- Erectile Dysfunction (ED) – go to The ED blog here.
- Premature ejaculation (PE)
- Delayed ejaculation
Premature Ejaculation (PE) can be really frustrating for men and their partners. PE that starts from early adult life tends to be more ‘severe’ than late-onset PE. Behavioural therapy such as the ‘stop & start’ or ‘squeeze’ methods from the 1970s are worth a try but unlikely to work on their own. A recent major guideline states that ‘Behavioural therapy may be most effective when used to ‘add value’ to medical interventions.‘ In a nutshell, Medication can be very effective and is recommended first-line treatment for longstanding PE.
There is an important clinical role for testosterone replacement therapy (TRT) in accordance to national and international clinical guidelines. Dr Beatty does regularly see guys for second opinions regarding the need to start or stop TRT. He ‘thinks like’ an Endocrinologist in that he is physician trained (MRCP UK) & always investigates the cause for testosterone deficiency.
Please read the TRT blog prior to making an appointment regarding Testosterone prescribing. The important point to note is that Dr Beatty is unable to prescribe TRT for anything other than medical purposes. You may have received TRT prescriptions elsewhere for doubtful therapeutic purposes. Dr Beatty will need to see clear evidence that the therapy was helpful before continuing prescribing.
Conditions of The Scrotum or Testicle
- Hydrococele (fluid collection in the scrotum)
- Infection of the testicle (Orchitis) or, more common, the epididymis (epididymitis)
- Epididymal Cyst (very common, and can usually be diagnosed clinically without a scan)
Skin Conditions of the Male Genitalia
The rim around the head of the penis (the glans) may have small pink bumps called Penile Pearly Papules or ‘PPPs’ which doctors (annoyingly) call a ‘normal variation.’ Men often don’t see it this way. PPPs may be treated on-demand by Dr Beatty with cryotherapy or electrocautery. You’ll need to make a long appointment. A penile block will ensure good anaesthesia.
Dermatological conditions of the male genitalia include Psoriasis, Dermatitis, Scabies, Balanitis (foreskin infection), molluscum, genital warts. Lichen Sclerosus and Lichen planus are important conditions to diagnose and treat. Around three quarters of these issues may be managed at the clinic whilst around a quarter require a referral to a Dermatologist.
Breast Enlargement in Men
Gynaecomastia is enlargement of the male breast tissue caused by excessive glandular tissue (True Gynaecomastia).
More common is Pseudo-Gynaeomastia which is caused by excessive fatty non-glandular tissue. The doctor distinguishes these two by a careful examination. True gynaecomastia is fairly common between the ages of 10 and 17, and in men age 50 to 70. The two questions that need answer are:
- Is there an underlying medical problem,
- Is it a cosmetic issue?
Blood tests are helpful, and medication may be worth a trial.
Chlamydia in Australia is now more common in males than females. STD Testing in heterosexual men involves a simple pee-in-a-pot and/or blood test. STD Testing in Men who have sex with men is easily arranged through self-taken swabs.