By Dana Ullman MPH, CCH
(Excepted from Everybody’s Guide to Homeopathic Medicine, Stephen Cummings, MD, & Dana Ullman, MPH Tarcher/Putnam, 2004)
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The health of the male reproductive system is a reflection of overall well-being as well as sexual habits. We cover common menís health concerns, including sexually transmitted diseases, urethritis, prostate problems, irritation of the foreskin, and less common serious problems of the testicles.
Sexually Transmitted Diseases
Sexually transmitted diseases, or STDs, include about fifteen infectious illnesses that may be transmitted during lovemaking. Symptoms of these infections can include discharge from the penis, various kinds of eruptions or sores on the genitals or surrounding skin, and swelling of the lymph nodes in the groin. Any such symptoms require medical evaluation and treatment. Two of the most common STDs are genital herpes simplex and venereal warts; homeopathic treatment can be helpful during either of these infections.
Serious illnesses such as AIDS and some forms of hepatitis can also be transmitted during sex. They are beyond the scope of homeopathic self-care. Short of abstinence, the best way to avoid sexually transmitted diseases is by practicing “safer sex,” which includes limiting the number of sexual partners, selecting them carefully, and using condoms correctly until youíve been in a long-term, strictly monogamous relationship with no evidence of STDs in either partner. These measures do not guarantee you will escape infections, but they will improve your chances dramatically.
Urethritis and Bladder Infections
Urethritis is infection and inflammation of the lining of the urethra, the tube that runs the length of the penis, carrying urine and semen. Urethritis is most often associated with sexually transmitted infections, though sometimes no infection can be documented. A variety of germs can infect the urethra and trigger the bodyís inflammatory response, which can result in symptoms of burning and stinging as well as discharge of mucus or pus.
The Chlamydia bacteria is one of the germs most frequently associated with urethritis. Occasionally this infection leads to chronic symptoms of urethral irritation and discharge, and to infections of the prostate or testicles. Of more concern, Chlamydia is often passed on to women where it may cause infections of the female reproductive tract that result in pain and sterility.
The most worrisome infection of the urethra is gonorrhea, since the gonorrhea bacteria can spread to other parts of the body, causing general illness and infections in the large joints, usually elbows and knees. It, too, can cause serious infections in women. A gonorrhea infection of the urethra usually causes the penis to discharge a copious, thick, yellowish pus, along with burning pain at the opening of the urethra, felt during urination especially. In some cases. however, the discharge may be watery, scanty, or completely nonexistent, and there may be no pain. Gonorrhea can also infect other mucous membranes. Gonorrhea infections of the throat and rectum after oral or anal sex are not uncommon. Rectal gonorrhea may result in pain or discharge of pus, or there may be no symptoms at all.
There are many other kinds of germs associated with urethritis in men. Most of these are not now considered causes of other health problems, but they have not been well studied. Urethritis can sometimes be caused by physical irritation by soap, for exampleóor it may occur after taking antibiotics. Health practitioners may give the diagnosis of “non-specific urethritis” if no infection with Chlamydia or gonorrhea is found.
We want to point out that the symptoms of all urethral infections, even when caused by gonorrhea, are largely evidence of the bodyís efforts to heal and remove the aggressive germs. Inflammation brings blood to the area so that more white blood cells, antibodies, and other components of the body’s immune system are available to help destroy the bacteria. The extra blood also helps carry away dead cells and speeds the replacing of tissue damaged by the infection. The discharge flushes away debris and dead bacteria and blood cells, as well as infecting germs. Still, we strongly recommend antibiotic treatment, along with homeopathic treatment, for anyone with gonorrhea or Chlamydia urethral infections.
Discharges are uncommon in children but may develop if a child has put something in the urethra. A child with a penile discharge needs medical care.
Unlike women, males rarely get bladder infections (cystitis), because the male urethra is longer and not so near the anus. A bladder infection in a boy or man is often evidence that something is structurally wrong with the urinary organs, and he must be evaluated by a urologist.
General Home Care
Home treatment of urethritis should be begun whether or not you ultimately take antibiotics. Drink extra fluids and urinate frequently to wash the germs out of the urethra. You should pay attention to the general health practices of resting, eating a simple and nutritious diet, and avoiding stress, for these enable the bodyís own defenses to better fight the germs and heal the inflamed tissue.
Casetaking Questions for Urethritis
- What is the color and consistency of the discharge from the penis?
- If there is pain, what is its characterócutting (sharp), burning, or otherwise?
- At what time of day are the symptoms worst?
- Is ejaculation painful?
- Does the urine smell unusually strong?
Remedy Summary for Urethritis
- Even if antibiotics are prescribed, homeopathic medicines should also be given, particularly if symptoms continue after completing antibiotic treatment. Give the medicine: Twice a day for up to five days. As soon as the symptoms have improved significantly, repeat the dose only when they worsen again. When to try another medicine: If there is no improvement after 2 days (wait until the third day to make this decision).
- Thin discharge that is clear, mucousy, or milky in colorConfirmatory symptoms
- Discharge appears clear when it is wet but leaves yellow spots on the underwear
- Cutting or burning pains at the urethral opening during or after urination or just as urination is finished
- Painless discharge
- Thick mucus or pus accompanied by inflammation and burning pain of the urethraConfirmatory symptoms
- Discharge white, yellow, or green
- Symptoms often worse at night
- Thin or mucousy discharges with burning pain during ejaculation; or
- The general symptoms of the medicine are evident (see materia medica section)
- Burning pain during ejaculation
- Thick, greenish or yellowish dischargeConfirmatory symptoms
- Strong-smelling urine
- Patient chilly in general
- Thick, yellow or green urethral discharge that is bland, causing little pain or irritation;
- The general symptoms of Pulsatilla are presentNatrum muriaticum is one of the primary medicines for men with urethritis. The discharge is usually thin and clear, mucous, or milky in color. Sometimes a greenish discharge occurs. The discharge may appear clear when it is wet but then leaves yellow spots on the underwear. There may be cutting or burning pains at the urethral opening during or after urination or just as urination is finished.Pulsatilla should help men with thick, yellow or green urethral discharge that is bland and causes little pain. The medicineís general symptoms may indicate its use more than the specific syrnptoms of the discharge.Mercurius is indicated when thick mucus or pus is accompanied by inflammation and burning pain of the urethra. The discharge may be white, yellow, or green. Often the symptoms are worse at night. Sulphur should be considered for thin or mucous discharges when there is burning pain during ejaculation or when the general symptoms of the medicine are evident (see the materia medica section).
Nitric Acid is another alternative when the discharge is accompanied by burning pain during ejaculation. In this case, the discharge is more likely to be thick and greenish or yellowish. The urine may smell very strong and the patient is usually chilly in general (whereas the Sulphur patient is “warm-blooded”).
The walnut-size prostate is located at the floor of the pelvis behind the base of the penis. During ejaculation the prostate contributes a milky alkaline fluid to the semen to enhance the fertility of the sperm. Several maladies involving the prostate are fairly common in men, including prostatitis (prostate infections), benign prostatic hypertrophy (prostate enlargement), and prostate cancer.
Benign prostatic hypertrophy
The prostate grows larger with age. Once a man reaches middle age, problems with urinating often result as swelling of the prostate gland constricts the urinary passage. This is called prostatic hypertrophy. There may be trouble getting the urinary stream started, or the stream may be weak or interrupted. Frequent urging to urinate, together with passing of only small amounts, is also common. These symptoms should be evaluated medically. Constitutional homeopathic treatment can be helpful during the early stage of prostatic hypertrophy. Conventional treatments include various recently-introduced medicines as well as surgical procedures.
The treatment of cancer is beyond the scope of this book, but we do have a few words of advice: Since prostate cancer is one of the most common malignancies in men, regular contact with your doctor after the age of forty is wise, even if you have no symptoms. Screening tests for cancer include physical exam of the prostate and a blood test, the prostate specific antigen (PSA). Although the value of screening for prostate cancer is controversial (the benefits of treating cancer detected by screening tests arenít clear) your practitioner will have some recommendations and can keep you informed of medical progress in this area. Prostate cancer is often very slow-growing and your doctor may recommend no specific treatment. Constitutional homeopathic care would be appropriate under these circumstances.
Because the urethra passes through the prostate on its way from the bladder, bacteria can travel through the urethra to settle in the prostate. The prostate gland is susceptible to both acute infection and to chronic infection or inflammation. An acute infection can cause severe pain and tenderness in the region of the prostate, sometimes extending up into the genitals, pelvis, or back. Other symptoms can include increased urge to urinate, burning during urination, difficulty starting urination, discharge from the penis, and general symptoms such as fever and weakness.
Chronic inflammation of the prostate can develop after an acute infection or on its own. Symptoms are similar to but milder than those of acute infection and tend to come and go over long periods. Vague aching in the region of the prostate, dribbling of urine, trouble starting or maintaining a forceful stream of urine, and discharge of prostatic fluid from the penis after a bowel movement, for instance, are common symptoms. Often it is impossible to identify the bacteria involved in chronic prostatitis; it may well be a self-perpetuating problem that persists even after infecting bacteria have been eliminated.
General Home Care
Home treatment for acute prostatitis includes drinking plenty of fluids, urinating frequently to help wash out the infecting bacteria, getting rest, eating a simple, nutritious diet, and avoiding stress.
Chronic prostatitis is difficult to heal completely. Still, the measures used for acute prostatitis can be helpful. In addition, hot sitz baths may bring some relief. You can also try ìKegel exercisesî as a mild form of self-massage to express excess fluid from the prostate and thereby reduce symptoms: Firmly tighten the muscles you would use to interrupt the flow of urine, repeating 50 to 100 times per day. Some urologists advise their patients to ejaculate regularly to expel some of the prostatic fluid and reduce pressure in the gland.
During either acute or chronic prostatitis, homeopathic care can complement conventional medical treatment. In acute cases, you can use homeopathic medicines while you take antibiotics to speed the healing process. If symptoms persist after antibiotic treatment, or in chronic cases that have developed with no acute onset, you may try homeopathy instead of antibiotics (after seeing a health practitioner to rule out dangerous infections such as gonorrhea or Chlamydia). We recommend you see a professional homeopath if one is available, but if not, go ahead and try homeopathy at home.
Unfortunately for the homeopath, the typical case of prostatic trouble gives rise to few distinguishing symptoms that help in remedy selection. If no remedy stands out as a good match for the affected personís symptoms, you can try the ones listed below one at a time.
Casetaking Questions for Prostatitis
Character of the symptoms:
- What is the character of the pain or discomfortóis it an ache, a sensation of pressure, or sharp pain like a needle?Modalities:
- How is the pain affected by sitting, standing, walking, and urinating?Other symptoms:
- Describe the color and consistency of any discharge from the penis. Is there pain in the urethra or bladder?Remedy Summary for Prostatitis Give the medicine: During acute symptoms, one dose two times a day for up to five days, less frequently as the symptoms improve. For chronic cases, one dose of the 30th potency per day for five days, or a low potency twice daily for up to two weeks.When to try another medicine: In acute cases, if there is no improvement after 36-48 hours. In chronic cases, if the symptoms havenít improved within 10-14 days.
- Pain in the prostate after urination; or
- The general symptoms of Pulsatilla are present (see the materia medica section)Confirmatory symptoms
- Sharp pains or spasms in prostate area extending into the bladder and pelvis
- Thick, bland discharge from the penis
- Soreness in the region of the gland is worse with pressure, especially during sitting Confirmatory symptoms
- Sensation of sitting on a ball or of painful swelling.
- Discharge of mucus from the penis or the presence of stringy mucus in the urine
- Prostate pain aggravated by walking; must stand still for relief
- Needlelike pain or drawing pains extending from the prostate into the penis
- Burning in the urethra after urination
- Discharge of very thick, sticky, or stringy material from the penis
- Pressure and pulsations in the prostate with pain extending into the urethra and bladder after a few drops of urine have passed.
- Indicated during chronic prostatic enlargement with difficult urination; there may be burning during urination as well.
- Pressure in the prostate aggravated during and after urination
- Needle-like pains in the bladder and anus
Pulsatilla is a good medicine for the man who experiences aggravation of pain in the prostate after urination. There may be sharp pains or spasms in the region of the prostate that extend into the bladder and pelvis. A thick, bland discharge from the penis may be present. Men who show strong general symptoms of this medicine can be given Pulsatilla even when the specific symptoms donít clearly confirm it.
Chimaphilla umbellato is more difficult to find – even at some homeopathic pharmacies – than most of the medicines covered here, but it is well indicated for many men with prostatitis. Soreness in the region of the gland is worse with pressure, especially during sitting. There may be a sensation of sitting on a ball or simply of painful swelling. A discharge of mucus from the penis or the presence of stringy mucus in the urine may be noted.
The Kali bichromium patient’s prostate pain is worsened by walking, and he must stand still for relief. The pain may be needle-like or there may be drawing pains extending from the prostate into the penis. There may be burning in the urethra after urination. A discharge of particularly thick, sticky, or stringy material may be found at the urethral opening.
With Causticum there are pressure and pulsations in the prostate with pain extending into the urethra and bladder after a few drops of urine have passed. In contrast, Lycopodium covers pressure in the gland that is worse during and after urination. Needle-like pains in the bladder and anus especially indicate this medicine.
Sabal serrulata has also been found effective during prostatic problems. However, its indications are fairly general: enlargement of the prostate with difficulty passing urine or burning while urinating.
Foreskin Irritation If a skin irritation on or under the foreskin develops, you can treat it at home by gently pulling the foreskin back, applying dilute Calendula tincture (see Chapter 14), and allowing the area to dry before returning the foreskin to its normal position. If a sexually active adult has sores or a rash, or if pus has formed, see your practitioner.
Occasionally the foreskin may get stuck in a retracted position and become swollen or inflamed. Apply ice wrapped in a cloth to the area and try to gently work the foreskin back into its normal position. If you are not immediately successful, emergency care is required.
Testicular Problems Pain or swelling in the testicles or vicinity requires medical attention. A variety of problems may cause such symptoms.
Epididymitis is an infection of the epididymis, a compact, coiled tube attached to each testicle and in which newly formed sperm mature. Although epididymitis does not occur too often, it is more common than orchitis, infection of the testicles. Both these infections cause pain and swelling in the testicular area.
Testicular pain may also be caused by twisting of the testicle and the structures within the scrotum that connect it to the body. Called testicular torsion, this is not only extremely painful but also dangerous, because if the blood supply is interrupted, the testicle may be lost in a few hours.
Testicular cancer is one of the most common cancers in men under thirty. You should get checked immediately if you notice change in the size of or any lumps or nodules in a testicle. A cancerous testicle is typically painless. Testicular cancer is usually easy to treat when it is discovered early. Men should make it a habit to regularly feel their testicles (in the shower is a good time) to be sure that no changes have occurred.