Monday, August 3, 2015

Teen male sexual health: What should they know?

They don't have menstrual cramps and can't get pregnant, but teen males may have sexual health issues of their own. Some may be normal variants while others may be abnormal and need medical attention.

Teen male sexual health: What should they know?

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True, they don’t have menstrual cramps and can’t get pregnant.  Nevertheless, teen males may have sexual health issues of their own. Some may be normal variants while others may be abnormal and need medical attention. Here are several; note that some of the links below are to medical illustrations and drawings.

Gynecomastia, or breast development in a male, may occur during puberty.  Understandably, this may cause a teenage boy to stress. It can occur on one or both sides and usually goes away in a few years. Although usually normal, gynecomastia may be a symptom of something else so ask your teen’s doctor to check him.

“Pearly penile papules” are tiny bumps along the base of the glans penis. Not only are they normal, but they are also common: 15-20 percent of male adolescents have them. If your teen doesn’t know that they are normal, my bet is that he will probably be worried about them. (More about this condition may be found on http://www.dermnet.com

Sometimes lumps, bumps or masses may affect the testicles or scrotum during the teenage years. The mass may be a varicocele, hydrocele, cyst or, rarely, cancer. 

Varicoceles are like varicose veins in the scrotum.  Varicoceles are usually found above the left testicle but can be present on both sides.  Found in up to 15 percent of adolescent boys, a varicocele is usually not of concern but ask your teen’s doctor to confirm. (Here is an illustration of a varicocele.) 

A hydrocele is a collection of fluid that surrounds a testicle. Usually, a hydrocele is not painful and does not require any treatment. However, your teen’s doctor should examine him to rule out other causes of scrotal swelling. (Here is an illlustration of a hydrocele.) 

Spermatoceles (or epididymal cysts) are small fluid-filled cysts that appear along the epididymis, a part of the reproductive tract that is behind the testicle.  A spermatocele feels like a smooth lump that is not attached to the testicle. Spermatoceles do not require treatment unless they are large or cause discomfort. (Here is a drawing of a spermatocele.)

An inguinal hernia occurs when a small portion of the bowel bulges through the muscles of the abdominal wall and into the groin. The bulge may become more obvious when coughing, straining, or lifting heavy objects. An inguinal hernia needs to be fixed with surgery and can be an emergency if the bowel gets trapped. (Here is an illustration of an inguinal hernia.)

Testicular cancer is the most common cancer in American males between the ages of 15 and 34. Signs and symptoms of testicular cancer include:

  • A lump in a testicle which may or may not be tender
  • A feeling of heaviness in the scrotum
  • A dull ache in the abdomen or groin
  • A sudden collection of fluid in the scrotum
  • Enlargement or tenderness of the breasts

(Here is a diagram of testicular cancer.)

Testicular torsion is the twisting of the testicle and the spermatic cord. This cuts off the blood supply to the testicle. The symptoms may be sudden and severe pain in the testicle or lower abdomen and nausea. Torsion is a surgical emergency. If surgery is performed within six hours, the testicle can usually be saved. Torsion is most common between the ages of 12 and 18 years. (Here is a drawing of testicular torsion.)

Epididymitis is inflammation of the epididymis caused by infection or trauma.  A teen may experience the gradual onset of pain in the scrotum, inguinal area or abdomen as well as tenderness of the epididymis.  Treatment is usually antibiotics. It is important for your teen’s doctor to make sure that it is not testicular torsion.

My advice: Talk to your teenage son about doing monthly testicular self-examinations. If your teen finds a lump, bump or mass, or has pain in the scrotal area, ask your teen’s doctor to evaluate it as soon as possible.


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Adolescent Medicine Specialist at Crozer-Keystone Health System
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Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
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Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
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Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
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