Dear Need help,

A gold star to you for thinking about your sexual health and for not being too embarrassed to Go Ask Alice! If you feel embarrassed talking to your father, another place to start can be your health care provider; not only are they knowlegable, it's also part of their job to explain self-exams.

Let's first clarify your question. A prostate exam can be complicated and is difficult to do on your own. Generally your health care provider should check your prostate health as part of a routine exam.

The exam you can, and should, do yourself is the testicular exam, which is relatively easy to perform (see the steps below). By doing a monthly testicular self-exam (TSE), men can learn more about their own anatomy, including knowing what's familiar for them and what's not. Monthly exams can help with early detection of lumps, changes in sensation or size, aches, or other unusual symptoms in the genitals. Testicular cancer and other conditions, when caught at an early stage, are easier to cure (these are the same reasons monthly breast self-exams are recommended for women). Unlike many kinds of cancer, testicular cancer is more common in younger men, meaning men should start performing TSEs around age 14.

Steps for doing a testicular self-exam:

1. Stand in front of a mirror and look for any changes, especially swelling, in the appearance of your scrotum (the sac that holds the testes). It's useful to do this immediately after a shower or bath, when the heat of the water relaxes the scrotum.
2. Rotate each testicle between your fingers and thumbs (fingers on the underside the testicle and thumbs on the top).
3. Examine the rest of your scrotum's contents (especially the epididymis) for any changes, particularly hard, small lumps. The epididymis can feel like a cord or rope, and may seem like a lump at first, however it is a normal structure; become familiar with the feel of the epididymis so you can notice actual lumps if they appear.
4. Be on the lookout for hard lumps, masses, or nodules. Often cancerous lumps are painless, but pain can be a symptom of cancer as well as a number of other infections or conditions, so keep note of any discomfort.

It's normal for one testicle to be a little larger than the other, and it's normal for your testicles and scrotum to look a bit different from those of your friends or male family members. The key is knowing what's normal for you, and keeping an eye out for any changes. If you notice pain, swelling, redness, lumps, cysts, or any abnormal changes while doing an exam, you should visit your health care provider right away. Urologists are the type of doctor who specialize in male genital health, however you can begin with your regular provider and get a referral to a urologist if necessary. Many abnormal changes could be signs of an infection (rather than cancer), which are also important to diagnose and treat. Students at Columbia can make an appointment with their primary care provider through Open Communicator or by calling x4-2284.

If you need to brush up a little on male genital anatomy, check out these diagrams from Teenwire, or a health or anatomy book. Pretty soon you'll be able to teach a class on how to do a testicular self exam!

Alice

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