Penis health: Identify and prevent problems

Penis health is an important part of your health. It's more than the ability to get and keep an erection, ejaculate and reproduce.

Penis problems can be a sign of another health condition. Ongoing health issues affecting your penis also can affect other areas of your life. They can cause stress, relationship problems or low self-confidence. Know the symptoms of penis problems and what you can do to protect your penis health.

What conditions affect penis health and function?

Problems related to sexual function, sexual activity and penis health include:

• Erectile dysfunction. This condition makes it difficult to get and keep an erection firm enough for sex.
• Ejaculation problems. These include the inability to ejaculate, premature ejaculation, delayed ejaculation, painful ejaculation, reduced ejaculation or retrograde ejaculation. Retrograde ejaculation happens when semen enters the bladder instead of going out through the penis.
• Anorgasmia. This is the inability to achieve an orgasm despite enough stimulation.
• Decreased libido. With this condition, desire for sex is lower than usual.
• Sexually transmitted infections. These include genital warts, gonorrhea, chlamydia, syphilis and genital herpes. These infections can cause painful urination, penis discharge, and sores or blisters on the penis or in the genital area.
• Yeast infection. This condition can cause inflammation of the head of the penis, also called balanitis, a rash, differently colored patches of skin on the penis, itching or burning, and a white discharge.
• Peyronie disease. In this condition, scar tissue develops inside the penis. This often results in bent or painful erections.
• Penile fracture. This rupture of the fibrous, tubelike tissue in the penis happens during an erection. It is usually caused by an erect penis forcefully striking the female pelvis during sex.
• Priapism. This condition is a lasting and usually painful erection that isn't caused by sexual stimulation or arousal.
• Phimosis. In this condition, the foreskin of an uncircumcised penis can't be retracted from the penis head. This can cause painful urination and erections.
• Paraphimosis. This happens when the foreskin can't be returned to its usual position after being retracted. This condition can cause painful swelling of the penis and impaired blood flow.
• Penile cancer. The cancer may begin as a blister on the foreskin, head or shaft of the penis. It then becomes a wartlike growth that discharges watery pus.

What factors increase the risk of problems?

A number of risk factors can affect penis health. Some can be changed and some cannot. For example:

• Heart disease, diabetes and related conditions. Heart disease, diabetes, high blood pressure, high cholesterol and obesity can increase the risk of erectile dysfunction.
• Certain medicines. Erectile dysfunction is a possible side effect of some common medicines. These include blood pressure medicines, antidepressants, prescription sleep medicine, medicines that decrease hunger, ulcer medicines and prostate cancer medicines.
• Prostate cancer treatment. Surgical removal of the prostate gland, called radical prostatectomy, and surrounding tissue as treatment for prostate cancer might cause urine leaks and erectile dysfunction.
• Smoking. Along with other health risks, smoking raises the chances of having erectile dysfunction.
• Excessive drinking. Drinking too much alcohol can lead to lower sexual desire, erectile dysfunction and poor choices in sexual behaviors.
• Hormone levels. Hormone imbalances, especially not having enough testosterone, have been linked to erectile dysfunction.
• Psychological factors. Depression, severe stress or other mental health problems, as well as medicines for these conditions, may raise the risk of erectile dysfunction. In turn, erectile dysfunction may contribute to anxiety, depression, low self-esteem or stress about sexual performance.
• Neurological conditions. Stroke, spinal cord and back injuries, multiple sclerosis and dementia can affect the movement of nerve impulses from the brain to the penis. This can cause erectile dysfunction.
• Getting older. Aging generally results in lower testosterone levels. These lower levels can lead to a higher risk of erectile dysfunction, less intense orgasms, lowered force of ejaculation and less sensitivity of the penis to touch.
• Sex that is not safe. Sex without using protection, sex with multiple partners and other risky sexual behaviors raise the risk of sexually transmitted infections.
• Piercings. A penis piercing can cause a skin infection and interrupt the flow of urine. Depending where the piercing is placed, it also might lower the ability to achieve an erection or orgasm.

When should you see your doctor?

Talk to your health care provider as soon as possible if you have any of the following symptoms:

• Changes in the way you ejaculate.
• Sudden changes in sexual desire.
• Bleeding during urination or ejaculation.
• Warts, bumps, sores or a rash on your penis or in your genital area.
• A severely bent penis or curve that causes pain or interferes with sexual activity.
• A burning sensation when you urinate.
• Discharge from your penis.
• Severe pain after trauma to your penis.

What can I do to keep my penis healthy?

You can take steps to protect your penis health and overall health. For example:

• Be sexually responsible. Use condoms or have sex only with a partner who's been tested and does not have sexually transmitted infections.
• Get vaccinated. If you're age 26 or younger, consider the human papillomavirus (HPV) vaccine to help prevent cancers associated with the virus.
• Stay physically active. Moderate physical activity can reduce the risk of erectile dysfunction.
• Make healthy choices. Staying at a healthy weight can help reduce the risk of developing high cholesterol, high blood pressure, type 2 diabetes and other risk factors for erectile dysfunction.
• Practice good hygiene. If you're not circumcised, regularly clean underneath the foreskin with soap and water. Return your foreskin to its usual position after sex.
• Know your medicines. Discuss medicine use and possible side effects with your health care provider.
• Pay attention to your mental health. Get treated for depression, anxiety or other mental health conditions.
• Stop smoking and limit alcohol. If you smoke, quit. If you need help quitting, talk to a member of your health care team. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.

Not all penis problems can be prevented. However, regularly checking your penis can make you more aware of the condition of your penis and help you notice changes. Regular checkups also can help ensure that problems affecting your penis are found as soon as possible.

It might be difficult to talk about problems affecting your penis with your health care provider. But don't let embarrassment stop you from taking charge of your health.