Some men have a penis that curves to the side, upward or downward when erect. This is common, and a bent penis in most men isn’t a problem. Generally, a bent penis is only a cause for concern if your erections are painful or if the curvature of your penis interferes with sex.

Peyronie’s disease is a disorder in which scar tissue, called a plaque, forms in the penis—the male organ used for urination and sex. The plaque builds up inside the tissues of a thick, elastic membrane called the tunica albuginea. The most common area for the plaque is on the top or bottom of the penis. As the plaque builds up, the penis will curve or bend, which can cause painful erections. Curves in the penis can make sexual intercourse painful, difficult, or impossible. Peyronie’s disease begins with inflammation, or swelling, which can become a hard scar.

The plaque that develops in Peyronie’s disease is not the same plaque that can develop in a person’s arteries. The plaque seen in Peyronie’s disease is benign, or noncancerous, and is not a tumor. Peyronie’s disease is not contagious or caused by any known transmittable disease.

Early researchers thought Peyronie’s disease was a form of impotence, now called erectile dysfunction (ED). ED happens when a man is unable to achieve or keep an erection firm enough for sexual intercourse. Some men with Peyronie’s disease may have ED. Usually men with Peyronie’s disease are referred to a urologist—a doctor who specializes in sexual and urinary problems.

How does an erection occur?

An erection occurs when blood flow increases into the penis, making it expand and become firm. Two long chambers inside the penis, called the corpora cavernosa, contain a spongy tissue that draws blood into the chambers. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The tunica albuginea encases the corpora cavernosa. The urethra, which is the tube that carries urine and semen outside of the body, runs along the underside of the corpora cavernosa in the middle of a third chamber called the corpus spongiosum.

An erection requires a precise sequence of events:

• An erection begins with sensory or mental stimulation, or both. The stimulus may be physical contact or a sexual image or thought.
• When the brain senses a sexual urge, it sends impulses to local nerves in the penis that cause the muscles of the corpora cavernosa to relax. As a result, blood flows in through the arteries and fills the spaces in the corpora cavernosa like water filling a sponge.
• The blood creates pressure in the corpora cavernosa, making the penis expand.
• The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining the erection.
• The erection ends after climax or after the sexual urge has passed. The muscles in the penis contract to stop the inflow of blood. The veins open and the extra blood flows out of the penis and back into the body.

What causes Peyronie’s disease?

Medical experts do not know the exact cause of Peyronie’s disease. Many believe that Peyronie’s disease may be the result of

• acute injury to the penis
• chronic, or repeated, injury to the penis
• autoimmune disease—a disorder in which the body’s immune system attacks the body’s own cells and organs

Injury to the Penis

Medical experts believe that hitting or bending the penis may injure the tissues inside. A man may injure the penis during sex, athletic activity, or an accident. Injury ruptures blood vessels, which leads to bleeding and swelling inside the layers of the tunica albuginea. Swelling inside the penis will block blood flow through the layers of tissue inside the penis. When the blood can’t flow normally, clots can form and trap immune system cells. As the injury heals, the immune system cells may release substances that lead to the formation of too much scar tissue. The scar tissue builds up and forms a plaque inside the penis. The plaque reduces the elasticity of tissues and flexibility of the penis during erection, leading to curvature. The plaque may further harden because of calcification––the process in which calcium builds up in body tissue.

Autoimmune Disease

Some medical experts believe that Peyronie’s disease may be part of an autoimmune disease. Normally, the immune system is the body’s way of protecting itself from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. Men who have autoimmune diseases may develop Peyronie’s disease when the immune system attacks cells in the penis. This can lead to inflammation in the penis and can cause scarring. Medical experts do not know what causes autoimmune diseases. Some of the autoimmune diseases associated with Peyronie’s disease affect connective tissues. Connective tissue is specialized tissue that supports, joins, or separates different types of tissues and organs of the body.

How common is Peyronie’s disease?

Researchers estimate that Peyronie’s disease may affect 1 to 23 percent of men between 40 and 70 years of age.¹ However, the actual occurrence of Peyronie’s disease may be higher due to men’s embarrassment and health care providers’ limited reporting.¹ The disease is rare in young men, although it has been reported in men in their 30s.¹ The chance of developing Peyronie’s disease increases with age.

Who is more likely to develop Peyronie’s disease?

The following factors may increase a man’s chance of developing Peyronie’s disease:

• vigorous sexual or nonsexual activities that cause microscopic injury to the penis
• certain connective tissue and autoimmune disorders
• a family history of Peyronie’s disease
• aging

Vigorous Sexual and Nonsexual Activities

Men whose sexual or nonsexual activities cause microscopic injury to the penis are more likely to develop Peyronie’s disease.

Connective Tissue and Autoimmune Disorders

Men who have certain connective tissue and autoimmune disorders may have a higher chance of developing Peyronie’s disease. A common example is a condition known as Dupuytren’s disease, an abnormal cordlike thickening across the palm of the hand. Dupuytren’s disease is also known as Dupuytren’s contracture. Although Dupuytren’s disease is fairly common in older men, only about 15 percent of men with Peyronie’s disease will also have Dupuytren’s disease.² Other connective tissue disorders associated with Peyronie’s disease include

• plantar fasciitis––inflammation of the plantar fascia, thick tissue on the bottom of the foot that connects the heel bone to the toes and creates the arch of the foot
• scleroderma––abnormal growth of connective tissue, causing it to get thick and hard; scleroderma can cause swelling or pain in muscles and joints

Autoimmune disorders associated with Peyronie’s disease include

• systemic lupus erythematosus––inflammation and damage to various body tissues, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain
• Sjögren’s syndrome––inflammation and damage to the glands that make tears and saliva
• Behcet’s syndrome––inflammation of the blood vessels

Family History of Peyronie’s Disease

Medical experts believe that Peyronie’s disease may run in some families. For example, a man whose father or brother has Peyronie’s disease may have an increased chance of getting the disease.

Aging

The chance of getting Peyronie’s disease increases with age. Age-related changes in the elasticity of tissues in the penis may cause it to be more easily injured and less likely to heal well.

“In 2021, 4.3% of adults aged ≥18 years reported being bothered a lot by headache or migraine in the past 3 months with the percentage among women (6.2%) higher than that among men (2.2%). Percentages were higher among women than men in all age groups: 7.4% versus 2.5% in adults aged 18–44 years, 6.7% versus 2.4% in those aged 45–64 years, and 3.1% versus 1.5% in those aged ≥65 years. Among men and women, the percentage of those bothered a lot by headache or migraine in the past 3 months was lowest among those aged ≥65 years.”

Source: National Center for Health Statistics, National Health Interview Survey, 2021. https://www.cdc.gov/nchs/nhis.htm Center for Disease Control and Prevention

June is National Migraine & Headache Awareness Month (MHAM), an opportunity to raise awareness about migraine and other headache diseases. Migraine impacts forty million people in the United States, one billion people across the globe, and is recognized as the #2 cause of disability worldwide. Currently, about 16 million people with migraines in the U.S. are undiagnosed. Approximately 400,000 Americans experience cluster headaches, recognized as one of the most painful diseases a person can have.

The word “headache” is a broad term used to describe pain in the scalp, head and neck. There are many different types of headaches. They may be primary conditions such as tension headaches, migraines and cluster headaches, or they may occur due to underlying health conditions.

Headaches are very common, most people experience them to some degree during their life.

“Headache disorders are amongst the world’s most debilitating conditions globally,” says Susan Broner, M.D., medical director of the Weill Cornell Medicine Headache Program. “In fact, migraine itself is the second most disabling condition in the world in terms of years lost to disability. And if you look at populations of people under 50, it’s the first most disabling condition yet many people go undiagnosed and untreated.”

Severe or recurring headaches of any type can significantly impact daily life. Learning about them can help you communicate your concerns more clearly to your primary care provider.

Tension Headaches:

Tension headaches are the most common type of headache. People often experience occasional tension headaches and don’t seek medical care. However, if you have tension headaches 15 days per month or more, you should consult with your primary care provider.

Causes of Tension Headaches

These headaches are caused by tense muscles around the head and neck, often due to stress, anxiety or depression. Tension headaches may also be triggered by:

• Alcohol
• Caffeine or caffeine withdrawal
• Dental problems such as frequently grinding your teeth or clenching your jaw
• Eyestrain
• Keeping your head in one position for a long time
• Not getting enough sleep

Treating and Preventing Tension Headaches

Occasional tension headaches can often be prevented by:

• Exercising regularly
• Getting enough sleep
• Maintaining good posture while seated and taking breaks from sitting
• Managing daily stress

Chronic tension-type headaches are typically treated with stress reduction techniques such as meditation or cognitive behavioral therapy and biofeedback.

Over-the-counter pain medications (e.g., ibuprofen or acetaminophen) may be used to decrease pain. Muscle relaxers or prescription antidepressants may also be recommended in some cases.

Migraine Headaches:

Migraines are a severe, recurring type of headache that is often debilitating. About 12% of people in the United States have migraines and they are more common in women.

Causes of Migraines

The exact cause of migraines is unknown. But researchers believe that genetics plays a part. Having certain medical conditions may increase your risk of developing migraines, including:

• Anxiety
• Bipolar disorder
• Depression
• Epilepsy
• Sleep disorders

Migraines can be triggered by several factors. Caffeine is one of the more common triggers people encounter.  Caffeine is always a mystery to people because many people find that it helps a headache,

There is currently no cure for migraine, but we are in a renaissance of new treatments, therapies, and approaches to managing the disease.  If you have been struggling in silence, now is the time to speak up, educate yourself, and seek care. You might just change your life for the better.

During the Covid pandemic, there was a significant rise in telemedicine. According to a survey by the Headache and Migraine Policy Forum and MigraineAgain, 78% of migraine and headache patients used telemedicine after the start of the pandemic, in comparison to just 22% before the pandemic. This trend was ushering in a new era of care, where patients could interact with health professionals from the convenience and comfort of their homes. The survey also revealed that there had been a nearly 70% rise in the number of migraine attacks during the pandemic and 84% of people had more stress managing their disease.

On the treatment front, there are new options for patients to explore. “Migraine and headache patients now have more options due to a wave of innovation in acute and preventive care,” noted Dr. William Young, Professor of Neurology, Thomas Jefferson University and Medical Advisor for the Coalition for Headache and Migraine Patients. “These include CGRP monoclonal antibodies, gepants, lasmiditan, and several neuromodulation devices.”

It is so much easier to for many humans to feel since they don’t see anything a migraine or general headache is not so bad but when you experience you may feel different when seeing those people with that symptom.  Headache specialists play a vital role in migraine advocacy and awareness efforts. The symptoms of migraine often cause patients living with the disease to withdraw from their daily lives.. Others may refrain from identifying themselves as a migraine patient, due to stigma surrounding the disease and a lack of compassion surrounding its symptoms. For these patients and so many more, we as healthcare professionals must continue to advocate on their behalf.

A disease awareness month plays a vital role to raise public knowledge, address stigma and build a stronger community of patient advocates.

“On an x-ray, the spine of a person with scoliosis looks like an “S” or “C” instead of a straight line. Providers use a special measurement tool to measure the angle of the curve, called a Cobb angle. A slight curve may be normal. Scoliosis is diagnosed when the Cobb angle is 10 degrees or greater.

Scoliosis usually isn’t life-threatening or painful, and those who have it can live normal and active lives. While there are no known ways to prevent the development of scoliosis, early diagnosis and treatment can help prevent the condition from getting worse.”.

Gillette Children’s (https://www.gillettechildrens.org/conditions-care/scoliosis-idiopathic-neuromuscular-and-congenital/what-is-scoliosis)

Scoliosis is a problem with the spine where the spine is curved instead of straight, with the upper back being rounded and the lower back having a “swayback,” or inner curved problem, reports WebMD.

According to the Scoliosis Research Society, 85 percent of all scoliosis causes are idiopathic, meaning the cause is unknown. The remaining causes of scoliosis include birth defects, such as vertebrae that form abnormally before birth, and certain disorders such as cerebral palsy, Marfan’s syndrome, muscular dystrophy and Down syndrome. Infections and spinal fractures can also cause scoliosis.curvature of the spine during surgical correction of this condition. Screws and rods are placed in order to stabilize and straighten the spine.

What You Should Know About Adult Scoliosis

Scoliosis is defined as a curve of the spine of 10 degrees. Adult scoliosis is broadly defined as a curve in your spine of 10 degrees or greater in a person 18 years of age or older. Adult scoliosis is separated into 2 common categories:

• Adult Idiopathic Scoliosis patients have had scoliosis since childhood or as a teenager and have grown into adulthood.  We do not yet know the cause of idiopathic scoliosis, but there is a lot of genetic work going on in an attempt to answer this question.

• Adult “De Novo” or Degenerative Scoliosis develops in adulthood. Degenerative scoliosis develops as a result of disc degeneration. As the disc degenerates, it loses height. If one side of the disc degenerates more rapidly than the other, the disc begins to tilt. As it tilts, more pressure is placed on one side of your spine and gravity tends to cause the spine to bend and curve. The more discs that degenerate, the more the spine begins to curve.

Scoliosis is more common in girls than in boys, and the diagnosis is usually made after a child reaches 10 years of age. A doctor performs a physical examination and may take X-rays to definitively diagnose the disease. An X-ray tells if there is any growth left in the growth plates of the femur or humerus, and scoliosis can become worse if the patient has more growing to do, states MedicineNet. Serial X-rays are performed to track the changes of the spinal curve, which helps determine the best course of treatment.

Types of idiopathic scoliosis are categorized by both age at which the curve is detected and by the type and location of the curve.

When grouped by age, scoliosis usually is categorized into three age groups:

• Infantile scoliosis: from birth to 3 years old
• Juvenile scoliosis: from 3 to 9 years old
• Adolescent scoliosis: from 10 to 18 years old

This last category of scoliosis, adolescent scoliosis, occurs in children age 10 to 18 years old, and comprises approximately 80% of all cases of idiopathic scoliosis. This age range is when rapid growth typically occurs, which is why the detection of a curve at this stage should be monitored closely for progression as the child’s skeleton develops.

Terms Used to Describe Spinal Curvature

Scoliosis curves are often described based on the direction and location of the curve. Physicians have several detailed systems to classify specific curves, but here are some common terms used to describe scoliosis:

Terms that describe the direction of the curve:

• Dextroscoliosis describes a spinal curve to the right (“dextro” = right). Usually occurring in the thoracic spine, this is the most common type of curve. It can occur on its own (forming a “C” shape) or with another curve bending the opposite way in the lower spine (forming an “S”).

Severe scoliosis can lead to heart and lung problems if not treated, as the ribs press against the chest, making breathing more difficult, states Mayo Clinic. Adults who had scoliosis as a child may experience more back pain throughout their lives as compared to people without scoliosis.

Symptoms of scoliosis include an uneven waist, uneven shoulders, disjointed hip and a protruding shoulder blade, according to Mayo Clinic. The spine also curves or twists in acute cases, and the disease can cause one side of the ribs to protrude more than the other. Severe cases also induce labored breathing and back pain.

Diagnosis

Scoliosis can be recognized and diagnosed with a clinical exam, but xrays are necessary to fully evaluate the magnitude and type of scoliosis present. For a proper scoliosis evaluation, full length, whole spine xrays need to be performed. An MRI may also be recommended if there are symptoms of leg pain that may be associated with stenosis or if there is concern about possible spinal cord compression or abnormalities.

Treatment

The treatment of adult scoliosis is very individualized and based on the specific symptoms and age of the patient. Many patients have scoliosis and have very minor symptoms and live with it without treatment. Patients with predominant symptoms of back pain would typically be treated with physical therapy. Patients with back pain and leg pain may receive some benefit from injection treatment to help relieve the leg pain.  If lumbar stenosis (narrowing of the spinal canal) is present and is unresponsive to non-surgical treatment, then a decompression( removal of bone and ligaments pressing on the nerves) may be recommended. If the scoliosis is greater than 30 degrees, a fusion procedure will most likely be recommended along with the decompression. The fusion is recommended to prevent the curve from progressing when the spine is destabilized by the bone removal that is necessary to  decompress the nerves. Fusions are usually accompanied with metal rod and screw placement into the spine to help correct and stabilize the scoliosis and help the bone heal or fuse together. The length of the fusion, or the number of spine levels included, depends on the type of scoliosis and the area of the spine involved. The goal of adult scoliosis surgery is to first remove pressure on the nerves, and second to keep the scoliosis from progressing further.

“At every stage of life, men are encouraged to consider three equally important aspects of their health—physical health, mental health and social connection. Men’s Health Month in the United States is observed every June. This month aims to raise awareness of the same health concerns of Men’s Health Week but lasts the whole month. It is different from November, which is held in November and focuses on men’s mental health as well as prostate cancer. During the month of June, men are encouraged to set goals for their own health and wellness and begin to create a roadmap for achieving those goals.  This is for men to address medical or health problems that may be starting or already there or hopefully cleared as healthy and to continue yearly to make sure its cleared healthy or if not address before the issue gets severe.”

Lifespan / Miriam Hospital (https://www.lifespan.org/lifespan-living/importance-mens-health-month)

Men in this age range are encouraged to discuss the health concerns below with their doctors. These discussions can be part of a yearly annual wellness visit. While you may think you don’t need some of these tests, establishing a base line can be useful for continued health monitoring as you age, or as more acute health concerns arise.

• Physical exam: check blood pressure, screen for obesity and assess body composition (waist circumference). Testicular exam and testicular self-exam are important at this age.
• Metabolic screening: fasting blood sugar and fasting lipid profile based on risk and family history.
• Vaccines: influenza, COVID-19, Hepatitis A/B, HPV, Tdap and MMR should be considered.
• STI screening: HIV, Hepatitis B/C, syphilis, gonorrhea and chlamydia screening should be considered, and pre-exposure prophylaxis for HIV (PreP) should be discussed.
• Assessment of risky behaviors: discuss any use of tobacco, alcohol, recreational drugs, anabolic steroids, as well as use of seatbelts and helmets and gun safety.
• Family planning: “pre-conception” counseling to educate men that adopting a healthy lifestyle—exercising, eating healthy foods, and avoiding substances—at an early age improves the chances of conceiving and having a healthy pregnancy and a healthy child.

Recommended screenings for adult men over 40

These screenings are similar to those recommended for younger men but start to look at health concerns that most often appear in middle age.

• Physical exam: check blood pressure, screen for obesity, measure body composition and consider prostate exam (in some cases).
• Metabolic screening: fasting blood sugar and fasting lipid profile and estimation of cardiovascular risk.
• Vaccines: influenza, covid-19, Hepatitis A/B, HPV (through age 45), Tdap and MMR. Shingles vaccine is recommended for adults over 50.
• STI screening: HIV, Hepatitis B/C, syphilis, gonorrhea and chlamydia screening should be considered, and pre-exposure prophylaxis for HIV (PreP) should be discussed.
• Cardiovascular screening: based on risk and symptoms (may include stress testing or coronary artery calcium score).
• Cancer screening: based on family history and personal risks. May include prostate, colon and lung cancer screening as well as skin exam.
• Eye exam.

Recommended screenings for adult men over 65

Older men should continue to evaluate their health and make lifestyle changes based on conversations with their doctors to ensure they are able to live life to the fullest.

• Physical exam: blood pressure, height and weight, waist circumference and prostate exam.
• Metabolic screening: fasting blood sugar, fasting lipid profile, thyroid function (in some cases).
• Vaccines: influenza, covid-19, Hepatitis A/B, Tdap, Pneumovax/Prevnar and Shingles.
• STI screening: based on risk.
• Cardiovascular screening: abdominal ultrasound, coronary artery calcium score and stress testing based on risk and symptoms.
• Cancer screening: prostate, colon and lung as well as skin exam.
• Osteoporosis: screening should be considered in men over 70, men who lose height over time or have a low impact fracture. Fall risk assessment should be completed.
• Eye exam.

Mental health is an important determinant of overall health and quality of life at every age. Although men are more likely to suffer “deaths of despair” including alcoholism, overdose and suicide, they are far less likely than women to seek out mental health services. Undiagnosed and untreated mood disorders in young men are associated with impaired learning, risk-taking behaviors, use of substances and violence. Adult men with chronic diseases like diabetes and cardiovascular disease have worse outcomes when they also suffer from depression, and depression is associated with decreased longevity in older men.  Men are less likely to get treated than a women in screening or when signs or symptoms arise until they get in the way or regarding mental health do men make a move and help yourself since no one may do it for you.  Help yourself its June make a change for the best in your health!

“Cataracts affect more than 20.5 million Americans age 40 and older, and 6.1 million Americans have had cataract surgery.  Prevalence of Age Related Macular Degeneration-AMD increases with age. For people age 80 and older, approximately 3 in 10 Americans have early AMD and 1 in 10 have late AMD.”

American Academy of Ophthalmology (https://www.aao.org/newsroom/eye-health-statistics)

Medications that can cause Cataracts:

Certain medications are well-known causes of cataracts, and some drugs can also accelerate their development. Steroid medications – whether pills, injections, or eye drops – are most frequently associated with cataract formation. If you are taking steroid medications to manage a long-term condition, it is important to note any visual changes and to have your ocular health managed by a qualified ophthalmologist. The medications that can cause cataracts include:  Corticosteroids, Eye drops containing steroids, Glaucoma medications, Certain antipsychotics and antidepressants, Certain medications for autoimmune conditions, and Medication to control heart arrhythmia

Signs and Symptoms of Cataracts:

You may not have any symptoms at first, when cataracts are mild. But as cataracts grow, they can cause changes in your vision. For example, you may notice that:

• Your vision is cloudy or blurry
• Colors look faded
• You can’t see well at night
• Lamps, sunlight, or headlights seem too bright
• You see a halo around lights
• You see double (this sometimes goes away as the cataract gets bigger)
• You have to change the prescription for your glasses often

These symptoms can be a sign of other eye problems, too. Be sure to talk to your eye doctor if you have any of these problems.

HOW YOU CAN PREVENT CATARACTS:

Maintaining healthy eating habits can help to prevent cataracts in two ways. First, a good diet will control your weight, thus eliminating one of the significant risk factors. Second, increasing your antioxidant intake can also inhibit the oxidation process. In a 2013 Swedish, researchers observed 30,000 women over age 49, and found that those who consumed the highest amounts of antioxidants had a 13 percent lower chance of developing cataracts than those who consumed the least amounts.

To reduce your risk for cataracts, be sure to eat plenty of foods high in antioxidants.

TREATMENTS FOR CATARACTS:

“June is Cataracts Awareness Month. As the year nears its midpoint, aging adults are advised to pause and learn more about a vision-worsening condition that occurs around age 40 when proteins in the eye lens begin to break down, clump and form a cloudy area over time. Cataracts affect 70 percent of adults by age 75, and recent CDC data* indicate more than 17% of adults above age 40 have a cataract in one or both eyes.

Risk factors linked to early development and quicker progression of cataracts include excessive sunlight exposure, smoking, and long-term use of steroid medication. Medical conditions linked to higher risk include diabetes, obesity, high blood pressure, and prior eye surgery or eye injuries. Aging adults should discuss their health behaviors and history with their eye specialist to evaluate risk for developing cataracts and other age-related eye diseases to prevent blindness.”

UNC school of medicine / school of medicine ophthalmology (https://www.med.unc.edu/ophth/2023/06/june-is-cataracts-awareness-month/)