HUGO

My Penis

We all know where our penis is and the amazing things it can do. The vast majority of us have probably been touching and stroking our penis since we were kids. And why shouldn’t we? It feels awesome. As a gay guy you have probably also seen at least a few other penises, and know that they come in many different sizes and appearances. Yet another awesome thing about the penis – no two are the same. So much to explore!

The penis essentially has four parts. The shaft, or body, of the penis extends from the lower abdomen, just below the pubic bone. It contains spongy tissue that can fill with blood making the penis increase in size, and become hard and erect. The shaft of the penis is actually much longer than what you can see. On the inside, the shaft extends past your balls down to the base, lying next to your anus. Yes, your dick is even bigger than you thought. The head of the penis is called the glans, and is very sensitive to touch. The most sensitive part of all is the frenulum, a small band of skin that runs between the head of your penis and the shaft, just below the pee hole. The foreskin is a layer of skin that slides over the head of the penis. There is considerable variation between guys as to the length of the foreskin. For some it just covers the head, while for others it extends past the head. When the foreskin is removed a guy is said to be circumcised. Lastly, the urethra is the tube that leaves the bladder, passes through the prostate, and travels down the penis, inside the shaft, to the pee hole at the tip of the head. This tube carries urine and cum.

When we are busy doing other things, the spongy tissue in the shaft of our penis is drained of blood, and our penis is soft and smaller is size. When our penis is stimulated, either by touching it or by thinking about some hot scene, the arteries delivering blood to the penis enlarge and the veins draining blood from the penis constrict. So, as more blood enters the penis than leaves the spongy tissue, the shaft fills up making our penis increase in size, and become hard and erect. The average length of an erect penis is 5.1-5.9 inches. While size varies, 95% of guys are somewhere between 4.2 and 7.5 inches when hard. For most guys, when their penis is hard it will point up, but for about a third of guys, their penis when hard will point horizontal or slightly down. As you know, some are “showers” and some are “growers”. The size of the penis when it is soft does not predict how big it will get when erect. In fact, there are no features, like the size of his feet, which predict how big a guy’s cock will be when hard. You will just have to find out.

The foreskin is a layer of skin extending from the shaft of the penis that folds over and envelopes the head of the penis. As guys grow up and generally by puberty, the foreskin becomes loose and may be either pulled over the head of the penis, or pulled back to expose the head. Circumcision refers to removing this skin; if you have foreskin you are uncircumcised, if you do not have foreskin you are circumcised. Circumcision is most often done shortly after birth, and the decision to circumcise is usually based on cultural, religious, or family norms. Circumcision has some health benefits and some potential drawbacks. The foreskin is somewhat vulnerable, and guys with foreskin are at increased risk of acquiring HIV, as well as syphilis, herpes, and genital warts. However, the foreskin does provide extra sensation, so circumcision may reduce sensitivity. With that said, studies have failed to find a reduction in sensation or sexual satisfaction among men who are circumcised.  Circumcision may be recommended for medical reasons such as phimosis, recurrent balanitis, and balanoposthitis (see below).

Chances are your penis is important to you, and so it deserves a lot of tender loving care. Clean it at least once every day while you are in the shower. For men who are not circumcised, that is have foreskin, washing under the foreskin daily is very important. You can get infections under the foreskin, a condition called balanitis, or even a urinary tract infection if you don’t clean regularly. A white, cheesy material called smegma can build up over the head of your penis under the foreskin. Smegma is really just dead skin cells and natural lubricant, but can start to smell bad and encourage bacteria to grow if not washed away. Cancer of the penis is extremely rare, but usually occurs in men who have foreskin and who do not maintain good hygiene of their penis. Regardless of what Dad said, wash under the foreskin every day! The most important thing is if you don’t it just smells bad right? If you are circumcised, that is don’t have foreskin, washing is still important. While you are there be sure to wash the shaft of your penis and your balls, and don’t forget the areas between your balls and your thighs, as well as between your balls and your anus.

Some men with foreskin have a condition called phimosis, where the edge of the foreskin is just too tight and you can’t pull it back, or sometimes it will come back when the penis is soft, but not when erect. For some guys, a tight foreskin can make erections uncomfortable. Also, if you can’t pull the foreskin back, you won’t be able to clean under it. This will allow bacteria to build up, and can lead to infection of the head of your penis and foreskin, a condition called balanitis. Talk to you doctor, there are creams that can help loosen the foreskin. If it is severe and the creams don’t work you can talk to a Urologist about circumcision.

Some guys find that the head of their penis seems tethered down along the bottom aspect of the head where it attaches to the shaft.  This is a condition known as a tight penile frenulum.  It usually only feels uncomfortable when you have an erection.  It is an easy procedure for a Urologist to fix it if it is causing you trouble.

Penile pearly papules (PPP) are small bumps along the edge of the head of the penis. They can be pink, white, yellowish, or even clear. They are usually 1-2 mm in size, and occur in 1 or 2 rows along the edge of the head of the penis. Many guys worry these are warts; they are not. And they are not sexually transmitted, they are perfectly normal and you don’t worry about them.

Sebaceous cysts or inclusion cysts can occur anywhere on the scrotum (your ball sac) or on the shaft of the penis. These cysts look like a ball of firm, white, cheesy material close to the surface of the skin. They are a result of plugged sebaceous ducts at the site of a hair follicle. When the duct is blocked, sebum, oil from your skin, can’t drain and builds up into a ball under the skin.  They are typically firm, mobile, and painless unless they get infected.  Do not try to “pop” or drain them.  That won’t fix the problem and they are more likely to get infected. They won’t cause you any harm, but some guys don’t like the appearance. Talk to you doctor if you want them removed.

Hypospadius is a condition where the opening of the urethra (where the urine comes out) is NOT right at the end of the head of the penis.  It can be anywhere from the tip of the head down to the bottom side of the shaft of the penis.  This too can be a normal variation.  If you are having problems urinating, or the stream is spraying because of this problem, talk to your doctor. 

Erectile Dysfunction (ED) or Impotence

Most men have heard of this condition. It refers to when guys have difficulty getting or maintaining an erection. Don’t confuse this with decreased libido (that is, decreased sex drive), as that’s a different issue and is usually related to low testosterone. There can be both physical and psychological causes for erectile dysfunction. There are lots of potential physical causes, and these are usually related to things that affect the blood vessels in the penis…the most common causes being smoking and diabetes. Other causes include heart disease, high blood pressure, increased cholesterol, medications, and substance abuse. Anything that affects the nervous system in that area can do it as well, including Parkinson’s disease, Multiple Sclerosis, prostate surgery, or pelvic surgery. 

Sorry guys…if you smoke it’s one of the leading causes of erectile dysfunction…and also for cancer of the bladder…so two good reasons to consider throwing the cigarettes away.

Psychological causes for erectile dysfunction are very common as well and include depression, stress, being in a bad relationship, a breakup, etc.  What often happens is the difficulty with the erection then causes embarrassment, self esteem issues, lack of confidence, and “stage fright”…and thus further worsening of the condition…a vicious cycle in a way.

Talk to your doctor about this because there are some great treatments. Tell your doctor exactly what the problem is; I know it may seem embarrassing, but trust me, your doctor has heard everything and that’s what he or she is there for. Let them know if it’s trouble getting the erection or keeping it up, or if it’s just lack of interest in sex or low sex drive because the treatments differ.

Erectile dysfunction is defined as the persistent inability to get or maintain an erection that is hard enough for sexual satisfaction: be it fucking, oral sex, or masturbation. It’s true that as we get older our erections won’t be as hard and throb like they did when we were 18, but irrespective of age you should still be able to get hard and enjoy your penis. It is also true for all of us that sometimes our penis does not cooperate. If you are just not into sex at the moment, or you have something important on your mind, you may find your penis is not as responsive as it usually is and you may have trouble getting hard. If you are tired, or you are just not connecting with the guy you are with, you may find your penis is not into it either and you get soft. This is not erectile dysfunction. To diagnose erectile dysfunction two things need to be the case. (1) When you are into it and you really want to get off, either with another guy or by yourself, but your penis remains soft or only gets partially hard. Or, you need to continuously stroke your penis to stay hard; as soon as you stop your penis immediately starts to deflate. (2) This happens most, if not all, of the time.

Most of the time your doctor can make the diagnosis based on what you describe and when it happens. Your doctor may do some basic tests to make sure you do not have any underlying conditions, like high blood pressure or diabetes, and if you smoke he or she will almost certainly encourage you to quit.

 

So let’s talk about treatment!  For many men ED can be psychological and due to things like depression or anxiety, or commonly due to a bad relationship, fighting, etc.  Of course when this is the case the treatment is to address those issues. You may well benefit from counseling or therapy. Many family physicians are excellent with that kind of thing, and if not, will point you in the direction of someone who can help.

Of course if you have medical problems that affect your penis, like high blood pressure or diabetes, you need to make sure these are well treated.  Smoking and substance abuse are common causes of ED and should be avoided.

There are three excellent medications on the market for ED; Viagra, Cialis, and Levitra.  All three cause increased blood flow into the penis in response to sexual stimulation making your penis hard and erect. Some common side effects of these medications are headache, indigestion, nasal congestion, facial flushing, and lower back pain.  Check with your doctor for the best choice for you.

If your ED is more advanced, and none of the three pills are helping, then injections of a different type of medication, known as prostaglandins, into the base of the penis work very well.  These injections, using a small syringe and needle, are given into the side of the shaft of the penis.  A doctor who knows how to, or a Urologist, will be able to teach you how to do it yourself.  It is VERY important that you learn how to do it correctly, and to use the dose your doctor determined is best for you.  If you use more than the correct dose it can result in a condition known as priapism, an erection lasting more than four hours. While that may sound great, prolonged erections lasting hours are painful and require emergency treatment that often leads to permanent damage to the penis and erectile dysfunction.

Some men like a penis pump.  This is a device that fits over the penis and you pump it to create a vacuum around the penis. This helps draw blood into the penis and gives you an erection. You then take the pump off and put a “cock ring” around the base of the penis to hold the erection.

Finally, if you have severe ED; usually as a result of years of smoking, diabetes, or surgery for prostate cancer; there is the possibility of a penile implant.  This is a surgery done by a Urologist, and he or she would determine if it would be appropriate for you.

The bottom line on erectile dysfunction…don’t be shy or embarrassed to talk to your doctor about this…again trust me…they have heard it many times. You penis is awesome, and if you want to enjoy it you should. There are great treatment options out there for you!