Penis Exam: When to Get One & What to Expect

If you wince at terms like spermatic cord and epididymis, the idea of having a medical professional examining your genitalia likely seems a bit awkward. However, a penis exam can help your doctor screen for problems like cancer or sexually transmitted infections, and there’s likely nothing you have that they haven’t seen before.

Whether you’re dealing with pain, erectile dysfunction, or some sort of infection, sucking up the potential awkwardness and seeing your healthcare provider is usually your best option.

Don’t worry if you’re dreading your appointment and don’t know what will happen. Below, we cover what to expect from a penile exam, what it can screen for, and what might happen after a male genital exam.

We’ll also share some treatments for erectile dysfunction (ED) — a popular reason for getting a penis checkup and one you might have some questions about.

You’ve likely already had a comprehensive physical exam at some point where a doctor checks aspects of your health such as your body weight, blood pressure, and heart rate.

Unlike full physical exams, penis exams are quick, targeted checkups for your genital region and male reproductive system. Although, your healthcare provider may combine a penis examination with an overall physical exam. If this exam is not performed, you can request it. 

A penis exam might also be done by a specialist called a urologist, especially if there’s a particular issue that requires more comprehensive screening. A urologist is a doctor who specializes in your urinary tract and reproductive system.

If the idea of having a doctor poke around down there seems awkward to you, that’s understandable.

Research suggests men often prefer seeing a same-sex urologist rather than a urologist of the opposite sex, largely due to feelings of embarrassment or feeling like a person of the same sex may understand their body better. 

In a 2022 study from Germany, researchers surveyed roughly a thousand people (of which a quarter were male) on their preferences when choosing a urologist.

The researchers found that 43 percent of males felt a same-sex urologist understood their body better, while fewer than 2 percent thought a female urologist understood their body better (the remainder reported no preference).

Because “penis exam” isn’t really an official procedure, you can assume having your penis examined will include a broader assessment of your entire reproductive and urinary systems.

A general examination of your genitals will screen for many problems that develop in your penis or the structures around it such as:

• Penile cancer

• Yeast infections

• Parasites like pubic lice

• Erectile dysfunction

• Hernias

• Urethral tract infections

• Cysts or lesions

• Sexually transmitted infections (STIs)

• Undescended testicle (when a testicle doesn’t move down into your scrotum)

• Orchitis (testicular swelling and inflammation)

• Phimosis (inability to retract the foreskin)

• Varicocele (enlarged veins in the scrotum)

• Hydrocele (swelling in the scrotum)

• Hypospadias (when the urethra opening isn’t at the tip of the penis)

That’s just a short list of what a urologist can effectively look for. Now, let’s take a look at how they’ll do the screening.

Your healthcare provider will want an unobstructed view of your penis so they can accurately check for any visible abnormalities or deformities.

Ideally, a male genital exam is performed while you’re standing with your underwear off, your penis flaccid, and your healthcare provider sitting in front of you. The exam may also be carried out while you’re on an exam table.

Review of Medical History

Your healthcare provider will likely start the penis checkup (while you’re still clothed) with a general review of your:

• Personal medical history

• Family medical history

• Sexual history

Gathering this information helps your doctor narrow down your diagnosis if you’re coming in with complaints of a specific problem. For example, if you’ve had multiple sexual partners in the recent past, your doctor will probably be more likely to suspect an STI than if you weren’t sexually active.

Observation

Once your healthcare provider collects your medical history, they’ll likely visually examine your genitals for any abnormalities. They’ll examine your penis, pubic hair, testicles, and other nearby structures.

Some of the problems they may be able to see include:

• Herpes

• Warts

• Fungal infections

• Ulcers

• Friction burns

• Pubic lice

If you’re uncircumcised, your healthcare provider may pull back your foreskin to examine the glans (head) of your penis.

Penile Exam

Key parts of your penis will be examined for abnormalities, including your:

• Foreskin: Your foreskin is the flap of skin that covers the tip of your penis. It’s removed in circumcised men.

• Glans: The glans of your penis is the spongy head at its tip.

• Shaft: The shaft of your penis refers to the area between your pelvis and its spongy head.

• Urethra: Your urethra is the tube that carries urine from your bladder to the outside of your body. It also carries semen when you ejaculate. Your healthcare provider might swab your urethra to test for STIs such as gonorrhea.

Testicular exam

To screen for testicular cancer and other issues, your healthcare provider will feel one testicle at a time with their fingers and thumb, checking for lumps or abnormalities in their shape.

It’s normal to have one testicle that hangs a little lower than the other one.

During a testicular exam, your healthcare provider will also check structures such as your:

• Scrotum: Your scrotum is the pouch of skin that covers your testicles.

• Epididymis (sperm duct): Your epididymis is a coiled structure attached to each testicle where sperm cells mature.

• Vas deferens: Your vas deferens is a long tube that carries sperm out of your testicles.

• Veins and arteries: A bundle of veins and arteries connect your testicles with the rest of your body.

• Spermatic cord: Your spermatic cord is the rope-like structure that connects your testicles to your body. It contains structures such as veins, arteries, and your vas deferens. 

Aside from your prostate, most other structures are too deep to be examined during a physical exam. If your healthcare provider suspects a problem with deeper structures, they may order imaging like an ultrasound.

Prostate Gland Examination

If your urologist or GP suspects a problem with your prostate gland such as prostate cancer, they may perform a digital rectal exam. During this part of the examination, they insert a gloved finger into your anus and rectum to feel if your prostate is swollen or abnormally shaped.

The rectal exam is often the least looked-forward-to part of the appointment, but it serves double duty as a screening for problems such as: 

• Anal warts

• Hemorrhoids

• Fissures in that region

The American Cancer Society recommends men have a discussion with their healthcare provider to make an informed decision about prostate cancer screening. Usually, an annual prostate exam is recommended starting at age 50 for men at average risk of prostate cancer.

What happens if you get hard during a physical exam?

We’re all human, and every male's anatomy basically works the same way. Even if you’re not thinking sexual thoughts, stimulation to your genitals during a penis exam can increase blood flow and lead to an erection.

Although you may find this embarrassing, your healthcare provider has probably experienced this before and your erection will likely go away shortly.

Unlike many cancers, testicular cancer primarily develops in younger men. The average age at which it’s first diagnosed is around 33. Cure rates are very high when it’s identified and treated early.

Most healthcare professionals suggest carrying out regular self-examination to monitor any changes to your testicles. This DIY inspection should be done at least once a month.

It’s usually recommended to perform the exam during or shortly after a warm shower. Your scrotum relaxes in hot water, which can make it easier to feel changes in your testicles.

You can perform the exam by:

1. Holding your penis out to one side and examining each of your testicles separately.

2. Holding each testicle between your thumbs and fingers with both hands and rolling your testicles gently between these fingers.

3. Feeling for any hard lumps or round masses as well as changes in your testicles’ size, shape, or consistency.

If you find anything concerning, it’s important to see your healthcare provider. They can either reassure you that it's nothing serious or start the treatment process for problems that may be serious.

If you think you might have erectile dysfunction, your healthcare provider may want to examine your penis for obvious signs of damage. For example, a penile fracture might cause visible bruising.

Erectile dysfunction has many causes that are not visible with the eye, which can include:

• Nerve problems

• Psychological problems

• Hormonal problems

• Blood vessel or heart problems

Along with a visible exam of your penis, your healthcare provider may also order other tests to help identify the cause of your sexual dysfunction:

• Blood tests: Blood tests can screen for some problems like diabetes or hormonal imbalances. These conditions may contribute to the development of erectile dysfunction either directly or indirectly.

• Blood pressure check: Your healthcare provider usually checks your blood pressure with a cuff that goes on your arm. High blood pressure is common and can contribute to the development of erectile dysfunction.

• Urine test: A urine test can potentially help rule out conditions like diabetes or some sexually transmitted infections.

• Mental health exam: A psychological assessment might be performed to help identify non-physical causes like anxiety, depression, stress, or self-esteem issues.

• Ultrasound: A healthcare provider might order an ultrasound to evaluate structural problems with your penis such as traumatic injury.

What happens after your exam is largely determined by what a healthcare provider finds (or doesn’t find). Some of the tests we mentioned may come after an initial assessment, especially if the first exam happens as part of your annual physical.

Depending on your symptoms and whether your doctor found a particular problem, you may receive:

• A referral to a urology specialist

• Referrals for further testing that may not be available at your health provider’s office

• A prescription to see if your issues respond to medication

• A recommendation for therapy or counseling for problems related to mental health

Many treatment options are available to help treat problems with your genitals. The exact treatment you receive depends on what your healthcare provider finds. For example, STIs are often treatable with medication.

If you’re dealing with erectile dysfunction, the good news is that it’s often treatable. The first-line treatment is often erectile dysfunction medications called phosphodiesterase type 5 inhibitors (PDE5 inhibitors). These medications make it easier to achieve and maintain an erection by increasing blood flow to your penis. Medications approved by the FDA include:

• Tadalafil (Cialis^®)

• Sildenafil (Viagra^®)

• Avanafil (Stendra^®)

• Vardenafil

These medications are available as tablets and in chewable hard mints, a discreet alternative you can get online through our telehealth platform.

For psychological ED, treating anxiety, depression, and specifically sexual performance anxiety with therapy or medication can help with recovery.

Learn more about ED treatments.

Regular checkups may seem like more of a hassle than they’re worth, especially when it comes to your genitals. However, these exams can be potentially life-saving, even if they can be a little awkward.

Here are the big takeaways as you prepare for your appointment:

• A penis exam, or a male urology exam, is a complete examination of your genitals and urinary organs.

• A penis examination may be performed by a urologist, your GP, or another healthcare professional.

• If you’re worried about your erectile, testicular, or prostate health, getting medical advice is essential. It can prevent diseases, cancer, and other serious problems from becoming worse.

Have questions or want to know more about health issues relating to your penis? We can help. Reach out today through our sexual health platform.