About

Bacterial prostatitis. There are two types of bacterial prostatitis: acute (meaning it develops suddenly) and chronic (meaning it develops slowly over several years). Both types can be treated with antibiotics. Each type affects about 1 in 10 men. Symptoms of acute bacterial prostatitis are often severe, and therefore quickly diagnosed..

Nonbacterial prostatitis occurs in about six out of 10 men with prostatitis. Although the causes are unknown, the inflammation may be related to organisms other than bacteria, like a reaction to the urine or substances in the urine. For example, men with a history of allergies and asthma sometimes develop nonbacterial prostatitis. More research needs to be done as currently as currently healthcare providers cannot be sure exactly how these conditions are related. Healthcare providers do know that nonbacterial prostatitis is not found in men with recurrent bladder infections.

Prostatodynia (pain in the area of the prostate gland) occurs in about 3 out of 10 men with prostate irritation. Normal testing to diagnose infection and other problems with the prostate gland are not applicable. In some instances, the pain may be caused by a muscle spasm (an involuntary sudden movement or contraction) in the bladder or the urethra.

FYI

Certain activities increase your risk of developing prostatitis. These include:

• Having had a recent bladder infection
• Having benign prostatic hyperplasia (BPH)
• Having gonorrhea, chlamydia or another sexually transmitted disease
• Having frequent, unprotected sex or unprotected sex with multiple partners
• Excessive alcohol consumption
• Eating a lot of spicy, marinated foods
• Injury to the lower pelvis (often as a result of cycling, lifting weights, etc.)

Symptoms

• Occasional discomfort in the
  • Testicles
  • Urethra
  • Lower abdomen
  • Back
• Discharge from the urethra, especially during the first bowel movement of the day
• Blood or urine in ejaculate
• Low sperm count
• Sexual difficulties
• Fever
• Aching muscles
• Chills
• Fatigue
• Frequent and/or painful urination

Prevention

Learning how to prevent prostatitis is not an easy task however it is possible. Here are some tips to help you get started.

1. Taking probiotics, or beneficial bacteria, may be an effective addition to antibiotic therapy for men who have bacterial prostatitis and are looking for natural prostatititis prevention.
2. Practice good hygiene, and keep your penis clean
3. Drink enough fluids to cause regular urination
4. Seek early treatment of a possible urinary tract infection
5. Eat a low-fat, low-sodium, low-cholesterol diet
6. Quit smoking
7. Drink less alcohol
8. Get more exercise. Exercise builds muscle, improves blood flow and helps get the cholesterol out of your blood. It also improves your mood and self esteem.

Diagnosis

Diagnosis is usually made during a DRE (digital rectal exam), where the health care provider inserts a lubricated, gloved finger into the rectum to feel the prostate, or by examining fluid from the prostate under a microscope. Some healthcare providers use a symptom index questionnaire developed by the National Institutes of Health. Still, diagnosing prostatitis isn’t easy, so the most important diagnostic tool your health care provider has is you and your detailed descriptions of your symptoms. While prostatitis is not considered a serious disease and it does not lead to cancer, if you live with the condition it is painful, extremely inconvenient, and sometimes difficult to cure.

Questions to Ask Your Health Care Provider

It’s important that you become proactive in your healthcare to get the best treatment. Here are some questions you can ask your healthcare provider about prostatitis.

1. What treatment is best for me?
2. Are there any side effects from my treatment?
3. Is there anything I can do to feel better until my treatment starts working?
4. Could my symptoms be caused by something other than prostatitis?
5. Do I have chronic bacterial prostatitis or acute prostatitis?
6. Is there anything I can do to avoid getting prostatitis again?
7. Will I be at higher risk of developing prostate cancer?

Treatments

Treatment for prostatitis is based on the cause. There are a number of treatment options that usually provide relief.

These include antibiotics, anti-inflammatories and surgery. Antibiotics are used to treat prostatitis that is caused by a bacterial infection. You might have to take antibiotics for several weeks or a few months. If prostatitis is severe, you might have to go to a hospital for treatment with fluids and antibiotics.

Resources

Find out more about prostatitis at the following websites:

Mayo Clinic
Prostatitis Foundation
Medline Plus
WebMD

About

Male infertility is the result of one or more of several factors, including:

• Abnormal spermatogenesis (the ability to create sperm)
• Impaired sperm motility
• Erectile dysfunction
• Impaired ejaculation
• Varicoceles (dilated veins in the scrotum)

FYI

Risk Factors

Several external causes have the potential to contribute to one or more male infertility factors. They include:

• Exposure to environmental toxins
• Drug and alcohol consumption (including prescription drugs)
• Prior medical treatment such as surgery or chemotherapy
• Previous sexually transmitted infection or urinary tract infection
• Radiation exposure
• Exposure to extreme heat
• Genetic conditions

Symptoms

What to do if you think you are experiencing male infertility:

If you believe you are experiencing male infertility, consult your healthcare provider. They will conduct a thorough medical history and physical examination of the penis, testes and prostate. Depending on your symptoms, your healthcare provider may also order laboratory screening of sperm, prostatic fluid and hormone levels. They may also test for the presence of sexually transmitted infections, or perform an ultrasound or digital thermography to assess tissue health.

Questions to Ask Your Health Care Provider

It’s important that you become proactive in your healthcare so that you may get the best treatment. Here are some questions you can ask your healthcare provider about infertility.

1. My partner and I are having trouble conceiving. Is it possible that one of us is experiencing infertility?
2. What treatments are available for male infertility?
3. What are the risks, benefits, and side effects of these treatments?
4. What personal behaviors may contribute to infertility?
5. Is there anything in my medical history that could lead to infertility?
6. If treatment does not lead to conception, do I have any other options?
7. When should I consult a fertility specialist?

Treatments

Because male infertility stems from many different of causes, the type of treatment will vary. Common treatments include:

• Surgery- for physical conditions such as varicoceles
• Medication – for conditions involving sperm production and some ejaculatory problems

If these treatments do not work, fertilization techniques such as intrauterine insemination (inserting sperm directly into the uterus) or in vitro fertilization (fertilizing the egg outside of the body and implanting it in the uterus) may also be used to assist in conception.

Resources

For more Information about male infertility visit:

Centers for Disease Control and Prevention
Urology Care Foundation
Hormone Health Network
Medline Plus
Urology Care Foundation

About

Some doctors identify the problem as Low Testosterone, a lowering of the level of testosterone present in the body. Unlike the sudden drop in estrogen level that occurs for women, there is a natural and gradual reduction of the level of testosterone with increasing age for men. Other factors such as diet, nutrition, diabetes and cardiovascular diseases also affect the level of testosterone. It is important to have regular medical exams to be sure the changes are not part of a disease process and are rather a part of the normal aging process.

Symptoms

Symptoms that men may experience include:

• erectile dysfunction (ED)
• decreased bone density or osteoporosis
• hot flashes
• mood swings, irritability, or depression
• loss of muscle mass and fat redistribution
• tiredness
• dry and thin skin
• increased sweating
• poor concentration
• loss of enthusiasm

If you experience the above symptoms, it is important to seek care from your healthcare provider to find out what is causing the symptoms. Some of the symptoms may be due to a gradual decrease in testosterone levels.

See the section on Hypogonadism (Low Testosterone) for more information.

About

As a man gets older, it’s common for the prostate to grow bigger and obstruct the flow of urine or interfere with sexual function. This condition is called benign prostate hyperplasia (BPH) and may require treatment with medicine or surgery. BPH is not cancer, but can cause many of the same symptoms as prostate cancer. You should always seek the advice of your healthcare provider.

There are 2 different ways that your prostate grows:

1. A multiplication of cells around your man’s urethra, resulting in a ‘squeezing’ effect.
2. Middle-lobe prostate growth where cells grow into the man’s urethra and bladder outlet often requiring a surgical procedure.

FYI

There are 3 factors that increase your risk of developing BPH:

• Age: Starting at age 45, the risk of developing BPH increases.
• Family history: If any immediate blood relative was diagnosed with BPH, you are more likely to develop the condition.
• Some research indicates that medical conditions such as obesity may contribute to the development of BPH.

There is no connection between BPH and cancer. However, if left untreated, the condition can cause bladder infections and kidney stones, and in some cases, permanent bladder and/or kidney damage.

Symptoms

Half of men between the ages of 50 and 60 will develop BPH, and by the age of 70 or 80, about 90% will have experienced BPH symptoms, which may include:

• Frequent, often-urgent need to urinate, especially at night
• Need to strain or push to get the urine flowing
• Inability to completely empty the bladder
• Dribbling or leaking after urination
• Weak urine stream

Because male urinary symptoms can also herald more serious conditions, such as prostate cancer, it’s important to see your health care provider to determine the cause of your symptoms. BPH symptoms vary with the individual. Since the prostate gland continues to grow in many older men, the symptoms may worsen with time and those who suffer from the condition may find it interferes with sexual function.

Diagnosis

The risk of developing BPH symptoms can almost be eliminated by diagnosing the condition early.  Your health care provider may order tests to measure how quickly urine flows from the bladder, or do ultrasound or x-ray examinations of the bladder, kidneys, urethra and prostate. He may order a PSA (prostate specific antigen) test. This blood test is often used to diagnose and monitor BPH and to help rule out prostate cancer.

For more information on the PSA test, see the prostate cancer section.

Questions to Ask Your Health Care Provider

It’s important that you become proactive in your healthcare in order for you to get the best treatment. Here are some questions you can ask your healthcare provider about BPH.

1. What are the best treatment options for me?
2. Is surgery an option?
3. Will there be any side effects from my treatment?
4. Does this mean I am at higher risk of developing prostate cancer?
5. Is there anything I can do to make urinating easier?
6. Could my symptoms be caused by something other than BPH?
7. Will there be any sexual side effects of my treatment?

Treatments

If you are diagnosed with BPH, your healthcare provider has a number of options to choose from.

Active Surveillance

This means keeping an eye on your BPH symptoms without receiving any form of treatment. For men with minimal to mild BPH symptoms which do not interfere with daily routines, this may be a preferred choice. Annual exams also contribute to the active surveillance.

Medications

Drugs called alpha-blockers are the most common treatment prescribed to manage BPH symptoms. By relaxing the muscles around the prostate so that there is less pressure on the urethra, alpha-blockers work quickly to improve urinary flow. Common side effects can include stomach or intestinal problems, a stuffy nose, headache, dizziness, tiredness, a drop in blood pressure and ejaculatory problems.

No matter what kind of treatment is prescribed, patients and healthcare providers need to be aware of potential drug interactions with treatments used to manage other conditions common among aging men, such as erectile dysfunction and hypertension.

Surgical Treatments

Surgery is typically used only in those patients with major BPH complications such as frequent urinary tract infections or bladder stones. There are several non-surgical approaches that use heat therapy to reduce the size of the prostate, thereby widening the urethra. These heat treatments include microwave therapy, radiofrequency therapy, electrovaporization and laser therapy. In the most extreme cases, open surgery may be required. Surgery treats BPH symptoms by reducing the size of the prostate, but it does not prevent the cause of the disorder. This means that surgery might need to be repeated within a few years. Side effects of surgery may include urgency and frequency of urination for some period after the event, difficulty in achieving an erection, blood in your urine, inability to hold your urine (incontinence) or a narrowing of the urethra (scarring).

Resources

For More Information on Benign Prostatic Hyperplasia Visit: 

NIDDK
Urology Care Foundation

About

Living with ED means that you can’t regularly achieve or keep an erection long enough to satisfy your sexual needs or those of your partner. Whether men they admit it or not, most have had an occasional erection problem. But for as many as 30 million American men—10% of all men, up to 15-25% of men over 65, ED is an ongoing problem. It can start at any age in adult men and can develop slowly over time or suddenly. There are a lot of myths out there about ED. Some people insist that “it’s all in your head.” Others say that “it’s what happens when you get older.”

Causes of ED

While there are real physical and psychological reasons for ED, there’s no single cause. The chart below outlines the most common causes of ED.²

ED is not just a medical issue; it can also deeply affect relationships. It can limit intimacy, affect self-esteem, and impact the most important relationships.

FYI

About 70% of the time, ED is the result of a physical problem. It can almost always be treated successfully. Medical problems contributing to or causing ED include heart disease, high blood pressure, diabetes, smoking, alcoholism, back injuries, testosterone deficiency  (very rarely), prostate problems, surgery and over 200 different prescription drugs.

Insurance Coverage
Most insurers cover the diagnosis and medically necessary treatment of ED. Medicare has a national coverage policy for ED, which includes penile implants—however coverage may vary by geography and plan.

ED affects you AND your partner! Below are ways to start the ED talk with your partner.

1. Always stay open and honest when discussing ED.
2. Never shut out your partner and try to deal with ED alone. Talking to your partner can be difficult, but your ED affects her too.¹ And she wants answers as much as you do.
3. Not only is good communication essential to successful diagnosis and treatment, it can help your partner understand what you are going through. And help you understand her feelings too.

Sex, ED, and Relationship Conversation Starters

1. I wonder if one of the medicines I’m taking causes the problems I experience when we try to have sex. Do you think I should see a doctor?
2. I thought the problems I’ve been having would just go away, but they haven’t. Do you think I could have ED?
3. I wonder if the surgical procedure I had caused ED. Do you think I should see a doctor?
4. I read that ED might be a sign of other health problems. Do you think I should see a doctor?
5. I miss being physically intimate with you. I want us to stay close. So what can we do while I look into treatments and try to solve this problem?

Symptoms

Physical and psychological factors including depression and performance anxiety are factors in the presence and severity of ED. Men who suffer from ED often feel inadequate and unsure of themselves. That can make them anxious, tense, angry or worried that they can’t satisfy their partner. Those feelings only make the ED worse. Even a “mild” case of ED due to physical or psychological factors will usually be made worse by performance anxiety.

If you’re experiencing ED, help yourself and your partner by scheduling a visit to your healthcare provider sooner rather than later. Chances are, they will be able to help your ED problem in just one or two visits. They will ask about your health habits, diet, prescription drugs and under what circumstances the ED happens. Your provider may also order tests of your blood, urine, heart function and hormone levels. Underlying medical problems are very common as men age and frequently they are a symptom of a much bigger issue like atherosclerosis.

ED may also be a sign of heart problems. The arteries in the penis are smaller than those in the rest of the body so blood flow issues appear sooner than in other areas. It is important to discuss sexual health with your healthcare provider as he can prescribe medications to improve your sexual function, and may be able to prevent a major heart problem or heart attack.

Prostate cancer itself does not cause ED but treatments for the disease can. The current methods of treating prostate cancer include surgery with radical prostatectomy (removal of the entire prostate gland), radiation therapy — whether by external beam or brachytherapy (seed implant) — and hormone therapy. All of these can cause ED

Prevention

If you’re at risk of developing erectile dysfunction, here are some steps you can take to prevent ED:

• If you smoke, stop smoking
• Exercise regularly
• Eat a healthy diet and maintain a healthy weight
• Take prescribed medications as prescribed by your healthcare provider
• Drink alcohol in moderation
• If you have a chronic illness such as diabetes or kidney disease, follow your doctor’s instructions

Questions to Ask Your Health Care Provider

It may be difficult for you to talk to your healthcare provider about ED. But the more information you share about yourself, the easier it will be for your doctor to properly diagnose your condition. Here are some questions you can ask your doctor.

1. What is the cause of my erectile dysfunction?
2. What are the treatment options?
3. Could any of my lifestyle habits be affecting my sexual function, such as smoking?
4. What are the possible treatments for erectile dysfunction?
5. What treatment is appropriate for me? Why?
6. What risks and side effects should I expect?
7. Will treatment affect my normal activities?
8. Will I be able to father children after treatment?
9. What is likely to happen without treatment?
10. What medications are available to me and what are the benefits/side effects?
11. Will these medications interact with other medications, over-the-counter products, or
12. Should I change my diet? If so, what dietary changes should I make?
13. What are my chances of returning to satisfying sexual function?

Treatments

In many cases, taking steps to improve your overall health will help reduce or even eliminate ED. This means:

• Eat a low-fat, low-sodium, low-cholesterol diet.
• Quit smoking. Chemicals in cigarette smoke can narrow blood vessels, making it harder to maintain an erection.
• Drink less alcohol. Alcohol slows your body’s reaction times.
• Get more exercise. Exercise builds muscle, improves blood flow, and helps get the cholesterol out of your blood. It also improves your mood, which will make you feel better about yourself.
• Cut back on coffee.
• Use it or lost it. The more erections you get, the easier it is to get them.
• Sexual activity, including masturbation, increases blood flow and oxygen to the penis.

If these lifestyle changes aren’t successful, your healthcare provider may prescribe one or more treatments for ED.

Treatment Options
There are multiple options to treat ED.

Oral Medications. There are a number of prescription medications available that may improve blood flow to the penis. Combined with sexual stimulation, this can produce an erection, when taken before sexual activity.³ 

By allowing the blood vessels that supply blood to the penis to dilate better during sexual stimulation, these medications alleviate the symptoms of ED. These should only be taken under medical supervision because other health related issues need to be addressed to ensure the heart is healthy enough for additional medication and stress.

Injections. With injection therapy a needle is used to inject medication directly into the penis. The medication allows blood to flow into the penis, creating an erection.

Vacuum Erection Devices. A plastic cylinder is placed over the penis, and a pump (either manual or battery operated) creates a vacuum suction within the cylinder, drawing blood into the penis to create an erection. A stretchable tension band is placed at the base of the penis to help maintain the erection.

Urethral Suppositories. An applicator containing a small pellet (suppository) is inserted into the urethra and the pellet is released. The pellet dissolves and increases blood flow to the penis, creating an erection.

Penile Implants. A medical device that is implanted into the penis. Entirely contained within the body, a pump fills two cylinders and creates an erection. Penile implants require a surgical procedure by a physician, typically an Urologist who has been trained and is skilled in penile prosthetics.

There are three different types of penile implants: 3-piece inflatable implant, 2-piece inflatable implant, and a 1-piece bendable (malleable) implant. Because each type of implant offers unique features, the risks and benefits should be discussed with the physician to help choose the most appropriate option.

Resources

For more information on erectile dysfunction visit:

WebMD
Medline Plus
Urology Care Foundation

1. National Institutes of Health (NIH) Consensus Conference. NIH Consensus Development Panel on Impotence. Impotence. Journal of the American Medical Association.1993;270:83-90.
2. Ridwan Shabsigh, MD, Tom F. Lue, MD. A Clinician’s Guide to ED Management. New York: Haymarket Media Inc.; 2006.
3. Erectile dysfunction (ED). www.auanet.org/content/education-and-meetings/med-stu-curriculum/ed.pdf. American Urological Association Web site. Downloaded January 21, 2013.

About

There are two basic types of male hypogonadism, which both result in decreases in sperm and testosterone production.

Primary hypogonadism is low testosterone due to a dysfunction or defect in the testes.

Secondary hypogonadism is low testosterone due to a dysfunction or defect in the pituitary gland or hypothalamus (the parts of the brain that signal the testicles to produce testosterone).

What is Testosterone?

Testosterone is the most important sex hormone in the male body. It is needed for masculine growth and development during puberty, and the development of male characteristics such as body and facial hair, muscle growth, strength and a deep voice. Normal levels of testosterone also influence the production of sperm, promote sexual function and sex drive. The brain and the testicles work together to keep testosterone levels within a normal range. When levels of testosterone are below normal, the brain signals the testicles to make more. When testosterone levels are too high, the brain signals for the testicles to make less.

FYI

TESTOSTERONE & AGING

The ability to produce testosterone declines as men age, resulting in a condition called hypogonadism or Low Testosterone (Low T). This loss of testosterone may lead to uncomfortable and distressing symptoms. Researchers estimate that hypogonadism affects from 2-6 million men in the United States with only 5% receiving treatment.*

Low T may affect a man’s interest in sex, his ability to perform sexually and it can result in sexual impotence, infertility, loss of muscle mass and strength, reduction in bone density, mood changes and fat accumulation. Causes of Low T vary, and some men are born with the condition, while others develop it later in life. Low T is characterized by low levels of testosterone and presents such symptoms such as decreased sexual desire, erectile dysfunction, decreased energy and depression.

It’s normal for a man’s sex drive to slowly decline from its peak in his teens and 20s, but libido and sex drive vary widely among men and also for an individual over time. It is affected by stress, sleep, general health and opportunities for sex. Men may not recognize a problem until a partner considers it an issue or the man recognizes he cannot function sexually.

Symptoms

In Puberty: Hypogonadism may delay puberty or inhibit development. You may notice the following symptoms:

• Decreased development of muscle mass
• Lack of deepening of the voice
• Impaired growth of body hair
• Impaired growth of the penis and testicles
• Excessive growth of the arms and legs in relation to the trunk of the body
• Breast enlargement (gynecomastia)

In Adulthood: Hypogonadism may alter physical characteristics, cause health problems or impair reproductive function. You may notice the following symptoms.

• Erectile dysfunction and other sexual problems
• Infertility
• Decreased beard and body hair
• Decrease in muscle mass
• Breast enlargement (gynecomastia)
• Loss of bone mass (osteoporosis)

Some men may also experience the following signs and symptoms:

• Fatigue
• Decreased sex drive
• Difficulty concentrating
• Hot flashes

CAUSES OF HYPOGONADISM IN MEN INCLUDE:

• Obesity
• Certain medications
• Certain inflammatory diseases
• Injury or infection involving the testicles
• A genetic abnormality, such as Klinefelter’s syndrome, in which males have an extra “X” chromosome
• Undescended or absent testicles
• Iron overload (hemochromatosis)
• Cancer treatment, including radiation and chemotherapy
• Toxic damage from alcohol or heavy metals
• Congenital hormone disorders affecting the hypothalamus or pituitary gland, such as Kallmann’s syndrome
• HIV/AIDS
• Normal aging

Prevention

GET SCREENED
You may want to ask your healthcare provider to check you for low testosterone levels if you experience symptoms associated with Low T. A primary care provider checks testosterone levels with a blood test to determine if you have Low T and determine if testosterone therapy is right for you. You might also ask your healthcare provider about a referral to an endocrinologist or urologist who specializes in treating Low T.

Questions to Ask Your Health Care Provider

In order to get the best treatment, it’s important that you become a proactive partner in your healthcare. Here are some questions you can ask your healthcare provider about Low Testosterone.

1. I don’t feel sick; I just don’t feel like myself anymore. What could be causing it?
2. Are the symptoms I am experiencing and my other conditions related to Low T?
3. What medical treatment options are available if I have Low T?
4. What are the benefits/side effects of the medications you prescribe?
5. Are there dietary changes I should make? How do I go about it?
6. Will I still be able to work and participate in activities?
7. What is the difference between the different testosterone replacement therapies?
8. If I have Low T, what happens if I don’t have it treated?
9. How often do I need to come in for check-ups?

Treatments

If you do experience symptoms of Low Testosterone and are diagnosed by a healthcare provider, the good news is that the condition very often is treatable.

There are several FDA-approved testosterone replacement therapies, including:

Gels and Solutions
Testosterone gels and solutions are applied directly to the skin and are absorbed into the body. These generally require daily application.

Patches
Patches allow testosterone to be absorbed by the skin. Patches are applied daily, typically to the back, abdomen, upper arm or thigh.

Injections
Testosterone injections, usually in the upper buttock, are typically given every 1-2 weeks. However, there are some long-acting injections that can be administered every 10 weeks.

Buccal Tablet
In your mouth, the tablet is applied to the gum, where testosterone is absorbed over a 12-hour period. They are taken twice daily.

Pellets
Pellets are implanted under the skin near the hip during a surgical procedure by a healthcare provider.

REMEMBER:
Regular checkups and age-appropriate screening, including low testosterone, can improve your health and extend your life.

Testosterone therapy should not be used in men with carcinoma of the breast or known or suspected carcinoma of the prostate. Geriatric patients treated with androgens may be at an increased risk for the development of prostatic hyperplasia and prostatic carcinoma.

Resources

To learn more about Hypogonadism visit the following pages

Medscape
Cleveland Clinic
Medline Plus
What Men Should Know About Testosterone

The following professional and patient care organizations are available as resources for further information about low Testosterone and testosterone replacement therapy:

American Academy of Family Healthcare providers (AAFP)
11400 Tomahawk Creek Parkway
Leawood, KS 66211
913-906-6000
www.aafp.org

American Osteopathic Association (AOA)
142 E. Ontario St.
Chicago, IL 60611-2864
800-621-1773
www.osteopathic.org

American Association of Clinical Endocrinologists (AACE)
1000 Riverside Avenue, Suite 205
Jacksonville, FL 32204
904-353-7878
www.aace.com

American Society for Reproductive Medicine
1209 Montgomery Highway
Birmingham, AL 35216
205-978-5000
www.asrm.org

American Urologic Association (AUA)
1000 Corporate Boulevard
Linthicum, MD 21090
410-689-3700
www.auanet.org

The Endocrine Society
8401 Connecticut Avenue, Suite 900
Chevy Chase, MD 20815
301-941-0200
www.endo-society.org

The Hormone Foundation
8401 Connecticut Avenue, Suite 900
Chevy Chase, MD 20815
800-HORMONE
www.hormone.org

Sexual Medicine Society of North America, Inc.
1111 North Plaza Drive, Suite 550
Schaumburg, IL 60173
847-517-7225
www.smsna.org