Wednesday, December 30, 2009

5 Questions Men Don't Ask Their Doctors

From hernia exams to tender testicles, here are the answers you may have wondered about.

by Rich Maloof for MSN Health & Fitness

Everyone has questions that go unasked and unanswered at the doctor's office. Whether out of embarrassment or the underlying fear that something may be seriously wrong, men may try to avoid asking about unusual pains or irregular symptoms. From hernia exams to tender testicles, here are answers to five questions you may have wondered about:

Q. Why do I have to turn my head and cough during a hernia exam?

A. Notice that when you cough, the muscles in your abdomen tighten and flex. That increase in abdominal pressure can make a hernia pop out, making it easier for a doctor to detect. Though hernias usually present as a bulge, you could easily have a hernia and not know it.

Another reason is to diagnose varicoceles, which are varicose veins of the testicles. With a good cough, the veins will protrude much like the veins in your neck do. Varicoceles are the most common cause of infertility in men.

The doctor asks patients to turn their heads to avoid being coughed on all day.

Q. Is it true that you never really get rid of herpes?

A. There is not a cure for herpes nor is there a vaccine to prevent it yet.

The herpes simplex virus (HSV1 is oral herpes; HSV2 is genital) remains in nerve cells for life. When active, which can be several times a year, HSV travels along nerves to the skin, where sores become apparent. After a recurrence, the virus travels to the bottom of the spine and remains dormant there until the next outbreak.

But herpes is manageable. Controlling outbreaks is vital both for your comfort and for preventing contagion. Talk to a health-care professional about taking care of sores and the medications available to speed healing.

Women who have had genital herpes and intend to get pregnant should consult their ob-gyn to learn what measures will ensure the baby’s safety and health. Also, the annual Pap smear is a must.

Herpes is a sexually transmitted disease, and a popular one at that. Government statistics from 2003 estimated that one out of five Americans over the age of 12 was infected with genital herpes.

Q. Is it true that there is a male birth control pill?

A. No. There is no male birth control approved for use, and it’s unlikely one will be developed. The best options for men are wearing a condom, having a vasectomy or abstinence.

Interestingly, testosterone—the hormone that gives men sex drive and erections—has contraceptive side effects. When it’s taken as a hormone supplement the testicles get the message that there’s already enough testosterone in the bloodstream, and sperm production is halted. Long-term testosterone therapy will lead to zero sperm count. (This is why steroids make men sterile.)

Testosterone supplements, which come as a gel or by injection, are FDA-approved only for hormone treatment—not for contraception. Also note that the testosterone pills available outside the U.S. can damage the liver and should not be used.

Q. Can stress cause body odor?

A. Indirectly, stress can contribute to BO. But don’t blame it all on your boss, your bills or even your overactive sweat glands.

The body uses different sweat glands for stress than for physical exertion. Anxiety stimulates the glands in the armpits, in the groin and on the scalp, palms and feet. Unlike the salty sweat that covers our chest and back when we need to cool down, stress sweat is fatty—which makes it an especially fine meal for bacteria.

Perspiration is itself odorless. But when bacteria on skin and clothes begins breaking down fatty sweat, that stinks.

The solution? Minimize the bacteria on your body by showering regularly and wearing clean clothes. Use deodorant, which not only masks odor but makes the skin acidic and therefore less inhabitable to bacteria.

It’s not complicated. Perhaps your co-workers will even chip in for soap.

Q. What causes tenderness in the testicles, besides injury?

A. Any noticeable soreness or tenderness in the testes should be brought to the attention of a urologist immediately. It may very well be nothing, but here are some things that could be wrong:

Epididymitis is an infection of the epididymis, the long tube coiled up behind each testicle that acts as a veritable “swimming school for sperm”—sperm enter relatively immobile and exit the other end doing a flutter kick. It’s the most common infection of the testicular area, and the usual suspect is the sexually transmitted disease chlamydia.

Testicular cancer typically presents as a lump on a testicle. Though usually painless, the area will sometimes be tender. TC is the most common but also one of the most treatable cancers in males ages 15 to 45.

Torsion sounds a lot like “torture,” and that’s regretfully accurate. Each testicle hangs on a thin stalk called the spermatic cord, and when no ligaments attach the cord to the scrotum (a condition known as bell clapper deformity), the testicle can spin freely. The cord gets twisted and cuts off blood to the testicle. As you might guess, it’s accompanied by acute pain. Torsion is a surgical emergency because the testicle can die within hours.

Gentlemen, you may be seated.

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