may continue to develop as you get older. You said you have had some wet dreams, and that you do masturbate, and I assume ejaculate, so your fertility is probably OK, and my guess is that you could father a child. I forgot to ask if you have a high sex drive – do you masturbate once a week or more than once a week? If it was less than that, it would be on the low side of “normal”.

OK, so where does this take us? I have counseled a man with a genetic trait in his family where some of the men lack what I would consider to be signs of “normal” masculine development – low levels of facial and body hair, for example, and in one case, abnormal penile development. (I forgot to ask you if you penis is anatomically normal. This might be important, because if it were hypospadic, i.e. the pee hole opened in the wrong place or the foreskin was hooded and incompletely formed, that could be a good indicator of a deficiency of testosterone in your body when you were growing in your mother’s uterus. You can read about hypospadias here.)

The man I counseled maintains that he did not experience anything like a normal puberty – no spots, no wet dreams, no masturbation until he was 19 (which points to a low sex drive), and he grew comparatively little body hair, although he did get spontaneous erections in his teens and masturbated a lot in his twenties. His position was exactly the same as yours – he said he felt like “a man in a child’s body”. Without the dramatic development that some boys go through, I think boys can feel they are not developing properly. Another male in this man’s family went through a more obvious puberty but even as an adult has little or no facial hair, although he does have a wife and two children. Which leads us to a possibility I want you to consider – that in fact you are at the lower end of normal development, and that you will be able to live as a normal male despite your feelings of deficiency. The problem then would be coming to terms with this.

On the other hand, you may have a real problem of development. Some of these problems can be treated by hormones, and some cannot. For example, if you lack male hormone, this could be administered by injection or patches. But if your problem is that you have normal levels of hormone, and your body tissues are a bit unresponsive to it, then there is little that can be done to make you more masculine than you already are. Suppose for a minute that for some reason you are deficient in your hormonal system. OK, either that can be corrected, or it can’t. But unless you go and see a doctor, you will not know the answer to this question. And you will, of course, continue to live with your self doubt, worry and unhappiness. My suggestion has to be that you get medical advice. I think it is important that you do that now, because the sooner any problem is treated, the better.

How would you go about this? Well, you could go to your family doctor, and explain, very clearly, what you believe to be the problem. A family doctor may be able to make some judgments about your development – for example, key indicators of testosterone production are testicle size and whether or not your voice has broken (I assume it has?) – but he is not really very well placed to give you an in depth analysis. If you want to pursue this to the natural conclusion, and set your mind at rest, you are going to need to see an endocrinologist (hormone doctor) who of course will be very well versed in such issues – obviously, that’s what he spends his life working at! Such a doctor will be a hospital specialist.

Now, can you do this? You have said that you don’t want to talk to your doctor or even your Dad for fear of looking like a fool. Well, as for looking a fool, forget it. Not taking care of yourself seems more foolish to me. This is your health, your future, and your happiness you’re talking about here. You need to see an endocrinologist, who will give you a thorough examination and set of tests. They are usually found in big city or teaching hospitals. I strongly suggest you get your family on your side, unless you have good reasons for not wishing to confide in them. Are you intimate enough with your girlfriend to ask her for support – would she be mature enough to act as support for you? But however you do it, I think you should act NOW! And I believe you have a real problem which needs the support of medical professionals.

54. What’s wrong with my penis?

Q: Hi, sorry to bother you but it would appear that something isn’t right down there! I suffer sharp pains when I urinate and the head of my penis is very sore when squeezed. Also there seems to be a whitish/yellow discharge leaking from the pee slit…the head does feel firmer than usual. I don’t know what to do. Please advise asap?

Ans: Well, it sounds like an infection – you need to see a doctor as soon as possible. If you have an infection and you leave it untreated, then you may get serious bladder or kidney problems. If you have had sex with a partner whose history you are unsure of then of course you may have a sexually transmitted disease, so you need to stop having sex, and get along to the sexually transmitted diseases clinic to find out what is going on.

55. Smegma?

Q: Could you please tell me if there is something wrong, as I have a white substance on my penis. It’s not a liquid. Can you tell me what this might be? I don’t have any irritation.

Ans: I think this is this “smegma” – a natural white substance that builds up from the dead skin and oils of the skin, easily removed by washing, completely natural and nothing to worry about. (except possibly the smell it generates if you don’t wash it off!)