Chances are, you don’t spend a lot of time thinking about the color of your urine. But urine color can tell you a lot about your health, so it’s worth paying attention.

What is urine, exactly?

Urine is a waste product made by your kidneys. It’s what remains after your kidneys filter your blood. Most of it — over 90% — is water. Other substances found in urine are salt, electrolytes, and waste products called urea and uric acid.

What color is healthy urine?

Most of the time, healthy urine is a pale shade of yellow. The color comes from a chemical called urochrome.

Urine might be a darker yellow if you’re dehydrated, as it contains more waste products. In fact, if your urine looks dark yellow, it could be a sign to drink more fluids. Once you’re hydrated again, your urine should go back to its pale yellow color.

Sometimes, a change in urine color is easily explained. Other times, discolored urine is a symptom of a health condition that needs diagnosis and treatment.

Why might urine change color?

There are times when your urine might be a different color, like red, brown, white, or even blue or green. Sometimes, a change in urine color is easily explained. Other times, discolored urine is a symptom of a health condition that needs diagnosis and treatment.

Foods and Food Dyes

Certain foods can change the color (and sometime the smell) of your urine. For example, you might notice red or pink urine after you’ve eaten rhubarb, blackberries, or beets. Fava beans can turn your urine dark brown. Carrots may turn it orange. And products with food dyes, like candy, gelatin, and certain breakfast cereals, might turn your urine green or blue.

Supplements of vitamin A, vitamin B-12, or vitamin C can make urine orange or yellow-orange. Other B vitamins may turn it green.

If you’ve had a kidney or bladder test using a dye, you might notice blue urine.

Medicines

Some medicines can change the color of your urine. A medication package insert might list discolored urine as a side effect, but you can also ask your doctor or pharmacist.

Here are some examples of medications that might change your urine color:

Health conditions

Certain health conditions can cause discolored urine. Here are some examples:

There are also times when your urine may be completely clear, with no color at all. This can be a sign of overhydration (drinking too much water). But consistently clear urine could be a symptom of diabetes or a kidney problem.

What about blood in the urine?

You might have blood in your urine if it’s reddish brown. (The medical term for blood in the urine is hematuria. When the blood cannot be seen with the naked eye, it’s called microhematuria.)

Possible causes of blood in the urine include:

• Urinary tract infection (UTI)
• Kidney infection
• Infections in the bladder, urethra, or prostate
• Trauma to the urinary tract
• Kidney stones
• Kidney cysts
• Bladder cancer
• Kidney cancer
• Prostate cancer
• Vaginal bleeding
• Endometriosis
• Enlarged prostate (benign prostatic hyperplasia)
• Benign (not cancerous) tumors
• Hemophilia
• Sickle cell disease
• Hard exercise, such as distance running
• Sexual activity

If you suspect there is blood in your urine, see your doctor as soon as possible.

Other qualities of urine

Aside from color, you might notice other characteristics in your urine. For example, urine that is cloudy, milky, or smelly could be a sign of a UTI. Foamy urine could also be caused by UTIs as well as diabetes, kidney disease, or medications.

If you notice these changes to your urine, call your doctor.

Should I call my doctor if my urine is a different color?

If you feel concerned about discolored urine, a call to your doctor is a good idea. If your doctor thinks there might be a medical problem, you can make an appointment right away. If they think it is caused by something harmless, they can put your mind at ease.

Your doctor might ask you:

• How long has your urine been this color? Has it been a couple of days? A few weeks? When did you first notice the change?
• Are there any other changes to your urine? Is it milky or foamy? Does it have a distinct odor?
• Do you have any other symptoms? Do you have any abdominal or back pain? Fever or chills? Do you have difficulty urinating or feel a more urgent need to urinate? Do you have pain or a burning sensation when you urinate?
• What foods have you been eating? What beverages have you been drinking? Have you had any changes in diet? Have you consumed any products that contain food dye, like candy or fruit punch?

Your doctor may also ask about your health history, family health history, chemical and dye exposure, smoking status, and exposure to secondhand smoke.

In addition, you will have a physical exam and might have some tests, such as the following:

• Urinalysis, a urine test used to diagnose urological conditions
• Urine culture, a test that checks for bacteria
• Urine cytology, a test that checks for cancer and other diseases
• Cystoscopy, a test that allows your doctor to see the inside of your bladder and urethra
• Imaging tests, such as ultrasound or CT scan, of your bladder and kidneys
• Blood tests to measure levels of waste products in the blood. The results may show how well your kidneys are working
• Liver function tests

Is there a treatment for discolored urine?

Discolored urine is not a health condition in and of itself. Rather, it can be a symptom of another health issue. When that health problem is treated, urine color may return to normal.

If your discolored urine is caused by food, drink, or medicine, you might find that it becomes pale yellow again once these products are out of your system. For example, if you’ve had beet salad at a picnic, your urine will probably go back to normal in a day or two.

If a medication is the culprit, your urine color may go back to yellow once you stop taking the drug. (Always follow your doctor’s instructions about taking medications.)

Should I worry about discolored urine?

Not necessarily. If you notice that your urine is not pale yellow, think about your activities and what you’ve been eating or drinking. If you’re dehydrated, take in more fluids.

If you’re not sure of the cause or have any other concerns, call your doctor.

Resources

Cleveland Clinic

“Urine”
(January 14, 2025)
https://my.clevelandclinic.org/health/body/urine

“Urine Changes”
(Last reviewed: September 28, 2023)
https://my.clevelandclinic.org/health/diseases/15357-urine-changes

“What the Color of Your Pee Says About You”
(November 8, 2021)
https://health.clevelandclinic.org/what-urine-color-means

Mayo Clinic

“Porphyria”
(April 5, 2023)
https://www.mayoclinic.org/diseases-conditions/porphyria/symptoms-causes/syc-20356066

“Urine Color”
(January 10, 2023)
Symptoms & Causes: https://www.mayoclinic.org/diseases-conditions/urine-color/symptoms-causes/syc-20367333
Diagnosis and Treatment: https://www.mayoclinic.org/diseases-conditions/urine-color/diagnosis-treatment/drc-20367351

MedlinePlus

“Cystoscopy”
(Reviewed: May 17, 2024)
https://medlineplus.gov/ency/article/003903.htm

“Cytology exam of urine”
(Reviewed: July 1, 2023)
https://medlineplus.gov/ency/article/003905.htm

“Urine - abnormal color”
(Reviewed: July 1, 2023)
https://medlineplus.gov/ency/article/003139.htm

“Urine culture”
(Reviewed: October 9, 2024)
https://medlineplus.gov/ency/article/003751.htm

National Institute of Diabetes and Digestive and Kidney Diseases

“Hematuria (Blood in the Urine)”
(Reviewed: October 2022)
https://www.niddk.nih.gov/health-information/urologic-diseases/hematuria-blood-urine

Urology Care Foundation

“The Meaning Behind the Color of Urine”
(August 22, 2018)
https://www.urologyhealth.org/healthy-living/care-blog/2018/the-meaning-behind-the-color-of-urine

VeryWellHealth

Burch, Kelly
“Why is My Pee Green? 5 Possible Causes”
(Updated: February 17, 2025)
https://www.verywellhealth.com/green-pee-5272140

Fertility is a common concern for people who have been newly diagnosed with cancer, and many wonder whether they will be able have children after their treatment.

The answer isn’t always clear. Unfortunately, some cancer treatments can make it more difficult, sometimes even impossible, to create a pregnancy. Infertility may be temporary or permanent.

For example, the strong cancer-fighting drugs used in chemotherapy may also damage egg and sperm cells and the organs that create them (ovaries and testes). Strong x-rays used in radiation therapy can also cause damage.

Surgery can also make patients infertile. If the ovaries or testes need to be removed, then it will be impossible for the body to make eggs or sperm cells. If the uterus is removed, then a pregnancy is not possible. If nerves are damaged during surgery, men may not be able to ejaculate sperm.

While this news can be heartbreaking, there is hope. Fertility preservation encompasses many ways that cancer survivors may still have children after treatment. These approaches may include:

• Cryopreservation. Reproductive cells or tissue are “harvested” before treatment begins and kept frozen until a pregnancy is desired.
• Radiation shielding. Cells and tissues may be protected from the strong x-rays used during radiation therapy.
• Surgery. The ovaries may be surgically repositioned to make them less vulnerable to damage. If one ovary needs to be removed, it may be possible to keep the other one intact.
• Hormonal therapy. Hormonal therapy may allow women with endometrial cancer to have children before they have cancer-treating surgery.

Sometimes, more than one method is used.

Some cancer treatments can make it more difficult, sometimes impossible, to create a pregnancy.

Fertility preservation takes planning. If you’re facing cancer treatment and would like to have a child in the future, it’s important to talk to your cancer care team about fertility as early as possible, before treatment begins. In some cases, fertility preservation means delaying cancer treatment, and this isn’t possible for everyone. Your doctor may also recommend that you delay pregnancy for a certain period of time after treatment.

Now, let’s look at fertility preservation approaches in more detail.

Note: In this article, we are using the terms women, men, female, and male to refer to biological sex at birth. We recognize that transgender and nonbinary individuals may have reproductive organs that do not match their gender identity.

Cryopreservation

The word cryopreservation refers to the freezing of cells or tissue for later use.

Egg banking and sperm banking

Some cancer patients decide to bank, or preserve, mature sex cells — egg cells (produced by the ovaries) or sperm cells (produced by the testes). These methods are called egg banking and sperm banking, respectively.

Cells are frozen and safely stored, sometimes for many years. (In fact, sperm cells can be frozen for decades.) When you’re ready for pregnancy, the cells are thawed and used with assisted reproductive technology (ART) methods, such as in vitro fertilization (IVF).

Egg and sperm banking may also be options for children with cancer, if they have gone through puberty.

Your doctor can give you more information about cryopreservation storage in your local area.

Cryopreservation can be costly. Check with your health insurance company to see if you have coverage. There are also annual storage fees for frozen cells and tissue.

Retrieving egg cells for egg banking

Harvesting egg cells for freezing can take a few weeks, and there are several steps:

• Hormone injections are given for 10-12 days to help the ovaries produce multiple eggs.
• Doctors typically do ultrasounds and blood work to make sure the eggs are maturing as they should.
• Once mature, a doctor uses a needle to surgically remove the eggs from the ovaries. The eggs are then retrieved through the vagina. This procedure takes about 30 minutes, and patients are given anesthesia.

Retrieving sperm cells for sperm banking

Sperm cells can be obtained in a number of ways:

• Masturbation. The man masturbates in a private room at a clinic. Sometimes, this might be done at home.
• Penile vibratory stimulation. A vibrator is applied to the tip of the penis to stimulate ejaculation.
• Electroejaculation. If you are unable to ejaculate, a device is used to stimulate the prostate gland with electrical currents, leading to ejaculation.
• Collection from urine. Some men have retrograde ejaculation, which means sperm travels backward into the bladder instead of forward out of the penis during ejaculation. In such a case, it might be possible to retrieve sperm cells from a man’s urine.
• Sperm extraction. Sperm is removed from testicular tissue with a procedure called microsurgical testicular sperm extraction (microTESE). Small incisions are made in the scrotum and testis while a man is under anesthesia. A small amount of testicular tissue is removed. It is then analyzed by a lab to see whether it contains viable sperm. If it does, the cells are harvested and frozen.

Freezing embryos

An embryo is formed when a sperm cell fertilizes an egg cell. Some cancer patients choose to have embryos created in a lab before treatment. The embryos are then frozen for the future. Egg cells and sperm cells are obtained with the same procedures described earlier in this article. When it is time for a pregnancy, embryos are thawed and implanted into the uterus.

Tissue freezing

Freezing tissue from the ovaries or testes may be another viable way to preserve fertility, especially in cancer patients who have not yet reached puberty.

Ovarian tissue

A doctor can remove tissue that contains immature eggs; however, in some cases, an entire ovary is removed. The tissue is cut into small pieces, and it can be frozen for many years.

When a person is ready for pregnancy, the tissue is thawed and surgically placed back in the abdomen, close to remaining ovarian tissue.

Freezing ovarian tissue comes with risks. In some cases, there can be undetected cancer cells in the ovarian tissue. It’s possible that these cancer cells could be returned to the body when the tissue is implanted. Your doctor will discuss the risks with you and help you make a decision based on the type of cancer you have.

Testicular tissue

Researchers are still studying whether testicular tissue can be frozen and used later to create a pregnancy. At the moment, cryopreservation of testicular tissue is considered an experimental procedure.

Radiation shielding

During external beam radiation treatment, powerful beams of energy are aimed directly at the areas affected by cancer. The beams come from a machine outside the body.

If radiation could affect your reproductive organs, your doctor may suggest radiation shielding. This means covering those organs with lead shields, worn outside the body, to keep the radiation from getting through.

Shielding may also protect from scatter radiation, when energy beams bounce off something else in the body, like another organ or piece of tissue. Scatter radiation can send energy beams in directions that aren’t intended, which can put tissue, including reproductive tissue, at risk for damage.

Surgical techniques

Ovarian transposition (oophoropexy)

Ovarian transposition is a surgical way to protect the ovaries from radiation. It involves moving the ovaries out of the way of the energy beams. Usually, they are moved to an area above where they normally sit.

For some women, the ovaries naturally fall back to their original place over time. Other women have another surgery when they are finished with their cancer treatment to move the ovaries back into place.

Ovarian transposition can be an option for females before and after puberty. The ovaries may still be at risk of scatter radiation exposure.

Other surgical approaches

Ovarian cancer

If possible, patients with early ovarian cancer may have just the affected ovary removed, with the healthy ovary staying where it is. Eggs can still be produced by the remaining ovary, and a pregnancy may still be possible.

Cervical cancer

Patients with early cervical cancer may have a procedure called radical trachelectomy. The surgeon removes the cervix, the organ that connects the uterus and the vagina. The upper portion of the vagina is also removed, but most of the uterus remains. The uterus is stitched closed in the area the cervix once was.

After this surgery, women may be able carry a fetus and deliver a baby by cesarean section.

Hormonal options

Endometrial cancer

Endometrial cancer (sometimes called uterine cancer) starts in the endometrium — the lining of the uterus. Patients with this type of cancer usually have a hysterectomy (surgery to remove the uterus), but some are able to postpone surgery until after they’ve had a child.

Doctors prescribe hormones called progestins to help cancerous tumors shrink or go away temporarily, giving patients time to have a child. However, this approach can be risky, as the cancer may still spread. Close monitoring by a doctor is critical.

After the child is born, patients have a hysterectomy.

Ovarian suppression

Pre-menopausal women might opt for ovarian suppression, which uses medicines called GnRH agonists to stop the ovaries from making the hormone estrogen. Some experts believe that this process protects egg cells from cancer treatment. This approach is still being studied, and the Alliance for Fertility Preservation considers it experimental.

Is fertility preservation always successful?

While fertility preservation techniques offer hope to cancer patients looking to start or expand their family, they cannot guarantee a pregnancy.

Age can be a significant factor. For example, women who are younger when their eggs are retrieved tend to have a better chance of pregnancy than women who are older.

Also, the type and stage of your cancer may play a role. Your doctor can give you more details about your personal situation.

Keep in mind that even if fertility preservation efforts are not successful, you can still grow your family:

• If a woman’s eggs or man’s sperm cells are not viable, a couple might consider using egg or sperm cells from a donor. With this approach, a sperm cell fertilizes an egg cell in a lab to create an embryo. The embryo is then implanted into the uterus and the baby is carried to term.
• If a person is unable to carry a pregnancy (for example, if their uterus has been removed), they might consider using a gestational carrier (sometimes called a gestational surrogate). A gestational carrier has the embryo placed in their uterus and carries the baby until birth.

Questions to ask your cancer care team

You’ll likely be meeting with several specialists throughout your cancer journey. Chances are, you’ll have lots and lots of questions, and that’s normal. Sometimes, it’s hard to keep all our questions straight, especially when we’re talking to healthcare providers. This list can help. Be sure to jot down any additional questions you have.

• Will you refer me to a fertility preservation specialist?
• What fertility preservation options do I have? What do they entail?
• What are the risks and benefits of my options?
• How successful are these approaches for someone in my situation?
• When would fertility preservation efforts start?
• Will I need to delay my cancer treatment? If so, is that okay?
• Will I need to have surgery? What are the details of the procedure? What kind of a recovery might I expect?
• Can you recommend a reliable sperm bank or egg bank?
• How long can my cells or tissue be frozen?
• How much do these approaches cost?
• Can cancer cells be reintroduced to my body through any of the procedures above?
• How soon after treatment can I try for a pregnancy?
• Will I need to use assisted reproductive technology (ART)?
• Can you refer me to a support group or a counselor?

Resources

Alliance for Fertility Preservation

“Ovarian Transposition”
(no date)
https://www.allianceforfertilitypreservation.org/options-for-Patients/ovarian-transposition/

“Ovarian Suppression”
(no date)
https://www.allianceforfertilitypreservation.org/options-for-Patients/ovarian-suppression/

American Cancer Society

Susan G. Komen
“Ovarian Suppression”
(Updated: March 3, 2025)
https://www.cancer.org/cancer/managing-cancer/side-effects/fertility/preserving-fertility-in-Patients.html

“Preserving Your Fertility When You Have Cancer (Men)”
(Last Revised: January 17, 2025)
https://www.cancer.org/cancer/managing-cancer/side-effects/fertility/preserving-fertility-in-men.html

“Preserving Your Fertility When You Have Cancer (Patients)”
(Last Revised: January 17, 2025)
https://www.cancer.org/cancer/managing-cancer/side-effects/fertility/preserving-fertility-in-Patients.html

“Radiation Therapy”
(Last Revised: June 9, 2025)
https://www.cancer.org/cancer/managing-cancer/treatment-types/radiation.html

“Surgery for Cervical Cancer”
(Last Revised: June 28, 2024)
https://www.cancer.org/cancer/types/cervical-cancer/treating/surgery.html

“Treatment Choices for Endometrial Cancer, by Stage”
(Last Revised: February 28, 2025)
https://www.cancer.org/cancer/types/endometrial-cancer/treating/by-stage.html

American Urological Association

“Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline”
(2024)
https://www.auanet.org/guidelines-and-quality/guidelines/male-infertility#x15007

Cleveland Clinic

“Electroejaculation”
(Last reviewed: August 12, 2022)
https://my.clevelandclinic.org/health/treatments/23997-electroejaculation

“Microsurgical Testicular Sperm Extraction (microTESE)”
(Last reviewed: March 26, 2024)
https://my.clevelandclinic.org/health/procedures/microtese

Johns Hopkins Medicine

Hosseinzadeh, Pardis, MD, MSC
“Freezing Eggs: Preserving Fertility for the Future”
(February 24, 2025)
https://www.hopkinsmedicine.org/health/wellness-and-prevention/freezing-eggs-preserving-fertility-for-the-future

“Ovarian Tissue Freezing (Cryopreservation)”
(no date)
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/ovarian-tissue-freezing-cryopreservation 


Journal of Clinical Oncology

Su, H. Irene, MD, et al.
“Fertility Preservation in People With Cancer: ASCO Guideline Update”
(Full text. Published: March 19, 2025)
https://ascopubs.org/doi/pdf/10.1200/JCO-24-02782

Mayo Clinic

“Fertility preservation: Understand your options before cancer treatment”
(March 7, 2024)
https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility-preservation/art-20047512

Memorial Sloan Kettering Cancer Center

“About Ovarian Tissue Freezing”
(Last updated: March 16, 2023)
https://www.mskcc.org/cancer-care/patient-education/ovarian-tissue-freezing

Up to Date

Oktay, Kutluk, MD, PhD, FACOG and Sonmezer, Murat, MD
“Fertility preservation: Cryopreservation options”
(Topic last updated: February 13, 2023)
https://www.uptodate.com/contents/fertility-preservation-cryopreservation-options

“Patient education: Preserving fertility after cancer treatment in men (The Basics)”
(Accessed: June 2, 2025)
https://www.uptodate.com/contents/preserving-fertility-after-cancer-treatment-in-men-the-basics

“Patient education: Preserving fertility after cancer treatment in Patients (The Basics)”
(Accessed: June 2, 2025)
https://www.uptodate.com/contents/preserving-fertility-after-cancer-treatment-in-Patients-the-basics

Can a simple pill help men with low testosterone? Yes, it’s possible…at least for some men. Read on to learn more.

What is testosterone?

One of the most important hormones for men is testosterone. It’s the reason men grow facial hair, have deeper voices, and produce sperm cells. It contributes to their muscle mass and bone health. And it’s essential for their sexual health: both libido and erections are driven by testosterone.

Testosterone production is triggered by the pituitary gland in the brain, which “tells” the testes (glands located near the penis in a sac called the scrotum) to start making the hormone.

What happens when a man’s body doesn’t make enough testosterone?

Sometimes, there is a problem with the testosterone production process.

The problem might be something a man is born with (congenital). Some examples are Klinefelter syndrome (when a male child has an extra X chromosome) or intersex conditions (when a child is born with both male and female sex organs).

Injuries, illnesses, and cancer treatment can affect testosterone production, too. For example, if a man has a pituitary gland disorder, if he has had trauma to his testes from an accident, or if he has had radiation treatment to his genital area, his body might make less testosterone. Obesity, diabetes, liver disease, kidney disease, metabolic syndrome, HIV, or AIDS are other factors.

In addition, men’s bodies naturally make less testosterone as they get older. This is a normal part of aging, and the change is gradual—about 1% a year once a man is in his thirties.

Doctors refer to this overall situation as low testosterone, low T, or hypogonadism. These words mean that the body is not making enough testosterone.

What are the symptoms of low testosterone?

As a result, men might feel weaker, depressed, grumpy, or fatigued. They might lose interest in having sex or experience erectile dysfunction (an inability to get an erection firm enough for sexual activity). Some men with low testosterone lose muscle mass and body hair, and some grow breasts.

It’s important to note that these symptoms can be related to other health conditions or medications as well. For example, erectile dysfunction is a common problem for men with diabetes. Men with depression might lose interest in sex. So it’s important to see a doctor if you have any of these symptoms.

What is testosterone deficiency?

When a man has low testosterone levels and accompanying symptoms, doctors use the term testosterone deficiency (TD). To diagnose TD, doctors take a complete medical history, ask questions about medications used, and conduct a thorough medical exam, including blood tests to check the levels of testosterone and other hormones involved with its production, like luteinizing hormone (LH) and prolactin. (Learn more about TD diagnosis.)

What happens next? Doctors treat the root cause of the TD. If a man has diabetes, they will suggest ways to keep his blood sugar under control. If he has kidney disease, that will be addressed. Proper diet and exercise may be recommended for men with obesity.

Another option is testosterone replacement therapy (TRT). With TRT, a man receives medicine to raise his testosterone levels back to a normal range. Many men find that symptoms like low sex drive and moodiness improve with TRT.

When a man has low testosterone levels and accompanying symptoms, doctors use the term testosterone deficiency (TD).

How is testosterone replacement therapy given?

Nowadays, men have a few options for receiving testosterone:

• Transdermal or topical treatments. These treatments are applied to the skin and usually come as gels, creams, and patches. They’re easy to use, but there are some disadvantages. Some men get rashes or itchiness when they use transdermal treatments. It’s also critical that other members of the household, especially women and children, not get any of the product on their own skin.
• Injections into a muscle. Your doctor might offer regular testosterone injections at their office. You can also learn to do your own injections at home. Depending on the injection schedule, this might be more convenient. But injections aren’t for everyone; if you feel squeamish about needles, they might not be for you.
• Intranasal (through the nose). Testosterone is administered (usually three times a day) through the nostril using a special pump. This method isn’t invasive, but some men have side effects like nasal congestion and changes in smell.
• Pellets. Your doctor places small pellets of testosterone under the skin of your buttocks, thigh, or abdominal wall. Over the next three to six months, the pellets dissolve. Then, the process is repeated. Some men like this method because it can be done every three to six months. But they still need to travel to the doctor’s office, and some have pain, swelling, and bruising.
• Oral route. Oral medications are capsules that you take by mouth. In the rest of this article, we’ll go over the details.

What is oral testosterone?

Oral testosterone is a capsule that you swallow. It is absorbed by your intestinal lymphatic system and the testosterone is carried through your bloodstream.

Currently, doctors prescribe a product called testosterone undecanoate, which was approved by the U.S. Food and Drug Administration in 2019. Testosterone undecanoate is marketed under several brand names, including Jatenzo, Kyzatrex, Tlando, and Undecatrex.

As a capsule, oral testosterone is a convenient, easy-to-take option.

Like other forms of TRT, the goals of oral testosterone therapy are to bring low testosterone levels back up to a normal level (generally above 300 ng/dL) and to relieve symptoms.

How has oral testosterone changed over the years?

At one time, an oral testosterone product called methyltestosterone was the common form prescribed. However, scientists were concerned about side effects, such as jaundice, liver disease, and liver damage. These problems occurred because the medicine was absorbed by the body’s portal system; it was going from the digestive system to the liver.

Methyltestosterone is not typically used nowadays. Scientists developed testosterone undecanoate, the current form, which is not processed through the liver, making it a safer option in this regard.

Is oral testosterone better than other forms, like gels, pellets, or injections?

All types of testosterone are effective, so often men choose their method depending on their preferences. As a capsule, oral testosterone is a convenient, easy-to-take option. Some men find gels and creams to be messy, and there is the risk of transferring the medicine to people in the household. Others are uncomfortable with the idea of injections or pellets under the skin.

Side effects may also play a role. For example, men who have skin irritation from injections or creams may decide that the oral route is a better fit.

If one method isn’t ideal for you, ask your doctor about trying another method.

Is oral testosterone OK everyone?

Before prescribing oral testosterone, your doctor will take your complete medical history and conduct tests. They’ll also need to know what other medications you currently take (both prescription and over-the-counter) as well as any vitamins or supplements. If you have allergies, be sure to let them know that, too.

Men should also let their doctor know if they have any of the following conditions:

• Diabetes
• Prostate cancer
• High blood pressure
• High cholesterol
• Heart disease or a history of heart attack
• Sleep apnea
• Liver disease
• Lung disease
• Blood disorders
• Problems with blood clotting
• An enlarged prostate
• Breast cancer
• Obesity
• A history of drug dependence
• High levels of calcium in the blood

It’s critical to be open and honest about your health history and medications. Some drugs, like bupropion (an antidepressant), insulin (for diabetes), and warfarin (a blood thinner used to reduce the formation of blood clots) can interact with oral testosterone. Your health information will help your doctor determine whether the oral route is best for you or if any adjustments need to be made.

Also note that testosterone undecanoate has been FDA-approved only for men who have low testosterone caused by medical conditions. It has not been approved for men who have low testosterone caused by aging.

Women should not take oral testosterone.

How should I take oral testosterone?

Like all medications, oral testosterone should be taken exactly as a doctor prescribes. Your dose will be based on your personal needs, depending on your testosterone levels and symptoms. Over time, your doctor will follow up and monitor your progress. If necessary, your dose can be adjusted.

Some men take oral testosterone once a day; others take it twice a day. It should be taken with food. You might decide to take it with breakfast or dinner.

What risks of oral testosterone should I be aware of?

One concern is high blood pressure, which can raise your risk for a stroke or heart attack. If you’ve already had a stroke or heart attack before taking oral testosterone, your risk might be even higher.

Some men measure their blood pressure at home while taking oral testosterone. If your blood pressure increases, you may need to take medicine to control it. Or you might need to stop taking oral testosterone altogether.

Other potential risks include the following:

• Higher levels of red blood cells, which could increase your risk for blood clots, heart attack, and stroke
• Worsened enlarged prostate symptoms, like trouble urinating
• Blood clots
• Lower sperm count and fertility issues
• Liver issues
• Sleep apnea
• Swelling of ankles, feet, or body
• Mood changes, irritability, depression, or suicidal thoughts
• Higher levels of calcium, cholesterol, and fats in the blood
• Breast swelling or pain
• Increased risk for heart or blood vessel problems

Currently, the U.S. Food and Drug Administration (FDA) warns that men taking testosterone could be at a higher risk for prostate cancer. However, guidelines issued by the American Urological Association (AUA) in 2024 state that “there is accumulating evidence against a link between testosterone therapy and prostate cancer development.”

For some men, oral testosterone is habit forming and they might start to abuse it.

What are some common side effects of oral testosterone?

Some men experience:

• Diarrhea
• Nausea
• Gas
• Burping
• Heartburn
• Indigestion
• Sore throat
• Upset stomach
• Runny nose
• Nasal congestion
• Headache
• Higher levels of the hormone prolactin
• Weight gain
• Muscle or bone pain
• Upper respiratory tract infection

Often, these side effects go away as your body gets used to the medicine. If they trouble you, talk to your doctor. It may help to adjust the dose, but any changes should be made under a doctor’s care.

How soon will I start feeling better?

This answer is different for each man, but many men start seeing improvements in their symptoms—such as better sexual function and mood—within a few weeks.

What kind of follow-up will I have when taking oral testosterone?

Your doctor will want to see you regularly for follow-up visits. At these appointments, they’ll likely do further blood and urine testing to see how well the medicine is working. They will also check your blood pressure and red blood cell count.

Can oral testosterone affect my fertility?

For some men, oral testosterone reduces sperm count, making it more difficult to conceive a child. If you are planning to have a child, tell your doctor before you start taking oral testosterone.

Does oral testosterone have to be prescribed by a doctor? Can I use the over-the-counter versions I see online and in stores?

All forms of testosterone should always be prescribed by a doctor and taken with a doctor’s guidance. Over-the-counter products and supplements are not regulated by the U.S. Food and Drug Administration and may contain ingredients that are harmful for you.

Be sure to tell your doctor about any other medications, vitamins, or supplements you take. They should also know about any allergies you have.

Summary: Key points about oral testosterone

• Testosterone deficiency means that a man’s body does not produce adequate amounts of testosterone. It is accompanied by symptoms like low libido, poor erections, moodiness, and weakness.
• Testosterone replacement therapy (TRT) is one way to treat testosterone deficiency. The goal of TRT is to raise testosterone levels to a normal range and alleviate symptoms. Many men see improvements in their sexual function, mood, and overall quality of life when they undergo TRT.
• There are several ways to administer testosterone replacement therapy. They include transdermal (through the skin), injections, nasal sprays, and oral formulations.
• A previous formulation of oral testosterone, methyltestosterone, had side effects, such as jaundice, liver disease, and liver damage. Scientists have since developed a safer version called testosterone undecanoate, which is the type used today.
• Testosterone undecanoate is a capsule taken by mouth. It is marketed under brand names like Jatenzo, Tlando, Kyzatrex, and Undecatrex.
• Men may find that oral testosterone is more convenient than other formulations, like injections, gels, and creams.
• Oral testosterone dosage depends on a man’s personal situation.
• Oral testosterone does have some risks and side effects. High blood pressure is a particular concern. Men should have a thorough medical exam before starting therapy.
• Regular checkups with a doctor are essential for men taking oral testosterone.
• Oral testosterone is available by prescription only. Over-the-counter products are not the same and could be harmful. It’s important to follow your doctor’s guidance.

Resources

American Urological Association

Azad, Babak K., MD and Faysal A. Yafi, MD, FRCSC.
“Oral Testosterone Replacement Therapy: What’s Available and What Took so Long?”
(September 19, 2023)
https://auanews.net/issues/articles/2023/september-extra-2023/oral-testosterone-replacement-therapy-whats-available-and-what-took-so-long

Mulhall, J.P., et al.
“Evaluation and Management of Testosterone Deficiency (2024).”
(2024)
https://www.auanet.org/guidelines-and-quality/guidelines/testosterone-deficiency-guideline

Cureus

Ahmad, Syed W., et al.
“Is Oral Testosterone the New Frontier of Testosterone Replacement Therapy?”
(August 8, 2022)
doi: 10.7759/cureus.27796
https://www.cureus.com/articles/26237-is-oral-testosterone-the-new-frontier-of-testosterone-replacement-therapy

Drugs.com

“Undecatrex: Package Insert / Prescribing Info”
(Last updated September 25, 2024)
https://www.drugs.com/pro/undecatrex.html

The Endocrine Society

“Study finds oral testosterone therapy undecanoate is effective, with no liver toxicity”
(Press release. March 20, 2021)
https://www.endocrine.org/news-and-advocacy/news-room/featured-science-from-endo-2021/study-finds-oral-testosterone-therapy-undecanoate-is-effective-with-no-liver-toxicity

Jatenzo.com

“Important Safety Information”
https://jatenzo.com/oral-testosterone-safe-effective/

Kyzatrex.com

“Medication Guide”
https://www.kyzatrex.com/medication-guide/

Mayo Clinic

“Testosterone (oral route).”
Drug information provided by: Merative, Micromedex^®.
(Portions last updated February 01, 2025)
https://www.mayoclinic.org/drugs-supplements/testosterone-oral-route/description/drg-20461351

Tlando.com

“Important Safety Information”
https://www.tlando.com/introducing-tlando

Up to Date

Snyder, Peter J., MD.
“Testosterone treatment of male hypogonadism.”
(Topic last updated October 21, 2022)
https://www.uptodate.com/contents/testosterone-treatment-of-male-hypogonadism

Many people may have experienced going to the bathroom and noticing that their urine looks unusually foamy or bubbly. While it might be alarming at first, foamy urine is a relatively common occurrence. In most cases, it's nothing to worry about, but in some situations, it could be a sign of an underlying health issue. It's important to understand what causes foamy urine and what actions should be taken if it is noticed.

What Causes Foamy Urine?

In most cases foamy urine is nothing to worry about, but in some situations, it could be a sign of an underlying health issue.

There are several reasons why urine might appear foamy:

Dehydration

When a person isn't drinking enough fluids, their urine becomes more concentrated. This can cause it to appear darker and foamier than usual. The foam is caused by the higher concentration of proteins and other compounds in the urine.

Rapid urination

If someone has a full bladder and urinates with a lot of force, the stream can create bubbles in the toilet bowl. This is a normal occurrence and not a cause for concern.

Cleaning products

Sometimes, residual cleaning products in the toilet bowl can react with urine and create foam. This is not related to a person's health.

Kidney disease

In some cases, foamy urine can be a sign of kidney disease. When the kidneys are damaged, they can allow protein to leak into the urine, causing it to appear foamy. This condition, known as proteinuria, can be an early sign of kidney dysfunction.

Diabetes

High blood sugar levels can cause the kidneys to work harder, potentially leading to kidney damage and protein leakage into the urine. In fact, moderately increased albuminuria (microalbuminuria) is often one of the first signs of diabetic kidney disease.

Certain medications
Some medications, such as those used to treat hypertension (ACE inhibitors and ARBs), can cause proteinuria as a side effect.

Urinary tract infections

While not a common cause of foamy urine, UTIs can sometimes lead to excess protein in the urine due to inflammation.

Other Factors Affecting Urine Foam

Interestingly, the composition of urine itself can contribute to foam formation. A recent study published in the Clinical Journal of the American Society of Nephrology discussed how certain organic compounds called surfactants, which are naturally present in urine, can cause bubbling. These surfactants have both hydrophilic and hydrophobic ends, allowing them to trap pockets of air and create bubbles.

The researchers found 16 metabolites with surfactant properties in normal human urine, mostly bile salts and fatty acid esters. In some conditions, such as liver disease (cholestasis) or small intestinal bacterial overgrowth, these metabolites may be present in higher than usual amounts, potentially leading to foamy urine even in the absence of proteinuria.

When to See a Doctor About Foamy Urine

If a person notices foamy urine frequently, especially if it’s accompanied by other symptoms, it’s a good idea for them to see a doctor.

If a person notices foamy urine frequently, especially if it's accompanied by other symptoms like swelling in the legs or around the eyes, it's a good idea for them to see a doctor. The doctor can run some simple tests to check kidney function and rule out any underlying health issues.

The doctor will likely start with a urine dipstick test, which can detect the presence of protein in the urine. If the test comes back positive, they may recommend additional tests, such as a 24-hour urine collection, to get a more accurate measure of the amount of protein being excreted. In some cases, the doctor may also recommend imaging tests like an ultrasound or CT scan to get a better look at the kidneys and check for any structural issues.

What to Do About Foamy Urine

If foamy urine is caused by dehydration, the solution is simple: the person should drink more fluids! They should aim for at least 8 glasses of water per day, and more if exercising or spending time in hot weather.

If an underlying health condition is causing the foamy urine, treatment will depend on the specific issue. For example, if a person has diabetes, managing blood sugar levels through diet, exercise, and medication can help protect the kidneys and reduce protein leakage.

If kidney disease is the culprit, the doctor may recommend medications to help control blood pressure and slow the progression of the disease. In some cases, lifestyle changes like eating a low-sodium diet and getting regular exercise can also help.

It's important to note that while foamy urine can be a sign of kidney problems, not all cases of proteinuria indicate significant kidney damage. Isolated proteinuria (protein in the urine without other signs of kidney dysfunction) is often benign and may not require extensive evaluation. However, if proteinuria is persistent or associated with other concerning symptoms, further workup is warranted.

The Bottom Line

Foamy urine is often harmless, but it can sometimes be a sign of an underlying health issue like kidney disease or diabetes. If a person notices foamy urine frequently, especially if it's accompanied by other symptoms, it's a good idea for them to see their doctor for an evaluation. With prompt treatment, many of the conditions that cause foamy urine can be managed effectively.

People should pay attention to the clues their urine provides about their overall health, and it's always better to err on the side of caution when it comes to protecting the kidneys.

Resources

Northwestern Medicine^®

Ghossein, Cybele, MD
"Foamy Urine: What's Normal, What's Not"
(No date.)
https://www.nm.org/healthbeat/healthy-tips/foamy-urine-whats-normal-whats-not

Medical News Today

Nall, Rachel, MSN, CRNA
"Why is my urine foamy?"
(Updated: May 31, 2023)
https://www.medicalnewstoday.com/articles/322171

UPMC Health Beat (University of Pittsburgh Schools of the Health Sciences)

"When to Worry About Bubbly or Foamy Urine"
(Medically reviewed: March 11, 2021)
https://share.upmc.com/2021/03/foamy-urine/

UpToDate

Rovin, Brad H., MD
"Assessment of urinary protein excretion and evaluation of isolated non-nephrotic proteinuria in adults"
(Topic last updated: August 8, 2022)
https://www.uptodate.com/contents/assessment-of-urinary-protein-excretion-and-evaluation-of-isolated-non-nephrotic-proteinuria-in-adults

Clinical Journal of the American Society of Nephrology

Khitan, Zeid J., and Richard J. Glassock
"Foamy Urine: Is This a Sign of Kidney Disease?"
(November 2019)
https://journals.lww.com/cjasn/fulltext/2019/11000/foamy_urine__is_this_a_sign_of_kidney_disease_.21.aspx

Many men who have undergone a vasectomy have later expressed a desire to have it undone. Experts estimate that 6% to 15% of men who have vasectomies eventually have a change of heart and undergo a vasectomy reversal, a procedure that makes pregnancy possible again. Vasectomy reversal, while a complex procedure, offers many men a second chance at natural conception.

Vasectomy reversal, while a complex procedure, offers many men a second chance at natural conception.

There have been remarkable advancements that have reshaped the landscape of medical research and practice. In recent years, the domain of vasectomy reversal has undergone a profound transformation. What was once considered a challenging and uncertain procedure has evolved into a reliable and accessible option for men seeking to regain their fertility.

The evolution of vasectomy reversal

Before delving into the reasons men might consider vasectomy reversal, it helps to understand the evolution of this procedure.

Historical Context: Vasectomy reversal has a history dating back to the early-20th century. Initially, it was perceived as a complex and uncertain surgery, with variable success rates. This perception has undergone a dramatic shift over the years, thanks to advancements in surgical techniques, instrumentation, and medical research.

Surgical Techniques: Modern vasectomy reversal techniques have evolved significantly, resulting in improved success rates. These advancements include refined microsurgical techniques, allowing for more precise reconnections of the vas deferens. Such advancements have increased the likelihood of successful reversal, even if several years have passed since the vasectomy.

Research and Understanding: Ongoing research has deepened our understanding of male fertility, sperm function, and reproductive anatomy. This knowledge has enabled urologists to make more informed decisions during vasectomy reversal surgeries, leading to improved outcomes.

The changing landscape of male fertility

When exploring the reasons behind the growing interest in vasectomy reversal, it is essential to recognize the changing landscape of male fertility and family planning.

Delayed Parenthood: Societal trends, such as delayed parenthood, have become more prevalent. Men who had previously chosen vasectomy as a means of contraception may now find themselves in situations where they wish to expand their families later in life.

Relationship Changes: Life is marked by change, including changes in relationships. After a divorce or the end of a relationship, men may begin new relationships where they desire children.

Improved Success Rates: As mentioned earlier, advancements in vasectomy reversal techniques have significantly increased success rates. (Success is defined as sperm returning to a man’s semen.) This newfound confidence in the procedure has prompted many men to reconsider their previous decisions and explore the possibility of vasectomy reversal.

Reasons a man might have a vasectomy reversal procedure

There are several reasons why men are choosing vasectomy reversal after having previously had a vasectomy.

Desire for Parenthood: The Overarching Motivation

The most frequently cited reason for choosing vasectomy reversal is the desire for parenthood. Many men who undergo vasectomy reversal long to expand their families or start a new one. The longing for biological children — the deep-seated desire to experience the joys and challenges of parenthood — is a driving force that compels men to seek this procedure.

Relationship Changes and New Beginnings

It is not uncommon for men who have previously undergone vasectomy to find themselves in new relationships where the prospect of parenthood arises. The desire to share the experience of raising children with a new partner is a compelling reason for vasectomy reversal. This reflects the importance of strong, loving relationships in the decision-making process.

Evolving Desires

It's human nature for desires and plans to shift over time. A couple initially confident in their decision not to have more children may, with the passage of years, experience a change of heart.

Changing Life Circumstances

Some men who had previously chosen vasectomy for various reasons, such as financial concerns, career paths, or personal circumstances, later reassess their priorities. After achieving stability in these areas, they might feel more prepared to support a growing family.

Health and Well-being: Improvements in health or lifestyle changes may prompt men to consider vasectomy reversal. Better health can increase the desire and ability to be an active parent.

Legacy and Family Traditions: Cultural factors and the desire to continue family traditions can influence a man's decision to reverse his vasectomy. Preserving one's family legacy and honoring cultural values may take precedence.

Emotional and Psychological Factors

The decision to pursue vasectomy reversal can be influenced by various emotional and psychological factors.

Emotional Recovery: Some men view vasectomy reversal as a means of emotional healing and closure, particularly following the loss of a child or other life-changing events. It can symbolize moving forward and embracing the future.

Psychological Well-being: The desire to become a father or have additional children can significantly impact one's overall psychological well-being. Some men feel incomplete after having a vasectomy; a reversal may lessen these feelings.

Partner's Influence: The support and desires of one's partner play a vital role in the decision-making process. Partners who express a strong desire for children can be a significant motivator.

Improved Surgical Techniques and Success Rates

As has been previously noted, advancements in medical technology and surgical techniques have substantially improved the success rates of vasectomy reversal. Highly skilled urologists, equipped with state-of-the-art microsurgical tools, can now achieve precise reconnections of the vas deferens, even in cases where vasectomy was performed several years ago.

Men may choose vasectomy reversal because of these advancements, which instill confidence in the procedure's efficacy. The increased likelihood of success is a reassuring factor for those contemplating vasectomy reversal and is a powerful motivator for men who may have been deterred by lower success rates in the past.

Non-Invasive Alternatives:

The availability of other techniques to achieve pregnancy, such as non-surgical sperm retrieval methods, may encourage men to reconsider vasectomy reversal. While these methods are effective, some men may prefer the natural route offered by vasectomy reversal.

Post-Vasectomy Pain Syndrome

Though rare, some men experience chronic testicular pain following vasectomy. For a subset of these men, vasectomy reversal can offer relief from this discomfort.

Personal or Religious Beliefs

Personal, moral, or religious revelations might lead some men to reconsider their earlier decisions, seeking reversal as a way to align their life choices with these evolving beliefs.

Considerations before vasectomy reversal

Before embarking on the journey of vasectomy reversal, men should consider several critical factors and consult with a qualified urologist.

Individual Circumstances: The success of vasectomy reversal can vary based on factors such as the time elapsed since the vasectomy, the technique used during the vasectomy, and the patient's overall health. A thorough evaluation by a urologist is necessary to assess the likelihood of success.

Support System: Emotional support from loved ones is crucial during the decision-making process and recovery period. Couples should discuss their family planning goals and ensure alignment before proceeding.

Alternative paths to parenthood

While vasectomy reversal is a promising option, it may not guarantee pregnancy. Couples should be prepared to explore alternative paths to parenthood, such as adoption or assisted reproductive technologies like IVF, if necessary.

Assisted Reproductive Technologies (ART): Techniques like in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) offer effective alternatives to vasectomy reversal. Couples may choose these methods if a man prefers not to undergo surgery.

Sperm Retrieval Techniques: Procedures like testicular sperm extraction (TESE) and percutaneous epididymal sperm aspiration (PESA) can retrieve sperm directly from the testicles or epididymis for use in ART.

The vasectomy reversal procedure

Understanding the vasectomy reversal procedure is crucial for making an informed decision. The two primary techniques employed are vasovasostomy and epididymovasostomy.

Vasovasostomy: This technique, which connects the vasa deferentia directly, is used when each vas deferens shows no signs of blockage. It is the preferred choice when possible. Success rates for vasovasostomy are generally higher.

Vasoepididymostomy: In cases where the vas deferens is blocked or damaged, a vasoepididymostomy may be necessary. This technique involves connecting the vas deferens directly to the epididymis (the coiled tube where sperm cells mature, located between the testis and the vas deferens). It is a more complex procedure with somewhat lower success rates.

Sometimes, men may need to have a vasovasostomy for one pair of vasa deferentia and a vasoepididymostomy for the other pair.

Making the decision

In summary, the information presented throughout this article offers a glimpse into the complex tapestry of motivations that drive men to consider vasectomy reversal.

Vasectomy reversal represents a significant step towards achieving the dream of parenthood for many men. Whether driven by the desire to start a family, changes in relationships, advancements in medical techniques, evolving life circumstances, personal preferences, or some other motivation, each individual's journey towards vasectomy reversal is unique and deserving of respect and support.

Men who are contemplating vasectomy reversal should seek counsel from experienced urologists and discuss their options with their loved ones. The journey may be filled with challenges and uncertainties, but it is one that holds the promise of renewed hope and the potential for the joy of parenthood.

Resources

ClevelandClinic.com

“Vasectomy Reversal: Facts You Need To Know”
(September 13, 2022)
https://health.clevelandclinic.org/how-reversible-are-vasectomies/

“Post-Vasectomy Pain Syndrome”
(Last reviewed: May 13, 2022)
https://my.clevelandclinic.org/health/diseases/23048-post-vasectomy-pain-syndrome

F1000 Research

Fainberg, Jonathan and James A. Kashanian
“Recent advances in understanding and managing male infertility”
(Full-text. First published: May 16, 2019)
https://f1000research.com/articles/8-670/v1

Healthline.com

Jewell, Tim
“Vasectomy Reversal: What You Need to Know”
(Updated: December 15, 2017)
https://www.healthline.com/health/vasectomy-reversal

Health Psychology Research

Anderson, Danyon J., et al.
“Vasectomy Regret or Lack Thereof”
(September 14, 2022)
https://healthpsychologyresearch.openmedicalpublishing.org/article/38241-vasectomy-regret-or-lack-thereof

Human Reproduction

Khandwala, Yash S., et al.
“The age of fathers in the USA is rising: an analysis of 168 867 480 births from 1972 to 2015”
(Full-text. Published: August 30, 2017)
https://academic.oup.com/humrep/article/32/10/2110/4096427

Human Reproduction Update

Mills, Melinda, et al.
“Why do people postpone parenthood? Reasons and social policy incentives”
(Full-text. Published: June 7, 2011)
https://academic.oup.com/humupd/article/17/6/848/871500

Mayo Clinic

“Post-vasectomy pain syndrome”
(September 9, 2022)
https://www.mayoclinic.org/diseases-conditions/post-vasectomy-pain-syndrome/symptoms-causes/syc-20527047

Sparks, Dana
“There are a number of reasons for a vasectomy reversal”
(March 21, 2019)
https://newsnetwork.mayoclinic.org/discussion/there-are-a-number-of-reasons-for-a-vasectomy-reversal/

Medical News Today

Davis, Kathleen, FNP
“What to know about assisted reproductive technology”
(October 19, 2021)
https://www.medicalnewstoday.com/articles/assisted-reproductive-technology

Pew Research Center

Schaeffer, Katherine and Carolina Aragão
“Key facts about moms in the U.S.”
(May 9, 2023)
https://www.pewresearch.org/short-reads/2023/05/09/facts-about-u-s-mothers/

Saudi Medical Journal via PubMed

Amarin, Zouhair O. and Basil R. Obeidat
“Patency following vasectomy reversal. Temporal and immunological considerations”
(Abstract. Published: August 2005)
https://pubmed.ncbi.nlm.nih.gov/16127514/

United States Conference of Catholic Bishops

“Natural Family Planning”
(No date)
https://www.usccb.org/issues-and-action/marriage-and-family/natural-family-planning/catholic-teaching/upload/Natural-Family-Planning-2.pdf

Urology Care Foundation

“Sperm Retrieval”
(No date.)
https://www.urologyhealth.org/urology-a-z/s/sperm-retrieval

“Vasectomy Reversal”
(No date.)
https://www.urologyhealth.org/urology-a-z/v/vasectomy-reversal

“What Patients Should Know About Vasectomy Reversal with Dr. Larry Lipshultz”
(Podcast. No date.)
https://www.urologyhealth.org/healthy-living/urology-care-podcast/general-urology-podcasts/what-patients-should-know-about-vasectomy-reversal-with-dr-larry-lipshultz

Urology Clinics of North America via ScienceDirect

Kim, Howard H., MD and Marc Goldstein, MD, FACS
“History of Vasectomy Reversal”
(Full text. Published: August 2009)
https://www.sciencedirect.com/science/article/abs/pii/S0094014309000421?via%3Dihub

VeryWellHealth.com

Boskey, Elizabeth, PhD
“The Anatomy of the Epididymis”
(Updated: June 30, 2022)
https://www.verywellhealth.com/epididymis-anatomy-4774615

When seeing a urologist for erectile dysfunction (ED), many men ask about oral medications (pills that can be taken by mouth).

These drugs have been a major force in erectile dysfunction treatment for over two decades. Sildenafil (brand name Viagra^®) was the first to be approved by the U.S. Food and Drug Administration (FDA) in 1998. Tadalafil (Cialis^®) and vardenafil (Levitra^®) followed; both drugs were approved in 2003. The FDA approved the fourth ED drug, avanafil (Stendra^®) in 2012.

All of the drugs are classified as phosphodiesterase type 5 (PDE5) inhibitors, and they work in similar ways. Many men find them effective and convenient.

Still, they’re not right for every man, and there are differences among them that men should be aware of.

How do oral ED drugs work?

There are differences among oral medications for ED that men should be aware of.

For a man to get an erection, muscles in the penis need to relax so that blood can flow in during sexual stimulation. As the penis fills with blood, it becomes firm and erect. A chemical called nitric oxide, which is naturally produced by the body, helps this process along.

The four oral ED drugs help nitric oxide do its job so that the penis muscles can relax and let the blood in.

ED drugs do not create an erection automatically, however. A man still needs sexual stimulation to achieve an erection.

How are oral ED drugs similar?

Oral ED drugs share these similarities:

In the United States, they are available by prescription only.

ED drugs are not sold over the counter, and men need a doctor’s prescription to obtain them.

It’s important for men to see a doctor when they start having trouble with erections. ED can be a sign of health conditions like diabetes and heart disease. If these conditions are found, they can be treated along with the ED.

ED can be a sign of health conditions like diabetes and heart disease.

ED drugs don’t increase sexual desire.

ED drugs allow blood to flow into the penis more easily to create an erection, but they do not affect sexual desire. Men need to have the drive for sexual activity as well as sexual stimulation for the drugs to work.

ED drugs don’t prevent pregnancy or lower risk for sexually transmitted infections.

Couples still need to use contraceptives and follow safe sex practices, like using condoms and dental dams.

ED drugs have some side effects in common.

The 4 ED drugs do share some mild side effects, such as headache and flushing.

They also have some more serious side effects in common. If any of these symptoms occur, patients should seek emergency medical care:

• An erection lasting longer than 4 hours
• Sudden loss of vision
• Sudden loss of hearing
• Ringing in the ears
• Dizziness
• Swelling of the face, mouth, throat, hands, feet, or legs

However, other side effects may be different for each drug:

Avanafil

Mild side effect:

• Back pain

Side effects that need emergency care:

• Rash
• Itching

Sildenafil

Mild side effects:

• Heartburn
• Diarrhea
• Nausea
• Nosebleeds
• Numbness or tingling in the limbs, hands, or feet
• Pain in muscles, back, or limbs
• Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green
• Sensitivity to light
• Nasal congestion

Side effects that need emergency care:

• Blurred vision
• Fainting
• Chest pain
• Shortness of breath
• Rash, itching or hives
• Difficulty breathing or swallowing

Tadalafil

Mild side effects:

• Heartburn
• Nausea
• Diarrhea
• Pain in the muscles, back, arms, legs, or stomach
• Coughing

Side effects that need emergency care:

• Blurry vision
• Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green
• Chest pain
• Hives, rash, blisters, or peeling skin
• Difficulty breathing or swallowing

Vardenafil

Mild side effects:

• Nausea
• Heartburn
• Stuffy or runny nose
• Flu-like symptoms

Side effects that need emergency care:

• Blurry vision
• Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green
• Hoarseness
• Difficulty breathing or swallowing
• Fainting
• Hives or rash

Patients should note that some side effects are more common with specific drugs. For example, men who take sildenafil may be more likely to experience a blue/green tinge to their vision than men who take tadalafil. And men who take tadalafil may be more likely to have muscle pain (myalgia) than men who take sildenafil.

A man’s doctor can best advise on the likelihood of certain side effects and how they might affect a man’s personal situation.

ED drugs are not safe for all men.

Men who take drugs containing nitrates should not take ED medications. This combination can cause a dangerous drop in blood pressure. Some examples of nitrates are nitroglycerin, isosorbide mononitrate, and isosorbide dinitrate. Nitrates are prescribed to prevent or treat chest pain related to heart disease.

ED drugs are also not appropriate for men with low blood pressure, uncontrolled high blood pressure, and severe liver disease. Men who are on dialysis for kidney disease should also not take ED drugs.

Men who take alpha blockers for enlarged prostate symptoms may need to space out their doses of these drugs and ED drugs to avoid an interaction.

Men should always tell their doctor about any other medications, street drugs, herbs, or supplements they use. These products may interact with ED drugs.

In addition, men should let their doctor know if they typically eat grapefruit or drink grapefruit juice, as this combination may cause an interaction as well.

How are oral ED drugs different?

Dosing may be different.

Sildenafil, avanafil, and vardenafil are taken on an as-needed basis, meaning a man takes them before he wishes to have an erection. Tadalafil may also be taken this way, but some prescriptions call for it to be taken every day. Men should be sure to take their medicine as directed.

The time between taking the drug and getting an erection may vary.

ED drugs do not produce an erection immediately. It takes some time for the drug to work, and these time frames vary by medication. For example, men usually get an erection about 30 to 60 minutes after taking sildenafil or vardenafil. Men who take tadalafil as needed (not daily) may need to wait 30 to 45 minutes. For those who take avanafil, the wait may be 15 to 30 minutes.

They last for different durations.

ED medications also vary in how long they are effective. For example, once sildenafil or vardenafil take effect, a man might be able to get an erection for four to five hours. For avanafil users, the time frame is about six to twelve hours. Tadalafil has the longest effective time—usually 24 to 36 hours for as- needed users. Men who take tadalafil daily should be able to get an erection at any time.

Which ED drug should a man choose?

When prescribing ED drugs, doctors take many factors into account. They consider a man’s overall health and the drugs and supplements he currently takes.

Sometimes, it takes time to find the most effective ED drug. These medications have been shown to be quite effective, but results vary from man to man. If a particular drug doesn’t work as well or has bothersome side effects, a man’s doctor may prescribe a different drug or suggest a different ED treatment.

It’s important to remember that in the United States, ED drugs are available only by prescription. Men may see online advertisements for non-prescription products that claim to improve erectile function. But these claims are often misleading, and taking such products could be dangerous. (Learn more about sexual enhancement supplements here.)

---

Resources

American Urological Association

Burnett, Arthur L., MD
“Erectile Dysfunction: AUA Guideline (2018)”
(2018)
https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

Harvard Health Publishing / Harvard Medical School

“Which drug for erectile dysfunction?”
(August 9, 2022)
https://www.health.harvard.edu/mens-health/which-drug-for-erectile-dysfunction

Mayo Clinic

“Erectile dysfunction: Viagra and other oral medications”
(December 20, 2022)
https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-20047821

MedlinePlus

“Avanafil”
(Last revised: February 15, 2017)
https://medlineplus.gov/druginfo/meds/a614010.html

“Sildenafil”
(Last revised: April 15, 2023)
https://medlineplus.gov/druginfo/meds/a699015.html

“Tadalafil”
(Last revised: April 15, 2023)
https://medlineplus.gov/druginfo/meds/a604008.html

“Vardenafil”
(Last revised: January 15, 2022)
https://medlineplus.gov/druginfo/meds/a603035.html

National Institute of Diabetes and Digestive and Kidney Diseases

“Treatment for Erectile Dysfunction”
(Last reviewed: July 2017)
https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment

The Pharmaceutical Journal

Connelly, Dawn
“Three decades of Viagra”
(May 25, 2017)
https://pharmaceutical-journal.com/article/infographics/three-decades-of-viagra

Erectile dysfunction (ED) — difficulty with erections — is quite common. In fact, an estimated 30 million men in the United States have ED to some extent. Some men are unable to get an erection at all. Others may get an erection, but it’s not firm enough for sex.

No matter what causes it or how it develops, ED can affect a man’s well-being and his ability to enjoy sex. Men may question their masculinity and their ability to satisfy a sexual partner. They may become anxious about sex and worry about their performance. And they may feel sad about changes to a once-active sex life.

There is good news, however. Over the years, scientists have developed several effective treatment approaches, including lifestyle changes, pills, injections, vacuum devices, suppositories, and penile implant procedures.

Still, it can take a little time to find the right treatment. And with lifestyle changes and surgery, it takes time for the situation to improve. What can men do in the meantime? How can they cope with ED in the here and now?

Read on to find out.

Learn about ED

Over the years, scientists have developed several effective treatment approaches

Learning as much as possible about ED is a useful starting point. A man’s doctor can recommend reliable websites, brochures, podcasts, videos, books, and magazines for learning more. Asking questions while seeing the doctor is another opportunity. Some men write out their questions before their appointment so they don’t forget them.

For example, men might ask:

• What’s causing my ED? What can I do about it?
• What treatment options are available to me?
• Are treatments covered by insurance?
• Do you think sex therapy would help me?

Once men have some background knowledge, they can come up with a treatment plan with their doctor.

Communicate with partners

Some people shy away from talking about sex. But being open and honest about ED is an important part of coping — for both partners.

Such discussions allow couples to better understand each other’s point of view. One partner may not be aware of how the other is feeling.

For example, if the man with ED starts avoiding sex, his partner might worry that they are not attractive or fulfilling his needs. And that might not be the case at all.

Having these conversations allow partners to comfort, reassure, and encourage each other. Couples who need help with their communication skills might consider counseling.

Redefine intimacy

There is more to intimacy than penetrative intercourse, and couples can maintain their intimate bond in other ways. Doing so can be as simple as holding hands at the mall, cuddling on the couch during a movie, or giving each other a massage at the end of a long day. In the bedroom, it can be having oral sex or role playing a favorite fantasy.

This is a time to experiment, relax, and have fun. Couples may discover new activities they enjoy — activities that they continue after erections improve. Some see a sex therapist for new ideas, perspectives, and communication tips.

Stay healthy

Eat nutritious foods. Exercise regularly. Quit smoking. Get enough sleep. Practice self-care. These suggestions often top lists of recommended healthy habits. They help with erections, too.

For example, healthy habits lower the risk of health conditions like diabetes and heart disease, which can lead to ED. Research suggests that following a Mediterranean diet could be good for erections, too.

Staying fit and maintaining a healthy weight boosts confidence and body image. It may also improve depression or anxiety that often accompany ED.
Read more about lifestyle changes and ED here.

Celebrate successes

Even if ED is frustrating, treatment offers many reasons to celebrate:

• Making a first appointment with a urologist
• Talking about sex with a partner
• Trying a new way of intimacy
• Trying a new treatment
• Seeing a counselor or sex therapist
• Eating healthier meals for a week
• Sticking to a workout routine
• Making a plan to quit smoking.
• Getting a firmer erection than last time

No matter how small an achievement may seem, celebrating progress can boost motivation, confidence, and hope for the future. How men celebrate is up to them. Having date night with their partner, playing a round of golf, or seeing a favorite band can all work.

Stay in touch with a doctor

As noted above, ED treatment can take time. What works well for one man might not be so effective for another. That’s why it’s important for men to stay in touch with their doctor throughout the process. If one approach doesn’t seem to work, there are others to try. Keeping the doctor informed can help them tailor treatment.

Resources

Harvard Business Review

Johnson, Whitney
“Celebrate to Win”
(January 26, 2022)
https://hbr.org/2022/01/celebrate-to-win

National Institute of Diabetes and Digestive and Kidney Diseases

“Erectile Dysfunction (ED)”
(Last reviewed: July 2017)
https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/all-content

PsychCentral.com

Rowe, Steven
“What Research Says About Erectile Dysfunction in a Marriage”
(March 24, 2022)
https://psychcentral.com/health/erectile-dysfunction-and-affairs

PsychologyToday.com

Cheyette, Benjamin MD and Sarah Cheyette MD
“Why It's Important to Celebrate Small Successes”
(November 22, 2021)
https://www.psychologytoday.com/us/blog/1-2-3-adhd/202111/why-its-important-celebrate-small-successes

Cooper, Sari, CST, LCSW
“The Masculinity Myths Surrounding Erectile Dysfunction”
(December 2, 2022)
https://www.psychologytoday.com/us/blog/sex-esteem/202212/the-masculinity-myths-surrounding-erectile-dysfunction

Urology Care Foundation

“Erectile Dysfunction”
(Updated: June 2018)
https://www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed)

VeryWellHealth.com

Boskey, Elizabeth, PhD
“Coping With Erectile Dysfunction”
(Updated: November 15, 2022)
https://www.verywellhealth.com/erectile-dysfunction-coping-4774329

A penile implant (also called a penile prosthesis) is a surgically placed, mechanical device that helps a man get an erection—and keep it—for as long as he likes. It’s one of several treatment options for men with erectile dysfunction (ED). And it has high satisfaction rates.

Still, men need to weigh some important pros and cons before getting an implant. Read on to learn more about the different types of implants, the surgery involved, and what men can expect afterward.

Why do men choose penile implants?

Erectile dysfunction—the inability to get an erection firm enough for sex—is a common problem. While there are several treatments available, such as pills, self-injections, and vacuum devices, they’re not suitable for all men. For example, men who take nitrates for heart conditions cannot use ED medications because of a dangerous drug interaction.

Success with ED treatments can vary, too. What works for one man may not work for another. Generally, men try other ED treatment options before deciding on an implant.

Men with Peyronie’s disease may also get penile implants. This condition causes the penis to bend, sometimes to a point where intercourse becomes quite difficult. An implant can straighten the penis and help with any erection problems.

Transgender men may get penile implants as they undergo gender affirmation surgeries. During these procedures, surgeons create a penis and may implant a prosthesis to aid sexual activity.

Types of penile implants

In general, there are two different types of implants:

Inflatable implants

The most common type of implant is a 3-piece inflatable implant. The three parts are connected by tubes. They include:

• A pair of inflatable cylinders that are inserted into the shaft of the penis
• A fluid-filled reservoir placed in the abdomen
• A pump placed in the scrotum

When a man wishes to have an erection, he simply activates the pump in his scrotum. Saline fluid from the reservoir then moves into the cylinders and inflates them, creating the erection. When the man is done with sexual activity, he presses on the pump again. The cylinders deflate and the fluid moves back to the reservoir.

A 2-piece inflatable implant is also available, but it’s less common. This type works in a similar way, but the reservoir and the pump are in the same piece.

Malleable (semirigid) implants

These implants are flexible silicone rods that are inserted into the penis. When a man wants an erection, he can simply lift his penis up into position, then move it back down when he is finished with sexual activity. Malleable implants are not common nowadays, but they might be suitable for men who may have trouble activating a pump in the scrotum.

Advantages of penile implants

• The man has full control. A man can get an erection and keep its firmness for as long as he likes. He can also have as many erections in a day as he wishes.
• They have high satisfaction rates. Studies have shown that the satisfaction rate among men with 3-piece implants is 90% or higher.
• Sex can be more spontaneous. A man does not have to worry about timing the dose of a pill or stopping sexual activity to give himself an injection or use a vacuum device. Instead, he can create an erection in the moment.
• Implants last for years. Some men get 15 to 20 years of use from the same implant before it needs replacing.
• They’re discreet. The penis looks natural. People usually can’t tell if a man has an implant by looking at his penis. (Malleable implants may be an exception, as the penis is always somewhat firm.) During intercourse, partners usually cannot tell that a man has an implant.
• They don’t affect sexual desire or performance. For most men, sexual sensations, ejaculation, and orgasms feel the same as they did before the implant.
• They may boost a man’s sexual confidence. Men may feel less anxious about intimacy knowing that they can get a firm erection every time they have intercourse.

A man can get an erection and keep its firmness for as long as he likes.

Disadvantages of penile implants

• A surgical procedure is involved. Like any surgery, penile implant surgery has risks, such as infection, bleeding, and injury to surrounding areas. However, surgeons take special precautions to lower the risk of complications. Infection rates are estimated to be 1% to 2%. If there is an infection, the device is usually replaced.
• Implants can malfunction. There are times when a penile implant can malfunction, although this is rare.
• They are permanent. Because of the nature of implant surgery, a man can no longer have natural erections once he has an implant. Other ED treatments, such as pills or injections, will no longer be options.

What happens during penile implant surgery?

Before surgery, a man’s doctor will tell him how to prepare. The man may receive special instructions for taking medications or supplements, eating and drinking, and bathing beforehand.

The surgery itself is performed under general anesthesia and takes about one to two hours. It may be done as an outpatient procedure, and many men can go home the same day. However, some men may need to spend a night in the hospital.

To implant the device, the surgeon makes a small incision in the genital area. The inflatable cylinders (or bendable rods, if a malleable implant) are inserted into the shaft of the penis. If it is a 3-piece inflatable device, small incisions are made so that the reservoir can be placed in the abdomen and the pump can be placed in the scrotum. The pieces are then connected and the incisions are closed. The man may have a temporary surgical drain.

Men having implant surgery will need to have someone drive them home. They should also have someone stay with them for the first day or two.

Note: Not all men are good candidates for implant surgery. Men who are at higher risk for complications and those who have heart disease or poorly managed diabetes may not be able to have surgery.

Recovering from penile implant surgery

Back at home, men recovering from implant surgery may experience swelling, pain, or discomfort for the first week. These symptoms may be managed with medicines and ice packs. If there is a drain, it will be removed in the first few days after the procedure.

Men will need to avoid heavy lifting and vigorous activity, including exercise, for up to four weeks. If they work a desk job, they can return to work after a week or so. Men with more physical jobs may need to wait up to four weeks before returning to work.

Sex—both intercourse and masturbation—will need to wait four to six weeks while the body heals. At this time, the man’s doctor will teach him how to use the implant.

Men who have the following symptoms during recovery should call their doctor right away:

• Heavy bleeding
• Fever
• Worsening pain
• Infection

Adjusting to a penile implant

It may take time to adjust to sex with a penile implant. However, many men find that their sex life improves, knowing that they can now count on having a firm erection. Men who have problems with their device or have further questions should talk to their doctor.

Resources

Cleveland Clinic

“Penile Implants”
(Last reviewed: November 11, 2022)
https://my.clevelandclinic.org/health/treatments/10054-surgical-penile-implants

EAU Patient Information (European Association of Urology)

“Penile Implants”
https://patients.uroweb.org/treatments/penile-implants/

“Penile Implants”
https://patients.uroweb.org/penile-implants2/

Medscape

Hellstrom, Wayne John G., MD, FACS
“Penile Prosthesis Implantation”
(Updated: June 14, 2022)
https://emedicine.medscape.com/article/446761-overview

Urology Care Foundation (American Urological Association)

“Penile Implant”
https://www.urologyhealth.org/healthy-living/urologyhealth-extra/magazine-archives/spring-2020/insights-penile-implant-x8259

“What to Know about Penile Implants with Dr. Melissa Mendez”
(Urology Care Podcast. 2021)
https://www.urologyhealth.org/healthy-living/urology-care-podcast/sexual-health-podcasts/what-to-know-about-penile-implants-with-dr-melissa-mendez

Can a supplement improve a person’s sex life?

Looking at store shelves and media advertising, one might think so. Around the world, people spend millions of dollars on dietary supplements each year. Many of the products are advertised as sexual enhancement products, claiming to boost libido, increase sexual pleasure, or give a man firmer erections.

Supplements are attractive for many reasons. For one, they’re discreet. A man searching for solutions for erection problems might order a supplement online, and nobody has to know he’s seeking help. For another, they’re easy to find in drugstores, convenience stores, and health food stores. And third, people think they might find a solution to a problem and can avoid discussing such a personal issue with another person, even if it is a doctor.

However, consumers need to approach these products with a great deal of skepticism. They often do not live up to manufacturers’ claims, and some can be dangerous.

Below are some things to think about before taking a sexual enhancement supplement.

Supplement ingredients

Sexual enhancement supplements may contain ingredients like the following:

• Tribulus terrestris
• Ginseng
• Maca
• Fenugreek
• Horny goat weed
• Arginine
• Zinc
• Yohimbine (sometimes called yohimbe)
• Vitamin B6
• Vitamin B9 (folate)
• Vitamin D

Consumers need to approach these products with a great deal of skepticism. They often do not live up to manufacturers’ claims, and some can be dangerous.

FDA doesn’t test or approve dietary supplements

Unlike drugs, dietary supplements do not go through a testing or approval process with the U.S. Food and Drug Administration (FDA). In addition, manufacturers are not required to give the FDA any backup to their safety claims.

The supplement may not be as effective as claimed

Are sexual enhancement supplements effective? This is a difficult question to answer, as the sexual effects of these substances may not be widely studied—at least not in humans. For example, in a 2019 Journal of Sexual Medicine paper, researchers examined 413 studies on sexual enhancement supplements. Only 17% of the studies involved humans.

Claims on effectiveness may not be backed up by scientific study, and positive reviews might not be truthful.

Lack of peer-reviewed study—or any kind of study in humans—raises questions as to whether supplements are as effective as their manufacturers claim.

Product reviews are another concern. When researching supplements online, consumers may see vast praise from reviewers, with claims like “It completely cured my erection problems!” or “Sex is better than ever!” However, the internet is rife with unreliable reviews. Some companies pay reviewers to give positive reviews, even if the reviewer did not have a positive experience (or any experience) with the product.

In the above study, researchers used review analysis software to filter out reviews that met the criteria for being unreliable. Once the questionable reviews were removed from the analysis, positive claims dramatically fell. The authors wrote:

After filtration, we observed a 77% decrease in reviews reporting improved erection strength, an 83% decrease in reviews reporting improved ability to maintain erection, a 90% decrease in reviews reporting increased sexual satisfaction, an 88% decrease in reviews reporting increased enjoyment with intercourse, and an 89% decrease in reviews reporting increased erection confidence.

In short, claims on effectiveness may not be backed up by scientific study, and positive reviews might not be truthful.

Products may include hidden ingredients, which could be dangerous.

Supplements may include ingredients that are not listed on the package label. (These are called undeclared ingredients.) There have been cases where sexual enhancement supplements have included erectile dysfunction drugs like sildenafil and tadalafil. These drugs are effective for many men, but not all men can take them safely. They can be especially dangerous for men who take nitrates. But if the ingredients are not declared, it’s difficult for people to know if a product contains substances that could harm them.

Sex problems may be related to another health issue, which could be dangerous.

A sexual problem is often a sign of an underlying medical condition. And often, treating that underlying condition solves the problem.

For example, erectile dysfunction can be an early symptom of diabetes or heart disease. It’s also common in men with obesity. For many men, taking steps to control blood sugar, blood pressure, weight, and other health issues leads to better erections—and better sex.

Seeing a doctor for a sexual issue can help solve the problem and lower the risk of having other health issues, and perhaps avoid a major health crisis, in the future. It’s a win-win situation.

Also, adopting healthy habits can go a long way in improving erections—and sex in general. Many people feel more energetic, confident, and attractive when they take good care of their health.

Take action

When faced with a sexual problem, trying a supplement may seem like an easy plan to try. But it’s important to do some homework first:

See a doctor. Sexual issues are common, and one of the best ways to start addressing them is getting a full check up with a doctor. If another health condition, like diabetes or heart disease, is causing the sexual issues, then it’s important to treat that. (Sexual problems often improve when the underlying cause is treated.)

Ask a doctor or pharmacist about the supplement. These experts can provide information on the safety of a product’s ingredients and what side effects may occur. They can also answer any questions.

Read the supplement label and packaging insert. If anything looks amiss, the manufacturer should be able to give more information.

Check the FDA’s list of tainted sexual enhancement products. The FDA maintains a public list of supplements that could be risky.

With good information, people can make informed decisions. And the best information for a person’s individual situation comes directly from their doctor, not from a supplement manufacturer that doesn’t know the consumer and might not have patients’ best interests at heart.

Resources

AUANews

Jenkins, Lawrence C., MD, MBA, et al.
“AUA2022: REFLECTIONS: The Safety and Efficacy of Sexual Supplements”
(August 1, 2022)
https://www.auanews.net/issues/articles/2022/august-2022/aua2022-reflections-the-safety-and-efficacy-of-sexual-supplements

Healthline

“Can Testosterone Supplements Improve Your Sex Drive?”
(Updated: September 30, 2022)
https://www.healthline.com/health/low-testosterone/do-testosterone-supplements-work

Harvard Health Publishing / Harvard Medical School

“Can supplements save your sex life?”
(No date)
https://www.health.harvard.edu/staying-healthy/can-supplements-save-your-sex-life

The Journal of Sexual Medicine

Balasubramanian, Adithya BA, et al.
“An Analysis of Popular Online Erectile Dysfunction Supplements”
(Full-text. Published April 26, 2019)
https://academic.oup.com/jsm/article/16/6/843/6966876

Medical News Today

Bell, Alex
“Natural remedies and supplements for erectile dysfunction”
(Updated: January 10, 2023)
https://www.medicalnewstoday.com/articles/vitamins-for-ed

Urology Times

“Dietary supplements for urologic conditions may pose risks to patients”
(January 25, 2023)
https://www.urologytimes.com/view/dietary-supplements-for-urologic-conditions-may-pose-risks-to-patients

U.S. Food and Drug Administration

“Questions and Answers on Dietary Supplements”
(October 26, 2022)
https://www.fda.gov/food/information-consumers-using-dietary-supplements/questions-and-answers-dietary-supplements

“Tainted Sexual Enhancement Products”
(Content current as of February 7, 2023)
https://www.fda.gov/drugs/medication-health-fraud/tainted-sexual-enhancement-products

Sex can be a sensitive topic for any couple. Some people are shy about their bodies or feel embarrassed discussing a subject so private and personal. But there are times when sexual issues need attention, and Peyronie’s disease can be one of those times.

Peyronie’s disease can make intercourse difficult—and sometimes impossible. Plaques (scar tissue) form just beneath the skin of the penis, which becomes less flexible. As a result, the penis starts to bend. The extent of the curvature varies, but it can be as high as 90 degrees.

If there are lots of plaques, the penis might take on an hourglass shape. It could also narrow at the tip (a “bottleneck” deformity) or at the base (a “cobra head” deformity). For some men, there is a “hinge” effect that could make the penis unstable during an erection

Peyronie’s disease can be painful, too. And some men develop erectile dysfunction. They may have sex less often or stop having sex altogether.

There’s an emotional component to Peyronie’s disease as well. Men may feel ashamed of the way their penis looks, have doubts about their masculinity, and worry that their partner will think they’re less attractive. They may also feel anxious about their partner’s sexual satisfaction and fear changes in the relationship. Depression is common, as many men miss the robust sex life they once enjoyed.

And Peyronie’s disease impacts partners. They often notice that the relationship has changed and miss what used to be. If the man with Peyronie’s withdraws, partners may feel isolated or neglected.

Fortunately, like many sexual problems, Peyronie’s disease can be treated in several ways. The process starts with a conversation. And good communication between partners can make treatment more successful.

Broaching the subject

Couples might start the conversation when they’re alone and feeling relaxed.
Here are some sample openings:

There’s something that’s been on my mind lately—something sexual—and I was hoping we could talk about it.

• I really enjoy our intimate times together, but there’s something troubling me. Can we talk?
• It’s okay to admit to feeling nervous or awkward. Often, the subject has been on the partner’s mind, too, but they haven’t been sure how to approach it. Starting the dialogue might bring a sense of relief.

Opening up

Peyronie’s disease comes with a range of emotions, and it’s good to get those out in a constructive way. Frustration, depression, fear, anxiety—they’re all valid. When such feelings are out in the open, couples gain some perspective. They can listen to each other, reassure each other, and approach the future together, as a team.

Keeping the conversation going

Talking about Peyronie’s disease doesn’t need to be a “one and done” conversation. Over time, and as treatment progresses, feelings and perceptions might change. Checking in with each other from time to time can enhance the overall dialogue.

Learning together

Peyronie’s disease isn’t a term people hear every day. For some, it might be brand new. Researching the topic together is another way to keep the conversation going. Some couples share what they discover online, on television, or in magazines. They might also attend doctor’s appointments together and ask questions.

Exploring together

Peyronie’s disease doesn’t have to stop a couple from being intimate, and sex is more than intercourse. Couples can focus on what is possible and enjoyable. This part of the conversation can be creative and fun.

Staying supportive

Encouragement is important for couples facing Peyronie’s disease, and each partner can be a cheering section of sorts. For example, after a man finishes a round of
treatment, a partner might say, “That couldn’t have been easy. I’m proud of you!” Or if a man has trouble keeping an erection during a sexual encounter, the partner might say, “That’s okay. I love what we do together."

Considering counseling

Even when they have the best of intentions, couples may still struggle with communication. This is when a couples counselor might help. A trained therapist can teach strategies for expressing thoughts clearly, listening respectfully, and responding constructively. Urologists can make referrals for therapy.

For single men

For single men with Peyronie’s disease, starting new sexual relationships can be especially daunting. If they are still getting to know a new partner, they may be unsure of what to disclose and when.

Much of the advice above can apply to single relationships. Building trust takes time, but couples just starting out can still have similar conversations about Peyronie’s disease and its effects on intimacy.

A man might say, “Before we take the relationship further, there’s something I want to talk to you about.” If the relationship has been supportive and based on trust up to this point, chances are the partner will respond positively and be open to discussing other options for intimacy while the man seeks treatment.

Wrapping up

Sometimes the hardest part of having a sexual discussion is starting it. But all it takes is a deep breath. It may not be perfect or go exactly as planned, but starting the conversation is usually better than not having it at all.

Resources

Association of Peyronie’s Disease Advocates

“Impact on Relationships”
https://www.peyroniesassociation.org/living-with-peyronies/impact-on-relationships/

“Talking to Your Partner”
http://www.peyroniesassociation.org/living-with-peyronies/talking-to-your-partner/

“Psychological Impact of Peyronie’s disease”
Video available at: https://www.peyroniesassociation.org/living-with-peyronies/impact-on-relationships/

Saga.co.uk

Green, Siski
“Living with Peyronie's disease: the impact on sex and relationships”
(Updated: March 17, 2021)
https://www.saga.co.uk/magazine/relationships/love-sex/living-with-peyronies-disease-impact-on-sex-relationships

Sexual Medicine Reviews

Kern, T., et al.
“Peyronie's Disease: What About the Female Sexual Partner?”
(Abstract. Published: December 17, 2020)
https://www.smr.jsexmed.org/article/S2050-0521(20)30117-7/fulltext

Translational Andrology and Urology

Terrier, Jean E. and Christian J. Nelson
“Psychological aspects of Peyronie’s disease”
(Full text. June 2016)
https://tau.amegroups.com/article/view/10542/11177