PATIENTS SHOULD BE ADVISED THAT MANY ‘GROIN GRIPES’ USUALLY RESPOND WELL TO A COMBINATION OF LIFESTYLE MEASURES
penis, pain during urination and a frequent need to urinate.
As with STIs, the most common treatment is antibiotics.
Smegma If the penis is not washed regularly, a cheesy- looking substance called smegma can build up. Smegma is a natural lubricant that keeps the penis moist and is usually found on the head of the penis and under the foreskin. If it does build up in the foreskin, it can begin to smell and can prevent easy foreskin movement.
Preventing a build-up of smegma is a matter of good personal hygiene - cleaning the genitals regularly with warm water and mild soap during baths or showers. If smegma is problematic, patients should be advised to wear underwear made of breathable materials like cotton.
Balanitis Balanitis is a condition where the head of the penis becomes red and swollen. Balanitis can often be related to a build-up of smegma, which
can occur if the penis isn’t washed regularly, but it can also be caused by an infection, such as thrush and skin conditions such as psoriasis.
Balanitis requires medical attention. Depending on the cause of the balanitis, different treatments may be prescribed. Typical treatment is a topical or oral antibiotic. Providers will recommend that those with balanitis to wash and dry under their foreskin often to reduce the risk of recurrent balanitis.
Irregularities in the testicles Most men's testicles are about the same size, but it's common for one to be slightly bigger than the other. It's also common for one testicle to hang lower than the other. The testicles should feel smooth and there shouldn’t be any lumps or bumps. On occasion, however, testicular lumps and swellings can be felt.
Causes of testicular lumps and swellings can include: • varicocele – caused by enlarged veins in the testicles (may look like a bag of worms)
• hydrocele – a swelling caused by fluid around the testicle
• epididymal cyst – a lump caused by a collection of fluid in the epididymis
• testicular torsion – a sudden painful swelling that happens when a testicle becomes twisted (this is a medical emergency and requires surgery as soon as possible)
Erectile dysfunction (ED) Erectile dysfunction (ED) is a condition where there is an inability to get and maintain an erection long enough to have sexual intercourse. It is a very common condition affecting half of men between the ages of 40 and 70 years to some degree.
The main physical cause of ED is when there is not enough blood flowing into the penis, but ED can sometimes be caused by health conditions, such as heart and circulation problems, injury to the penis nerves or low levels of the male hormone testosterone. Certain medications can also play a part in ED. The most common are diuretics, anti- hypertensives, fibrates, antipsychotics, antidepressants and corticosteroids.
Treatments include phosphodiesterase-5 (PDE-5) inhibitors, which are recommended first-line, regardless of suspected cause. These include sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra)
The role of the pharmacist In all of these conditions, your role is primarily one of support and as an information resource. Patients should be advised that many ‘groin gripes’ usually respond well to a combination of lifestyle measures (such as weight loss, smoking cessation, and reducing alcohol consumption) and drug treatment.
ED IS A VERY COMMON CONDITION AFFECTING HALF OF MEN BETWEEN THE AGES OF 40 AND 70 YEARS
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