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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
Penile discharge can either be a normal part of the male body mechanism or something that needs to be treated.

Penile discharge can be perfectly normal

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: 

Penile discharge can be abnormal

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:

Penile discharge that is non-infectious/non-sexually transmitted disease related

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.

balantis
Balantis is characterised by penile discharge, redness, inflammation, and itchiness of the penis head.

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.

prostatitis
Prostatitis occurs when the prostate gland becomes inflamed or irritated.

Penile discharge that is infectious/related to sexually transmitted infections (STIs) 

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. 

When should I see a doctor if I have penis discharge?

You are advised to seek advice from your doctor if you notice penile discharge when you are not:

OR if you are experiencing:

Important note

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.

References

  1. Adler MW. Urethral Discharge: Diagnosis. British Medical Journal (Clinical Research Edition)Vol. 287, No. 6402 (Nov. 5, 1983), pp. 1360-1362 (3 pages)
  2. Zenilman JM. Chapter 3. Urethral Discharge. In: Klausner JD, Hook EW, III. eds. CURRENT Diagnosis & Treatment of Sexually Transmitted Diseases. McGraw Hill; 2007. Accessed April 24, 2023. 
    https://accessmedicine.mhmedical.com/content.aspx?bookid=369&sectionid=39914779

Andropause, the Male Menopause

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.

What is the Cause of Andropause?

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.

What are the Symptoms of Andropause?

What do I expect when I see my doctor?

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.

What are the treatment options of Andropause?

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

Is Testosterone Replacement Safe?

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.

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