Know Your Knob: all our penis health links

Free PDF of Size Isn't Everything - all penis FAQs answered

Split foreskin

Q . My boyfriend has had a scar on his penis on the thin bit where the foreskin pulls back and joins with the head. Recently this split and although it healed a bit it tore again when the skin was pushed back during sexual intercourse. Please can you advise us on whether this is likely to heal as we currently feel unable to do anything for fear of making it worse.

A. Relax. This frenulum often tears and invariably heals very poorly so it tends to break again in the same place. Unfortunately there is a little artery in there which bleeds quite heavily and can be a tad scary. Simply pressing on it with a cloth or thumb will stop the bleeding. He can have it removed for good with surgery.

Foreskin concerns

Q . I am becoming increasingly worried about the appearance of my penis. When I have an erection my foreskin reamains unchanged, it does not come back to reveal my head as I feel it should. Do I have a larger then normal foreskin and can anything be done about it? I have no problem in pulling my foreskin back but it does not remain there during masturbation or intercourse.

A. Believe me, it is far better to have too large a foreskin than one too small which can cause phimosis and a hasty trip down to the A&E department when it refuse's to go back to its rightful place. Like many things in life there are larger and smaller. You can have it removed or even modified by surgery but I honestly don't think it is worth the pain or money (it cannot be done on the NHS). Far better to grow into to it rather than suffer a tight pullover.

Painful penis and difficulty in passing urine and semen

Q . For some time now I have had a painful penis around the base of the helmet. I am circumsised and there is no discharge. Also when having an ejaculation I cannot feel the semen passing up through the penis as I used to. When passing sperm or urine it does not feel free flowing but seems to require effort to make it pass out.

A. I would really need you age and any past history but unfortunately the sensation of ejaculation does tend to decline with years. Being dehydrated will cause this to some extent so take plenty of fluids. So long as there is no discolouration of the semen or difficulty passing water there is unlikely to be anything nasty going on. Even so, keep an open mind and see your own doctor if you find things getting worse.

Leaking with erection

Q . Ever since puberty, whenever I have a sustained errection for any time exceeding about 3 minutes or so I seem to "leak" some sort of fluid. This can be very embarrassing. I usually wear two or three layers as not to show spots on my pants but even then it still shows through.What is this and is there anything I can do?

A. The prostate gland just at the base of the bladder secrets the nutrient material to keep sperm alive on their long trip to the uterus. With an erection the prostate is stimulated to produce plenty of this fluid which is slightly milky looking. Not surprisingly some of this can leak and cause staining.

Most importantly you must remember that any sperm sitting around at the time will be washed down and passed out with this leakage so you could make a women pregnant without realising it if you are having unprotected intercourse. It is quite normal and difficult to stop. One way incidentally of getting a semen sample is to stimulate the prostate with a finger massaging it from inside the anus. Not every mans idea of a good day out.

Repercussions after bending penis

Q. I am a healthy 30 year old man. My wife and I have always enjoyed a very good sex life. About two months ago, during vigorous sex, I bent my erect penis and felt awful pain. I finished without saying anything, but since then I have had a hard time maintaining my erection. When my wife is on top, I go limp. This is so devastating and I am too embarassed to go to the doctor. (We have moved away from home and this would be my first visit to a doctor I do not know.) I can maintain the erection while I am on top, but nothing like I used to be able to do. Also, my penis looks curved when erect now. It does not get nearly as hard as it used to. I am very upset and am not sure what to do. A lot of my sensation is gone, as well. Please answer me by email as soon as you can. I'd really appreciate it. Thanks.

A. I'm afraid you may have fractured your penis. This is possible despite there being no bone present. When the penis is fully erect it is liable to 'break' with trauma. There are different levels of this and it depends upon the amount of damage done to the erectile tissue. You may find that the penis tends to bend to one side, upwards or downwards. This can be treated but you need to see your GP who will refer you to a urologist.

Can't get proper erection

Q . A while ago I went biking. I biked for about 2 hours on a bad saddle. During the trip and afterwards I had a lot of pain in the area between the scrotum and the anus. This was 2.5 weeks ago, and still there is some pain. But, my real problem is the following: before this happened I very easily got an erection. Now with difficulties, and the penis is not getting real hard. It also seems as if it is "broken" at the root. Can you tell me how serious this is and what I should do about it?? Many thanks in advance.

A. You have succumbed to the dreaded blazing saddles syndrome. Fortunately it is usually quite reversible. A bad saddle under constant use can bruise the pudendal nerve which runs just beneath the skin below the crotch. It supplies all the muscles and blood vessels which control the erection and to some degree passing water at the toilet. Constant bashing of this nerve can cause a paralysis or neuropraxia which can take quite some time to recover. A similar comparison is the dead arm feeling after falling asleep with your arm over a chair arm or trapped under your body while drunk. In most cases it will return to normal service. You need to look very seriously at your saddle and how it is adjusted.

Penis crawls inside body

Q . I am a circumsized 31 year old male, with an unusual question... when I don't have an erection and my penis is in an unaroused state it crawls back into my body so that you can't even see it. It comes out and performs normally when aroused. I am wondering if this condition is normal and if it can cause problems down the road?

A. Coming from Northern Ireland, I can think of quite a few roads down which having a penis, circumcised or otherwise, performing normally could cause problems. You might also be quite glad for a penis which gets itself out of harms way!

Being overweight is the commonest cause of the 'disappearing penis' and by simply losing a few kilos it reappears as if by magic. Most of us men are obsessed with the length of our tackle but we look at it the wrong way. Don't compare yourself to the man in the next urinal as any sideways view gives a much better perspective than looking downwards. Get a good look in a mirror and get back on the road, stud!

Uncomfortable sex

Q . After kissing and petting with a young lady two days later I had a sharp pain in my penis lasting for about 20 seconds. No sex at all had taken place. Another two days after a reddish purple rash appeared under my foreskin. I had a sharp pains to my penis on initial sex. I think the young lady was just coincidence as I had similar sharp pains months before which lasted about one month but with no rash, this went away. I am not circumcised. I visited the doctor who thought that it could be thrush so I used caneston for many months. This seemed to do no good.

I have now had this problem 14 months and now find sex very uncomfortable. The rash now seems to have calmed down and blends to the colour of my penis. When my penis is erect the rash seems to flare up becoming bright red/purple a little lumpy too. If you look close you can see like little bloodshot veins. I have visited the GUM clinic and a specialist who said it looked OK but unless it's erect it's very hard to see the problem.

I just feel now that sex is a chore as I know it will be an uncomfortable experience. I also noticed that at the same time this rash appeared my sperm had started to produce little transparent lumps in it like jelly which was not there before. The rash sometimes sends my foreskin underneath all red as well which goes after a day. I suffer from no other symptons in this area. I hope you can lead me in the right direction as no one seems to know the answer but I know it's not normal. Thankyou.

A. I am taking this very seriously. The good news is that if you have had this problem for 14 months there can be nothing really horrible going on as the real nasties tend to get worse - not better - with time. Let's look at the problem in bits first:

Pain lasting 20 seconds to two days after sex. This, as you correctly say, is unlikely to be of any significance. Use of Canesten: If it wasn't thrush, and it probably wasn't, it would make no difference, which it didn't.

Appearance of the penis: From what you describe, I would need more detail, it sounds normal.

Lumpy sperm: This is very normal. Sperm is a small part of semen. The goo which keeps the sperm alive does go lumpy, particularly if you collect it on a paper towel, or even your hand.

The rash extends to your foreskin: Being a wee bit brutal with masturbation or sex will certainly make the foreskin and the helmet go red like any other skin. Similarly, washing it too much will do the same thing.

I'm delighted to say that from what you have told me I really don't think you have a problem. Even so, if you are not happy, you are obviously an intelligent man and you should go back to the GUM clinic and explain your concern and that you want to discuss this in greater detail.

Concern about behaviour of foreskin

Q . When I become sexually aroused, my foreskin drops behind the head of my penis (I think it's called the corona). Is this normal? Also, once the sexual activity has finished, the foreskin remains behind this ridge, causing my penis head to swell slightly and also causing me great discomfort because the head rubs against my underwear. Please can you tell me whether this is normal and how to solve this problem.

A. It is lovely to get a question which, with my hand on my heart, I can say 'there is no abnormality'. The foreskin generally does retract behind the helmet of the penis during sex or even masturbation. Generally it will make its own way back again once the penis has become flaccid. Occasionally it delays the whole process by acting as a ligature around the penis causing it to get bigger instead of smaller. You should use a water based lubricant (oil based lubricants dissolve condoms) to make it easier returning the foreskin yourself after sex. After a while you will probably not need to use a lubricant at all. Do not be tempted into a circumcision. It is perfectly possible to stretch the foreskin without having to chop it off.

I think I have phimosis

Q . I am seeking advice concerning a personal problem I have. Having done some very minor research upon it, I believe that the medical condition may be known as phimosis. However, in most phimosis problems, it seems that the foreskin can be retracted to a certain extent, and in some cases, fully retracted when flaccid. My problem is that the foreskin is not retractable at all. There is a small circular opening in the foreskin measuring approximately 7/8mm in diameter. I have never experienced any pain from this condition, and I am very confident that it is clean because I take care to wash it carefully.

The main worry I have with this is what a partner might think of it. It is ruining my self confidence. My friends know about this and treat it as somewhat of a joke, while I have to grin and bear it, laughing along with them.

I would greatly appreciate any advice.

A. The fact that your friends know about this 'problem' tells me you are not going to be too downhearted over the whole thing. Most men would rather tell their mates that Hitler was their best friend than discuss anything about their willy.

Phimosis - the tight pullover - is indeed common and is often a cause of referral to urologists for circumcision. The good news is that, with exercises, you may not need this surgery which is often performed totally unnecessarily. We circumcise boys and men more than most other European countries with no real evidence to support the practice.

You should lubricate your penis well with a water based jelly and pull the foreskin increasingly further back until you can achieve a full retraction while the penis is flaccid. Do not do this with an erect penis as it may prove difficult to bring the foreskin back to its rightful place. Real eye watering stuff. Once you can achieve this, and it may be painful, try doing it with the penis in various stages of increasing erection. Always return the foreskin immediately. If you leave it retracted while very tight it can cause the blood to remain inside the penis making it get even bigger (the basis of 'cock rings' and the vacuum device for impotence).

Only if this doesn't work should you consult your GP with a view to circumcision. Oh, and tell your mates to piss off. At least you know your hairy bits work.

Is this pain with erection normal?

Q . When I have an erection and my foreskin is all the way past my glans, I feel pain from a sort of "webbing" of skin (sort of looks like the skin between thumb and index finger) that goes from part of my inner foreskin almost to the opening (urethra?), and it feels like this is pulling at the glans and causing the pain.

Is this normal? I've never had any problems when masturbating as I keep my foreskin over the glans, but I've recently begun a relationship and I'm worried that if it progresses to intercourse it will be very painful.

Would it be possible to get part of this web cut surgically so that it does not pull on the glans when erect? If so, how long would it likely take to heal?

A. Time to relax. You have just noticed the curse of the energetic bonker: the dreaded frenulum. It is a thin piece of skin connecting the foreskin to the base of the glans (helmet). It is normal and serves two purposes:

1. To supply arterial blood to the foreskin particularly when the penis is erect. Fortunately, the foreskin is perfectly capable of surviving on other supplies which is just as well as the other purpose of the frenulum is.....

2. To scare the total shit out of you during frenetic intercourse when it snaps and squirts blood all over your girlfriend's favourite duvet given to her by her now dead granny.

Worse still, it appears at first that you have done fatal harm to your partner's internal organs with that dangly device of yours that she just knew had a serrated edge to it. I routinely get calls from very upset couples experiencing this for the first time. The frenulum is easily torn and thanks to its little artery makes its presence felt in no uncertain terms. You can have it cut surgically but frankly you may as well wait until nature does the job for free. Your calmness in the presence of spurting red stuff will convince her she has finally met Gladiator and his Fearsome Weapon. Just watch your back mate - for her husband Cassius

Worried about sexual intercourse with bent penis

Q . For as long as I can remember I have had a bent penis. I am now 21 and have never been sextually active. I am planning on starting soon. I don't seem to have pain or bumps from this problem. My concern is with sex. I don't know the angle needed in intercourse. For example, missionary position etc, or which ones I should use in my situation. I worry about getting all the way in and freedom of movement once I am in. I can bend ny penis straight but only at a 45-40 degree angle. Not to a 90 degree angle. Additionally, should I be worried about having difficulty entering her vagina in the first place?

Thank you! After years of worry, I finally found someone to ask.

A. Every now and then I get a letter which is a pleasure to answer. Instead of terrible, heart wrenching pathos and tragedy I can answer, with my hand on my hard drive that you do not have a major problem. Bent willies - Peyronie's -are very, very common and generally do not cause any problem with intercourse. So long as you can attain a usable erection, the angle of dangle or any deviation from the Harrier Jump Jet take off compared to that of the Lancaster Bomber will make little difference to the satisfaction for either you or your partner. If the 'bend' is particularly bad, surgery can improve matters, but wait and see the results of your bottle of champagne, soft music and gentle caress first. At the age of 50 years, the words Lucky and Swine come to mind. Get back to me if there is still a problem. Best of luck.

Bendy penis when erect

Q . When erect, the tip of my penis bends to the right. I can't think why this should happen, and want to find out what could be the problem, and what I could do.

A. It is possible that you have Peyronie's disease. I have enclosed some information below but you must NOT act on this information until the diagnosis has been confirmed by your GP, or a specialist. You have not mentioned whether this curvature is new, or has always been the case. If it has always been the case then it does not sound like Peyronie's disease. Some people do have a curvature of the penis - unless this is very severe it is unlikely you will need any treatment.

Peyronie's Disease.

Peyronie, who first described the condition, was a french Physician. The cause of the condition is not known although there is some evidence that minor trauma during intercourse may result in the condition later on. What happens is that the affected person develops some fibrous tissue in the corpora cavernosa of the penis - these are two blood filled chambers of the penis which enlarge during erection. These fibrous plaques can be painful, and are typically found on the upper side of the penis. The erection usually curves upwards but may also curve to one or either side. Sometimes it is possible to continue having intercourse, and sometimes not.

Over the course of 18 months or so the condition settles down. Usually the fibrous tissue becomes less painful during this time. Once the curvature of the erection stops getting worse on of three things may happen:

* The erection may go back to how it was before the condition started.

* The erection may remain curved during intercourse, but intercourse is perfectly possible and not painful

* The erection may be too curved to allow intercourse to occur

In either the first or second situation it may be possible to continue as before without treatment. If the erection is too curved to allow treatment then a urologist may be able to perform an operation (known as Nesbitt procedure) to straighten the penis.

Penis not feeling normal

Q . Recently my girlfriend and I have been having sex without condoms. She said she was tested four months ago for STDs when she began taking birth control. However, just recently, my penis has not been feeling normal. There is no pain when I urinate or anything, no blood in my urine, and there is no visible sign of open sores on my penis, but like I said, it just feels different. Similiar to that of a bruise. The feeling comes and goes as well. What's going on here?

A. Short answer - I don't know. These symptoms are not those of an STD and your girlfriend has been tested (presumably clear). Providing neither of you has had intercourse with another partner during this time it seems unlikely you could have developed an STD.

I think you should see you GP for a full examination to see whether this helps with the diagnosis of your interesting symptom.

Phimosis?

Q . I wonder if I have got 'phimosis'. My problem is retracting the foreskin completely (i.e. totally below the head) during an erection. I have no problem when flaccid.Also, when I retract my foreskin, I have recently noticed whitish lumps all around the bottom of the penis head (i.e. bell-end). I expect this to be related to the fact that I never/rarely used to retract my foreskin, in order to see these lumps. I have recently started washing this area now, but this is sensitive, and I cannot wash these lumps away (scraping them with my thumb).

This problem has bothered me for a while, and I hope I don't need circumcision. Please advise - Thanks.

A. The whitish lumps you describe is probably smegma - this is an oily secretion produced by glands at the base of the glans penis ("bell end"). This secretion is normal but you probably haven't been aware of it because of your inability to retract the foreskin. You should be able to clean this area properly, but please see your GP if you have problems. Whether or not you need a circumcision is tricky - from a purely medical perspective you probably do not, given that you can pass water normally.

However you are clearly having problems with hygiene due to the difficulty with retracting the foreskin. Furthermore, it appears to be uncomfortable for you to retract the foreskin when you have an erection. Be careful that you always pull the foreskin forewards after intercourse because if the foreskin is tight it can become stuck behind the glans. This is known as a "paraphimosis" and can need hospital intervention to treat it.

I think you would be wise to discuss this with your GP, and perhaps ask for an appointment with a urologist to talk over the pros and cons of a circumcision.

Could this be thrush?

Q . I believe I had thrush which I think I got because of poor hygiene. Red mottling etc. Canesten at first worked then didn't. N ystaform HC, prescribed by doc, got rid of it. Three weeks later, my foreskin became noticeably red again, slightly itchy, smelly, but nothing on the glans. Dried flaky stuff abounding there. Smegma? I'm using canesten on it again.

Do you think it could be thrush, or something else? My genitals are quite itchy at times, red, as is my anus. Doc wants diabetes check though I have none of the primary symptoms. He didn't really pay me much attention. Is Nystaform OKk for psoriasis and can it be used for longer than 7 days?

A. Thrush is caused by a yeast infection - Candida. You describe the signs and symptoms very well. It can be picked up by sexual intercourse but by far the majority of cases arise spontaneously. Recurrent thrush is often a sign of some underlying immune problem caused by drugs (eg steroids) or related to a medical condition (eg diabetes). This is more the case if you also suffer from oral thrush as well.

Getting checked out makes good sense for a whole lot more reason than just your thrush infection. If your partner is also infected he or she needs to also be treated as you will simply pass it on to each other. Avoid rigorous washing with strong soaps or detergents as this will only further reduce the natural protection from friendly bacteria.

Severe pain in red swollen testicle

Q . My son of 13 years has developed a sudden severe pain in his left testicle. This is very red and swollen. He's in a lot of pain.

A. This is most likely to be due to torsion of the testis. It is most common in the newborn period and at puberty. The pain is usually very severe and sudden in onset and is usually in the testicle itself although occasionally

it may be in the abdomen as well. Half of the scrotum is swollen and is often red in colour. The scrotum and testis is extremely painful to touch.

The treatment is emergency surgery. Delay will affect whether the testicle survives or not. Providing an operation is performed within six hours of onset f the problem, the testicle is likely to recover. At operation it needs to be fixed into the scrotum. The problem is due to the fact that the testicle has not quite descended properly and, therefore, can twist. For this reason the other testicle should be fixed so that it will not twist in

the future and this is usually undertaken at the time of the operation for the testicle which has the torsion.

Baby with foreskin which won't retract

Q . My baby boy of 6 months has a foreskin which will not retract. What should be done about this?

A. It is often normal for a baby boy's foreskin not to retract until he is between 5 and 8 years old. Rarely the foreskin may be tight and urine is passed in a very fine stream. When this happens the foreskin may balloon-up when your baby passes urine. Very rarely the foreskin may need to be stretched usually under a general anaesthetic. If you have concerns it is advisable to see your GP.

Ten month old baby with swollen and sore penis

Q . My son of ten months has a swollen and sore tip of his penis. What should I do about this?

A. Occasionally young boys have an infection at the end of the penis, below their foreskin. This can lead to redness and swelling and sometimes pus-like material may appear at the end of the penis. Secretions are produced from the gland or the penis and can build-up behind the foreskin. This is called smegma. With normal daily washing of the end of the penis with soap and water whilst retracting the foreskin as far as is comfortable for your child without causing him pain, will almost certainly prevent infection.

If infection does occur frequent washing (2-4 times daily) of the end of the penis with soap and water is likely to reduce the infection and clear the problem. Occasionally antibiotics are needed and if the problem is not settling within one to two days it is appropriate to see your GP.

Circumcision is not required for this problem.

Ejaculation question

Q . I have a question about my ejaculation. I had my right testicle lowered at about the age of 11, I am now 22. I am not involved in frequent sexual activity and I have only had about 3 wet dreams in my whole life. Is this uncommon? I can produce ejaculation when masturbating. In my ejaculation I often find a clear yellowish threadlike substance a bit like spaghetti. Sometimes up to 4cm long. There is no real pain when ejaculating, but I can feel the stuff come out of somewhere. I haven't asked anyone about this before and am wondering what is it? And is it serious?

A. There is unlikely to be any connection between what you observe in your ejaculate (semen) and having an undescended testicle. Even so, there is an increased risk of testicular cancer in an undescended testicle so you are wise to be cautious. Check each testicle in turn while in a warm bath or shower. Cradle them with one hand and feel with the other for any lumps or bumps. There will be difference in size and they will hang lower. (this lets us close our legs without getting a high voice). The knobbly bit at the top of the testicle is the epididymis and is normal. Any blood or pus in your semen or urine makes a visit to your doctor a very wise move.

What you describe doesn't in itself sound sinister but because of your undescended testicle I feel you should report this to your GP.

Penile yeast infection

Q . I have diagnosed myself as having penile yeast infection. This tends to be recurrent. I have tried Nirzole cream and canestan but they do not seem to be effective. I can't find any information about male yeast infection anywhere. Can you help?

A. Candida, thrush, is a yeast infection which causes problems for both men and women. You tell me that you have diagnosed this for yourself but you have not given any of the symptoms. Please make sure because you may be trying to treat something the wrong way and possibly making it worse.

Thrush shows itself as a red mottling on the helmet of the penis. There may be a build up of yellow pus under the foreskin unless you are circumcised. A burning sensation may be present when you pass water. There are some things which will increase your risk from thrush. Diabetes, prolonged courses of antibiotics and immune system problems. AIDS is a thankfully rare cause but you should be checked out for any risk factor.

It looks as though you are using the correct treatments for thrush but they are not working. Maybe you don't have thrush. There are other infections which can cause similar problems. If you have pain passing water, or there is a discharge from your penis you may have a sexually transmitted infection. Nip down to your local GUM clinic where you don't need to give your name and no-one, including your GP will ever know.

Painful sex without condom

Q . Me and my girlfriend have been having sex for about 11 months and nearly all the time we use a condom. We have done it without sometimes but when the skin gets pulled back during sex it hurts when I cum. It has got less painful the more times we have done it, I was just wondering if there was anything I could do to make it any less painful?

A. You have just given the answer to your own question. Phimosis 'a tight pullover' invariably cures itself with sex or even masturbation. Tight foreskins are as common as foreskins or at least before circumcision. Some doctors would advise a circumcision to ease the pain. Don't do it. Hang on to that bit of skin unless there is a very good medical reason to lose it. The UK has a dreadful record for removing foreskins without good reason. Before you make love smear a little water-soluble jelly over the helmet of your penis. Make it part of your love play for fun. This will work even if you are using a condom. Petroleum jelly will dissolve a condom. I presume you are using some other form of contraception or planning for a family by no longer using a condom. There are vaginal lubricants available from the pharmacist to help ease the pain of a tight foreskin and prevent it remaining pulled back. It also improves the sensation of lovemaking for both partners. Foreplay is still the best way of producing pain free sex for both. Lots more fun too.

Bendy penis accompanied by pain

Q . Hi there, I seem to have developed a bend in my penis over the last few weeks. During erection, it was perfectly straight before, but now bends upwards at the end. I did have some pain in the groin area about two months ago, which has now disappeared, but my erections are painful at times.

Can you offer any advice and reason why this should have happened ?

A. It sounds as if you have the condition known as Peyronies Disease. The bending of the penis is caused by localised fibrosis (scaring) within the penis. The fibrous tissue forms in plaques which can sometimes be felt as hard bands or nodules. Nobody knows the exact cause of this problem but a lot of suggestions have been made including injury, infection, degeneration and atherosclerosis (furring up of the arteries). Often the condition is associated with pain, often before the bending occurs. In fact, the pain sometimes disappears when the bending starts.

There is no single effective treatment for Peyronies Disease. Occasionally the condition appears to resolve spontaneously after many months or even years. Therefore, if the bending does not cause too much trouble, erections still occur and there is no pain, it would be sensible to wait and see what happens. If the condition does not improve then high doses (200 — 1000 units daily) of vitamin E sometimes helps. Another medical treatment that is sometimes used is para-aminobenzoic acid (POTABA) but treatment has to be continued for many months. When medical treatment fails surgery can be the last resort but is only considered when the bending is too severe to allow intercourse, erection is associated with marked pain or if erection no longer occurs.