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Here’s the Sexual Health Self-Exam You Should Be Doing

A step-by-step guide for what to check, how to do it, and when to see your doctor.

By Elizabeth Millard  Published: Aug 30, 2022

This article is a repost which originally appeared on Men’s Health.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our Takeaways:

· Testicular cancer is most common among men 20-40 years of age.

· Testicular exams during a shower are optimal.

· Men should also examine their chests to ensure there’s no development of breast cancer.

Two-thirds of sexually active men agree it’s important to regularly perform below-the-belt self-exams—but 47 percent have no clue how to do one, according to a survey by Men’s Health parent company Hearst Media. No need to count yourself in the clueless half; below is your instruction manual on how to perform a sexual health exam in the privacy of your home—and why doing so is crucial for your health.

Step 1: Start as early as possible

Because testicular cancer skews young—the disease is seen mainly in men between the ages of 20 and 40—self-exams should start as early as possible. Ideally, that would be in your teenage years, says Adam Ramin, MD, urologist and medical director of Urology Cancer Specialists in Los Angeles. Begin self-exams when there doesn’t seem to be a problem, so you can establish a baseline of what’s normal for you.

Step 2: Take a shower or bath

Doing a self-check while showering or bathing is easier because it relaxes the skin of your scrotum, says Boback Berookhim, MD, director of male fertility and microsurgery at Lenox Hill Hospital in New York. Plus, you’re already naked, so why not?

Step 3: Examine one testicle at a time

Move your penis out of the way and assess each testicle individually. Dr. Ramin says it should feel firm, similar to the webbing on your hand between the forefinger and thumb. Press gently to feel all parts of the testicle. As you feel behind the testicle, there may be a pea-sized lump; these are often benign, since cysts are common in that area, but if you find one, take note of its size and check with your doc if it’s painful or starts getting larger.

Step 4: Compare them to each other

It’s common for one testicle to be slightly different in size or shape than the other. If you’re noticing a change in what constitutes normal for you, that should prompt a checkup.

Step 5: Examine the scrotal sac

The upper part of the testicles may have veins that look like a “bag of worms,” says Dr. Berookhim. Called “varicose seals,” these veins aren’t usually cause for concern, but if they start to enlarge or harden, get checked because that could affect fertility.

Step 6: Do a visual check of the penis

Look for skin changes, pimples, pustules, painful warts, or sores, all of which could be associated with a sexually transmitted infection.

Step 7: If you’re uncircumcised, pull foreskin back

If bringing the foreskin back causes pain or is difficult, see your doctor. This could be an indication of diabetes, says Dr. Ramin.

Step 8: Assess for sensitivity or change in shape

Your penis should be straight, so if there’s a slight bend that’s more pronounced during an erection it could be Peyronie’s disease. According to Dr. Ramin, this condition could occur when excess calcium forms plaque in your penile blood vessels, or be caused by scar tissue caused from an injury. If your penis is painful to touch, it’s best to get it checked.

Step 9: Do a chest check, too

Yes, men have breast tissue and can get breast cancer, so whenever you do a self-exam, check your chest as well. Gently but firmly press in a circular pattern around each nipple and outward, feeling for any small lumps. If you feel one, don’t put off getting checked; men have a higher mortality rate for breast cancer than women, which experts link to delayed diagnosis and treatment.

Step 10: Grab a hand mirror

Once you step out of the shower, use a small mirror to inspect the underside of your penis and the inside of your thighs for sores or moles. Melanoma in the genital region is very rare, says Dr. Berookhim, but it does happen.

Now, repeat every six months

If you’re not detecting an issue, do a self-check every six months, suggests Dr. Ramin. But if you’ve had a problem or there’s an area you’re keeping an eye on, check more often.

Fertility Tests for Men: Options and How They Work

All About Male Fertility Testing

Medically reviewed by Carolyn Kay, M.D. — Written by Rhona Lewis on November 30, 2020

This article is a repost which originally appeared on Healthline

Edited for content

If you’re planning to father a child, know that fertility is a 50-50 deal: half egg, half sperm. So it probably isn’t coincidental that male fertility is a factor in 50 percent of infertility challenges.

This isn’t a blame game, though. It’s about empowering yourself with the knowledge you need to get the outcome you want. If you and your partner are having a hard time getting pregnant, it’s a good idea for you — both of you — to get checked.

Let’s take a look at male fertility testing and what may (or may not) be contributing to the challenge of having a child.

Factors that can affect male fertility

Research shows that male infertility affects up to 6 percent of men in North America. But what causes it? Several factors could contribute:

  • anatomical or genetic abnormalities
  • systemic or neurological diseases
  • infections
  • trauma
  • gonadotoxic radiation therapy
  • sperm antibodies

Can you just use a home fertility test kit and call it a day?

When you’re feeling the sting of another letdown, you may start weighing the pros and cons of home fertility tests. These lists give you a full picture:

The pluses

  • A home kit relieves you of the stress of providing a sperm sample in the doctor’s office.
  • Your concerns remain private.
  • The kits are inexpensive, as well as quick and easy to use.
  • A good kit, like SpermCheck Fertility can reliably tell you whether your sperm count is typical, low, or very low. This will help you plan your next step.

The minuses

  • Home kits won’t give you all the information you need. While they can tell you if your sperm count is normal or not, these numbers are only one factor in male fertility.
  • The range for low and optimal sperm counts varies between the kits.
  • Some kits don’t measure sperm counts below certain levels.

For these reasons, while a home kit might be a helpful first step, you’ll need to be medically evaluated by a doctor for a more complete picture of your fertility.

What to expect at an initial medical evaluation appointment

You’ve booked the initial appointment. Knowing that you’re prepped will ease any tension you may be feeling. Here’s a breakdown of what to expect.

First comes the physical exam. The medical practitioner will examine your penis and testicles.

Next, you’ll be asked questions about your:

  • medical history
  • lifestyle
  • sex life

Questions about your medical history may include:

  • Which medications do you take?
  • Have you had any sexually transmitted infections?
  • Have you had past surgeries?

Questions about your lifestyle may include:

  • How much do you exercise? (Give an honest answer!)
  • Do you smoke or take recreational drugs?

When it comes to your sex life, you can expect a frank discussion that includes any problems you may have, such as:

  • erectile dysfunction (ED)
  • delayed ejaculation
  • retrograde ejaculation

Semen Analysis

After the physical exam and the questions, you’ll be asked to provide a semen sample.

How semen analysis is done

Semen samples are given in two different ways.

You can ejaculate into a special container at the doctor’s office. If this isn’t an option because of your religious or cultural beliefs, you can use a special condom during intercourse.

Be prepared to possibly provide several samples, because sperm counts do fluctuate from one specimen to the next.

What semen analysis shows about fertility

You’ve done your part by providing the sample. Now it’s up to the clinician to analyze it. According to a 2015 study done in India, as much as 2 percent of all men have sperm measurements that aren’t optimal.

So what is your doctor looking for? In a nutshell:

  • Signs of infection. The presence of certain bacteria in semen can indicate infection.
  • Volume of semen. This is a measurement of how much semen in total is in your sample.
  • Sperm concentration. The World Health Organization (WHO) classifies sperm counts at or above 15 million sperm per milliliter of semen as average.
  • Vitality. This examines what percentage of sperm are alive.
  • Motility. Are the sperm moving? Above 63 percent motility indicates fertility, while less than 32 percent of sperm with motility indicates subfertility.
  • Morphology. How are the sperm shaped? Believe it or not, the majority of sperm in your sample won’t be perfect. But if more than 12 percent are of normal size and shape, it indicates fertility. A sample with less than 9 percent normal morphology could mean sub- or infertility. (Between 9 and 12 percent is inconclusive.)

So much for the numbers. Now let’s crunch them.

While the numbers help to distinguish between fertility, subfertility, and indeterminate fertility, none of them actually diagnoses infertility. That said, here are two things to keep in mind:

  • A semen sample with a decreased sperm concentration often also shows abnormalities in sperm motility and morphology.
  • The percentage of sperm with normal morphology is perhaps the best indicator of healthy semen.

Urinalysis

Sometimes, sperm cells pass all the standard medical tests for fertility, but you still have trouble growing your family.

That could indicate a condition called normozoospermic infertility, meaning that the sperm cells themselves are infertile. Here’s where urinalysis comes in.

How urinalysis is done

At the doctor’s office or the testing facility, you’ll be given a plastic cup and asked to be provide a small, clean urine sample. Use the cleaning wipe you’ve been given to wipe around your urethra to prevent bacteria on your penis from entering the cup.

What urinalysis shows about fertility

A 2014 study shows that doctors can now test for normozoospermic infertility by tracking the levels of five biomarkers (small molecules) in urine.

While standard fertility tests may capture 75 percent of cases, the researchers were able to correctly identify 86 percent of the infertile men and 87 percent of the fertile men.

What does that mean for you? While there’s still more research needed in this area, researchers suggest that the variant levels of these biomarkers may point to physiological problems as the root of normozoospermic infertility.

Making sperm is an energy-intensive process and any spoke in the production wheel could disrupt proper sperm production. The more we learn about the biomarkers, the easier it will be to fix any physiological problems.

Hormone testing

The pituitary gland, hypothalamus, and testicles work together when it comes to sperm production.

Follicle stimulating hormone (FSH) and luteinizing hormone (LH) — acting together with testosterone, which is produced in the testicles — are involved in the process.

A simple blood test will show the level of these three important hormones in your blood.

FSH

This hormone contributes to sperm production.

High levels may indicate that your testicles aren’t functioning properly or have been damaged by disease, X-rays, or chemotherapy. Low levels may show that you aren’t producing sperm.

LH

This is produced in the pituitary gland. In the testes, LT binds to receptors in the Leydig cells to release testosterone, which is needed to produce sperm.

LH levels can also be measured after giving an injection of gonadotropin releasing hormone (GnRH). The advantage to measuring LH this way is that your doctor can then pinpoint whether the problem is with your pituitary gland or another part of your body.

Testosterone

Healthy testosterone levels for men range between 300 to 1,000 nanograms per deciliter (ng/dL). Keep in mind that after the age of 40, testosterone levels decrease by an average of around 1 percent every year.

Imaging to check for anatomical issues and any obstructions

In some cases, your doctor may ask for imaging to check that your anatomical structure is OK and that there are no obstructions.

Scrotal ultrasound

In this exam, a handheld probe is swept across your scrotum. The scan uses high-frequency sound waves to check for:

  • infections
  • cysts
  • a collection of fluids inside the testicles
  • tumors

The test also checks for testicular torsion and varicoceles. While many adult men have a varicocele and are never bothered by it, if you’re dealing with infertility, your doctor may recommend surgery.

Transrectal ultrasound

A small, lubricated wand is inserted into your rectum. The imaging helps your doctor to check your prostate and check that there are no blockages in the vas deferens. Blockages can be corrected with surgery.

Anti-sperm antibodies testing

Usually, sperm doesn’t come into contact with the rest of your body and immune system. However, injury, surgery, or prostate gland infections can interfere with this protective system.

And when sperm comes into contact with your immune system, the body may produce anti-sperm antibodies.

Your doctor may ask for an anti-sperm antibody test if the cause for infertility is still missing.

You’ll be asked to provide a sample of semen. The test checks your semen for antibodies that fight against your sperm by using a substance that binds only to affected sperm.

The higher the level of sperm affected by antibodies, the lower the chance of a sperm fertilizing an egg. (These antibodies can also be found in women, so your doctor may ask for your partner to get tested too.)

Doctors are divided over whether this testing is advisable. Some say it doesn’t help set a treatment plan for infertility; others advise taking medication to lower the body’s immune response.

Testicular biopsy

This test may come at the end of the line if the other tests you’ve done aren’t conclusive.

In this test, a sample is removed from the testicle, either with a needle or through a small cut. If the results of the testicular biopsy show that sperm production is normal, your infertility may be caused by a blockage or some other problem with sperm transport.

Genetic testing

Following the development of in vitro fertilizing techniques, research on genetic causes for infertility has expanded. Genetic abnormalities are found in 10 percent to 20 percent of men who have severe disorders with sperm production.

Genetic testing carried out on DNA can help rule out chromosomal abnormalities, especially in men with either azoospermia (no sperm present in the semen) or oligozoospermia (low sperm count).

The test results can:

  • relieve you of uncertainty
  • help you avoid unnecessary surgical or medical treatments
  • help you make informed decisions on what your next steps should be

If everything checks out A-OK for you and your partner

If you’ve done all the tests and everything has come up as normal, you may hear your doctor saying “idiopathic infertility.” Basically, this means that at the moment, there’s no way of figuring out the cause for your infertility.

While it won’t ease your frustration and pain, know that your uncertainty is shared by many. Idiopathic infertility is an extremely common infertility diagnosis in both men and women.

The bottom line

Depending on your diagnosis, you may find that you need to draw on reserves that you never knew you had.

But there are many options for medically assisted pregnancy. And remember many male infertility diagnoses can be successfully treated.

Men’s Health Month – Testicular health

Men’s Health Month – Testicular health

Leigh Day

This article is a repost which originally appeared on LEXOLOGY

Edited for content

United Kingdom November 23 2020

We have reached the end of Men’s Health Awareness Month and we are now heading towards our first Coronavirus Christmas. My November has been spent in lockdown, glued to the US election whilst growing a tashe for Movember, a month-long charity event set up to highlight and fundraise for men’s health causes that include mental health, suicide prevention, prostate cancer and testicular cancer.

Did you know that in the UK, men visit their GP on average half as many times as women? On top of this worrying statistic is the fact that we are currently stuck in a global pandemic that has no end in sight. In April 2020, NHS England found that four out of 10 people were not seeking help from their GP because they were afraid of being a burden during a pandemic.

Being a burden should never be a consideration for not visiting your GP if you are worried about your health, regardless of how big or small you perceive the problem to be. The sooner a problem is shared, the quicker it can be solved.

One area that is important for men not to ignore is testicular health. Testicles are responsible for the production of sperm and also testosterone so it is vital we look after them.

Problems with your testicles can start when you develop a lump or a swelling. Whilst both these are not usually caused by anything serious, you should always speak with a doctor and get them checked.

The longer a problem with your testicles is left untreated, the worse it can get. With some testicular problems, time is very much of the essence and if you don’t act fast, there can be serious consequences.

In my role as a healthcare solicitor at Leigh Day, I have come across three different types of testicular problems where early discovery and diagnosis is vital to having the best long-term outcome. It is important that we all know the early signs of these problems, so that we seek GP advice if we are worried.

Testicular Cancer

Testicular cancer is where a tumour forms on or inside one of the testicles. Typical symptoms of testicular cancer include:

  • A painless swelling or lump in one of the testicles,
  • A change in shape, texture, firmness or appearance of a testicle,
  • A dull intermittent ache or pain or the feeling of heaviness in the scrotum.

Testicular cancer is the most commonly diagnosed cancer of men between the ages of 15 and 49 years old in the UK. It is also one of the most treatable types of cancer and it has a survival rate of above 95 per cent. However, if undiagnosed, the cancer can spread further than your testicles and become far more complicated to treat.

Testicular Torsion

Testicular torsion is when the testicle twists around the spermatic cord. When this happens, it cuts off the blood flow to the testicle. Symptoms of a testicular torsion include:

  • A sudden, severe pain on one side of the scrotum,
  • Swelling of the scrotum,
  • Abdominal pain,
  • Nausea and vomiting,
  • A testicle that’s positioned higher than normal or at an unusual angle,
  • Frequent urination,
  • Fever

A testicular torsion can happen at any time – during exercise, sitting, standing or even sleeping. It is a medical emergency and should be treated within four to six hours of the onset of pain. If the blood supply is not restored quickly, it will cause the testicle to shrink and die.

Testicular Infection

Epididymitis is a testicular infection where the tube at the back of the testicle becomes painful and swollen. Symptoms of epididymitis include:

  • A sudden or gradual pain in one or both testicles,
  • The scrotum feeling warm, tender and swollen,
  • A build-up of fluid around the testicle that feels like a lump or swelling

Whilst epididymitis can be treated easily with antibiotics, if it is ignored it can spread to the testicle and can lead to chronic testicular pain, the growth of an abscess, infertility and the loss of your testicle.

Examining yourself

It is important to examine your testicles once a month to check for any changes, swellings or lumps. The best time to do this is after you have taken a bath or shower by resting your testicles in the palm of your hand, and gently rolling each one between a finger and your thumb. For further information on examining yourself, please visit the Movember “guide to checking your nuts”. (https://www.bismillahrestaurant.com/)

If you find something strange, are experiencing swelling or sudden and unexplained pain in one or both of your testicles, don’t stew over whether it’s serious or not – get checked out by a doctor. The earlier a problem is diagnosed, the better the chance of successful treatment will be.

Conclusion

I understand that for some men, the idea of sitting and talking with a doctor about your testicles can be embarrassing, worrying or stressful. I also appreciate that whilst we are in a middle of a global pandemic, people want to avoid visiting the doctor. However, if there is a problem or you are worried about your testicles, go see a doctor and tell them what is worrying you.

The earlier the problem is diagnosed, the sooner treatment can be given and the better your chances will be of a full recovery will be.

UK man who survived testicular cancer becomes father: Here’s how to do testicle self-exam

UK man who survived testicular cancer becomes father: Here’s how to do testicle self-exam

Unlike other cancers, testicular cancer is much more common in younger men. Doctors recommend regular testicle self-examination to identify testicular cancer at its earliest stage. Watch out for these warning signs and symptoms.

By: Longjam Dineshwori

This article is a repost which originally appeared on THE Health Site

In what could be called a miracle, a UK man who lost his right testicle to cancer recently became a father. Joseph Kelley Hook was diagnosed with testicular cancer in 2017, when he was 29. Joseph knew something was very wrong when started feeling agonising pain in his groin and his right testicle had tripled in size. After a long fight, he finally defeated the cancer and was declared all clear in January 2018. But he never thought he would be able to have kids as he had his right testicle removed, plus chemo is known to reduce fertility. [The testicles produce male sex hormones and sperm for reproduction].

But in March this year, Joseph became a father when his partner Rachel gave birth to their son Jacob. He had frozen his sperm in case the couple ever needed it for IVF. But amazingly, he and Rachel were able to conceive naturally and didn’t need IVF.

Doctors in the UK say that testicular cancer is the most commonly diagnosed form of cancer in young men in the country. Joseph felt lucky that his cancer was caught early because of which could beat the deadly disease. He suggests all men to check their testicles and go to a doctor if they see or feel any changes.

Testicular cancer: Causes and risk factors

Compared with other types of cancer, testicular cancer is rare. But unlike other cancers, it is much more common in younger men, particularly those between ages 15 and 35. Men in their 30s are said to be at highest risk. (https://www.fasecolda.com/) Usually, testicular cancer affects only one testicle.

Doctors are not clear about what causes testicular cancer in most cases. But they know that it occurs when healthy cells in a testicle become altered. Sometimes some cells may develop abnormalities and grow out of control. These accumulating cancer cells may form a mass in the testicle. Testicular cancers mostly begin in the germ cells — the cells in the testicles that produce immature sperm. But what causes these cells to become abnormal and develop into cancer is unclear.

Factors that may increase your risk of testicular cancer include: An undescended testicle (cryptorchidism), abnormal testicle development, family history, age, and race. Testicular cancer is found to be more common in white men than in black men. Unfortunately, there’s no way to prevent this cancer from occurring.

Know the signs and symptoms of testicular cancer

In almost all diseases, early detection can lead to better treatment results and higher survival rate. Luckily, testicular cancer is highly treatable. The treatment will, however, depend on the type and stage of testicular cancer. Doctors also recommend regular testicle self-examination to identify testicular cancer at its earliest stage. So, watch out for these warning symptoms of testicular cancer to get it treated early.

  • A lump or enlargement in either testicle
  • Feeling of heaviness in the scrotum
  • 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
  • Back pain

If any pain, swelling or lumps in your testicles or groin last longer than two weeks, you need to see a doctor.