Doctor's Advice - Shrinking male organ

Q. Hi Doc. I am a 49-year-old male and I have a lot of problems. I am diabetic and currently on metformin, aspirin and water tablets. I have been taking these for 20 years.Doctor, I have noticed that my sex organs have become very small. My penis seems to have shrunk, and this has incapacitated me from having a normal sex life. Is there any medication which I could try?

A. I am sorry to hear about all your problems. It is well known that diabetes sometimes causes difficulties with erection. However, it does not cause shrinking of the male organ.

When a man complains that his organ is getting smaller, there are two main diagnoses to bear in mind. The first is called 'koro', and that is a psychological condition in which the man thinks that his organ is shrinking, though it is not. In some parts of the world, notably China and Malaysia, koro is quite common and tends to occur in wild outbreaks of mass hysteria in which large numbers of men become convinced that their penises are disappearing. It doesn't sound as if the diagnosis of koro applies to you, because I don't think you are suffering from hysteria.

The other possibility is a lack of male hormone. Some men produce less testosterone as they get older, and that may lead to a certain amount of shortening and thinning of the penis.

I am not saying that you definitely have a lack of male hormone. But I do think that you should see your doctor and ask him to do a blood test to find out what your testosterone level is. If it turns out to be low, or even at the low end of the normal range, I am sure that the doctor would be happy to prescribe some testosterone medication for you to take over the next six months or so. During that time, I hope that you find that you get some bulk in the shaft of your organ.

I had a lot of sex as a young woman and, as a consequence, I have what is described as early cancer of the cervix. My doctor says that the report from the lab states that I have cancer cells, which he calls CIN-2.

So the gynaecologist is going to do what is called a cone biopsy. What is this? Will I survive? Will I be able to have sex again? And will I be able to have children?  I can give you good news. You have been told that you have early cancer of the cervix, and most early cancers are curable!

Your CIN-2 or cervical intraepithelial neoplasia-2 is a fairly low rating, so your chances of survival are very good. The operation you are to have is called cone biopsy because the surgeon removes a cone-shaped piece of tissue from your cervix, taking away all the bad cells.  You will need a few weeks to fully recover from that, but you will definitely be able to have sex again. Be guided by your gynaecologist as to how soon you can resume. And yes, you will be able to have children if you want. Your womb will be left intact, and you will be perfectly capable of having a child. Good luck.

Q. I am a 43-year-old male. Would it be safe to have sex twice in a night, Doc?

A. If you can manage it, it will do you no harm at all.

Q. Doc, I am so embarrassed. Last night my girlfriend managed to tear my foreskin - probably with the rings on her fingers. Will it heal up again? When will it be safe to have sex?

A. Tears of the foreskin are very common. They usually heal up in about seven to 10 days. But if yours does not, you should see a doctor because you may need stitches.  You should be able to resume sex in about two weeks, but please take it easy at first. It would be a good idea to use a lubricant for a while, in order to prevent the tear from reopening.

Q. I am a 27-year-old female, and my mother used to employ a contraceptive called a cap. I think I might like to give that a try. But I don't understand how you use them. Do you put them inside, and do they stay there all the time?

A. No, you put it into the vagina shortly before having sex, and leave it in until the next morning. Then you take it out, wash it and dry it. You keep it in a special little box, like a make-up powder compact. The cap (or diaphragm) is an old method, but a pretty good one. However, you need to be taught how to use it by a doctor or nurse who is familiar with the method. Also, she has to begin by measuring your vagina to ensure that you are given the correct size.