Archive for the ‘infection’ Category

Problems “Down There” That Affect Your Sex Life

September 11, 2012

One of life’s greatest pleasures is intimacy with your partner. Nothing can put the ice on that relationship faster than when there is pain and discomfort for either a man or a woman associated with sexual intimacy. This article will review the most common causes of vaginal pain and what can be done to make the ouch go away.

Vaginitis
The itching, burning, and pain associated with vaginitis results from a disruption in the natural balance of bacteria that live in every healthy vagina. There’s no single cause. Common culprits include hormonal changes due to birth control, menopause, or pregnancy as well as chronic medical conditions, such as HIV and diabetes, which weaken the immune system. Frequent sexual intercourse and sex with multiple partners can be to blame as well. Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age. Women with BV may have a copious, thin grayish-white discharge. BV is easily treated with oral or vaginal antibiotics.
Yeast infections are caused by the overgrowth of one of several strains of Candida, a fungus that lives normally in the vagina. Women may notice a thick white discharge with a slight odor. However, many women complain of genital itching, soreness, or irritation. Treatment consists of a vaginal cream or an oral antifungal medication, Diflucan.
Treatment is painless and easy; most women simply insert at bedtime a prescribed cream or an ovule (a soft suppository) — generally soothing but messy — or they can take a prescription oral antifungal such as Diflucan. You’ll avoid the mess, but relief might take a few days longer.

Atrophic vaginitis is a result of a decrease in estrogen levels and the lining of the vagina becomes thin and easily irritated. Treatments such as estrogen creams or a vaginal estrogen ring can help.

Trichomoniasis, a sexually transmitted infection, can cause a greenish-yellow frothy discharge, with some itching and burning. This infection is easily treated with oral or vaginal antibiotics.

Vulvodynia

Vulvodynia is a condition where the pain so severe you can’t sit comfortably let alone have intercourse. The cause is unknown, but possible contributors include injury to nerves in the vulva, hypersensitivity to Candida, and pelvic floor muscle spasms. Treatment options include estrogens, oral antifungal medication, topical steroid creams, and physical therapy to loosen the muscles causing the spasms.
Vaginismus
This is a rare condition that fewer than 2% of women, which causes the muscles surrounding the vagina to contract so tightly that a woman can’t have sexual intercourse or even insert a tampon. The cause is unknown, but like vulvodynia, vaginismus responds to physical therapy. Now doctors are using Botox to relax the muscles and prevent spasms for up to six months.

Stress Incontinence
Stress incontinence occurs when there’s increased pressure or stress on the bladder or lower abdomen, such as when sneezing, when coughing, or during intercourse. This is a source of great embarrassment to a woman who loses urine during sexual intimacy. The cause is usually due to multiple vaginal childbirths, estrogen deficiency, obesity, and chronic constipation with the chronic straining to have a BM.
The easiest solution is for a woman to use the bathroom prior to sexual intimacy in order to empty her bladder. Kegel exercises can help build up the pelvic muscles that support the bladder and the urethra. Now there are minimally invasive surgical procedures that can help restore continence that can be done on an outpatient basis with immediate results.

Bottom Line: If you think you have any of these, see your doctor. Over-the-counter creams will often make the problem worse. The diagnosis is easily made in the doctor’s office and treatment can begin immediately and you will put the icing back on your sexual cake.

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Safe Sex For Seniors

February 3, 2012

The days of the dirty old man are over. Let the truth be told; older men and women want to remain sexually active. Seniors have more open attitudes toward sexuality, better health among seniors, the option for Internet dating, and the availability of medications like Viagra, Levitra, and Cialis, many older adults are remaining sexually active. It is important to emphasize that seniors are also vulnerable to sexually transmitted diseases (STDs) just as younger adults. Therefore it is important that seniors make certain that they are practicing safe sex. This article will provide suggestions for safe sex for seniors.

Do your homework. Seniors need to know your partner’s sexual background before having sex. This includes oral sex, anal sex, as well as vaginal sex. All types of sexual intimacy can spread STDs. It is important for seniors to talk about their sexual histories, and tell one another whether they have recently been tested for STDs and share with each other the results of those tests. It is also important to ask if there has ever been a history of injecting illegal drugs. HIV/AIDS can also be spread via a shared hypodermic needles though the most common risk factor for older women is sex with an infected man.

Make sure you can pass this test! The best way to protect yourself and your partner is for both partners to get tested for HIV and other STDs before starting to have sex. If one of the partners has not been tested, then it is imperative that the tested partner encourage the other partner to obtain testing. Remember that STDs don’t always cause obvious symptoms such as a rash, discharge, fever, or urinary symptoms. Also, some symptoms of STDs or HIV, such as fatigue, can be mistaken for age-related health problems such as low testosterone levels in men.

Condoms count. I suggest that seniors use a condom as well as a lubricant every time you have sex until you are in a monogamous relationship and your know your partner’s sexual history and HIV status. Lubricants such as KY Jelly are important because they can lower the odds of getting a sore or a tiny cut on the penis or inside the vagina. These sores or cuts can significantly increase the risk of getting STDs.

Bring your doctor into the equation. Your doctor can offer additional advice about protecting yourself from STDs. He or she can also recommend treatments for common sexual problems such as vaginal dryness and erectile dysfunction (ED).

It is quote common for senior women to have vaginal dryness as a result of estrogen deficiency. Vaginal dryness results in discomfort when a woman engages in sexual intercourse and can make for an uncomfortable experience. Solutions range from over the counter moisturizers and lubricants or the use of supplemental estrogen prescribed by your doctor. Estrogen can be given by pills, topical vaginal creams and estrogen impregnated rings that are inserted into the vagina.

Though ED is more common with age, it isn’t an inevitable part of the aging process. ED is often due to an underlying medical condition such as heart disease, diabetes, or the side effects of medication. As a result there is a likelihood of nervousness with the onset of a new relationship. Since ED may be the first sign of an underlying medical condition, it’s particularly important to speak with your doctor if you are having difficulty obtaining or holding an erection adequate for sexual intimacy.

It is not uncommon for seniors to have lost a partner and to go without sexual intimacy for months or years after losing a spouse. Consequently, there is anxiety associated with embarking on a new sexual relationship. Occasionally, counseling is in order to help the seniors jump start their sex lives.

There are numerous medications for ED, which are not recommended for men who use any form of nitroglycerin. Other treatments for ED include testosterone replacement therapy for men who have symptoms of decreased libido, lethargy, and falling asleep after meals. Finally, there are operations which includes penile implants for men where oral medications are not effective.

Bottom Line: It is acceptable and even normal of seniors to engage in sexual intimacy. If a man and women are healthy, are free of STDs, and wish to be sexually intimate, they can plan to successfully engage in sexual intimacy. In 2012, no one needs to suffer the tragedy of the bedroom.

If Your Tie-Wearing Doctor Is On The Cover Of GQ, He Could Just Be Spreading Disease

June 7, 2011

Concerned about picking up a nasty bug while in the hospital? Forget about whether your doctor washed his hands before examining you. Ask when he last dry-cleaned his tie.

Neckties worn by doctors can and do carry dangerous germs. It suggests a bedside visit by a well-dressed physician could be hazardous to your health.

The presence of bugs on ties suggests doctors aren’t washing their hands enough, or at the right times.

Here’s how it can happen: Doctors lean over and the tie touches one patient, then visit another and the ties touches that patient. A swinging neckties may come in contact with patient bedding, even patients themselves.

Earlier studies have found bacteria on everything from doctors’ stethoscopes to pagers and pens. Doctors now know to clean those items frequently. Shirts and lab coats are washed more frequently, sometimes as often as every time they worn.

Of the 42 physician neckties sampled at a prominent New York hospital, 20 contained one or more microorganisms known to cause disease.

So what’s the solution to the tie dilemma?  The study coordinator recommends abolishing ties from clinical practice altogether.  As a New Orleans physician who finds it uncomfortable to wear a tie much of the time, especially in the summer, I concur and will help promote his idea!

Safe Sex May Be Just A Spray Away!-Spray On Condoms

November 9, 2010

Good news for men whose penises are either so large or so small that they can’t find a condom to fit them: A German inventor has come up with a sprayed-to-measure system that should ensure a snug fit for even the most unusual sizes.

A German condom expert has developed a “spray-on condom” system in the form of a pump that squirts out liquid latex that cover the erect penis with a latex sheath.  If you go into a drug store to buy condoms, the ones they sell are mainly suited to men with the average penis length of 5.5 inches, but a lot of people have penises that are smaller or larger than that. Jan Krause, director of the Institute for Condom Consultancy, thought developing a condom that fits the man rather than the man fitting the condom.

The system works a bit like a car wash. The man put his penis in a chamber and presses a button to start the jets of liquid latex. A puff of latex is delivered to the penis forming a condom around the penis that is form-fitting and customized exactly for the man.  The rubber dries in seconds and is later rolled off and discarded like a conventional condom.

The spray-on condom will be more expensive than conventional ones. The cost is around €1 or $1.39 per condom, compared with around 50 cents per conventional sheath.

The condoms will be available in red, green, yellow and transparent, but they won’t come in different flavors!

Bottom Line: The spray on condom gives new meaning to “Puff the Magic Dragon”!

 

Water, Wet and Wonderful

May 3, 2010

Water is one of life’s best elixirs; there are few things as available, inexpensive and health-giving —so drink up.

Even though it is readily available, tasteless and free, most Americans do not drink enough water. And water remains one of nature’s most perfect medications. In fact, water is the most essential component of your diet.

While you can live for several weeks without food, you can live only a few days without water. Water loss of three percent of the body weight or approximately two quarts without replacement can result in weakness and lethargy. A 15-20 percent water loss can be fatal.

Nearly half the total body weight consists of water. To ensure good health, the average person requires two to three quarts of water per day because this is the volume that is lost in perspiration, urine, feces and breath. Nearly half of the food we eat consists of water.

Water is necessary for nearly all bodily functions such as digestion, circulation, excretion, nutrient transmission and temperature regulation.

More specifically, there are thirteen ways that water works in the human body:

  1. Water quenches thirst. There is no better liquid to quench your thirst than water. Many people are incorrectly informed that you only need to drink water in hot weather. The truth is large volumes of water are lost through your breath in cold, dry weather. Although you can substitute other beverages such as colas, coffee and electrolyte drinks, there is no other drink that contains fewer calories and more nutrients than water. In fact, affricated beverages can act as diuretics and cause the body to excrete water and important chemicals like potassium.
  2. Water aids digestion. Water dilutes the acidity in the stomach and causes the release of enzymes necessary for digestion. Water is also a natural laxative and relieves constipation.
  3. Water cools the body during exercise. As the body heats up during exercise, the internal thermostat promotes perspiration. Internal body temperature can be decreased with the consumption of cold water. Cold water is best because it is absorbed into the circulation more quickly than warm water.
  4. Water promotes waste excretion. The kidneys are the paired organs used to remove metabolic bodily water material. Water is essential for these incredible filters to do their work and flush out the body’s waste products.
  5. Water carries nutrients to the cells. All of the body’s cells are bathed in a saltwater solution.  Blood moves nutrients to the cells and removes the waste products to the kidneys and liver. Water is necessary to maintain the blood volume to carry out these vital functions
  6. Water reduces kidney stones. If too much calcium, oxalate or uric acid is excreted in the urine, crystals will form and start the growth of kidney stones. The best treatment to reduce kidney stones is to drink enough water to keep the particles from hitting one another and starting the crystallization process
  7. Water lubricates the joints. The bones glide against one another with minimal friction because of a lubricant called synovial fluid. Drinking plenty of water increases the synovial fluid and reduces the wear and tear on the joints
  8. Water promotes good skin tone. Skin elasticity is maintained when the body is well hydrated.  Chronic fluid loss leads to dry, wrinkled skin.
  9. Water dilutes alcohol and relieves headaches. There is no better remedy for a hangover than several glasses of water. Water dilutes the alcohol content in the blood stream and decreases its effect on the brain and central nervous system alleviating headache and hangover associated with excessive alcohol consumption.
  10. Water decreases pre-menstrual fluid retention. Some women experience salt retention during their menstrual periods. This leads to excess water retention as well. Diuretics or water pills only offer a temporary solution. Paradoxically, you can promote salt excretion by drinking more water. As the water is passed through the kidneys, it excretes the excess salt as well as the excess water.
  11. Water is a diet aid. Drinking a glass of water before each meal leads to a sensation of fullness before you sit down to the table, thus acting as a natural appetite suppressant. Water helps the body metabolize stored fat. If there is not adequate water to rid the body of waste through the kidneys, then the liver must be called in to do the kidney’s work. If the liver is doing the kidney’s work, it cannot metabolize body fat and weight loss is slowed or stopped.
  12. Water is a natural relaxer. Water is an excellent way to wash away tension. Swimming induces a feeling of calmness and exhilarates the body, similar to a jogger’s high.
  13. Water aids pregnant women. A pregnant woman should be especially conscious of getting eight to ten glasses of water a day. Water will clear her system of added metabolic body waste contributed by the fetus. It will also help prevent dehydration that may result from morning sickness.

How much water is enough? The time-honored advice of drinking eight to ten glasses of water a day still holds true. However, the more you exercise, the more you need to drink. A good rule of thumb is to drink approximately one quart of water for each hour of exercise.

Drinking too much water is rarely a problem. Too much water, more than six quarts a day, can dilute body minerals and electrolytes producing lethargy, confusion and if not corrected, convulsions and coma. The treatment is simple: Decrease the water intake and allow the kidneys to flush out the excess.

Bottom Line: Water is truly the elixir of life.  So enjoy one of life’s greatest medicines and it’s free.  Drink up!

Urinary Tract Infections in Women-Taking the Burn Out of Urine

May 3, 2010

Urinary tract infections (UTI) are a serious health problem affecting 8.3 million Americans each year. 53% of all women have had at least one urinary tract infection during their lifetimes. Many women suffer from frequent UTIs. Nearly 20 percent of women who have one UTI will have another infection. This article will cover the causes, symptoms, and treatment of UTIs in women.

What are the causes of UTI?

Most infections arise from bacteria, Escherichia coli (E. coli), which normally lives in the colon. These bacteria gain access to the urinary tract through the urethra or the tube that carries urine from the bladder to the outside of the body.

An infection limited to the urethra is called urethritis. If bacteria move to

the bladder and multiply, a bladder infection, called cystitis, results. If the infection is not treated promptly, bacteria may then travel to the kidneys. A kidney infection is called pyelonephritis.

Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in women, but these infections tend to remain limited to the urethra and reproductive system. Unlike E. coli, Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both partners.

Who is at risk?

In women the rate of UTIs gradually increases with age. Scientists are not sure why women have more urinary infections than men. One factor may be that a woman’s urethra is short, allowing bacteria quick access to the bladder. Also, a woman’s urethral opening is near sources of bacteria in the anus and the vagina. For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.

Some women are more prone to getting a UTI than others. Women with diabetes have a higher risk of a UTI because of changes in the immune system. Any other disorder that suppresses the immune system raises the risk of a urinary infection.

According to several studies, women who use a diaphragm are more likely to develop a UTI than women who use other forms of birth control. Recently, researchers found that women whose partners use a condom with spermicidal foam also tend to have growth of E. coli bacteria in the vagina.

What are the symptoms of UTI?

The most common symptoms include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad all over-tired, shaky, washed out-and to feel pain even when not urinating. Often women feel an uncomfortable pressure above the pubic bone. The urine itself may look milky or cloudy, even reddish if blood is present. Normally, a UTI does not cause fever if it is in the bladder or urethra. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.

How is UTI diagnosed?

To find out whether you have a UTI, your doctor will test a sample of urine for pus and bacteria. In the urinalysis test, the urine is examined for white and red blood cells and bacteria. Then the bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys the bacteria.

How is UTI treated?

UTIs are treated with antibiotic medications. The choice of drug and length of treatment depend on the patient’s history and the urine tests that identify the offending bacteria. The sensitivity test is especially useful in helping the doctor select the most effective drug. The drugs most often used to treat routine, uncomplicated UTIs are trimethoprim (Trimpex), trimethoprimlsulfamethoxazole (Bactrim, Septra, Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and ampicillin (Omnipen, Polycillin, Principen, Totacillin). A class of drugs called quinolones includes four drugs approved in recent years for treating UTI. These drugs include ofloxacin (Floxin), norfloxacin (Noroxin), ciprofloxacin (Cipro), and trovafloxin (Trovan).

Often, a UTI can be cured with I or 2 days of treatment if the infection is not complicated by an obstruction or other disorder. Many doctors ask their patients to take antibiotics for a week or two to ensure that the infection has been cured. Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria. During treatment, it is best to avoid coffee, alcohol, and spicy foods.

Recurrent Infections in Women

Women who have had three UTIs are likely to continue having them. Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. A woman who has frequent recurrences (three or more a year) can take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. If taken at bedtime, the drug remains in the bladder longer and may be more effective.

Additional steps that a woman can take on her own to avoid an infection:

I. Drink plenty of water every day.

  1. Urinate when you feel the need; don’t resist the urge to urinate.
  2. Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.
  3. Take showers instead of tub baths and avoid bubble baths.
  4. Cleanse the genital area before sexual intercourse.
  5. Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.
  6. Use cotton underwear as synthetics will trap bacteria.

Bottom line: UTIs are one of the most common infections occurring in women. The diagnosis is easily made and most women can be cured with a single course of antibiotics. Others need low-dose daily medication to control their infections.

Bladder Testing-Urodynamics

May 3, 2010

Urodynamics are simply a combination of several useful tests which provide information about your lower urinary tract. This information is obtained much in the same way that an electrocardiogram (EKG) proxies information about your heart. Urodynamics “draws a picture” for your doctor and helps to determine the diagnosis and what will be the appropriate treatment of your urinary problem(s).

Urodynamics testing is done at the office and usually takes 30-45 minutes.

During the test you will be catherized at least once. Your bladder will be filled one or more times with carbon dioxide gas or water or both. You may have a very small tube placed in the rectum. The nurse will tell you beforehand whether you are to have this done. Muscle activity in your pelvis will be recorded during the tests by small electrodes which are placed on the skin near the rectum. These electrodes are very similar to those used for an EKG.

Preparation for Urodynamics

It is important to have a full bladder when you arrive for the studies; please be ready to urinate! There are no other special preparations or food restrictions for this test. If you wear padding, external catheters, etc., you may wish to bring extra supplies for replacement after the test. You can help to make the test easier by remaining relaxed. Each step of the evaluation will be explained to you throughout the test by the experienced nurse who performs the studies. Every effort will be made to make you as comfortable as possible during the procedure. A urodynamics evaluation usually includes the following tests:

CystometrogramlElectromyogram (CMG\EMG)

This test involves filling your bladder through a catheter with sterile gas or water. The nurse will ask you when you feel the urge to urinate, and when your bladder feels completely full. Pelvic muscle activity will be recorded as already described.

Flow Rate

A flow rate is done simply by asking you to void into a special toilet which records the pattern of your urine stream on a graph and the amount of urine you void. Muscle activity in your pelvis will usually be recorded while you void via the electrodes already described. The amount of urine left in your bladder after you void (the residual urine) will also be measured at this time.

Cystoscopy

Cystoscopy is a test that allows your doctor to look at the interior lining of the bladder and the urethra. The cystoscope is a thin, lighted viewing instrument that is inserted into the urethra and advanced into the bladder.

The cystoscope is inserted into your urethra and slowly advanced into the bladder while your doctor looks through the scope to examine the inside of the urethra. Your doctor then examines the inside of your bladder for stones, tumors, bleeding, and infection. Cystoscopy allows your doctor to look at areas of your bladder and urethra that usually do not show up well on X-rays. Tiny surgical instruments can be advanced through the cystoscope that allow your doctor to remove samples of tissue (biopsy) or samples of urine from each kidney.

Cystoscopy can also be used to treat some bladder problems. Small bladder stones and some small growths can be removed by using tiny surgical instruments that slide through the cystoscope. This may eliminate the need for more extensive surgery.

After Urodynamics:

After urodynamics, you may experience some burning on urination or some increased frequency of urination for a short time. If you drink plenty of fluids afterwards, it will help to alleviate this sensation. You may also have some blood in your urine for a short while, which should be minimal. To decrease the risk of urinary tract infection, you will be given a few days of antibiotics to take by mouth.

You should notify your doctor if you experience fever, chills, severe bleeding or severe discomfort after your urodynamic study.

Cystitis-How To Leave Home Without It

April 13, 2010

What does sex, bubble bath and thongs have in common?  Answer: They may all be causes of cystitis.  If you are a woman who has ever suffered from cystitis then you will know just how debilitating and miserable it can be, you you can perhaps take comfort from the fact that you are far from alone.  It seems that at last 20% of women have had an attack at some point in their lives, and 20% of those will get more than one episode a year.

There is certainly no mistaking the feeling it brings, which usually starts with a strong sensation of needing to urinate.  When you try to go, it either burns horribly, or nothing seems to come out.  You may have a full, uncomfortable sensation in the bladder, plus an aching back and stomach and a general feeling of being unwell.  The most common cause is an infection caused by bacteria.  It isn’t only a female problem but far more common in women than men.  The reason is that the internal plumbing of women is much shorter than in a man and the relationship of the rectum which is usually the source of the bacteria is closer to the urinary tract in women than in men.

A bacteria, called E. Coli, is usually the culprit.  Since E. Coli coming from the rectum can reside in the vagina and then can have easy access to the urethra or the tube that transmits urine from the bladder to the outside of the body.  This is why it is beneficial for women to wipe from front to back when they use the restroom.  If you swipe the wrong way, you can move the bugs from the rectum into the vagina and then into the urethra.  Another recommendation is to switch from nylon or synthetic underwear to the cooler cotton briefs which discourage the growth of bacteria.  Also, thongs and G strings may be very sexy but they are bad news for cystitis sufferers as the string is an effective way for bacteria to hitch a ride from your bottom to your bladder.

Another suggestion is to change the bacterial flora of the gastrointestinal tract.  This can be accomplished by regularly eating yoghurt which contains the good bacteria lactobacillus or acidophilus.

It is also crucial to drink large quantities of water to flush away any bacteria.  Also, it is recommended that sufferers of frequent cystitis go the toilet when you first feel the urge.  The longer you hold in urine, the fuller your bladder is, with more potential for bacteria to grow and proliferate.  Using bubble baths or irritating soaps around the vagina should also be avoided as these agents can upset the delicate balance of acidity and alkalinity in your skin so that bacteria can flourish.

It also appears that sexual intercourse, promotes moving bacteria from the vagina into the urethra.  This then starts the process of bacterial multiplication in the bladder and creates the symptoms of cystitis.  Therefore, it is important for women who get cystitis after intercourse to urinate frequently after sexual intimacy to wash the bacteria out of the urethra so they don’t become permanent residents and create an infection.

For years doctors have recommended cranberries of a method to reduce the attacks of recurrent cystitis.  Initially, it was thought that the cranberries were a source of acid and this prevented cystitis.  Now research has shown that the cranberries contain chemicals that help stop the bacteria from sticking onto the bladder wall.  Because cranberry juice can be quite high in sugar, you might prefer to take one of the cranberry supplements that are available.

Beating back an attack

The first practical step is to consume 2 glasses of water every 20 minutes for the first three hours.  This will help you ladder to flush itself out, and sometimes is enough on it s own to prevent further problems.  If not, gulp down a few glasses of cranberry juice.  Sipping a glass of water with a teaspoon of bicarbonate of soda stirred into it may help the burning sensation when you urinate.

If these simple measures don’t relieve your symptoms in a day or two, you may need to see your doctor and take a short course of antibiotics.  Failure to treat the infection can result in a much more serious kidney infection.  Also, if you have more than 3-4 infections in a 12 month period you will want to see your doctor to be sure there isn’t something else more ominous causing these infections.

When Your Urine Turns Red

April 13, 2010

Most men have an ejaculate (the fluid that contains the sperm) that is white and slightly cloudy.  When it turns red, it is a frightening occurrence.  Hematospermia, or blood in the ejaculate, is a symptom that provokes great anxiety in patients due to fears of malignancy or sexually transmitted diseases. For most men, hematospermia is not a serious, life-threatening condition.

One could think of blood in the semen in almost the same way one would think of blood in nasal mucus when one has a bad cold or sinus infection. It certainly is a sign of problems, but it’s nothing to panic about. Seeking a medical opinion is highly recommended in any instance.

Most men with hematospermia usually report brownish to red discoloration of the ejaculate. More than 90% of patients have no prior genitourinary symptoms or significant factors in their history. The ages range from 14 to 75, with an average age in the late 30’s. It is not uncommon, however, for it to affect men between the ages of 30 and 40. About 90% of men who have had hematospermia will have repeated episodes.

The cause is not specifically known and is poorly understood. Most commonly, it results from nonspecific inflammation of the urethra, prostate and/or seminal vesicles.

In about 50% of patients the cause of hematospermia is not clearly understood or known. Semen originates from multiple organs, including the testicles, epididymis, vas deferens, seminal vesicles, and prostate. Most of the semen comes from the seminal vesicles and prostate and it is probably from these two organs that most hematospermia cases originate.

Infections or inflammation of the organs listed above account for most of the other causes. Cancers are rarely causative and account for a very small percentage of hemospermic diagnoses.

With the introduction of ultrasound-guided prostate biopsies, we are seeing a large number of patients — about a third of the patients who received the test — with hematospermia after the biopsy.

Patients with hematospermia are usually categorized into one of two groups. The primary hematospermia group is where the patient’s only symptom is blood in the ejaculate. This means that there is no blood in the urine (neither visually nor under a microscope). Also, the patient has no symptoms of urinary irritation or infection and the physical exam is completely unremarkable. Patients who have this type of hematospermia with no other findings are essentially found to have no other problem. The condition is “self-limited”, which means it will go away in time without treatment. About 17% of patients will have one episode and no recurrence.

Secondary hematospermia is when the cause of bleeding is known or suspected, such as immediately after a prostate biopsy, in the presence of a urinary or prostate infection, or cancer. Unusual causes include tuberculosis, parasitic infections and any diseases that affect blood clotting such as hemophilia and chronic liver disease. Patients who have hematospermia associated with symptoms of urinary infection or visual and/or microscopic blood in the urine require a complete urologic evaluation.

Most men with hematospermia are in their 30’s and the problem almost always subsides spontaneously, usually within several weeks. Hematospermia may be associated with infection, but is rarely secondary to malignancy. Patients that have persistent hematospermia for longer than three weeks should undergo further urologic evaluation to identify the specific cause.

The physical exam should include a genital and rectal exam, as well as a blood pressure test. Hypertension can be associated with hematospermia. Some urologists recommend transrectal ultrasounds to look for stones and cysts in the prostate, seminal vesicles and ejaculatory ducts. This may also help rule out prostate cancer.

Other urologists recommend cystoscopy because hematospermia can be secondary to urethral and prostatic pathology. Overall, hematospermia almost always resolves spontaneously and rarely is associated with significant urinary pathology. In a Japanese study, less than 1% of patients had prostate cancer associated with hematospermia.

Hematospermia can be a very frightening occurrence to any male, but in the end, most of these patients are found to have no abnormalities and require no therapy. Hematospermia is prone to continue on and off, but it is usually self-limited and carries no increased risk of any other disease, nor is the patient felt to be putting his sexual partner at risk. To reiterate; malignant cancers of the testicles and prostate are very rarely associated with hematospermia.

Bottom line-hematospermia is a frightening condition that suggests a mild inflammation of either the prostate gland or seminal vesicles.  No treatment or use of medication will result in return of the semen to its normal color.  If you have this condition, check with your doctor or your urologist.