Posts Tagged ‘infertility’

Smoking Is Also Hazardous to Your Urologic Health.

November 26, 2016

It is given that smoking is deleterious to your lungs and heart causing lung cancer, chronic obstructive pulmonary disease and heart disease, just to name a few of the common medical conditions causes by smoking.  There are also urologic conditions that are affected by smoking.

Bladder cancer is 4th most common cancer in men with nearly 80,000 new cases each year in the united States.  Smoking causes harmful chemicals and drugs to collect in the urine.  These toxic chemical affect the lining of the bladder and increase your risk of bladder cancer.

Nearly 30 million American men have erectile dysfunction or impotence  This is usually due to a reduction of poor blood flow to the penis.  Smoking can harm blood vessels, when decrease the blood flow to the penis.  As a result, men will have difficulty obtaining and keeping an erection adequate for sexual intimacy.

Kidney cancer is in the top ten most common cancers in both men and women with nearly 60,000 new cases every year.  Smoking puts noxious chemicals from the lungs into the blood stream where it is filtered into the kidneys and can cause kidney cancer.

Kidney stones affect 1 million Americans and smoking is a known cause of having kidney stones and also for having recurrent kidney stones.

Painful bladder syndrome affects 12% of women.  The condition is irritated by smoking and produces more symptoms of pain and discomfort in the pelvis.

Overactive bladder (OAB) affects more than 30 million American men and women.  Smoking irritates the bladder and increase the frequency of urination.  Smoking also is associated with coughing that can increase urinary leakage.

Infertility caused by male factors affects 50% of all problems related to difficulty with achieving a pregnancy.  Smoking can harm the genetic make-up in eggs and sperm.  The infertility rate for smokers in nearly twice that for those men who do not smoke cigarettes.

Bottom Line:  Most people are looking for reasons to stop smoking.  There are so many medical conditions that are caused by or are made worse by smoking.  Talk to your doctor about some of the effective ways to achieve smoking cessation.

What Women Need To Know About Their Partner’s Health

September 18, 2015

Women are drives of healthcare. They are responsible for helping to see that their partners take good care of themselves. My wife makes an appointment for my annual physical exam each year and accompanies me to the doctor to be sure that I explain all of my concerns and that she has the instructions for the recommendations and follow up. I don’t think my situation is unique as most women not take care of themselves but also the healthcare of their partner. This article will discuss 5 conditions that can impact a man’s health and should come to the attention of a physician\urologist.

Erectile dysfunction is often a sign of something more serious. About 70% of ED cases are caused by existing medical conditions, such as high blood pressure, diabetes, high cholesterol or heart disease. The more advanced these diseases are, the more at risk a man is for ED. In most cases, ED is treatable. If you loved one has ED, encourage him seek medical care.

Prostate cancer is the second most common cancer in men. About 1 in 7 men will be diagnosed with prostate cancer. The number jumps to 1 in 5 if he’s African-American and 1 in 3 if he has a family history of prostate cancer. Men should know their risk and talk to their doctors about whether prostate cancer screening is right for them.

Male infertility is more common than you think. In about 40% of infertile couples, the male partner is either the sole cause or a contributing cause of infertility.

If he has blood in his urine, pay attention. This can be a sign of a urinary tract infection, kidney stone, enlarged prostate or an early sign of bladder or kidney cancer. All men who have blood in the urine should see their doctor\urologist.

Testicular cancer is the most common cancer in men ages 15-35. Although there is nothing to prevent testicular cancer, if the cancer is caught early, there is a high cure rate. Signs of testicular cancer include persistent pain or a bump in the testicular area.

Finally, if they are going to the bathroom more than three times each night, they should be seen by a doctor. This could be a sign of a prostate or bladder problem, or potentially something more serious.

Bottom Line: Men have unique medical problems and women can be so helpful in directing men to a healthcare provider. I hope this article should be kept in mind regarding your male loved one’s medical health.

Sperm Counts Really Do Count-Improving Sperm Quality

March 24, 2015

Infertility affects 24% of couples wishing to have a baby. Nearly 1\3 are due to female causes, 1\3 to male causes, and 1\3 are due to both the man and the female partner. Therefore, men are involved in 2\3 of the problems that are responsible for failure to achieve a pregnancy. The first test for any man is the semen analysis. This test is obtained after two days of abstinence or no ejaculation and submitted for a sperm count, sperm movement or motility, and the shape of the sperm.

The world’s largest study on the effects of lifestyle on the quality of sperm has been published this week, with some surprising findings.
Researchers at the universities of Manchester and Sheffield found that smoking cannabis can have a severe effect on male fertility, yet other lifestyle choices such as drinking alcohol and wearing tight briefs were not considered to cause problems, despite earlier reports suggesting otherwise.

Sperm quality has been in decline for decades, and scientists seem unable to make up their minds as to the exact causes, citing everything from smoking to an increased exposure to estrogen.
The latest evidence is good news for jockstrap-wearers and bad news for dope smokers, but how else can you improve your sperm count? Here are five recommendations from leading experts:

1. Eat red food
Last month a report published by Ohio’s Cleveland Clinic, following analysis of 12 studies conducted by different groups around the world, found that consumption of lycopene improved the quality, mobility and volume of sperm dramatically, increasing sperm count by up to 70 per cent. Lycopene is an essential nutrient found commonly in red fruit and vegetables such as tomatoes, strawberries, cherries and peppers.

2. Lay off the laptop
A 2011 study published in the journal Fertility and Sterility suggested there could be a link between using a laptop with a Wi-Fi connection and a reduction in sperm quality. Sperm samples from 29 men were stored normally and under a laptop connected to WiFi. The sperm stored under the laptop became more sluggish and showed signs of DNA damage.

3. Get off your bike
Cycling has myriad health benefits, but not when it comes to your sperm. A 2009 Spanish study found that a prolonged spell on your bike can severely affect the shape and quality of your sperm. After monitoring 15 Spanish triathletes with an average age of 33 the study found that those men that cycled 300 kilometers a week (about 160 miles) – had dered a fertility problem.

4. Keep your cool
The optimum temperature for sperm production is 34.5 degrees celsius, which is slightly below body temperature. A three-year University of California study in 2007 found that five out of 11 men who stopped taking hot baths (including saunas) experienced a sperm count rise of almost 500 per cent.

5. Drink coffee – Go For Joe-but not too much
In 2003, researchers from Sao Paolo University in Brazil studied 750 men and concluded that drinking coffee can improve the swimming speed, or motility, of human sperm, although whether this means pregnancy rates are higher among coffee drinkers is unclear.

Bottom Line: Men are part and parcel of the baby making equation. If you have any questions, see your urologist and start with a sperm count.

Low T-Is Clomid a Solution For Men Who Wish To Have Children?

February 19, 2015

I am now seeing many younger men with low testosterone levels who have symptoms of lethargy, decreased libido, and problems with their erections. Upon further testing, many of these men are found to have low testosterone levels or low T. This blog will discuss the use of Clomid for the management of younger men with low T levels.

Whether you are a 30, 50, 80 or even 110 year old man, having low testosterone levels (hypogonadism) is neither fun nor healthy. The symptoms of low testosterone in men range from lack of energy, depressed mood, loss of vitality, muscle loss, muscles aches, low libido, erectile dysfunction, and weight gain.
Low testosterone in men may be caused by problems in the testes (or gonads). This is called primary hypogonadism and can be brought on by the mumps, testicular trauma, or testicular cancer, etc., and is often treated with testosterone replacement therapy.

Traditionally, if low testosterone is diagnosed, testosterone replacement therapy is prescribed, and it most commonly comes in the form of a cream, gel, pellet, patch, and by injection. And although these types of therapy are effective, some methods are better than others, and there are side-effects with all of them. For example, testicular shrinkage, gynecomastia (breast enlargement), low sperm count/sterility, and polycythemia (overproduction of red blood cells) are common side-effects of testosterone replacement therapy.
However, specifically due to the risk of sterility and low sperm count, such testosterone treatments aren’t a good option for men who want to have children. In these young men, clomiphene citrate (or Clomid) and/or human chorionic gonadotropin (HCG) have been used for decades to increase testosterone production, increase sperm production, and increase fertility. Both these therapies effectively help stimulate the testes to produce testosterone and thereby increase testosterone levels.

Clomid works by stimulating the pituitary gland to make more LH and there is an increased production of testosterone by the testes. HCG works by mimicking LH, which also increases the release of LH to produce more testosterone in the testes. I caution you that using testosterone in a young man wishing to have more children does the opposite of what clomiphene and HCG do and can shut off the release of LH and thus affect the testicles production of testosterone and affect sperm production.

With traditional testosterone replacement therapy, the brain (hypothalamus and pituitary) gets the message that there is plenty of testosterone being made in the testes, so much so that it doesn’t need to make anymore. Subsequently, the pituitary stops producing LH, and the natural production of testosterone (and sperm) in the testes ceases, which is why traditional testosterone replacement results in testicular shrinkage and low sperm count. Clomiphene citrate and/or HCG do not turn off the testosterone manufacturing plant but rather turn it back on or reboot it. While some hypogonadal men require continuous use of clomiphene, for others it can be used for a 3-6 month time period and then discontinued. And, the checks and balances system is not interrupted, so there aren’t the testosterone replacement side-effects which may occur with tstosterone injections, gels, or pellets.
The 5 Main Reasons Clomiphene Citrate (Clomid) May be a Good Alternative to Testosterone Replacement Therapy in Men with Low Testosterone Due to Secondary Hypogonadism:
1. Clomiphene citrate stimulates the body’s own production of testosterone
2. Clomiphene citrate doesn’t interfere with the body’s checks and balances of testosterone
3. Clomiphene citrate comes as a pill easily administered by mouth
4. Clomiphene citrate is generic and very cheap
5. Clomiphene citrate has little side-effects and low risk of developing these side-effects

Bottom Line: Clomid is a treatment option in young men with low T who wish to continue to have children.

Male Infertility-Some Low Cost Practical Solutions

December 27, 2014

Infertility is a common problem affecting many American couples. One-third are due to the woman who may have a gynecologic problem, one-third due to male factor, and one-third due to a combination of both the man and the woman. This blog will discuss the treatment and solutions for male factor infertility.

Keeping Mobile Phone in Pocket
A finding by some researchers at the University of Exeter in England showed that keeping mobile phone in the front pocket which is near the scrotum could affect sperm quality. They found out that exposure to cell phone radiation lowers sperm motility or movement by 8% and viability of the sperm by 9%. This finding is still a controversial one but it would be safer to keep away mobile phones from the pocket as much as possible. Therefore, my recommendation is to keep your mobile phone out of your trouser pocket. I also suggest that you do not text holding your phone at waist level.

Heavy Drinking
It is said that alcohol affects the body’s ability to absorb zinc which is a nutrient vital for healthy sperm. It’s still unclear what quantity of alcohol is bad but it’s advisable to stay away from it as much as possible, especially heavy drinking.

Oxidative Stress
Another thing that can cause male infertility is oxidative stress. This is linked to lifestyle factors such as obesity, diet, pollutants, smoking and alcohol. Taking antioxidant supplements such as vitamin E, vitamin C, folic acid etc. is said to increase fertility.

Poor Diet
A healthy diet will help maintain a healthy sperm count and an poor diet otherwise. It is advisable that men eat foods that will guarantee the general health of the body such as fresh fruits and vegetables, whole grains, and a minimum of red meat.

Excessive Exercise
Exercise is good for the body but its excess especially when it is combined with body building steroids can decrease the production of testosterone and thereby lower sperm count.

Frequent Sex
Too much sex can decrease the quality of sperm cells. It is advised that couples wishing to conceive should limit intercourse to every two or three days.

Exposure To Heat
Heat from laptops, wearing tight underpants and other things that could increase the temperature around the testicles could cause low sperm count. As much as possible, it is advised that the general crotch area should be kept cool and men use boxer underwear.

Untreated Infection
When STIs are not treated on time, it could result in infertility. Chlamydia infection, gonorrhea, mumps etc can affect fertility and even cause sterility.

Exposure to Pesticides and other Chemicals
It has been found that exposure to harmful chemicals can affect sperm quality and quantity. Agricultural workers and fumigators in Nigeria need to be mindful of this. Some other chemicals like paints, adhesives and coatings have also been found to double the risk of fertility problems. Men working with chemicals are therefore advised to wear the appropriate protective gear and reduce their exposure to the chemicals as much as possible.

Doping
Sniffing drugs like cocaine and cannabis can impair fertility in males. It is said that cannabis seems to have a dramatic effect on sperm quality. Some prescribed drugs can also affect fertility; it is advised that a man seeking to conceive should consult the doctor before taking any drug.

Bottom Line: Other things that could cause male infertility include stress, aging, radiation (x-rays, radiotherapy etc.), and obesity. With this understanding, it would be wise for men especially those seeking offspring to take note of the things that could be responsible for infertility so that they can play their part in making sure they also reproduce in life.

Testosterone Replacement In Men Who Wish To Continue Family Planning

November 24, 2014

Testosterone Replacement In Men Who Wish To Continue Family Planning

Millions of men have testosterone deficiency. Most of the men are middle age and older and, therefore, family planning is not an issue. However, if younger men have a low testosterone level and wish to continue family planning, the usual replacement with testosterone injections, gels or pellets is contraindicated because testosterone can reduce the sperm count making fertility difficult or impossible. This blog will discuss treatment of low T in younger men who wish to continue to have a family.

Function of Testosterone

Testosterone is the most important sex hormone or androgen produced in men. The function of testosterone is primarily the producing the normal adult male characteristics. During puberty, testosterone stimulates the physical changes that constitute the attributes of the adult male.

Throughout adult life, testosterone helps maintain sex drive, the production of sperm cells, male hair patterns, muscle mass and bone mass. Testosterone is produced in men by the testes and in the outer layer of the adrenal glands.

The hypothalamus controls hormone production in the pituitary gland by means of gonadotropin-releasing hormone (GnRH). This hormone tells the pituitary gland to make follicle-stimulating hormone (FSH) and Luteinizing hormone (LH). LH orders the testes to produce testosterone. If the testes begin producing too much testosterone, the brain sends signals to the pituitary to make less LH. This, in turn, slows the production of testosterone. If the testes begin producing too little testosterone, the brain sends signals to the pituitary gland telling it to make more LH, which causes the testes to make more testosterone.

Symptoms of Low Testosterone

The failure of the testes to produce a sufficient level of testosterone in the adult male results in a low testosterone level. Physical signs of low testosterone in men may include:

Declining sex drive,
Erectile dysfunction (ED),
Low sperm count
Decrease in lean muscle mass
Insomnia or sleep disorder
Depression
Chronic fatigue.
Conditions Causing Male Testosterone Deficiency

Testosterone deficiency can be caused by different conditions: 1) effects of aging; 2) testes based conditions; 3) genetics; and 4) conditions caused by the pituitary and hypothalamus.

The effects of aging on testosterone production
Testes disorder
Pituitary/Hypothalamus disorder
Genetically-based condition
Function of Testosterone Therapy

The function of testosterone hormone replacement therapy is to increase the level of testosterone in the adult male diagnosed with testosterone deficiency (low testosterone) or hypogonadism. Testosterone replacement should in theory approximate the natural, endogenous production of the hormone. The clinical reasons for treatment of testosterone deficiency in men include:

Increased male sex drive
Improve male sexual performance
Enhance mood in men
Reduce depression in men
Increased energy and vitality
Increase bone density
Increased strength and endurance
Reduce body fat
Increase body hair growth
Reduce risk of heart disease
Develop lean muscle mass with exercise
Function of HCG Therapy is to Stimulate the Testes to Prevent Loss of Natural Testosterone Production and Avoid Testicular Atrophy while the Male Patient is Undergoing Testosterone Hormone Replacement Therapy

The hormone HCG is prescribed for men in this therapy to increase natural testosterone production during the course of therapy as a result of the stimulation of the testes by the HCG. No testosterone medication is administered in this treatment. The treatment objective is to cause the male testes to naturally produce a higher volume of testosterone by HCG stimulation of his testes with the result that the patient experiences a continuing higher blood level of testosterone while on treatment. Another treatment objective is to avoid the use of any anabolic steroid and its adverse side effects upon the patient.

HCG Therapy normally increases natural testosterone production by the male testes while HCG is administered to the patient during the treatment period However, HCG Therapy can also result in a continuation of increased testosterone production and a resulting higher level of testosterone in the bloodstream after treatment is completed when the cause of the patient’s low natural LH secretion by the pituitary is not due to the patient’s natural genetics, aging process, injury to or loss of one or both testes; a medical disorder or disease affecting the testes, or castration.

HCG Therapy can result in a continuing higher level of natural testosterone production by the testes after HCG Therapy is completed when the underlying cause of the low LH secretion and resulting low testosterone production (1) is due to the prior use of one or more anabolic steroids by the patient or (2) due to the administration of testosterone in a prior hormone replacement therapy without the required concurrent HCG Therapy to prevent the patient’s endocrine system (hypothalamus pituitary-testes axis) from shutting down the natural production of testosterone by the testes and causing testicular atrophy.

Types of Testosterone Therapy for Men

A good male testosterone replacement therapy produces and maintains physiologic serum concentrations of testosterone and its active metabolites without significant adverse side effects.

The leading types of testosterone therapy for men include:

Testosterone Injection with HCG
Testosterone Transdermal Cream with HCG
Testosterone Transdermal Gel with HCG
Benefits of HCG Therapy for the Male Patient Undergoing Testosterone Hormone Replacement Therapy

Increases natural testosterone production by the testes
Prevents loss of natural testosterone production by the testes while the male patient is undergoing testosterone hormone replacement therapy
Prevents atrophy of testes while male patient is being treated with testosterone replacement therapy
Increases physical energy and elimination of chronic fatigue
Improves sex drive
Improves sexual performance
Improves mood
Reduces depression
Increases lean muscle mass
Increases strength and endurance as a result of exercise
Reduces body fat due to increased exercise
Increases sperm count and therefore male fertility
HCG Therapy can also result in a higher level of natural testosterone production after HCG Therapy is completed when the cause of a man’s current low testosterone production is the prior use of anabolic steroids that shut down or reduced the pituitary gland’s production of LH and decreased testosterone production.
Human Chorionic Gonadotropin (HCG)

HCG is compounded by a compounding pharmacy or manufactured by pharmaceutical company in 10,000 IU (International Units) for reconstitution with sterile water for injections in 10 cc vials.

HCG is a natural protein hormone secreted by the human placenta and purified from the urine of pregnant women. HCG hormone is not a natural male hormone but mimics the natural hormone LH (Luteinizing Hormone) almost identically. As a result of HCG stimulating the testes in the same manner as LH, HCG therapy increases testosterone production by the testes or male gonads as a result of HCG’s stimulating effect on the leydig cells of the testes.

The Decline in Gonadal Stimulating Pituitary Hormone LH (Leutenizing hormone)

The natural decline in male testosterone production that occurs with aging is attributed to a decline in the gonadal stimulating pituitary hormone LH (Luteinizing hormone). As a result of the hypothalamus secreting less gonadoropin-releasing hormone (GhRH), which stimulates the pituitary gland to produce LH, the pituitary gland produces declining amounts of LH. This decrease in the pituitary secretion of LH reduces the stimulation of the gonads or male testes and results in declining testosterone and sperm production due to the decreased function of the gonads. The decreased stimulation of the testes by the pituitary’s diminished secretion of LH can also cause testicular atrophy. HCG stimulates the testis in the same manner as naturally produced. HCG Therapy is administered medically to increase male fertility by stimulating the testes to produce more sperm cells and thereby increase sperm count or Spermatogenesis.

The decreased stimulation of the testes by the pituitary’s diminished secretion of LH can also cause testicular atrophy. HCG stimulates the testis in the same manner as naturally produced. HCG Therapy is administered medically to increase male fertility by stimulating the testes to produce more sperm cells and thereby increase sperm count or Spermatogenesis.

How HCG Therapy Increases Plasma Testosterone Level in Men with Low Testosterone Production

HCG therapy uses the body’s own biochemical stimulating mechanisms to increase plasma testosterone level during HCG therapy. It is used to stimulate the testes of men who are hypogonadal or lack sufficient testosterone. The male endocrine system is responsible for causing the testes to produce testosterone. The HPTA (hypothalamic-pituitary-testicular axis) regulates the level of testosterone in the bloodstream. and . The hypothalamus produces gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland to release Leutenizing hormone (LH).

LH released by the pituitary gland then travels from the pituitary via the blood stream to the testes where it triggers the production and release of testosterone. Without the continuing release of LH by the pituitary gland, the testes would shut down their production of testosterone, causing testicular atrophy and stopping natural testosterone produced by the testes.

As men age the volume of hypothalamus produced gonadotropin-releasing hormone (GnRH) declines and causes the pituitary gland to release less Luteinizing hormone (LH). The reduction if the volume of LH released by the Pituitary gland decreases the available LH in the blood stream to stimulate the testes to produce testosterone.

In males, HCG mimics LH and increases testosterone production in the testes. As such, HCG is administered to patients to increase endogenous (natural) testosterone production. The HCG medication administered combines with the patient’s own naturally available LH released into the blood stream by the Pituitary gland and thereby increases the stimulation of the testes to produce more testosterone than that produced by the Pituitary released LH alone. The additional HCG added to the blood stream combined with the Pituitary gland’s naturally produced LH triggers a greater volume of testosterone production by the testes, since HCG mimics LH and adds to the total stimulation of the testes.

HCG Clinical Pharmacology

The action of HCG is virtually identical to that of pituitary LH, although HCG appears to have a small degree of FSH activity as well. It stimulates production of gonadal steroid hormones by stimulating the interstitial cells (Leydig cells) of the testis to produce androgens.

Thus HCG sends the same message and results in increased testosterone production by the testis due to HCG’s effect on the leydig cells of the testis. HCG therapy uses the body’s own biochemical stimulating mechanisms to increase plasma testosterone level.

Following intramuscular injection, an increase in serum HCG concentrations may be observed within 2 hours; peak HCG concentrations occur within about 6 hours and persist for about 36 hours. Serum HCG concentrations begin to decline at 48 hours and approach baseline (undetectable) levels after about 72 hours.

HCG is not a steroid and is administered to assists the body in the continuing production of its own natural testosterone as a result of LH signals stimulating production of testosterone by the testis.

This LH stimulates the production of testosterone by the testes in males. Thus HCG sends the same message as LH to the testes and results in increased testosterone production by the testes due to HCG’s effect on the leydig cells of the testes. In males, hCG mimics LH and helps restore and maintain testosterone production in the testes. If HCG is used for too long and in too high a dose, the resulting rise in natural testosterone will eventually inhibit its own production via negative feedback on the hypothalamus and pituitary.

HCG therapy uses the body’s own biochemical stimulating mechanisms to increase plasma testosterone level during HCG therapy. It is used to stimulate the testes of men who are hypogonadal or lack sufficient testosterone

FAQ From My Patients

April 12, 2014

I am frequently asked questions by my patients and the answers may be of interest to you. If you have any questions that you would like me to answer, please write me at nbaum@neilbaum.com. to your good health.

I am a 60 yr. woman with recurrent urinary tract infections. I was told to drink cranberry juice. Is that effective?
Studies have documented that within eight hours of drinking cranberry juice, the juice could help prevent bacteria from developing into an infection in the urinary tract. Previous studies have suggested that the active compounds in cranberry juice work to fight against bacteria, including E. coli. Naturopaths believe in the medicinal value of cranberries. My own experience with hundreds of patients is that cranberry juice helps but you must drink 4-6 glasses a day, which is also a lot of sugar. So I suggest the cranberry juice pills. Anyone who suspects they have an infection should see a doctor, but drinking cranberry juice may be an easy, inexpensive way to help keep E. coli at bay.
I have chronic prostatitis. Is zinc helpful for this condition?
Zinc plays an important role in maintaining and improving prostate health. While zinc is found in every organ, tissue and cell in the human body, in males, the prostate has more zinc than any other tissue except bone.
As men get older, they tend to exercise less and their diets change as well, often causing them to fall short of the recommended daily allowance of zinc. Men who don’t have significant levels of zinc in their diets tend to have higher instances prostatitis. They also have higher prostate cancer rates.
The recommended daily allowance for men is 11 milligrams. Zinc is found in many popular foods, including meat and poultry, as well as oysters, beans, nuts, crab, lobster, whole grains, fortified breakfast cereals and dairy products.

My urologist told me that I have a varicocele. Will this cause me to have a problem with infertility?

Yes it may. Varicoceles are enlarged varicose veins that occur in the scrotum. They are fairly common, affecting 15 out of 100 men overall and one of the most common causes of male infertility because the heat from the dilated veins affect sperm production. Varicoceles occur most often in the left testicle. A varicocele repair is done to improve male fertility and is accomplished on an outpatient basis with improvement in the sperm producing in 3-4 months after the procedure.

I had radiation therapy for prostate cancer and now have a loss of my sex drive. What is the cause?
Men who receive radiation therapy for prostate cancer often receive injections to lower the testosterone level to decrease the growth of the cancer. Testosterone is responsible for the sex drive or libido. Often the testosterone level will return to normal after the medication is discontinued after the radiation therapy. In some instances men can receive testosterone one year after radiation if the PSA level stays at a low level. I suggest you have a discussion with your urologist about the use of testosterone in men with prostate cancer.

Protect The Nuts-Testicular Injuries

October 27, 2013

This title came from a program called Save The Nuts, www.protectthenuts.com, which is focused on men checking themselves for testicular cancer.  A man’s testicles are important for reasons, which include their concept of their manhood, their confidence, fertility, and potency.  Despite the vulnerable position of the testicles, testicular trauma is relatively uncommon. Mobility of the scrotum may be one reason severe injury is rare. The testicles are also prone to injury because they are not protected by muscle or bone. Given the importance of preserving fertility, traumatic injuries of the testicle deserve careful attention.  This blog will discuss the common conditions associated with trauma to those gems down there!             

The anatomy of testicles

Testicles are also known as testes (one is a testis) or ‘balls’. They are two small, oval-shaped male sex glands that produce sex hormones and sperm. Each testicle is housed in a fibrous outer covering called the tunica albuginea. Sperm production needs a temperature that is around 2 °C lower than the body, which is why the testicles are located outside the body in a sack of skin (the scrotum).

Testicular torsion

The spermatic cord attaches the testicle to the body. Testicular torsion occurs when the spermatic cord twists and cuts off the blood supply to the testicle. This condition can occur at any age, but tends to be more common between the onset of puberty and the mid-20s. It requires urgent medical attention.

Hard physical activity can cause this twisting of the cord. In most cases, however, it is caused by abnormalities in a male’s anatomy (body structure and organs) that make it easier for the testicle to twist or rotate around the cord.

Symptoms of testicular torsion include:

  • Severe pain
  • Scrotal swelling
  • Nausea and vomiting.

These symptoms can often be confused with an infection of the testicles. An infection should not be diagnosed until torsion has been ruled out.

Urgent medical attention is needed to save the testicle when torsion is diagnosed. Surgery must untwist the spermatic cord and restore blood flow to the testicle. A doctor uses physical examination and ultrasound scans to make the diagnosis. Sometimes, a doctor can only make a conclusive diagnosis at the time of surgical exploration.

The survival rate of the affected testicle is poor unless surgery is performed within four to six hours. Unnecessary investigations should not take place if torsion is suspected, as delays to surgery can affect the viability of the testis. If the blood supply has been disrupted for too long, the testis may not be viable or salvageable and may need to be removed.

In many cases, the surgeon will also secure the spermatic cord on the unaffected side, to prevent future torsion of the other testicle. If the torted testicle has to be removed, then a surgeon can put a prosthesis or silicone testis into the scrotum for cosmetic reasons.

Other conditions that can affect the testicles include:

  • Epididymitis – the epididymis is a collection of small tubes located at the back of each testicle. They collect and store sperm. Epididymitis is infection and inflammation of these tubes. Causes include urinary tract infections and sexually transmissible infections (STIs). Treatment includes antibiotics
  • Epididymo-orchitis – infection of the epididymis and testicle that causes inflammation and pain. Treatment includes antibiotics
  • Varicoceleor varicose veins – 10 to 15 per cent of men have a varicocele, where veins draw blood from the testicle. This blood has to rise against gravity when the man stands up. Valves in the veins help this process. If the valves don’t work, blood pools in the veins. This swells the veins and gives the appearance of ‘varicose veins’. Varicoceles usually don’t need treatment, unless the varicocele is severe enough to cause discomfort or impair fertility. The links between varicocele and infertility are complex and research is ongoing. Treatment includes surgery or radiological techniques that can block the testicular veins
  • Haematocele – a blood clot caused by trauma or injury to the testicles or scrotum. In some cases, the body is able to reabsorb the blood. If not, the person will need surgery to remove the clot
  • Hydrocele – abnormal build-up of fluid that causes the affected testicle to swell. In some cases, the body can reabsorb the fluid. Even though the condition is painless, the hydrocele may become so large that the person will need surgery to remove it
  • Spermatocele – an abnormal build-up of sperm-filled fluid next to the epididymis, which feels like a separate lump on the testicle. This is harmless, but can be removed surgically if it becomes large or bothersome. It is more common after a vasectomy
  • Undescended testicles – either one or both testicles are missing from the scrotum and are lodged inside the lower abdomen. Premature and low-weight newborn boys are most prone to undescended testicles. This condition is a known risk factor for testicular cancer and strongly related to infertility. Unless the testicle is brought down into the scrotum by 12 months of age, there is a high risk of damage to sperm production in later life
  • Testicular cancer – an abnormal growth or tumour that appears as a hard and usually painless lump in either testicle. In most cases, testicular cancer can be cured if the person seeks medical treatment early. Surgical removal of the affected testicle (orchidectomy) is usually the first treatment for all testicular cancer.

Suggestions on how to reduce the risk of testicular problems include:

  • Take all reasonable precautions to prevent accidents. For example, drive safely and always wear a seatbelt.
  • Protect yourself from sexually transmissible infections (STIs) by wearing a condom.
  • Always use protective equipment such as a jockstrap or hard cup while playing sports.
  • If you injure your testicles, always seek urgent medical advice.
  • Perform testicular self-examination (TSE) once every month. Regular TSE helps you become familiar with the look, feel and shape of your testicles so you will notice any abnormalities. See your doctor for further information on how to perform TSE.

Always see your doctor if you experience any scrotal or testicular pain or unusual symptoms, or if you find a lump or swelling.

 Bottom Line

Those gems between our legs are worthy of protecting.  If you feel any discomfort or lumps or bumps down there, see your doctor your potency and fertility are worth protecting.

 

Fertility-Steps To Improve Your Chances

August 21, 2013

Common Causes of Infertility in Men

Hoping for a child

Hoping for a child


About 10 percent of reproductive-age couples in the United States will have difficulty getting pregnant. About 30 percent of cases are due to fertility problems in the man, 30 percent to fertility problems in the woman, and the rest to unexplained causes or multiple factors involving both partners.

If you’ve had regular, unprotected sex for more than a year (or six months if you’re over 35) without conceiving, see your doctor. The National Infertility Association says at least half of those who have an infertility evaluation and treatment will be able to have a successful pregnancy.

A reproductive urologist can identify male fertility issues, recommend treatment options, and help couples decide which options to pursue. You also may want to see a genetic counselor. Sometimes, there’s a genetic reason for male infertility that could be passed down to children. A genetic counselor can help couples understand their options for conceiving.

Read on to learn about the common causes of infertility and available treatments. Keep in mind that success rates may vary because one couple can have multiple fertility problems.

Lifestyle factors. Making healthy choices can improve your fertility. You may be at greater risk of having trouble conceiving if you:

Smoking can be deleterious to your fertility

Smoking can be deleterious to your fertility

• Smoke;
• Drink alcohol heavily; Use drugs;
• Take anabolic steroids;
• Take certain medications, including testosterone replacement therapy;
• Have been treated for cancer;
• Have poor nutrition;
• Are significantly over- or underweight;
• Are exposed to toxins, such as pesticides or lead.

If you have any of these risk factors, be sure to tell us about it during your consultation.

Blockages. A small percentage of men have a blockage in their ejaculatory duct that prevents sperm from getting into ejaculate fluid. If your vas deferens or epididymis tubes are blocked or damaged, they can prevent your sperm from getting to your partner’s egg. Infection, injury, congenital defects, or a vasectomy could cause this blockage.
• Possible solutions: Surgery to repair an obstruction or reverse the vasectomy, or surgery to remove sperm for in vitro fertilization (IVF).

Varicocele. Varicoceles (enlarged veins, similar to varicose veins, in the scrotum) raise the temperature in the testes, which may affect sperm production.
Possible symptoms: Some men have scrotal pain, and others have no symptoms. (The problem can be detected through a physical exam or ultrasound.)
Possible solutions: Surgery to repair the varicocele, artificial insemination, or IVF.

Sperm making contact with egg

Sperm making contact with egg


Irregular sperm. If you have little to no sperm, poor sperm motility (ability to move), or abnormally shaped sperm, your sperm may not be able to fertilize your partner’s eggs.
Possible solutions: fertility drugs; artificial insemination with donor sperm (or with your own if your count, shape, and motility are not too abnormal), or intracytoplasmic sperm injection (ICSI).

Where Have All the Young Sperm Gone? Decreasing Fertility of the Millennial Man

July 17, 2013

Normal appearing male sperm

Normal appearing male sperm


Where Have All the Young Sperm Gone? Decreasing Fertility of the Millennial Man
A recent article in the Wall Street Journal (Tuesday July 16, 2013) points out that there by a “sperm crisis” because they believe men’s sperm counts have been decreasing for a decade or more.

A 15 year study in France reported that the sperm concentration of men decreased by nearly one-third between 1989 and 2005. In the U.S., some historical data suggest a decrease in sperm count among American men, but no published recent data exist.
Suspected causes include exposure to pesticides, endocrine-disrupting chemicals like Bisphenol A and lifestyle habits like sitting for too long contribute to the proposed sperm crisis. Also, I reported how men who use lap top computers on top of their genitals for long periods of time, increase the heat to the testicles and the cells that are responsible for sperm production.

In general, men produce upward of 60 million sperm per milliliter of semen. As long as the count is roughly greater than 40 million per ml, men are considered fertile and have the same chance of getting their partners pregnant as someone who produces a higher count. But below that threshold and particularly under about 20 million per ml, their ability to conceive decreases.

Accumulating evidence suggests that early life influences make a difference. Some researchers say that there is a vulnerable period, perhaps between eight and 14 weeks of gestation, in which influences are irreversible. One of the most robust links with decreased sperm count is maternal smoking during pregnancy.

The male’s own current marijuana use was also linked to lower sperm count.

In additional to maternal smoking, there are environmental and lifestyle factors that can affect sperm count which include: shampoos containing phthalates found in plastic bottles, sedentary jobs especially for over hours at a time, hot water such as frequent hot baths which increase scrotal temperature, fatty food appear to contribute to a low count but this impact is potentially reversible.

Bottom Line: By adopting a healthy, balanced diet and lifestyle in pregnancy, you can give your developing baby the very best start in life which will minimize the risk of future decreases in sperm counts.