Armor Men's Health Show

EP 645: Big Balls and Big Anxiety: Dr. Mistry Explains What Your Testicle Size Means and How Adrenaline Affects Your Erections

• Dr. Sandeep Mistry and Donna Lee

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In this segment, Dr. Mistry and Donna Lee answer listeners' questions about testicle size and ED following sexual inactivity in older age. If you've ever wondered if your "balls" are bigger than average, or if it's too late to start ED medications, this episode is for you! Tune in to learn what a hydrocele is, how sexual activity can influence erectile dysfunction, and why knowing their patient's sexual history can help urologists better treat ED.

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode.

Phone: (512) 238-0762

Email: Armormenshealth@gmail.com

Website: Armormenshealth.com

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Speaker 1:

<silence>

Speaker 2:

Welcome back to the Armor Men's Health Hour with Dr. Mystery and Donna Lee.

Speaker 1:

Hello

Speaker 3:

And welcome to the Armor Men's Health Hour. I'm Dr. Mr , your host joining you today from Austin, Texas. I'm here with my co-host Donna Lee. That's

Speaker 4:

Right. Hello. Happy day To everybody out there.

Speaker 3:

If you're new to the show, Donna Lee is in fact a professional comedian.

Speaker 4:

I was, in fact, yes. On Nick at night search for the funniest mom in America. Number seven. I'm seventh funniest mom in the

Speaker 3:

World. And sometimes you're still looking for the opportunity to do a little standup act.

Speaker 4:

I am . We have clubs opening now again in Austin, so maybe I'll appear at one of them . <laugh>.

Speaker 3:

So Joe,

Speaker 4:

I could beg him . I have to call and say , can you please let me

Speaker 3:

Work <laugh> ? I'm hoping Joe Rogan is a , is a listener to our podcast in our radio show. I

Speaker 4:

Hope so, because maybe he'll throw a bone and you and I can do a little funny

Speaker 3:

And do and do a , a little standup at his new comedy show. Mm-hmm. <affirmative> .

Speaker 4:

That'd be amazing. Let's

Speaker 3:

Do it. That's awesome. This show is brought to you by N a u Urology Specialist. That's the urology specialty , uh, clinic that , uh, started in 2007. We have four physician providers. We have five physician assistant providers. We have three pelvic floor physical therapists. We have a sex therapist, and we have an amazing , uh, sleep , um, apnea , uh, management and testing program.

Speaker 4:

And you have one Donna Lee

Speaker 3:

And one Donna Lee . Mm-hmm. <affirmative>.

Speaker 4:

And your name is by the way, m i s t r y. If you would like to Google him.

Speaker 3:

Yes.

Speaker 4:

You like the Googling

Speaker 3:

<laugh>?

Speaker 4:

He's doing it all the

Speaker 3:

Time. I Google myself all the time . <laugh> . Um, this is a show in which we talk about men's health issues and , uh, your questions are the kind of thing that that drives this show. Uh, so we really appreciate you sending in your questions. Uh, we are seeing patients , uh, we are , uh, actively , uh, still seeing all patients that are new with all sorts of insurance. So if you , uh, have an issue that you'd like to get a second opinion on, or you'd like to have a men's health issue that we has not been addressed, you know, to your satisfaction , uh, we see them all the time, all day , uh, all week. Mm-hmm . <affirmative> . And so Donna, how do people get ahold of us and where are our locations? We

Speaker 4:

Are located in Round Rock, north Austin, south Austin, and Dripping Springs. If you're on the other side of the world, that means nothing to you. Just know we are in the best part of the whole country to live in our number's. 5 1 2 2 3 8 0 7 6 2 . Our website is armor men's health.com, and you can send your questions to Armor Men's health@gmail.com that we will answer anonymously. And you know, we have a lot of podcast listeners. They're not just the radio show listeners and they're listening from all over the

Speaker 3:

Place. Well, I'm so glad. Do we have any questions from one of them? We do

Speaker 4:

Have one of them. He's listening from , uh, across the state actually. He says, hi, I've been a regular listener to your weekly podcasts for years now and look forward to them each week. You've become my go-to for men's health issues. I have a question that perhaps can be discussed for myself and others. I'm a very fit 61 year old man, no major health issues and only take meds to keep my blood pressure in check. I do, however, have what I consider larger than average testicles. I've never had any test testicular pain injuries or detected any abnormalities when doing my self exams . But visually, the boys quote , boys seem very large. Even as a teen, I was aware that my scrotum and testicles were larger than others in the locker rooms and have always been very self-conscious about this. I've just heard, I've just learned how to cope with them by shifting them around when sitting or working out, just wondering if it's normal to have larger testicles and could they be something that I should be concerned with in my future years?

Speaker 3:

Well , it's a really great question. Mm-hmm . <affirmative> , because , uh, we often , um, it's got big balls. We'll see people, we'll see people , uh, that come to us for smaller than average testicles, whether they be from fertility concerns or prior trauma or prior surgery , uh, or because the abuse of medications, the most common reason would be testosterone use does shrink the balls to

Speaker 4:

Make them smaller. It does

Speaker 3:

Make them smaller. What

Speaker 4:

Makes them bigger? Is there a medicine that might make them bigger? Well, no, he's had this his whole life.

Speaker 3:

Yeah. So he is , had his whole life. So , um, if you're looking at your testicles mm-hmm . <affirmative> , and you're measuring them , um, you don't really want them to be bigger than two of your knuckles. So if you use your, if you use your , um, your index finger, you just want to go to the second knuckle, and that should be about the biggest that your testicle really is. Okay. Now, of course, if you have small hands or anything ,

Speaker 4:

Whatever , I have big hands, I'd have really big balls, I think. Right. Are you

Speaker 3:

Looking, actually, I've heard , I've heard that about you, <laugh> . So , um, and , and so that , that's , uh, that's about four to five centimeters in length. Mm-hmm . <affirmative> from top to bottom. So if it's bigger than that mm-hmm. <affirmative> , then it could be that that's not just the testicle. You could have something called a hydros eal , and that means that around the testicle there's a sack. Right . And that sack can fill with fluid, fluid

Speaker 4:

For that long, for his whole life. For

Speaker 3:

Sure. If nobody knew about it. No . You know, no . And it can be just enough fluid to not be overly noticeable to a doctor, but just noticeable to the patient. So , um, a small hydros seal would be probably be the most common reason to have larger than normal , uh, testicles. Mm-hmm. <affirmative> tumors are unlikely to be present for that long of a time, but there is put some types of tumors or cysts of the inside of the testicle or the EPIs mm-hmm . That can give the testicle a very large size. Mm-hmm . So if somebody has abnormally large testicles, I think doing an ultrasound, which has no radiation covered by insurance and is painless answers almost all of those questions. It tells you whether your testicles in the normal range, because you'll get the size. Okay . It'll tell you if there's fluid around the testicle. It'll tell you if there's cysts or there's anything going on , uh, like in the epididymus.

Speaker 4:

And where's

Speaker 3:

That, that is a little worm-like organ that lives right next to the testicle, and that's where the sperm gets stored. Mm-hmm . <affirmative> . So sometimes men who've had a vasectomy mm-hmm. <affirmative> and the sperm builds up in the testicles, they'll notice mm-hmm . <affirmative> that their testicles are a little bigger, their epi is a little bigger, and that can cause some swelling

Speaker 4:

And pain.

Speaker 3:

It can cause it pain, but most people do not have pain. Gotcha . But what's happening here is his , his nuts are getting stuck between his legs when he is working out and that's causing him discomfort. So that's big balls.

Speaker 4:

Yeah.

Speaker 3:

But let me talk to you about big scrotums. Oh ,

Speaker 4:

Okay. So

Speaker 3:

Sometimes people just confuse the words and confuse what's going on. So Yeah . I don't know. The nuts in the sack are , are your testicle. Right. But if the sack is real big mm-hmm . <affirmative> , it can start hanging down and that certainly gets worse as you get older. Right. That sounds annoying. I mean , we see some and you're like, man, they must be banging to your knees. That's a really low hanging fruit there. <laugh>

Speaker 4:

Women have a boob problem like that start sagging .

Speaker 3:

That's right . Things start sagging. Okay. So we actually have a repair for that. So , um, Dr. Dellinger, who's one of the plastic surgeons on this show that we work with all the time, he and I have to do these scrotal lifts, not infrequently like

Speaker 4:

Scrotox with some Botox up in there.

Speaker 3:

We don't do it with medicine this time where you like cut it out . There's actually a technique. It's called the diamond technique. Is

Speaker 4:

It like a facelift for your Totally to your , for your

Speaker 3:

Totally poopoo . Okay . And it , and it tucks everything ups, so it doesn't get in between your legs. And it's , um, I , most urologists can do them. Uh, the problem with the procedure is that because the scrotum hangs down, the gravity sometimes pulls the stitches apart. Oh . So if you get it done, you'd prefer to get it done by somebody who knows what they're doing. So they just put a lot more stitches in there that doesn't pull apart.

Speaker 4:

Oh , are the stitches underneath?

Speaker 3:

They're they

Speaker 4:

Tucked up and underneath.

Speaker 3:

They don't. They just, well , essentially all you do is you just take the extra scrotal skin out and it just kind of tucks everything up. Okay. It's a relatively painless , uh, it can be covered by insurance. If somebody is like really kind of, you know, kind of tricky about how they code it, but probably doesn't cost more than, you know, three grand to get a really nice scroop plasty done. Mm-hmm. <affirmative> . And , uh, it can really help alleviate this issue. And as you're getting older, and if you're getting more active, the tissues just seem to get thinner and more stretchy. Mm-hmm. <affirmative> , uh, you're gonna get a lot more veins in them . So we see a lot of veiny scrotums.

Speaker 4:

This is very unattractive sounding.

Speaker 3:

Well , I mean, I don't know. Women, women never really comment on how attractive a scrotum is.

Speaker 4:

Never. 'cause you guys don't have pretty parts. We have pretty parts <laugh>.

Speaker 3:

I really think this is a sexist kind of conversation. <laugh> scrotum is amazingly versatile

Speaker 4:

And it's versatile, but it's not pretty.

Speaker 3:

Well, I'll tell you , sometimes we take Bull scrotums and put 'em on our desk and put candy beans in them.

Speaker 4:

Oh , do we ?

Speaker 3:

I just said , I just said candy beans, <laugh> . I don't think that's a thing. <laugh> . It's a candy bean jelly beans <laugh>

Speaker 4:

Candy bean

Speaker 3:

<laugh> . If anybody looking for a gift for me,

Speaker 4:

Please bring a massive some candy beans , a

Speaker 3:

S girdle sack for what Some candy beans are my way to go. <laugh> , if you have questions about things that you have had for a long time or wondering if they're normal, we would love to answer them for you. And if you want any of these big ball issues prepared, that's something certainly we can, we can help you take care of. If you're having to readjust yourself so that you're not squeezing your balls between your legs, please come and see us. We would love to take care of it for

Speaker 4:

You. Please bring us some candy meat <laugh>.

Speaker 3:

How do people get ahold of us?

Speaker 4:

<laugh> , you can call us at (512) 238-0762. That was so enjoyable. Um, our website is armor men's health.com and our email address for these questions that are amazing that we will answer anonymously is Armor Men's health@gmail.com. We're located at Round Rock South Austin. North Austin and Dripping Springs. Listen to our podcast wherever you listen to free podcasts and you'll learn something. For sure.

Speaker 3:

For sure.

Speaker 4:

Thank you.

Speaker 3:

Hello and welcome to the Armor Men's Health Hour. I'm Dr . Mystery , your host here with my co-host, the Ever Present , ever Wonderful Donna Lee ever

Speaker 4:

Present . Is that a thing? That's right. It's

Speaker 3:

Like thing I'm ever present . It's like showing ups half the battle. Hey,

Speaker 4:

You're here again. <laugh> . Welcome to work.

Speaker 3:

It's half the Battle <laugh> . I'm a board certified urologist. This is a men's health show. This show is brought to you by N a u Urology specialists, or we have been in practice since 2007, almost coming upon our 13th magical year here in Austin.

Speaker 4:

You know, 13 is our lucky number at home. Well, when we go to Vegas, we bet on 13 all the time.

Speaker 3:

That's right. And

Speaker 4:

We win big.

Speaker 3:

Well, you're still coming to work, so maybe you're not winning too big.

Speaker 4:

You have to come to work to finish off

Speaker 3:

That maybe's a lucky number for me so that <laugh> , if you got rich, you wouldn't come to work anymore. <laugh> .

Speaker 4:

Okay, good point.

Speaker 3:

Uh , uh, our urology practice is dedicated to the treatment of both men and women , uh, for , uh, a variety of urologic needs, including kidney stones, bladder cancer, prostate cancer, you know, things that deal with the, the body from the belly button to the knees. Let's just say knees. Oh , or just above. Above the knees, below the belly button. We have , uh, four amazing , uh, physician providers. We have four amazing physician assistant providers. We have in-house sex therapy, in-house , um, uh, physical therapy and biomechanical therapy. Sweet . We in-house nutrition, in-house sleep, because we really care about you from your head to toe. Mm-hmm . Even though we only really take care of your belly button to your knees. The

Speaker 4:

<laugh> , the midsection. That's

Speaker 3:

Right. Just the midsection. Oh boy.

Speaker 4:

The Dingling and the Yum Yums. Oh

Speaker 3:

Yeah . That's the most important. <laugh> . If you had a bullseye on what our most important part of the body is, at least we know <laugh> . Donna, how do people get ahold of us? You

Speaker 4:

Can call us during the week at 5 1 2 2 3 8 0 7 6 2. We have a new website, Dr . Mystery . Well , we have an old website, but we combine some websites. So now it's a little different for people to get ahold of us. So they have to go to our website, north austin urology.com, and they have to click on the podcasts. So we have a podcast link. How exciting.

Speaker 3:

That's right. We we're podcast able ,

Speaker 4:

We're podcast able , as we like to say. So you can send us questions through our website. You can also continue to send your questions to Armor Men's health@gmail.com, which we respond to all of them we respond to. And we do have some questions today. So

Speaker 3:

Those questions and your engagement as our listeners, that really mean a lot to us. I don't know . I think a lot of my friends are lying when they say they're , they're listening to us. You think?

Speaker 4:

Yes. But who's , who's listening to the

Speaker 3:

Podcast? Everyone says they're always listening to me all the time. <laugh> everyone. I think they know that my ego is really fragile.

Speaker 4:

Oh , well, mine is now too. Thanks. Well ,

Speaker 3:

There you

Speaker 4:

Go. <laugh> . I went to look at our downloads. I was a little sad. I was like, oh , wasn't the thousands I was expecting. That's right.

Speaker 3:

No , not this week. Not this week. Well, let's spice it up, lady

Speaker 4:

<laugh>. Oh boy. I do have a question. Yeah, let's do it. Um, this one a little made me a little sad, so I'm gonna respond to this guy. He wanted to make a long story short, Dr. Mystery , I've been inactive sexually, so sexually inactive most of my life. In my early thirties, I had no problems getting aroused and having erections. However, invariably I went soft. This had nothing to do with losing interest. And then he said, I think I tried five or six times around that time when I was in my forties. I actually was in a relationship for several months due to religious reasons. We only had sex three or four times. The same thing happened. There was, there was no guilt related to my faith, nor did I lose interest during the act. Now he's in his sixties. He's wondering if Viagra would be useless now or do you think that there's promise there? Well ,

Speaker 3:

I think that's a great involved question that has several components to it. Although I'll try to address what this listener is asking. Um, I'm gonna start from the, just kind of the progression as he was going through his life. Mm-hmm. <affirmative>. So young people who are not sexually active, whether it be for religious reasons, self-esteem issues, anxiety issues. Mm-hmm. <affirmative> , those are things that we really pick up on here in our clinic. Many people, when they're going through a sexual history, if they ask the patient, are you sexually active? And they say, no, they may just stop there, but we are , are the kind of practice to say, why not? Right. You know, if you're a 27 year old healthy man or woman and you're not sexually active, and if it's for religious reasons or because you're not married or because you've chosen, chosen that, then that's, you know, that's fine. Right. But if it's because you have a sexual issue that you don't want to talk about or embarrassed to talk about mm-hmm . <affirmative> , that's something else. Gotcha . So in , in , in this case, it seems like what we have is a person who is not very sexually developed, not very sexually experienced, and then to try to try to start becoming sexually experienced in your thirties. Mm-hmm . <affirmative> , when you're with a sexually experienced partner causes tremendous subconscious anxiety, stress . Oh boy. For sure. There's no getting around it. I can't imagine. And , and in our physiology , uh, as, as humans, the one thing that kills an erection more than anything is , uh, a very strong dose of, of epinephrine. So when it's, its part of our fight or flight. Right. I mean, could you imagine if like a tiger was chasing us and you're

Speaker 4:

Trying to have an orgasm

Speaker 3:

And you had an erection, it would be the worst thing. You know, <laugh> , you know, James Bond is never really, you know, they're doing the things afterwards, not like in the middle of the Ja you know, what a confusing feeling. That's right . That's right. This is confusing. The , the anergic , uh, response of having that epinephrine course through our body, coming from our adrenal glands when we're having a fight or flight response. Mm-hmm. <affirmative> . That's why sometimes when you're just start losing an erection and you get really worried about it and you try to push harder, you know , uh, and so that's where we need that slide whistle. That Oh , And that's what's gonna happen. You're gonna have difficulty maintaining that erection. Then you, then you move to forties. Now you're in a committed relationship. You have nothing that's really kind of getting in the way of it, but now you start getting Ed mm-hmm . <affirmative> age related ed. Right. Which just seems unfair. You never got to use the thing in the first place. Right. And so , and now whether Viagra's gonna work or not, it almost certainly is likely to help tremendously, but to just throw a pill on the problem, right. That has existed for 40 years Right. Is unlikely to overcome kind of the deeper set issues.

Speaker 4:

Um , so the patient did reference though , uh, is this a more appropriate question for a sex therapist?

Speaker 3:

Well, I think that's a lot. Like , um, if your , um, lights are flickering mm-hmm . <affirmative> , and you call an electrician mm-hmm . <affirmative> , they're gonna say it's an electrical problem. If you call a carpenter, they may think that something's wrong with the substructure of the house. If you call mm-hmm . <affirmative> , you know, a , uh, a horoscope specialist, they're gonna tell you that your , your planets are not. So kind of , you're gonna get the answer from the, the type of practitioner you're going through. Right. So when you come to us, that makes sense. We have the sex therapist here. We have a pelvic floor physical therapist here. Mm-hmm. <affirmative> , I'm gonna handle your hormones and your, and your physiology. So whether your erectile issues or your ability to maintain your erection is neurologic. Mm-hmm. <affirmative> , hormonal, psychological , um, or vascular, which is blood flow. Mm-hmm. <affirmative> , you're gonna get a, an appropriate evaluation here. Mm-hmm . <affirmative> . So it's not either or, it's, and, okay. And so getting a sex therapist involved for this longstanding sexual dysfunction, along with understanding that at age 60, now there's going to be a variety of physiologic medical issues that are affecting you, I think is really important. Low testosterone, you know mm-hmm . <affirmative> impaired blood flow. And , uh, you know, let's, let's, you know, come on in. Let , let's, let's try to help make your sixties, you know, kind of that, that magic time. Um, the , the , the listener didn't say it, but I'm gonna guess it. Mm-hmm. <affirmative> , he probably never married.

Speaker 4:

I don't think

Speaker 3:

So. He doesn't have any children. Yeah . Yeah. So the kind of amazing like impact this has had on the course of his life mm-hmm. <affirmative> , uh, is, is tremendous. And so , um, for those of you out there that may be , you know, quietly suffering from a similar kind of condition mm-hmm. <affirmative> , you know, I try to encourage so many younger people to address these things when they're able to , uh, you know, alter the course of their lives. Right . We meet people from Asian countries , uh, immigrants often who may have grown up with , uh, different types of attitudes towards sex, and then they're forced into arrange marriages, for example. Right. And then they come and see us because they can't get pregnant. Yeah. They can't get pregnant because they've never had sex. You

Speaker 4:

Know , that was the marriage I needed.

Speaker 3:

<laugh> . Oh God . Don <laugh>

Speaker 4:

<laugh>

Speaker 3:

Course . Poor Michael . Poor Michael. Uh , so , um, uh, yeah. May maybe , yeah , maybe you should sign up for one of those. You know what I'm saying? It's not too late. Yeah , that's right.

Speaker 4:

Oh, I'm sorry, Michael. Oh, by the way, he wants to be on the show to defend himself.

Speaker 3:

He's gonna defend himself. Okay. <laugh>. He's gonna defend himself. I don't think we have, I don't think we have an option. <laugh> . Oh, boy. Well,

Speaker 4:

That's insightful. I felt really sad for him when I read that question. And I , I hope that he comes in, so I'll reach back out to him.

Speaker 3:

Well, that's a , uh, that's a great question. We, we really look forward to your questions. I think they give us a lot of , um, inspiration in our own practice to continue what we're doing. Mm-hmm . <affirmative> in the kind of way that we're doing it. Because , uh, I think that if you go somewhere and have such a complex scenario, or don't share your scenario with your doctors mm-hmm . <affirmative> , they know it's complex, then you know, all the Viagra in the world is only gonna , um, uh, give you a headache and , uh, change the blue-green , uh, outline of lights instead of Right . Really helping you get to the underlying issue. And

Speaker 4:

How brave was it for him to ask

Speaker 3:

That ? That was amazing. That was really , so thank you so much for that question a Donna . Mm-hmm . How , how do we get more brave questions?

Speaker 4:

You can send your brave questions about those lines chasing you while you're having an erection to Armor Men's health@gmail.com. That's Armor Men's health@gmail.com. You can visit our website north austin urology.com. Um, you can also still visit armor men's health.com and you'll just be given a whole beautiful blue website full of information and knowledge about the middle part of your body. Uh, call us at (512) 238-0762 during the week. You can ask for me. I'm happy to help. And , uh, we're located in Round Rock where Dr. Misery started 13 years ago. North Austin, south Austin , and Dripping Springs. And Dr. Misery is his real name. M i s g r y. Somebody called us zany the other day.

Speaker 3:

Well, better than gimmicky <laugh>.

Speaker 4:

We'll be back with our zany show.

Speaker 2:

The Armor Men's Health Show is brought to you by N a U Urology Specialist. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com .