Top Fixes for Problems With Your Junk

“WHY IN THE world are some of the most important functional parts of your body described as ‘junk?’ ” asks Larry Lipshultz, MD, a urologist at Baylor College of Medicine and an MH advisor. After all, your penis—and the associated testicles, prostate, and bladder—has two main (very important) jobs: peeing and sexing. Each task uses different hardware and has different things that can go wrong. Fortunately, there are ways to fix stuff that goes awry.

THE FUNCTION

Taking a Leak

URINE, YOU PROBABLY remember from Biology, is made in your kidneys, stored in your bladder, and released through a tube called the urethra. The things that go wrong are heavily skewed by age.

WHAT GOES WRONG:

Under 40

You pee and (yikes) blood or (sorry) a snot-like discharge comes out. These are signs of infection. STDs are common causes, but bladder and prostate infections are also possible. Blood usually means a bladder infection (or, possibly, bladder cancer); pain in the perineum (the skin from your scrotum to your anus) means a prostate infection. In any case, see a doc for a urinalysis, the first step to identifying the culprit, which antibiotics can likely defeat.

FIX IT: Drink plenty of water and pee when you need to, as urine that sits in the bladder too long can get infected. When it comes to sex, wear a condom to protect against STDs. And having a lot of sex—with a partner or solo, and especially if your routine suddenly changes, can inflame your prostate, while frequent penile penetration can cause inflammation of the urethra.

WHAT GOES WRONG:

Over 40

Odds are you have a low flow, are peeing often, or feel like you’re not fully emptying. That points a straight line to the prostate, says Dr. Lipshultz. Honestly, it’s just a bad design: The prostate wraps around the urethra, and as your prostate inevitably grows with age, it can constrict that tube. If you don’t pee everything out, you’ll feel like you have to pee again very soon. The reasons for prostate enlargement are mysterious; it may have to do with factors related to testosterone and its metabolite, dihydrotestosterone, Dr. Lipshultz says. If you can live with the symptoms, you probably don’t need treatment. If you can’t, there are drugs that can relax the muscles around the prostate, which helps, and other drugs that shrink the prostate. Surgery is also an option.

FIX IT: Consider staying away from foods and drinks—like coffee, alcohol, spicy foods, and even some tomato- or chocolate-based foods—that can irritate the bladder and cause more frequent urination, compounding your problems.

THE FUNCTION

SEX

YOU’VE BEEN DOING it since forever, but for many men, at some point things gradually or suddenly go wrong. No suffering needed; there’s plenty that can help.

WHAT GOES WRONG:

Erectile Dysfunction

Technically, ED means not being able to achieve or maintain an erection to the degree that it negatively affects your life. “About one in four guys experience some degree of erectile dysfunction,” says Zachary Glaser, MD, an assistant professor of urology at Rush University. As you know, there are physical and mental aspects to getting hard. A doctor will check…

• Your junk for physical issues like nerve damage or Peyronie’s disease, in which scar tissue builds up and causes curvature in your penis and erections.
• Your ticker (and cardiovascular system) for problems with your body’s ability to pump blood into your penis and keep it there. Atherosclerosis, diabetes, and other chronic illnesses are common contributors to ED.
• Your medical history for medications like those that lower blood pressure or treatments for something like prostate cancer (more below) that can lead to ED.
• Your T for low levels, which in otherwise healthy guys can be a cause of ED.
• Your head—that is, to try to determine if your biggest issue might be something you’re concerned or worried about.

FIX IT: Viagra, Cialis, or another phosphodiesterase type 5 (PDE5) inhibitor, which help blood flow to your penis. If those don’t work, there are other options, all less appealing than taking a pill: a vacuum device that pulls blood in, drugs you inject into the base of your penis when it’s go time, and even a penile implant.

WHAT GOES WRONG:

Premature Ejaculation

For the record, doctors’ guidelines say this is when you last less than a minute. But don’t worry about the time; see a doc if the situation is unsatisfying to you or your partner.

FIX IT: Antidepressants, prescribed off-label, can help, says Dr. Glaser, and there are also numbing creams that can lessen the (over-)excitement.

WHAT GOES WRONG:

Delayed Ejaculation

This one’s tricky, since there’s no pill to prescribe. There’s not even a specific definition: It’s when it takes you a long time to ejaculate, or you don’t do it at all. When it’s interfering with your sex life, expect a deep dive with a doctor, since it’s not clear what causes it.

FIX IT: You might also be referred to a sex therapist. Which can actually help with all these problems. “There’s a close brain-penis relationship in men who have those types of issues,” says Dr. Lipshultz.

When Babies Just Aren’t Happening

Troubleshooting tips:

• Generally, you should try for a year before seeing a doctor.
• The usual lifestyle changes—more rest, more exercise, better diet, less booze and drugs—work wonders for fertility.
• A wide range of drugs (Rx and even weed) can lower your sperm count. Ask your doctor.
• Supplemental T suppresses sperm production, but it’s often reversible.
• One to two percent of men just don’t have sperm in their ejaculate. There are surgical and hormonal treatments that may help.

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Cancers of the Junk

THE YIN AND yang are prostate cancer and testicular cancer. Prostate cancer is very common, increasingly so with age. There’s a blood test to screen for it—and maybe a finger in the butt— but you generally don’t need it until you’re in your 40s or 50s (talk with your doctor about when you should start). And certain prostate tumors grow slowly, so the safe approach to treatment might be close monitoring with blood tests and MRIs. Testicular cancer is rare—but it’s the most common cancer among guys ages 15 to 45. There’s no screening test, but regular self-exams to check for lumps are crucial, says Neema Navai, MD, a urologist at MD Anderson Cancer Center. Most often, treatment starts with removing the testicle. The good news: Both cancers are super treatable.