Have you ever had an episode where you had to cross and uncross your legs in public due to the itchy sensation below? Or an episode of urgent need of the bathroom to scratch the itchy genitalia? The symptom may sound trivial, but it can profoundly impact our lives, affecting our daily routine and causing embarrassment when socialising with others.
Genital itch is a common medical symptom that can occur in anybody. It is a non-discriminative symptom, regardless of your educational or socioeconomic background.
Genital itch symptoms can be broadly categorised into dermatological versus infectious/sexually transmitted disease STD-related causes.
Some various bacteria or parasites can cause symptoms of itch over the genitalia when the infection is left unattended. This includes chlamydia trachomatis, Neisseria gonorrhoea, Mycoplasma Genetalium, Gardnerella bacteria, Trichomonas parasites, etc. These are commonly associated with sexually active people. If you are having trouble with genital itching and you are in a sexual relationship, do discuss it with your doctor and consider further screening for sexually related infections. These bacterial/parasitic-related sexually transmitted infections are treatable, and they do not resolve on their own unless treated with the correct medications.
A genital itch can be an embarrassing symptom to present to your doctor. Nonetheless, the condition is manageable if the right cause is determined and dealt with.
You are encouraged to see your doctor when your symptoms persist and cause impairment and nuisance to your daily routine.
Further red flags to note and consider seeing your doctor if you have:
Although 'itch' is a generally benign symptom, it may be a tell-tale sign of a more serious medical condition that requires treatment. Do see your doctor if the genital itch symptoms are not improving or if you develop any of the red flags discussed above.
As genital discomfort or itch can be a private and embarrassing condition, you are encouraged to see a doctor that you are comfortable with.
Your doctor will obtain a relevant history of your symptoms and relevant social/sexual histories. Your doctor will then physically examine your genitalia region for skin integrity. In females, your doctor may request, with your consent, a vaginal examination. In males, your doctor may request, with your consent, to examine your scrotal and penis region. Depending on individual conditions, your doctor may examine the rest of the body for other relevant body signs associated with your symptoms. Your doctor may also offer various tests in the form of blood, swab, scrape, or even urine tests depending on the working differential diagnosis.
The treatment and management of itchy genital symptoms depend on the cause. In dermatological causes, your doctor may offer topical medicated cream as a steroid, antifungal, or antibacterial to manage the symptoms. In more severe cases of concern with fungal infections, your doctor may prescribe oral antifungals to manage the symptoms. Lifestyle advice to reduce triggers that irritate dermatological symptoms will be discussed.
If the underlying cause is an untreated infection, you may be offered targeted treatment through oral medication, cream, or even procedures such as cryotherapy or electrocautery.
Discuss your symptoms with your doctor, allow your doctor to examine your condition, and discuss the treatment options available to manage your genital itch symptoms with your doctor.
Although itch can be a completely benign symptom that potentially resolves spontaneously, if the symptom is not addressed appropriately, one may miss or delay diagnosing an underlying medical condition. In the event of dermatological-related itchy genitalia, if the underlying skin condition is not addressed, one may have recurring symptoms in the near future. In the event of infectious-related itchy genitalia, one will have an untreated infection and be at risk of developing complications from the infection and spreading the disease to people around you.
There are effective treatments to manage the itch in the genital region. Understanding the possible differentials and having the courage to seek medical help are paramount steps to take to take control of your health and your overall quality of life.
Penile discharge is the fluid that comes out of the urethra when you are not urinating.
The urethra is a tube over the urinary system that allows the flow of urine and semen from the bladder or ejaculatory ducts to the opening of the penis and thus the external body.
Urethral/penile discharge can sometimes be physiological and a normal part of the male body mechanism. However, when should we be alarmed about discharge from the penis? This article aims to educate readers on understanding the possible differentials and red flags that one should be looking out for in penile discharge.
Penile discharge can be completely normal and acts as the body’s mechanism to lubricate the penis. It is normal for the penis to produce discharge when a person is sexually aroused or during intercourse. You may notice penile discharge just before ejaculation or during ejaculation. Occasionally you may notice a white coating overlying the tip of the penis after a long day out or on a hot day.
Types of penile discharge include:
While some types of penile discharge are normal, there are others that are abnormal and may even be infectious.
Examples of abnormal penile discharge include:
Patients with balanitis can present with penis discharge and also associated redness, inflammation or irritation over the head of penis. One may notice odour over the genital region, and in more severe cases, an itch or burning sensation upon urination. The symptoms of balanitis can come and go over time. You are advised to speak to your doctor if you have concerns of balanitis.
Urinary tract infection (UTI) can affect any part of the urinary system including the urethra, bladder, or kidneys. Urinary tract infection occurs when bacteria from the surrounding area (skin or rectum) enters the urinary tract and causes inflammation and infection.
Risk factors for males developing urinary tract infection include:
Patients with urinary tract infection can present with abnormal penile discharge and developing symptoms such as:
Urinary tract infection is not contagious but must be promptly treated so as to avoid complications such as kidney infections or blood infection. Do seek medical attention if you have penile discharge or urinary tract infection symptoms.
Abnormal penile discharge can be due to underlying sexually transmitted infections (STIs) .
Common STIs that can be associated with penile discharge include:
Interestingly some patients with STIs can be completely asymptomatic but it is important to note that asymptomatic individuals can still spread STIs to their sexual partners. Not only is untreated STIs contagious, they are also associated with infertility in both men and women.
If you are experiencing penile discharge with unusual colour and consistency, itchiness, burning sensation over the penis, inflammation,rashes over the penis, and testicular pain or swelling, seek further medical investigation to screen for underlying medical condition.
You are advised to seek advice from your doctor if you notice penile discharge when you are not:
OR if you are experiencing:
While penile discharge can be a healthy physiological part of life, it can also signify underlying infection, inflammation, or medical condition. The silver lining– penile discharge that is abnormal is usually treatable. If you have concerns about penile discharge symptoms, avoid further hesitation, do see your trusted physician early.
In females, this occurrence is known as menopause. The male counterpart to this is known as Andropause. Male levels of sexual hormones start to gradually decline when they enter their 4th or 5th decades of life. There are some men who start to undergo this change much earlier, such as in their 3rd decade of life.
Andropause occurs when a man’s testosterone level is low. Testosterone is a hormone produced by the testes. It Is the male hormone responsible for a male’s physical characteristics such as sexual drive (libido), facial and body hair, deep voice, muscle mass, and competitive personality.
The onset of Andropause can occur earlier. This can be attributed to multiple factors, including genetic cases, lifestyle and certain medical conditions. Common chronic medical conditions such as metabolic conditions (i.e. obesity, hypertension, diabetes, raised cholesterol) are associated with earlier Andropause. Andropause can also occur in patients with testicular cancer, or patients who are taking medication to lower their testosterone as part of treatment of prostate cancer.
Your doctor will take relevant medical histories, understanding your concerns and expectations, and perform general physical examination. Your doctor will offer you blood tests such as blood sugar counts, cholesterol levels, kidney, liver and cell count blood tests. This is to screen for chronic medical conditions. Hormonal blood tests will be offered as well. Diagnosis will be based on physical examination and hormonal blood tests to determine if the patient has low testosterone levels.
While testosterone replacement is the backbone treatment for Andropause, this condition should be managed in a holistic manner, targeting different psychosocial and medical aspect of the associated condition.
Few important aspects to focus on:
As mentioned, treatment of Andropause largely revolves on testosterone replacement in the form of
Common side effects of testosterone replacement
As testosterone replacement can promote and increase the growth of prostate tissue, the treatment may not be suitable in men with prostate cancer or if they have an enlarged prostate.
When you are on testosterone replacement, it is important to follow up regularly with your doctor. Your doctor will monitor your condition closely and conduct frequent blood tests to watch for side effects.