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The 5 Most Common Male Genital Problems

Finding a sore on your genitals can be quite anxiety-provoking for men. Learn what the five most common culprits that cause lesions on the male genitals are, and how doctors treat them.

By
Sanaz Majd, MD,
April 7, 2016
Episode #211

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As a primary care physician, if you ask me what medical issues induce the most intense amounts of anxiety, besides the expected—a cancer diagnosis, panic attacks, and chest pain—I’d definitely include the presence of genital lesions on that high-anxiety list.

I recently had a young sexually active man see me in clinic for newly erupted spots on his genitals.  Before walking into the exam room, my nurse warned me about how nervous he appeared.  If he was trembling before I walked in, he seemingly began to near-convulse when he first saw me. 

“I thought you were a male doctor!” he exclaimed.

I get this a lot.  My name can be rather ambiguous for many, and I completely realize that I do not fit the typical “doctor” stereotype: older, male, gray hair, and glasses. If anything, I’m the exact opposite. 

After great reassurance and special finesse in my attempts to calm him, the color on his face gradually returned to normal, and he finally allowed me to examine him.  With a simple visual exam, I was able to quickly diagnose and even treat and destroy these seemingly elusive lesions in clinic.

He apologized at the end of the visit for his nervousness, and once he was reassured and relaxed, even continued to ask me numerous other questions in regards to sexual health thereafter. In fact, I now see this young gentleman in my office quite frequently for various medical issues.

This is unfortunately a more-than-common scenario that I encounter as a physician, and have learned that sometimes these anxiety-provoking, sexual health-related symptoms are just enough to put some people over the edge of insanity.  It can be overwhelming to simply not know or understand whether or not it’s a sexually transmitted infection, especially when you cannot be certain of its potential consequences. 

How did I get it? Is my partner cheating on me? Is it treatable?  Can I spread it? Is my life over?

So this has reminded me of the importance of some potential educational opportunities that involve male genital conditions.  Let’s discuss the top five:

Top 5 Male Genital Lesions

1.   Genital warts: 

Genital warts are by far one of the top causes of both genital lesions and sexually transmitted infections (STI’s).  They are caused by the Human Papilloma Virus (HPV)—yes, the same virus that is also responsible for cancer of the cervix in females (yet often in different strains). 

They are flesh-colored, purplish, bluish, or brown, small, round, and typically raised (but can also be flat) bumps that are painless.  The top surface may be smooth or appear cauliflower-like.  If you’ve ever had or seen a wart elsewhere on the body, most often hands (especially in children), they may appear similarly. They are often close in proximity to each other and may appear even in groups. 

They can spread on your own skin or to your sexual contacts quickly, yet are easily treatable with office liquid nitrogen application that “freezes” these spots and they subsequently fall off.  Or an alternative, if the lesions are more than just a few, is a prescription topical liquid that you can apply on your own several times a week in order to destroy them until they fall off.  Therefore, it’s vital to stop them in their tracks to help prevent their spread.

2.  Genital herpes: 

Genital herpes is definitely one of the most commonly found sexually transmitted infections on the male genitals, and is caused by the Herpes Simplex Virus (HSV). These are quite distinct when compared to genital warts.  They are small fluid-filled blisters or “ulcers,” in which the top layer of the skin appears as though it’s been lifted off.  And they are painful to the touch.  They can appear in clusters with surrounding redness.

Swab cultures and blood tests for herpes are inaccurate and greatly confusing to patients (and doctors) because they are not often very diagnostic. Therefore, the best way to diagnose genital herpes is by a simple visual exam of the lesions.

There’s no cure for genital herpes, unfortunately.  Once contracted, the virus lies dormant in your body and emerges to cause these painful sores during times of stress and/or when your immune system is down, and self-resolves as it withdraws in hiding once again.  Prescription anti-viral drugs can help shorten the duration of the symptoms when symptoms emerge, however, are not a cure.

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