glans sensitivity

The glans (glands) on my penis is overly sensitive up to, during and after orgasm. Any friction just before orgasm is uncomfortable and, obviously, diminishes sexual pleasure. The glans (glands) is also a little red at the top/front side (but not on the sides) - I also experienced discomfort from friction when wearing loose underwear (so I started wearing underwear with 5% spandex). I've only noticed this sensitivity with the last 8 months or so (before that I had never noticed any problem). I have never had sex. I'm circumcised. Also, before and during orgasm the head of my penis gets much bigger, and then, almost immediately diminishes a lot in size (although my penis is still erect) - at this point I notice white lines, like dryness, and after a few minutes they disappear. What could these symptoms indicate? What could be causing the problem? I'm worried that sex will be uncomfortable. Please help. Any suggestions would be immensely appreciated.

[Bhupinder Kaur, MD]

Hello,
From the symptoms it looks like friction rub to me. It occurs when the skin becomes irritated by the friction caused by rubbing – either against other skin or against a foreign material. Wash the areas several times with fresh water. Do not use any cosmetic products at the sites. You can apply some calamine lotion at the rash as it will help in soothing the skin. Also wear cotton undergarments. Application of mild corticosteroid cream and oral antiinflammatories like ibuprofen/acetaminophen are also helpful. If the symptoms are severe then it will be best to consult a dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[jesse123454321]

Thank you for your help. I notice that 100% cotton causes more friction than stretchier underwear (it allows more movement) - should I still stick to 100% cotton? The area is not inflamed, just a little bit reddish - would corticosteroid cream still help? I've noticed these symptoms (the main symptom being sensitivity) for many months now - could the problem be something other than a friction rash? (or can rashes last that long?)

[Bhupinder Kaur, MD]

Hello,
You can wear any breathable cloth through which sweat does not accumulate. If there is any itching then fungal infections causing balanitis ruled out. This can be confirmed by KOH examination of the skin scrapings and a skin biopsy done. If it is a fungal infection, then you may need topical and oral antifungals.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.