Shout Out Health

ASK THE DOC: What Are Those Small White Bumps?

Q: I've just recently been getting small white bumps on my penis.  What could this be? Is this something I should be concerned about....or is this just part of growing older?

A: Spots, or small white bumps on the penis are very common, and in most cases, are completely harmless. It is natural to feel concerned about them, but they usually do not indicate a significant health problem. Very often, they represent distended sebaceous glands--which may occur sporadically--or penile papules, both of which are benign conditions, and are nothing to be worried about. However, certain viral STDs can lead to similar lesions on the penis occasionally, and therefore, may require treatment. 

I recommend that you visit your physician, to leave no stone unturned. Self-examination of the penis should not be an option. If you feel embarrassed about discussing your concerns with your family physician, you can seek the advice of an expert in genitourinary medicine. -- Salil Kulkarni, M.B.B.S.

ASK THE DOC: Do I Still Have An STD?

Q:  I was recently diagnosed with gonorrhea after being symptomatic for about three weeks. I went to the health department and got tested and was treated for both gonorrhea and chlamydia.

I was given single doses (Zithromax & Cipro) in the clinic. Two weeks later I was reinfected. I returned to the clinic and was retreated and had an injection of Rocephin and was told to abstain for a week. I have had ZERO sexual contact outside of masturbation for 3 weeks and a couple of days ago I began noticing sensations in the head of my penis and spotting in my underwear and this morning noticed a whitish discharged come from my penis.

Am I still infected or is this a yeast infection?

A: My first question to you would be to ask if the clinic has given you any results from the tests you took?  Or did they just treat you empirically?  If there were tests done I would check on the results. Your treatment for gonorrhea and chlamydia should have been effective. There are cases of ceftriaxone (Rocephin)-resistant gonorrhea, but they are very rare.

Getting retested and asking for the lab to check sensitivities would be one way to go.  Alternatively this could represent infection with a different bug.  The patient could have a urinary tract infection that might require longer and/or different antibiotic treatment.  At this point, after 2 treatments, I would not go to the clinic, but would consult a primary care physician/clinic or an infectious disease specialist/clinic. -- Howard A. Grossman, MD

 

ASK THE DOC: Help, I have blood in my semen!

Q: After having sex recently, I noticed some blood in my semen after ejaculating. Should I be worried? What should I do? Please help...

A: It is not at all unusual to experience a random instance of blood in the semen after ejaculation.  A small broken blood vessel can cause this.  It will usually heal rapidly.  It is important to remember that just a drop or two of blood in urine or semen can cause them to turn red. If the presence of blood persists more than one or two times, then you should seek medical attention to make sure there is nothing more serious going on. -- Howard A. Grossman, MD

ASK THE DOC: How do I find a gay or gay-friendly doctor?

Q: I have small white bumps on my penis, and I need to find a doctor in the Hackensack, NJ area that I could go to see. I'm shy and would be much more comfortable with a gay doctor. Can you help me? Thank you.  

A: You can search for a gay or gay-friendly health care provider in your area here, via the Gay and Lesbian Medical Association's "Find a Provider" section. Good luck. -- Susan Ball, MD

ASK THE DOC: Should I discuss my sex life with my doctor?

Q: I'm a single guy in my 20s and I am also sexually active. I really like my doc, but I'm afraid to talk to her about my sex life. I feel ashamed or embarrassed, but she doesn't ask me about it, either.  How should patients initiate these conversations with their doctors?  

A: You are absolutely right that she should be asking you about your sex life. It shouldn't be your responsibility to bring it up but, nice as she is, it doesn't sound like she's asking enough questions to thoroughly take care of you. But you can help her! You might say something such as, "I feel fine but would you please test me for STDs? I know that there are a lot of things out there that I might be vulnerable to." 

Or, if that's too much, you could try something more subtle, like, "I'm dating someone new, is there anything I should worry about these days?" (hopefully she will pick up the hint). If all else fails you might try something like, "What is syphilis?" to initiate the conversation.

But the botton line is, you should not feel embarrassed or ashamed. You are smart to think about it and want your doctor to think about it, too! Good luck. -- Susan Ball, MD

ASK THE DOC: Can sex toys cause bacterial infections?

Q: My partner and I have been together for almost 9 years.  About 4 years ago we bought some sex toys (made from latex rubber) to spice up our sex life.  At first we were pretty good about washing them, wrapping them in a towel and storing them in our closet.  Over time I guess we got a little lazy/careless with our thoroughness of cleaning them and also began storing them under our bathroom sink.  There's where the trouble began.  I'm the only person the sex toys have been used on (I'm the bottom in our relationship, while my boyfriend only tops).  But over the past 2 years he has contracted 3 nasty bacterial infections that really seem painful for him, while I have remained symptom-less (though I do have an occasional light tingling sensation in my anus which I thought was from spicy food).  Each time we've gone to the clinic, the results have come back negative for chlamydia and gonorrhea. 

We have both been tested for everything and the results always come back negative.  I was wondering if you could share any knowledge with me regarding our situation.  Is it possible to get bacterial infections in the anus from using unsanitary sex toys?   

A:  I am not sure from your question exactly what kind of infection your partner got. If it wasn't gonorrhea or chlamydia, I am assuming he didn't have a syphilis or a herpes outbreak either, which makes me wonder if he had staph abscesses which can be recurrent in some people. If that is the case it may not have anything to do with you, although it's always a good idea to keep your sex toys and your body clean! I hope this is helpful! -- Susan Ball, MD