QUICK TIP:

Forget the boxers versus briefs debate. Men who want to boost their fertility should ease up on the hot showers and avoid saunas and hot tubs, since hot water both kills and damages sperm. Even an occasional hot shower is enough to reduce a man’s fertility for up to 74 days — the time it takes for his body to make fresh, healthy sperm.

FAST FACT:

A Roper Organization survey found 35 percent of America men say they deal with depression by watching TV.

f you're a middle-aged or older man who's going to the bathroom more often, guess what? Your prostate alone may not be to blame.

Until very recently, bladder and urination problems in older men were automatically assumed to be due to an enlarged prostate, specifically a noncancerous condition known as benign prostatic hyperplasia, or BPH. Treatment for BPH consists of prescription medications to shrink or relax the prostate gland or else surgery to reduce its size.

The prostate is a walnut-sized gland that lies just below a man's bladder and next to the urethra (the tube that carries urine from the bladder). Its function is to produce fluid to contain and nourish semen. Age, hormonal changes and disease can cause the prostate to enlarge, partially or completely obstructing the urethra and causing problems with urination.

In many cases, however, doctors are finding that bladder problems — not BPH — are causing their patients' chronic urinary symptoms. It's believed that when the prostate compresses the urethra and obstructs the flow of urine, the bladder may not empty completely. Because of this, the bladder muscles grow stronger in order to overcome the obstruction. The end result is that the bladder becomes harder to control, even if the prostate size is subsequently reduced.

Going Problems

Urinary difficulties are described differently, as either "obstructive" or "irritative," depending upon the exact problem being experienced. Specifically, obstructive problems are…

Hesitancy — It takes longer to start urinating.
Intermittency — The flow stops and starts repeatedly during urination.

Irritative problems, meanwhile, are classified as…

Urgency — a strong, sudden need to urinate
Frequency — needing to go to the bathroom often
Nocturia — an excessive need to urinate at night

(Note: Irritative problems also can be the result of obstructions.)

If a man is having difficulty urinating, the first step is usually a digital rectal examination in which a doctor inserts a gloved finger into the rectum and feels the prostate to determine if it is enlarged. This exam can occasionally be misleading, however, since the prostate also can swell inward, rather than outward. It's in this latter case that the urethra becomes compressed and urinary or bladder problems can develop.

For men with urinary problems, doctors usually start by checking for infection and ordering a PSA blood test. If there's no evidence of infection, the next step is prescribing prostate medication. If it resolves the problem, the cause is assumed to be BPH. If it doesn't, a course of bladder medications may be prescribed.

Most men with obstructive and irritative urinary problems get some relief from BPH medications. A study reported in The Journal of the American Medical Association, however, found that a combination of BPH drugs and a newer drug for overactive bladder (tolterodine, brand-name Detrol), provided even greater relief for these patients. Study results state that 80 percent of men who received combination drug therapy, rather than prostate or bladder medications alone, experienced improved urination.

ondoms can not only help prevent pregnancy, they also can help protect users against many sexually transmitted diseases (STDs). You can boost the odds that the condom you choose will do both by... (continued)