Here are answers to four men's health questions you may have wondered about but were too embarrassed to ask during an appointment.

1. Can I break my penis?

Yes. A penile fracture is a rare and painful injury, though there is no bone in the human penis. This injury occurs when an erect penis experiences sudden trauma. If an erect penis is bent abruptly or forcefully, the trauma can rupture the lining of the corpus cavernosum, which are the erectile tissues within the penis, responsible for obtaining and maintaining an erection. A flaccid (not erect) penis can’t be injured in this manner.

Symptoms of a penile fracture include the following:

• Audible snapping or popping sound
• Leaking blood from the urethra
• Bruising and swelling of the penis
• Sudden loss of erection
• Difficult urination
• Severe pain
• Bent penis

A penis fracture is an emergency that requires urgent medical attention. Not only is it an extremely painful injury, but left untreated, the penis may become deformed or result in the inability or difficulty to maintain an erection or the rigidity (hardness) necessary for sexual intercourse. The injury can be diagnosed with a physical exam, and surgery is almost always required.

2. What causes low libido in men?

Low libido is defined as a decreased interest in sexual activity. This condition can be caused by medications or mental health issues such as depression, but it can also be caused by male hypogonadism, also known as testosterone deficiency or low testosterone. Testosterone is the primary male sex hormone that plays a key role in the development of male reproductive tissues. Testosterone deficiency can develop over time due to many reasons. In adult males, this condition can have the following symptoms:

• Decrease libido or sex drive
• Difficulty obtaining and maintaining an erection
• Decreased energy and increased fatigue
• Difficulty with concentration

Treatment options for low libido includes the following:

• Testosterone gels or creams
• Testosterone injections
• Subcutaneous implants which can be placed/inserted in the office
3. Why can't I get/maintain an erection?

Many adult men have experienced trouble getting or keeping an erection at some point in their lives. Often, the problem goes away on its own, but when it is a persistent issue, it is known as erectile dysfunction (ED). According to the National Institute of Diabetes and Digestive and Kidney Diseases, it is estimated that 30 million men in the United States have dealt with erectile dysfunction. Erectile dysfunction occurs when a man can't get or keep an erection firm enough for sexual intercourse.

Erection problems have common causes, including diseases like diabetes, heart conditions, high blood pressure, depression, nervous system disorders, medications, substance abuse, or physical injuries (spinal cord, nerve damage, etc). It can also be attributed to issues with your relationship with your partner(s) or emotions.

When to see a doctor. If you have trouble getting or keeping an erection more than 25% of the time, you should see your health care provider about treatment options.

4. Can my foreskin get infected?

Yes. Primarily caused in men whom are uncircumcised, balanitis is an infection of the glans and foreskin. Signs and symptoms include:

• Itching
• Burning
• Redness
• Swelling of the glans penis

If the infection is severe, it can cause difficulty voiding urine or cause one to spray when they void. It can ulcerate and have purulent (consisting of, containing, or discharging pus) drainage within the foreskin. An infection is usually caused by yeast and/or sometimes bacteria.

Treatment includes medical creams/ointments with antifungal or antibacterial agents, steroids can assist and are many times found in the creams. Severe cases can require oral medications. Recurrent or severe cases may result in the patient requiring a circumcision. A careful exam is important and close follow up to assure that the infection resolves, because in certain instances some penile cancers can look like balanitis and need to be ruled out by your health care provider.

Another condition that can affect the foreskin is called phimosis. Phimosis is when the foreskin is so scarred that it can’t be retracted back to expose the glans. This condition can cause severe pain, splitting of the skin or, in severe cases, inability to even retract the foreskin back to the glans. In this situation, it can lead to recurrent balanitis, difficulty in screening for ulcers or even tumors. Sexual intercourse can be painful. Circumcision many of times is the treatment of choice when it becomes severe.

Make an appointment with urologist Dr. Brandon Cottrell at Ochsner Medical Center - Baton Rouge.