Biggest health hazards threatening your penis and balls in every decade of life – and how to combat them

TALKING about penis and testicle health doesn't come easily to a lot of men.

But it’s really important to know what’s normal for you when it comes to your own, whether you’re in your 20s or your 80s.

And if something is going on down there, there’s no need to be embarrassed about getting it checked out – your doctor has seen it all before.

Dr Rachel Ward, a GP at Woodlands Medical Centre, Didcot, says: “Often people feel quite embarrassed about being examined.

“But you can ask if you've got a preference to see a male, or female practitioner.

“You can ask for somebody else to be there – and the bottom line is that we do it all the time.”;

Here’s what to know about your penis and balls – and the red flags to watch out for in every decade...

In your teens and 20s

Bigger isn’t always better – but size can be a real worry for some, especially when you first start taking notice of your penis.

The average penis length in the UK is about 6.36 inches, not the 9in you might hear people claiming.

Dr Ward says: “Boys and young men can feel very conscious about things when they're growing, comparing themselves to other people.

“We have to encourage people that any size or shape is normal.”;

A more pressing concern in this age group is sexually transmitted infections, from chlamydia to gonorrhoea and genital warts.

Dr Ward says: “It's important in every age group, but when people start to become sexually active, it’s really important to know it's not a bad thing to be checking for STIs.

“It's not shameful. We should go for regular STI checks.”;

This is especially the case because although some trigger symptoms, like unusual discharge, sores, lumps, and rashes, many STIs don’t.

Remember to use condoms, they help protect against certain STIs as well as unwanted pregnancy.

Find your nearest sexual health clinic via the NHS website.

Brook centres also support anyone under 25 with their sexual health.

Inside your boxers is also “a classic place to get fungal infections”; says Dr Ward, thanks to warm, moist conditions.

She says: “If you are prone to things like fungal infections, always wear looser fitting cotton underwear.”;

In your 30s

“Thirty to 34 is the peak age for testicular cancer,”; says Dr Ward.

“It’s important for all ages, but particularly this age, to be aware.

“Check your testicles regularly, know what is normal for you and spot whether there is something different, whether there is a lump.”;

Ideally, check your balls once a month after having a shower.

[A curved penis] can be painful, so it's good to get it checked. Sometimes we will recommend a scan. Sometimes we give medication to slow down progression.

Dr Rachel Ward

If you notice anything unusual for you, whether swelling, soreness, a lump or changes in size or shape, see your GP.

Dr Ward says: “It may be that we're confident from just an examination that your testicles are normal, it may be that we need to refer you for a scan for further testing.”;

In this decade, having kids can jump up the agenda.

Dr Ward says: “If you're thinking you want to have a family, the lifestyle elements for optimising your fertility – good diet, regular exercise, minimising alcohol, not smoking – really do improve your sperm count and function.”;

Fertility issues might still come up – around one in seven couples may have difficulty conceiving, the NHS says – but there is help available, from support with lifestyle changes to IVF.

“Fertility is really complex because, of course, there's two of you in it,”; says Dr Ward.

“The general approach is that if you are struggling to get pregnant as a couple, we will automatically test both of you.”;

In your 40s

Your 40s could still be a decade filled with nappies, but you might also be considering a more permanent kind of contraception.

Vasectomies are an option – and an increasingly popular one.

Around 11,000 British men get a vasectomy on the NHS each year, most of them in their late thirties.

“It's a pretty small procedure, done while you're awake,”; Dr Ward explains.

“It's done with very small cuts and removal of part of the tube that carries semen.

“The only problem is that you can get failure – you have to do semen analysis afterwards to make sure the right tubes have been cut.”;

If you have a female partner who is happy to go onto contraception, Dr Ward says: “The Mirena coil, which is obviously a very reliable form of contraception for at least five years for women, has meant that a lot of people in their 40s move on to having that when they've completed their family.”;

Testicular cancer is likely on your radar, but what about penile cancer?

“Penile cancer is quite rare [760 cases per year in the UK], but there’s an increased risk as you get older,”; says Dr Ward.

“It's generally seen in older people, but you can see it in younger people.”;

Symptom-wise, look out for “a change, an ulcer or a sore or something that's not healing, something that looks different, a lump”;.

“You need to get it checked out because actually you can get aggressive penile cancers.”;

In your 50s and 60s

The wrinkles really settle in during these years – on your face and elsewhere!

“Sagging, wrinkles, you can often get increased fat around there too,”; says Dr Ward.

“We can get the idea that the penis is quite small because it's engulfed in fat padding.”;

This is all cosmetic stuff though, you only need to be concerned if you notice any new lumps or changes that are unusual for you.

Dr Ward adds: “You can get hernias in the groin as well, which you can see, and that can sometimes even go into the testicle.”;

These can be repaired through surgery.

Everyone’s different, but our sex life might also experience some (ahem) ups and downs.

“It's very variable – some men and women have very good libidos into an older age,”; says Dr Ward.

“There can be more physical challenges with stamina, but a lot of people continue to have a good libido.”;

Erectile dysfunction is, however, more common as you age.

“That may be related simply to age or to other underlying causes (like depression, diabetes, high blood pressure, anxiety), but that can be addressed with medication.”;

A slight curve to your penis is also normal, but if you’ve noticed yours is becoming noticeably more curved or there’s pain, it could be Peyronie’s disease.

“This is when you get scarring in the shaft of the penis. And so then, when you have an erection, it's curved,”; explains Dr Ward.

“How problematic it is depends on how much it is curved, but you should see a GP about that to make sure that there's nothing else.

“It can be painful, so it's good to get it checked.

“Sometimes we will recommend a scan. Sometimes we give medication to slow down progression.”;

In your 70s and beyond

UTIs aren’t just a problem for women.

“Men are always less likely to get urine infections than women, but you do see it in older men, and it can be quite serious,”; says Dr Ward.

Symptoms include being agitated, pain when urinating, cloudy, smelly urine and needing to pee more often.

She adds: “In your 50s and over, your prostate enlarges, and that means you go to the loo more and get up in the night more frequently.

“As you get older, this can lead to things like incomplete bladder emptying, which predisposes to urine infections.

“You may also end up not being able to adequately, regularly enough, empty your bladder, and may end up with a catheter.

“That happens to a statistically low number, but does happen.”;

Whatever your age, you should also flag any blood in your urine to your GP.

It could be a UTI, but it could also be a sign of cancer, amongst other things.

Dr Ward says: “If you ever pass blood in your urine, that is always something we would investigate.

“You might think, ‘Oh, it’s a bit of an infection,’ but we don’t view it like that; we’d always want to test and investigate.”;

It turns out that 20-year-olds and 70+-year-olds also have more in common than you might think.

Dr Ward says: “We have seen a surge in older people with STIs.

“We’re seeing people who are having a new relationship in later life because of divorce or bereavement, and that generation are just not as au fait with safe sex or getting tested.

“There’s been a surge in syphilis.”;

Going to the loo: What's normal and what is NOT

PEEING

What's normal

There are lot's of fluctuations between people. But peeing between six and seven times in a 24-hour period is normal for most.

Four to 10 times a day can be normal for someone, too, according to Bladder and Bowel community.

It's normal to wake up in the night to pee.

And urine should be a champagne sort of colour.

Pee should come out in a steady stream and you shouldn't need to force it.

What's NOT normal

You might consider that your peeing habits have become abnormal if you:

• are going more often than you used to
• keep going in the night
• experience pain
• it doesn't feel like you fully 'empty'
• the stream is not steady or is weak
• leak urine
• see blood in urine

There are lots of things that can influence how much we pee.

Urge incontinence, overflow incontinence, and total incontinence all refer to disruptions in the way your bladder stores and gets rid of urine. You can read about them on the NHS website.

The causes range from an enlarged prostate, constipation, not drinking enough water, caffeine and medications.

Serious conditions such as prostate cancer can influence your peeing habits.

So get any changes cheked out!

POOING

What's normal

People tend to go for a poo once a day or three to four times a week.

As long as the stool is easy to pass and is smooth and sausage or snake shaped (yes, medically, that is how scientists describe a healthy poo on the Bristol Stool Chart!).

What's NOT normal

Any changes to pooing habits should be seen to by a doctor because they could signal bowel cancer.

The symptoms can include:

• Persistent constipation or diarrhoea
• Very dark stools, blood in stool or blood on the tissue paper
• Pencil-thin poos

Pancreatic cancer can also cause stools that are described as being pale, oily, difficult to flush and bad-smelling.

It's important not to brush off these symptoms – seeing a GP could be the difference between life and death.

Other health conditions that may change your bowel habits include IBS.

Stools that are hard, difficult to pass or pellet-like can signal constipation. Read how to ‘go' easier here.

READ MORE

A GP reveals how normal is your poo

Can you tell the healthy poos from the unhealthy ones?

The 5 things your pee is telling you

How getting up to pee in the night could be a sign of silent killer – when to see your doctor