True underdevelopment of male genitalia is rare

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DEAR DR. ROACH: Can you give any reason why a penis wouldn’t grow or form like it is supposed to? My penis is undersize. It is not regular size for a man. I’d just like to know what could cause this. -- V.P.

ANSWER: I hear this question frequently, and most of the time when I perform an exam, the penis size is in the normal range (I examine a lot of men, and have a better appreciation of normal variation than most). However, there are medical conditions that can cause male sexual organs not to develop properly. The most important is failure of male hormones to work at the time of puberty, so in that case, many male characteristics are decreased or absent, including facial and body hair and deep voice. Both the penis and testes will be small. However, it is very unusual for this to go unrecognized and untreated into adulthood.

Many men are embarrassed to ask about this, but please do see your medical provider and get an exam. Let me just add that you should ignore advertising about penile enlargement, as there are no treatments I know of that are both safe and effective.

DEAR DR. ROACH: I am 60 years old, and for years have had trouble with a Bartholin cyst on one side. It is sore in that gland again, after taking turmeric for two months. It would bother me whenever I took hormone replacement a few years ago. Is it normal to still have trouble at this age? It doesn’t get big anymore, just sore sometimes. -- M.L.R.

ANSWER: The Bartholin glands are small structures located in a woman’s vulva. They secrete fluid that acts as a lubricant during sexual activity. The most common problems with Bartholin glands are cysts and abscesses. If these are symptomatic, they usually are treated with drainage, performed by a woman’s health specialist, usually in the office.

Bartholin glands normally get smaller after menopause. I could not find any reports of, nor any reason why, turmeric might make a Bartholin cyst abscess more likely (turmeric can act as an anti-inflammatory, and appears to have some anti-estrogen activity, so I wouldn’t expect it to cause problems). The one concern I have is that although cancer of the Bartholin gland is very rare (0.001 percent of cancers in women), it can happen. I would suggest that you get an evaluation.

DEAR DR. ROACH: My friend refuses to get a flu shot because he says it has mercury in it, which builds up in the body. Is this true? -- M.A.S.

ANSWER: Some flu vaccines do contain a preservative, when they come in a multidose vial. This is to prevent contamination of the vaccine, something that can lead to serious infection. The preservative, thimerosal, has a small amount of ethyl mercury, which the body is, in fact, able to get rid of and which does not build up in the body the way methyl mercury can (that’s the kind that is consumed in some fish, such as tuna). Neither of these is elemental mercury (the kind in a thermometer), which can be dangerous when its fumes are inhaled.

The chemistry is important to understand. For example, cobalt metal can cause nerve and heart damage, but cyanocobalamin is an essential cobalt-containing vitamin, commonly known as B-12.

There is no reason to be concerned about the tiny dose of thimerosal in a vaccine, but people can get a thimerosal-free single-dose vaccine as a prefilled syringe or vial.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.

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