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Is male menopause a reality?As opposed to the sudden drop in ovulation and hormonal levels in women, menopause in men is a gradual process. The consequences in men aren't that clear. The health risks, though, are significant and it is important to recognize the symptoms of male menopause early on. Read along to know more. A testosterone level of 300-1200 ng/dL is considered normal in a healthy male. As one ages, the testosterone levels too drop gradually. After 30 years of age, the levels drop by 1% per year. By the time a man crosses 50 years of age, he is in menopause. Look out for the following signs to know if your testosterone levels are dropping : Low Libido : A low sex drive or decrease in inclination to have sex is the first sign of decreasing testosterone levels. Erectile Dysfunction : Testosterone is responsible for releasing nitric oxide that leads to erection. As the levels of testosterone decrease with age, getting an erection and maintaining it for longer periods of time may become difficult. Low Semen Level : The normal amount of semen ejaculated each time varies between 0.1 and 10 mL. This normal level is due to the efficient functioning of the testes, seminal vesicles, and prostate, all of which work under the influence of testosterone. As you age, the testosterone levels drop and the amount of semen ejaculated also drops. Orgasm Troubles : As you age, having an orgasm every time may be a bit difficult due to the dropping testosterone levels. Mood Swings : This happens in men as much as in women! The interesting thing here is that the man who suffers from it is the last one to note it and acknowledge. So, if you find yourself snapping and getting irritated at the smallest of things, get your testosterone levels checked. Depression : When you feel dull and demotivated at all times, and even doing the slightest of activity seems like a chore, it means that your testosterone levels have dropped to a significantly low level. Abdominal Fat : This is again an early sign of decreasing testosterone level. Belly fat is a sign of advancing age. Low testosterone levels are a sign of advancing age. Not all men who have low testosterone levels may show symptoms. In such cases, there is no need for any kind of treatment. Low testosterone may also be due to some other conditions like thyroid disease, excessive alcohol use, sleep apnea, etc. After 30 years of age, the levels of testosterone drop by 1% per year. By the time a man crosses 50 years of age he is in menopause. Identifying and eliminating these causes will restore the testosterone levels to normal. However, if no cause can be attributed to the low testosterone levels, it is a clear indication of normal aging and 'menopause.' As with women, men too have the option of hormone replacement therapy. However, this treatment is controversial. In some men, the testosterone replacement may relive several symptoms, but the risks far outweigh the benefits. An increased chance of heart attack, prostate cancer, and other health problems are associated with testosterone replacement therapy. Herbal supplements for problems associated with decreasing testosterone levels are generally considered safe, but they too have no proven health benefits and are known to increase the risks for prostate cancer. Male menopause isn't as dramatic and abrupt as the menopause in women, but it is a reality. It happens gradually over a period of several years.
Mammary duct ectasiaSigns and Symptoms In most of the cases, female patients do not have any symptom. In few cases, women may present with nipple discharge, tenderness or inflammation of the surrounding region. In some cases, there may be a lump over the breast or the nipple may get inverted. Causes Exact cause of mammary duct ectasia is unknown. But few possible cause or risk factors have been proposed by the doctors : Increasing age - Probability of developing mammary duct ectasia increases with age. With ageing, the breast changes its nature. Glandular tissue is replaced by fatty tissue. This change may lead to duct ectasia. Smoking- Milk ducts are widened due to smoking. This increases risk of inflammation which may lead to duct Ectasia. Inverted nipple - Inverted nipple obstructs the milk duct. It may lead to inflammation followed by duct ectasia. Complications Complications of duct ectasia may be may be of varying severity. They are usually minor, but sometimes become serious. Localized discomfort- Discomfort occurs due to pain and swelling around the nipple. Nipple discharge - Ectasia is frequently associated with discharge of thick and sticky fluid from nipple. Infection- Bacterial infection may develop due to stagnation of fluid in the milk duct. If it is neglected, it may lead to localized collection of pus known as abscess. Abscess requires surgical treatment. Abscess is drained surgically. Diagnosis The doctor usually diagnoses duct ectasia by clinical examination. However, few investigations may be required. Mammography- X-ray of the breast tissue is known as mammography. It helps the doctor to evaluate the breast tissue. Ultrasound- Ultrasound enables the doctor to evaluate milk ducts beneath the nipple. Treatment Duct ectasia is usually relieved by treatment. Following are the treatment options : Medications: The doctor prescribes antibiotic therapy for 10 to 14 days. It may be accompanied by mild painkillers like ibuprofen, etc. for initial few days till the remission of the disease sets in. Most of the cases are usually relieved by medications. Surgery: If duct ectasia is not controlled with medications then the doctor chooses to remove the duct ectasia surgically. Surgery is required very rarely.  Self care measures Following self-care measures often provides relief to the patients. These remedies can be adopted at home. The patient may wear a breast pad or support bra. The patient may apply warm compression to the affected region. The patient must stop smoking. The patient may be advised to sleep on the opposite side of the affected breast. Female patients should be educated regarding mammary duct ectasia so that they can detect possible symptoms of duct ectasia themselves. This will help to prevent possible complications of mammary duct ectasia and early diagnosis will provide early cure.
Breast lumps- myths busted!The rise in the occurrence of breast cancer in women, since past decade or so, has made women, especially in the urban areas, very cautious about lumps in their breasts. Whenever there is a small lump in the breast, the first thought that comes to mind, is may be this is cancerous. However, instead of taxing your brain with worries, it is better to take action and consult your caregiver. Here are some of the myths that are regularly associated with breast lumps and the real facts related to the same. Myth: If there is a breast lump, it must be cancerous Statistics reveal that out of 10 cases of breast lumps in women, only 2 are cancerous. More often, these lumps are due to fibroadenoma or cysts. In many women, lumps are formed during the menstrual cycle and they go away after it ends. It is not simply possible to tell exactly what kind of lump it is, just by feeling through hands. However, it is important to detect the composition of the lump and to do so at the initial stages, so that if it is detected cancerous, early diagnosis and treatment can save your life. Myth: If your mammogram is normal, you are safe and the lumps are not cancerous This is not particularly true. To detect the presence of cancerous cells, you need to get more tests done; an ultrasound, an MRI and also a follow up mammogram, to get a second view of the lump. Doctors also suggest a biopsy to be 100 percent sure of the diagnosis. If the lumps persist but there is no detection, your doctor may ask you to keep doing the tests at frequent intervals, to assess the development. Myth: Malignant breast lumps do not cause any pain Although breast cancer patients do not suffer from much pain, this does not mean that if you do not have pain, the lump is non-cancerous. There are different types of breast cancers; and in some types such as the inflammatory breast cancer, the patient can suffer from warmth, tenderness, redness and swelling, followed by pain in the lumps. Myth: If you get a lump while breastfeeding, it is not cancerous It is true that breastfeeding reduces the chances of development of cancerous cells. But there is still a possibility and hence you should not ignore the formation of lumps. It is advisable to immediately get an ultrasound to confirm the condition of the lump. Myth: Lump in young women cannot be cancerous Women can develop breast cancer at any age. Hence, if you have a breast lump at a young age, or even if your teenage daughter has developed a suspicious lump in her breast, you should always get it checked, at the earliest. Most often, cancer develops in the breast when women are past their menopause period. But this, in no way means, that they cannot get it at younger age. Myth: Only a larger lump can be cancerous, not a smaller one Lumps in the breasts can be of all sizes; and the size, does not determine the presence of cancerous cells. According to breast-imaging specialist at New York's Manhattan Diagnostic Radiology, Melissa Scheer MD, you must immediately see a doctor, whenever you feel the presence of even a tiny lump, because, a small lump too may turn out to be aggressively cancerous. Most often, the lump in the breast is non-cancerous; however, it is advisable to consult your caregiver immediately, once you discover the lump for the first time.
Teach your kid to stand up to bulliesAlmost everyone has heard of the beach bully who goes around kicking sand in the face of the skinny lad. That's the quintessential imagery associated with bullies and it has stayed with us for over 3 decades since the first ads came out. The ads generally endorsed body building products using the classic 'Before' and 'After' construct, i.e. before you got your face sandblasted by the beach bully and after you took that protein shake or muscle builder to get even. Bullying is a phenomenon where a person or group wilfully targets someone with the intention of troubling them over a specific thing. (Bullies generally pick on someone they perceive as physically, mentally, financially, socially or racially inferior.) There is no age-limit for bullies as the bully could be a school going kid with an attitude problem or a fully grown adult, who could indulge in it from sheer force of habit or due to a mental problem. Again there is no age limit for the victim as well. Anybody could really be a target for the bully menace, right from school children, teenagers, disabled or even old people. Well bullying has changed considerably in these times and you also have the e-bully version where insecure bullies go about harassing people, especially teenagers over the internet. Bullies resort to tactics like causing public humiliation or embarrassment to hapless victims or resort to threats or other control-based abusive behaviour. Ok so everyone has undergone bullying from time to time but the question is should you allow it to happen to your teenaged son or daughter? Mind you, here it isn't simply a question of some leg pulling by friends or teachers but some serious malice that could well destroy your teenager's confidence and cause permanent scars on his self-esteem. Yes, if your teenager is being subjected to bullying then teach him how to kick the sand right back in the bully's face. Before we learn how to do that let's see the types of bullying that your kid could be subjected to: Verbal bullying This includes teasing or making caustic remarks directed at someone on a regular basis. The school bully does that, doesn't he? As you would probably remember from your own school days that fat lout who made you quiver with fright as he snatched your lunch box away to feed the dogs. Yes, the very same guy who pulled your sister's pig-tails and called you names which made you go red in the face. You could do nothing but pray he wouldn't notice you somehow. Well so something similar could be happening with your teenager. Verbal bullying need not be done by a school friend. Even a responsible teacher could target someone for deprecatory remarks causing much embarrassment, ridicule andfeelings of inadequacy to a teenager. Sometimes kids look up to their teachers for encouragement and support and those very people could actually damage a child's self-esteem by unjustified criticism and bullying behaviour.Teenage girls could suffer taunts and remarks about certain physical traits and since they are at a delicate age where their bodies are undergoing changes, such verbal abuse can indeed cause long-term depression or personality issues. Physical bullying Physical bullying is where your teenager could be subjected to physical harassment at the hands of the bully. Whether it is a simple case of holding your teenager's hand or unprovoked physical assault, the end result is the same-injuries to the body and mind. The bully may not go as far as inflict any visible scars on the teenager's body but the episodes could certainly cause great fear and trauma to him. Even teenage girls are not spared physical abuse at the hands of bullies. In certain cases, teens suffering from long-term bullying actually took some extreme measures by committing suicide or breaking down completely. Internet bullying Internet bullying is where your teenager is probably most vulnerable. At least school bullying is restricted to school, but here your teenager is at the mercy of just about everyone - from the school bully to the earnest paedophile! Causing embarrassment on public forums, threats of physical or sexual harm is the most common and as a parent you have to take every step possible to not just protect your child but also help him take care of himself or herself. The bully menace The school bully is comparatively easier to deal with than the internet lout! Well, one can't be too sure of that statement either since these days,school kids are known to blow up their own classmates or participate in a heist with adult precision. Always watch out for the classic signs of bullying. If your child appears withdrawn or disturbed after school hours then gently probe and encourage your child to tell it all. If you feel there is enough reason to think your child is being subject to bullying then bring it to the notice of the school immediately as others could have similar complaints. Do not admonish your child or scold him as it could cause him to withdraw in to the shell that the bully provided him in the first place. Parents and elder siblings can be bullies too so remember that. Teach your child to stand up to bullies. The bully is generally an insecure person who uses brute force to feel good about himself, at the cost of others. The school bully generally has his way and is not used to being challenged. Teach your child to look the bully in the eye and register protest. This will go a long way in teaching your child how to fight back and not take any nonsense from others.If the situation worsens, then always keep a track of your teenager's whereabouts especially if it is a girl. Once the bully realizes that he is being tracked he generally lies low or picks on someone else. Internet bullying requires different measures. You can monitor your child's online activities and teach them to never ever share any personal information or photographs online or on forums which are off-limits for children and adolescents. You can complain to the authorities if things get out of hand. If someone repeatedly issues threats to your teenager, either online or in real life, is a cause for real concern and one must take them seriously. If your child does not learn to cope with bullies it could affect him well in to adulthood, where he will feel helpless and easily scared by imposing people or even develop a hatred for authority figures. Bullying can fuel an already weak personality in to gaining an inferiority complex; the flip side is that kids who have been subjected to bullying can repeat the same patterns on their younger siblings or at school. So a bully creates another bully if continued unchecked. Mental problems in children are on the rise, so bullying is also no longer an innocent joke but could be a serious crime. Bullies whether children or grown-ups, suffer from some personality disorder or a serious inferiority complex which makes them compulsive trouble makers and their victims are generally people who cannot hit back or are vulnerable. Take Hitler for instance. Wasn't he just a bully who was unhappy in his own life? Look what he did to millions of innocent people. Wasn't that a bully gone berserk?  
A correctable disfigurement of face: Cleft lip and palateThe Times of India reports that "With an incidence of 7 per 1000 children, cleft lip and palate deformity is one of the most common deformities among Indian children." The number of infants born every year with cleft lip and cleft palate in India is 28,600. This means 78 affected infants are born every day or 3 infants with clefts are born every hour. Cleft lip and palate develop early in pregnancy where lack of adequate amounts of tissues lead to two parts of the face failing to join adequately at the middle. A cleft lip or hare lip (as it is commonly called) refers to separation of the two sides of the upper lip. There appears a narrow opening or gap over the skin of the upper lip. This separation may sometimes extend beyond the base of the nose and may involve the upper gum and/or the bones of the upper jaw. A cleft palate refers to the gap between the two edges of the roof of the mouth, causing it to remain open at birth. The bony front portion of the roof of the mouth or the hard palate may be involved alone, or along with the soft palate or the soft back portion of the roof of the mouth. Since lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate or vice versa. Causes of developing cleft lip and cleft palate: The exact cause of cleft lip and palate is unknown. Some research, however, suggests that these clefts are caused by a combination of genetic and environmental factors. The risk of such clefts thus can be reduced by adopting a healthy lifestyle during pregnancy. This includes avoidance of smoking, alcohol and having a healthy diet to avoid excessive weight gain during pregnancy. Cleft lip and palate can occur alone with no other problems or defects. This is called non-syndromic clefts. They may also occur as part of other birth defects and then may be called part of a syndrome. Cleft lip and palate may occur on one side (unilateral) or may occur on both sides (bilateral). Unilateral cleft lip and palate is more common than bilateral cleft lip and palate. Left-sided cleft lip and palate is twice as common as right-sided cleft lip and palate. The reason for this is unclear. A cleft lip or combined cleft lip and palate are seen more commonly in male babies. Cleft palate alone is more common in female babies. The face of the baby usually develops around 5th and 9th weeks of pregnancy thus this defect may arise early in pregnancy. Treatment of cleft lip and palate: Cleft lip and palate is usually corrected using cosmetic or plastic surgery. Results are usually very good. After treatment, most children have a normal appearance. To prevent and correct associated speech problems and dental problems, treatment is also sought from speech and language therapists, as well as dental surgeons (orthodontic specialists). Excellent results may be seen if the specialists work in tandem.
Mood disordersMood disorder is a category of mental health problems, and it includes all types of depression and bipolar disorder. The cause of mood disorder is not well known. Endorphins in brain are responsible for positive moods. The neurotransmitters regulate endorphins. Depression and other mood disorders are caused by a chemical imbalance in the brain. Life events such as unwanted changes in life may also contribute to a depressed mood. Mood disorders are inherited. Children, adolescents, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. Symptoms: Prolonged feeling of sadness Helpless feeling Low self-esteem Intense guilt Suicidal thoughts Loss of interest in daily activities Difficulty with relationships Disturbed sleep Change in appetite or weight Low energy Inability in concentrating Inability to make decisions Frequent physical complaints (i.e., headache, stomach ache, fatigue) Threats of running away from home Hypersensitivity to failure or rejection Irritability Aggressive behaviour Hostility In mood disorders, these feelings appear more intense than what a person may normally feel from time to time. Treatment Psychotherapy: It is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stress triggers in their environment and how to avoid them. Family therapy: Families play a vital supportive role in any treatment process. Antidepressant medications: Medications in combination with psychotherapy has shown to be very effective in the treatment of depression.
Fair skin - A modern obsession!History of Complexion - Complexion generally refers to the natural color, appearance, and texture of the skin, particularly on the face. Originated from the late Latin term 'complexio', complexion is traditionally referred to the temperament which was determined on the basis of the proportion of qualities of hot, wet, dry, and cold in the human body. It was believed that the body carried these qualities depending on the climate in which the individual lived. Thus, a person living in a cold climate was seen to have 'colder and moister' complexion and so on. The biological facet of complexion mentioned below tells us how the skin adapts its color according to the climate it finds itself in. Moreover, it was also seen to represent the character of the person into different categories like melancholic, choleric, sanguine, and phlegmatic. Complexion was the center which reflected the qualities which make a balanced person. Skin color is determined by the presence of pigment melanin. Located in the outer skin layer called epidermis, it is produced by cells called melanocytes. These cells contain receptors which are photosensitive and which detect the ultraviolet (UV) radiation from sun and other factors. In response to this detection, they give out melanin after exposure. The Biology of Complexion - The complexion of the body ranges from very dark brown of Africa and Aboriginal Australia to pink with yellowish hue of the Northern Europeans. In actuality, there is no skin which is black, yellow, red or white in absolute - it is generally a hue of many colors with one dominating over the other. Our biological actuality is not reflected by the words we use for our complexion these days. Skin color is determined by the presence of pigment melanin. This pigment is under the control of 6 genes. Both complexions of dark and light have melanin. Spatially located in the outer skin layer (called epidermis), it is produced by cells called melanocytes. These cells contain receptors which are photosensitive and which detect the ultraviolet (UV) radiation from sun and other factors. In response to this detection, they give out melanin after exposure. Those in tropical latitudes, where there is highest exposure to sun, have darker skin which contains melanin acting as a protective biological envelope against UV radiation. This protective layer prevents sunburns and other damages including those that could increase the risk of melanoma. The UV radiation reaching the earth increases during summers and reduces in winters. The skin adapts to this change by tanning - tanning indicates that your skin is increasing the size and amount of melanin grains to protect against the UV. Thus, your skin color is essentially determined by genetics and the geography of the place you live in. Biological Fact to Social Conclusion - We generally mold the biological fact of adaptability of our skin into a social meter of beauty. The complexion is a biological wonder of the nature which allows the skin to absorb enough vitamin D, prevent many illnesses like anemia, osteoporosis, and rickets determined by its environment. Thus, to claim that a certain skin color is superior to others is to only deny the reality of biology related to our skin and body, thus falling into the fallacy of unjustifiably jumping from a biological fact to a social conclusion. The health of your skin must be the starting point to declaring its beauty, not a presupposed social standard unrepresentative of the reality of the body. Taking Care of Your Skin - Every skin color is determined by its biological framework placed within the environmental setup. It is essential to take care of your skin to ensure that it is healthy and well taken care of : Make sure you eat a well-balanced and nutritious diet. Stay away from junk and heavily processed food items. Sleep for at least 7-8 hours daily to ensure that your skin gets enough time to recharge its mechanism. Drink loads of water to keep your skin hydrated. Go through the daily care routine: cleanse, tone, moisturize, and exfoliate. Use rose water to remove your make-up and ensure that you do not go to bed with make-up on. Keep dirt and germs away from your skin. The best way is to avoid touching your face with hands when you are out. A clean environment is the fertile ground for a healthy skin. Make sure you wash your pillows, their covers and clean the house regularly to keep away pollutants. Stress is one of the main causes of your skin's health withering. Your skin is the outer reflection of your inner mental state. Work towards mental detoxification to cheer up your skin and body.
Advantage of the average - Automated continuous blood pressure monitoring technologyAlthough mercury sphygmomanometers (though a deadline is set for them to be phased out due to environmental concerns) are still considered the gold standards, the Aneroid and Digital counterparts represent the future of blood pressure monitoring. The need of long-term blood pressure monitoring arises with disorders and health conditions that demand more attention from the medical teams. Experts say that the fluctuations in BP in conditions like cardiovascular diseases, pregnancy, etc., if tracked at regular intervals, can reduce 22% of risks due to delay and no treatment. This necessity pushed the invention of invasive arterial blood pressure to be used during surgical procedures and further a continuous noninvasive arterial pressure measurement (CNAP) system. There have been multiple researches to overcome some of the roadblocks in measuring the arterial blood pressure in the noninvasive and external approach. Among these developments, the need for measurement of mean blood pressure was felt and the 24-hour BP variation in the patient was taken into account. The 24-hour model eliminates the errors in readings taken during clinic visits due to factors such as fluctuations as a result of white coat fear or after-effects of some stress or exertion. Trendsetting New-age Technology : In 2004, the medical world received the BpTRU non-invasive automatic blood pressure monitoring device. BpTRU devices proved to be a superior and more precise alternative when compared to other manual BP assessment techniques and even other 24-hour ABPM alternatives. The automated oscillometric devices precision and accuracy of assessed BP and heart rate is earmarked with a unique automatic technique - the device records 6 consecutive BP readings of the patient, discards the earliest, and the rest of the five values are put to average function and instantly the resultant mean BP reading flashes on the screen. Compatible with guidelines of American National Standard/Association for the Advancement of Medical Instrumentation (ANSI/AAMI EC13:2002) this is a time-saving, portable, and user-friendly device. A compact and automatic wrist cuff BP monitor, the smart blood pressure monitor that can be synchronized with with Apple’s iOS devices and a Bluetooth connectable and Android compatible blood pressure monitor marks the revolution of CNAP in modern times.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
Penis healthHere's a quick one on how to go about doing the good work The function of penis is primarily passing urine and intercourse. So from the hygiene point of view it becomes imperative that the penis, testicles and scrotum should be washed regularly with mild soap and toweled dry to keep out any odor causing bacteria. The foreskin should pull back to expose the glans or it can cause bleeding while having sexual intercourse. The foreskin is that protective sheath around the glans. It appears a simple task to pull the foreskin back about a quarter of an inch. But it is difficult. So for those men whose foreskin isn't exactly the 'spirit of co-operation'. Soap and lubrication can ease the way down. Try it slowly and gently over a few days and then ease down with practice. It is important to slide the foreskin back while bathing to wash off the 'smegma', sticky substance that tends to accumulate there. Don't wear underwear which is too tight or it may restrict the blood flow to the penis. Besides that is not very good from the point of view of the quality of sperm generated by the testicles. 'It's really surprising how many men don't clean underneath their foreskin', says Patrick French, sexual health expert. A penis, for once, isn't a muscle and you could do some serious damage in trying to bend it. Secondly, it is meant to have erections so there is nothing abnormal about that. The penis has no bones in them but don't ever try to apply strength and/or fold your penis away. It is like a tube with blood vessels which fill up and give an erection. If you were to rough handle the penis by twisting it violently it can actually cause the vessels to rupture and cause a swelling which can be painful. Do not ignore any swellings, lacerations or spots on the penis as they could be symptoms of sexual disease or infection. Even circumcised men should wash under the glans regularly.
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