Body & Fitness

What’s your problem: Painful sex, low libido, lumps

Painful sex, low libido or a lump on your testicle? Northland-based doctor Cameron Schauer has the answers to your sensitive medical questions.
Sensitive medical questions.


Q. I’m thinking about circumcising my six-month-old son because I’ve heard it reduces infections later in life. Is this true?

A. Circumcision is the removal of the foreskin of the penis. Studies suggest this helps decrease the risk of getting human immunodeficiency virus (HIV), herpes virus and human papillomavirus (HPV). Circumcision does not protect against gonorrhea, chlamydia or syphilis. Condom use, penile hygiene and sexual precautions are a more practical method to help avoid infection.

Solution: Making this decision can be tough for some parents. Other considerations are cultural or religious beliefs. A decision is best made before the baby is born. The procedure can be performed at the hospital before the mother and baby are discharged. Circumcision can be performed as an outpatient procedure with local anaesthesia as late as three months after birth. After three months, however, the procedure usually requires general anaesthesia.

Low libido

Q. I have a new, slightly younger partner and I’m concerned my libido isn’t matching his. Is there something wrong?

A. Sexual problems are not uncommon. In the United States, approximately 40 per cent of women have sexual concerns and 12 per cent report distressing sexual problems. Many factors contribute to libido, such as stress, fatigue, lack of privacy, personal values and psychological issues. Depression and anxiety are strongly associated with female sexual dysfunction. Other medical factors include urinary incontinence, vaginal dryness, alcohol or other drugs, side effects from prescription medication and thyroid and diabetic disorders.

Solution: Referral to a professional counsellor can be useful to discuss psychological factors. If there are additional symptoms, such as pain, low mood and energy levels or if you have other medical conditions, it would be worthwhile to check in with your family doctor to discuss how these could be contributing.

Painful sex

Q. I’ve noticed recently that having sex hurts. What could be wrong?

A. Doctors call this condition dyspareunia. It is characterised by pain just before, during or after sex. It can happen in men and women, but it is more common in women. It can be around the opening of the vagina, inside the vagina or the lower abdomen area. There are many possible causes. These are varied and include vaginal dryness, skin problems around the vagina, infections in the vagina and bladder, endometriosis and painful past experiences or bad feelings in the relationship.

Solution: You should see a doctor. It can be embarrassing to discuss, but your doctor is a trained professional who will have seen many similar cases. Depending on your individual symptoms, age and situation, an internal examination, urine test and swabs may be taken. Treatment plans depend on what is found.

Testicular lump

Q. I felt a lump in my testicle two weeks ago and it hasn’t gone away. What could it be?

A. There are many conditions that can cause a lump in the scrotum. The main consideration is whether or not there is pain and/or swelling. There could be a build-up of fluid inside the scrotum (hydrocele), swollen veins (varicocele), or an infection of the epididymis, which stores sperm. A painless lump raises concerns about testicular cancer.

Solution: Your lump should be evaluated by a doctor. Testicular cancer is the most common malignancy in males between the ages of 15 and 35 years, but overall it accounts for just 1 per cent of male cancers. Your medical history and an examination can often point to the cause. However further tests may be carried out, such as an ultrasound.

Bent Penis

Q. My boyfriend has a bent penis. What is Peyronie’s disease?

A. There is variance surrounding how straight a penis should be. If it is curved and has associated pain or shortening during erection or sexual dysfunction, it may be a condition called Peyronie’s disease, which affects an estimated 5 per cent of men. It isn’t clear what causes it, but factors could include the accumulation of minor injury and genetic susceptibility.

Solution: Your family doctor should refer you to a urologist once a diagnosis of Peyronie’s disease is made. There are both medical and surgical options for treatment, depending on the severity of the problem. Evidence shows that curvature improves in 12 per cent of men when untreated, while it gets worse in more than 40 per cent of cases and remains stable in the rest. If curvature is mild (less than 30 degrees) and there is no sexual dysfunction, a urologist might suggest observation.

Genital warts

Q. I had genital warts when I was 18 and they’ve come back nearly two years later. Can I pass them on to my new partner?

A. Genital warts are a common sexually transmitted infection caused by the human papillomavirus (HPV). They cause skin-coloured growths around the vagina and anus, and can affect men and women. HPV is spread by direct skin-to-skin contact. People without visible warts may still have the disease and be able to spread it to others.

Solution: There are surgical options and several medicines, including liquids and creams, that can help get rid of warts. It is possible warts will return within weeks, months and even years because the virus can remain within cells and regrow. Some people clear the virus with their own immune system, but there is no medical cure. Condoms can help reduce the risk of infection but the virus can live on skin not covered by the condom and still spread.

This content is not a substitute for personal medical advice, a diagnosis or treatment. Always seek the advice of your GP regarding medical conditions.

Photos: Getty Images

Related stories