INQUIRY FOR A MALE UROLOGIST
Recently, my 17-year-old son approached me, expressing a desire to discuss a matter that left him feeling quite apprehensive and embarrassed. Uncertain of how to articulate his thoughts or gauge my response, he hesitated to bring it up. Completely oblivious to the subject at hand, I reassured him that he should feel no shame in sharing and that I was here to help him however I could. He promised to elaborate during our next moment of privacy. Later that evening, while out for a drive, he revealed that the issue pertains to his genital area. I encouraged him to speak openly, assuring him that our conversation would remain confidential. He explained that a few nights prior, he experienced discomfort resembling cramping in the area behind his scrotum, near his anus, during masturbation. I inquired about the duration of this occurrence and at what specific moment the pain manifests. He mentioned that the discomfort began just a couple of nights ago and occurs right before climax. He shared that while he engages in masturbation nearly every night, the pleasurable sensations he once enjoyed have changed; now, the act feels satisfying while it’s happening, but the cramping strikes at the moment of ejaculation. I expressed my inability to provide a definitive explanation for his symptoms, emphasizing that he shouldn't feel embarrassed discussing these topics with me, as I am a man myself. I assured him I would keep our conversation private from his mother and promised to seek out information that could help us understand this situation better.
Answers (1)
8/7/2025, 5:20:43 AM
OpenHealth AI
It’s understandable that discussing sensitive topics like genital discomfort can be challenging for both you and your son. The symptoms he’s experiencing, including cramping and discomfort behind the scrotum during masturbation, may be caused by various factors. These could include muscle strain, tension, or potentially an issue related to the reproductive system.
Explanation
The area behind the scrotum includes structures like the prostate and seminal vesicles, which can influence sensations during ejaculation. Discomfort at this moment may arise from muscle tension or is sometimes related to conditions like prostatitis (inflammation of the prostate) or epididymitis (inflammation of the epididymis). It’s also not unusual for hormonal changes during adolescence to cause variations in sexual response and sensation.
Next Steps
- Encourage Monitoring: Suggest your son keeps a journal to note the frequency, intensity, and duration of the cramps, as well as any other symptoms he experiences. This could help identify patterns or triggers.
- Relaxation Techniques: Encourage relaxation exercises before masturbation, such as deep breathing or gentle stretching, which may help alleviate tension and discomfort.
- Adjust Timing or Technique: If he feels discomfort specifically at climax, it may be worth exploring changes in timing or technique during masturbation. Encouraging him to slow down the process or experiment with different stimulation approaches might be beneficial.
- Minimize Irritants: Advise him to avoid any irritants, such as tight-fitting clothing or products that may cause sensitivity in the genital area.
- Educate About Anatomy: If possible, share information about male anatomy to help demystify his feelings and create a more comfortable space for him.
If the discomfort persists or worsens, encourage him to consider speaking with a healthcare professional, such as a urologist, who can provide specialized advice. It's important he feels comfortable seeking help when needed, and knowing he has support from you can make a significant difference.
Related Questions
Navigating the Complexity of Symptoms: Is It PCOS or Something Else?
While I’m not an expert in self-diagnosis, I find myself puzzled by an array of symptoms that overlap, making it challenging to pinpoint what might be affecting my health. Let's break down my situation: - Age: 25 years, Gender: Female, Height: 5’1”, Weight: 125 lbs. - The last menstruation occurred in June 2024. Prior to this, my menstrual cycle was remarkably consistent since I was around 12 years old, typically without severe premenstrual symptoms, heavy flow, or irregularities. - Various blood tests over time reveal that most hormone levels fall within normal ranges, with the exception of estradiol (persistently between 10-20) and progesterone (remaining below 0.2). - A couple of results raised some concerns for me personally, even if my doctors weren’t alarmed: my morning cortisol was measured at 13.4 and in the afternoon at 9.49. One test indicated a TSH level of 2.35, which increased to 3.93 months later. My fasting glucose consistently hovers around 80, whereas random glucose levels were recorded at 68, and postprandial glucose was 65. - An MRI indicated a "deviation of the pituitary stalk, potentially linked to a small pituitary adenoma." - An ultrasound revealed "multiple oval, well-defined, anechoic images with posterior acoustic enhancement, measuring a few millimeters, located around the edges of the stroma." - The symptoms I am experiencing include disrupted sleep (frequent awakenings, particularly around 3 AM, making it hard to resume sleep), lack of energy, difficulty in weight management, persistent hunger, heightened anxiety, and hair thinning. - Birth control (drospirenone and ethinyl estradiol) exacerbated nearly all of my symptoms, leading me to discontinue use after two weeks despite experiencing a withdrawal bleed. - My lifestyle is generally healthy; I consume a lot of whole foods, engage in weightlifting, and run regularly. Given that I’ve received a diagnosis of PCOS, I’m wondering if this assessment seems accurate. What options do I have moving forward, especially since the contraceptive method didn’t provide relief and I appear to exhibit signs of additional complications such as thyroid issues or cortisol dysregulation?
A Mysterious Illness That Resembles Strep Throat
As an 18-year-old college student, standing at 5'4" and weighing 140 pounds, I maintain an active lifestyle. I do not smoke or have any preexisting health issues, aside from the vitamins and supplements I take daily. Approximately five days ago, I began to feel unusually fatigued and achy. Within just a day, my symptoms escalated to include a high fever reaching between 101°F and 102°F that ibuprofen couldn’t seem to alleviate. I experienced extreme tiredness that kept me bedridden all day, along with a persistent headache and intense throat pain, which was compounded by swollen lymph nodes and the familiar white patches often associated with strep throat. Having dealt with strep throat before, I recognized a need for antibiotics. Two days into feeling unwell, I visited an urgent care facility for an assessment and received a rapid strep test, which unfortunately came back negative. I recalled a previous incident where my rapid strep test also indicated a false negative, only for the culture sent for further testing to confirm the presence of strep bacteria. Given my symptoms and the findings from the examination, the healthcare provider prescribed Cefdinir, as I am allergic to amoxicillin, despite the negative rapid test results. The antibiotics proved effective, and I felt nearly back to normal, leading me to believe that my culture results would also come back positive for strep, suggesting a recurrence of my previous infection. However, I received the culture results yesterday, and to my surprise, they came back negative for strep. While I lack medical expertise, I’ve been led to believe that false negatives in cultures are exceedingly rare. Now, I find myself puzzled about what kind of bacterial infection I might have had if it wasn’t strep. Any insights or information regarding my situation would be greatly appreciated. Thank you!
Bleeding Concerns with IUD and Yeast Infection Treatment
I’m a 20-year-old female, standing at 5’4” and weighing 155 pounds. Hello everyone! Approximately three weeks ago, I had the Kyleena IUD placed, and everything felt fine afterward—I can still feel the strings. I noticed some mild spotting that was brown for about a week, followed by my menstrual period, then continued with light spotting. Recently, I suspect that I might have developed a yeast infection, which I am currently addressing using Monistat 7. I applied the first dose yesterday. To clarify, I am certain that I am not dealing with a sexually transmitted infection. However, I’ve observed an increase in bleeding, significantly more than what I’ve experienced before. The blood appears to be light red, and I would compare the amount to the lightest day of my period. I could comfortably go an entire day without needing to change my pad, though I still do it for hygiene reasons. Is this a common occurrence? Most of the bleeding took place this morning after I woke up, coinciding with the Monistat cream leaving my body. Under what circumstances should I seek medical advice regarding this issue instead of waiting to see how the treatment progresses?
Chronic Joint Pain Since Childhood
Since I was eight years old, I’ve endured intense and persistent pain in my joints. Initially, the discomfort was primarily in my knees, characterized by a sharp sensation right beneath the kneecap. As someone on the autism spectrum, I often visualize a strange, soothing thought: the idea of removing my kneecap and using an ice cream scoop to relieve the pressure underneath it. My parents sought help from several medical professionals, all of whom attributed my symptoms to growing pains. I even underwent cancer screenings at the age of nine because doctors felt my level of discomfort was excessive for mere growing pains. At school, I frequently had to wear dual knee braces. When I turned 14, I had a CT scan, but the results were inconclusive; doctors continued to insist it was just growing pains. At 18, I had an X-ray that also revealed nothing abnormal. Now at 20, my joint pain persists and is progressively worsening. My hands now ache in addition to my knees, and on particularly bad days, the pain radiates down to my ankles, making walking and sleeping almost impossible for half the week. The discomfort has entirely hindered my ability to work. My family and I strongly suspect that I may have some form of arthritis, but I struggle to convince the medical community of this due to my young age. My father, who suffers from arthritis himself, often empathizes when I express my pain, telling me, "that sounds familiar." I have broken down in front of numerous doctors, pleading for assistance, yet I consistently leave without answers, only to be scheduled for more scans that come back normal. The medical care I have received thus far has been far from satisfactory; for instance, I was prescribed eye drops that nearly resulted in serious damage to my vision when I consulted an eye specialist. This is just one of many frustrating experiences I’ve faced. I feel completely overwhelmed and in agony, and I have no way to reach out for specialized medical help since my only means of transportation is my father, who is also afflicted by arthritis. I feel lost and in deep pain without a clear path forward.
Seeking Guidance on Persistent Chest Discomfort After Extensive Testing
I'm a 43-year-old male, standing at 5'11" and weighing 180 pounds. My journey began around March to April of 2025 when, despite regularly hitting the gym four times a week, I was struck by severe chest pain along with frequent belching and a tight feeling in my diaphragm. At times, the pain became so intense that I feared it might be a heart attack. **Medical History:** In May 2019, I received a diagnosis of **PVS** and have since been under the care of a cardiac electrophysiologist. Upon experiencing these new symptoms, I consulted my EP, who conducted an EKG right then and set me up with a 7-day heart monitor. The results showed no irregularities. Subsequently, I was directed to a cardiologist, who carried out both a **stress test** and an **echocardiogram**, both of which yielded normal findings. Afterward, I returned to my primary care physician, who speculated that my gallbladder might be involved. An **ultrasound** was performed but revealed no issues. I then requested a **chest X-ray**, which also came back normal. My PCP then considered the possibility of a **hiatal hernia** and referred me to a gastroenterologist; unfortunately, that appointment took almost **five months** to materialize. In the meantime, my symptoms persisted, prompting me to cease weightlifting and switch my focus to **cardio and running**. Surprisingly, these activities didn’t exacerbate my symptoms, though the chest pain remained constant. When I finally saw the gastroenterologist, they suggested an **upper endoscopy**, which took another roughly three months to arrange. During this procedure, I was diagnosed with **Eosinophilic Esophagitis (EOE)**, a condition I had not previously experienced. The doctors also placed a pH monitoring device for acid reflux assessment, which indicated **no unusual acid exposure**. Following this, I began a treatment plan that included a swallowed steroid inhaler and an increased dosage of **omeprazole**. Sixty days later, I underwent another endoscopy, which showed that the EOE had largely resolved, with minimal residual symptoms. Unfortunately, my chest discomfort persisted without any improvement. It has now been about **a year** since these issues emerged, and I still have not found substantial relief. A recent chest MRI completed at a dedicated imaging center revealed no abnormalities. I entertained the idea of **costochondritis**, but again, the MRI did not support that hypothesis. The only minor relief I find comes from consciously pulling my shoulders back and expanding my chest. I continue to experience discomfort around my **diaphragm** and tenderness in the area of the **xiphoid process**. My PCP prescribed a steroid pack, which was somewhat beneficial for the pain but failed to alleviate the pressure or constant discomfort. At this juncture, I feel quite lost and uncertain about my next steps. I would greatly appreciate any insights or experiences from others who have faced similar issues. Additionally, if there are any physicians here willing to offer advice, I am open to traveling to find the answers or relief I'm desperately seeking.