Sexual health problems are common among men, even if they don’t want to admit it. And while many conditions are preventable or treatable, experts say men are often too embarrassed to bring them up with friends, family or even physicians.

尽管许多男性不愿承认，但性健康问题在他们当中相当普遍。专家表示，虽然许多病症是可以预防或治疗的，但男性往往因为觉得太尴尬而愿向朋友、家人甚至医生提起。

No one wants to seem weak or less virile, explained Dr. Raevti Bole, a urologist at the Cleveland Clinic in Ohio. “Part of the job of a reproductive urologist is giving the reassurance that you are definitely not alone,” she added.

俄亥俄州克利夫兰诊所的泌尿科医生埃尔芙蒂·博莱博士解释说，谁都不希望自己看起来虚弱或不够有男子气概。“生殖泌尿科医生的工作之一就是让患者相信自己的问题并不罕见。”

As a result, doctors say, many men resort to the internet, only to find misinformation — like the supposed benefits of semen retention or horny goat weed.

医生们表示，其结果是许多男性转向互联网求助，却只找到了错误信息——比如所谓的禁欲排毒（保精）或淫羊藿的功效。

“I wish more young men would take the time to speak to their primary care physician about health questions rather than get their advice from A.I. or social media,” said Dr. Tony Chen, a urologist at Stanford Medicine in California.

加州斯坦福医疗中心的泌尿科医生托尼·陈博士表示：“我希望更多的年轻男性能够花时间与他们的初级保健医生讨论健康问题，而不是从人工智能或社交媒体获取建议。”

To help start the conversation, we asked experts what they wished men knew about their sexual organs. Here’s what they said.

为了帮助开启这一对话，我们咨询了专家，询问他们希望男性对其性器官了解些什么。以下是他们的解答。

Erectile dysfunction can be a sign of chronic disease.

勃起功能障碍可能是慢性疾病的征兆。

Around 50 percent of men over 40 will suffer from erectile dysfunction at some point, and the issue can represent broader problems with circulation.

40岁以上的男性中约有一半会在某个阶段受到勃起功能障碍的困扰，而这个问题可能代表着更广泛的血液循环问题。

Good blood flow is essential for achieving and maintaining an erection, and that is only possible with a healthy heart. A 2008 Dutch study of 1,248 men ages 50 to 75 found that those who said they had erectile dysfunction were at least 60 percent more likely to have a heart attack or stroke in the six years after the study concluded.

良好的血流量对于实现和保持勃起至关重要，而这只有在心脏健康的情况下才能实现。一项2008年针对1248名50至75岁男性的荷兰研究发现，那些自述存在勃起功能障碍的人在研究结束后的六年内患心肌梗死或中风的可能性至少高60%。

“Think of the penis as a barometer of somebody’s overall cardiovascular health,” said Dr. Matthew Ziegelmann, a urologist at the Mayo Clinic in Minnesota.

明尼苏达州梅奥诊所的泌尿科医生马修·齐格尔曼博士表示：“可以将阴茎视为衡量一个人整体心血管健康的晴雨表。”

Difficulties with physical arousal may be a sign of Type 2 diabetes or high cholesterol, for instance, both of which damage the lining of arteries and elevate the risk of a stroke or heart attack.

例如，生理唤起方面的困难可能是2型糖尿病或高胆固醇的征兆，这两者都会损害动脉内壁，增加中风或心肌梗死的风险。

“Ignoring erectile dysfunction means you are missing a really valuable opportunity to prevent cardiovascular disease,” said Dr. Vaibhav Modgil, a urologist and researcher at the University of Manchester in England.

英国曼彻斯特大学的泌尿科医生兼研究员瓦伊巴夫·莫德吉尔博士指出：“忽视勃起功能障碍意味着你错过了一个预防心血管疾病的极有价值的机会。”

Pay attention to your pelvic floor.

关注你的盆底肌。

The pelvic floor muscles in both men and women lie above the perineum, the area between the anus and genitals, and act as a hammock to support the bladder, bowel and sexual organs.

男性与女性的盆底肌均位于会阴（肛门与生殖器之间的区域）上方，像一张吊床一样支撑着膀胱、肠道和性器官。

Strengthening these muscles can improve bladder control, which is why Kegel exercises, done correctly, are often recommended to women during pregnancy and after childbirth. They can also help some men suffering from incontinence after prostate surgery and reduce premature ejaculation.

加强这些肌肉可以改善膀胱控制能力，这就是为什么常推荐孕期和产后女性进行正确的凯格尔运动。它们还能帮助一些在前列腺手术后遭受尿失禁的男性，并减少早泄。

But more often men suffer from the opposite problem: The muscles are too tense, which can cause pain during intercourse, erectile dysfunction or difficulty emptying the bladder or bowel.

但男性更多时候遭遇的是相反的问题：肌肉过于紧绷，这可能导致性交过程中的疼痛、勃起功能障碍，或排尿、排便困难。

“They rhythmically contract at certain points during the sexual cycle,” Dr. Ziegelmann explained. “And if they’re already tense and tight, it’s a cramped muscle that you’re then trying to move really fast, which can be painful.”

齐格尔曼解释说：“肌肉在性高潮周期的特定时刻会发生有节奏的收缩。如果原本就已经处于紧绷和强直状态，那就相当于一块抽筋的肌肉却还要强行让它快速运动，这可能会非常疼。”

Gently stretching your hips, glutes and hamstrings can help relax those muscles — as can diaphragmatic breathing. If you are experiencing serious long-term symptoms, however, Dr. Ziegelmann suggests seeking a pelvic floor physical therapist who can advise the best ways to loosen up.

柔和地拉伸你的臀部、臀大肌和腘绳肌有助于放松这些肌肉——腹式呼吸同样有效。然而，如果你正经历严重的长期症状，齐格尔曼建议寻求盆底物理治疗师的帮助，他们能指导你如何最好地放松肌肉。

Your age can influence sperm quality …

你的年龄会影响精子质量……

Multiple experts said they wished more men knew how age could affect sperm quality.

多位专家表示，他们希望更多的男性能够了解年龄会如何影响精子质量。

“There’s a misconception that if you can get an erection and ejaculate, you’re fertile,” said Dr. Michael Carroll, a reproductive scientist at Manchester Metropolitan University in England.

英国曼彻斯特城市大学的生殖科学家迈克尔·卡罗尔博士说：“有一种误解是，只要你能勃起并射精，你就是有生育能力的。”

Sperm quality tends to deteriorate with age, affecting how well they swim, damaging the DNA they carry and even increasing the chances of complications during pregnancy, Dr. Chen said. There’s no clear cutoff age, since DNA damage accumulates throughout a man’s life. One study found that the risk of miscarriage was 43 percent higher when the father was older than 45, compared to someone in their late 20s. Urologists urged men to consider their age when planning a family, much as many women already do.

托尼·陈表示，精子质量往往会随着年龄增长而恶化，影响精子的游动能力，损坏它们携带的DNA，甚至增加孕期并发症的概率。目前并没有明确的截止年龄，因为DNA损伤会在男性的一生中不断累积。一项研究发现，相比接近30岁的父亲，当父亲年龄大于45岁时，流产的风险要高出43%。泌尿科医生呼吁男性在规划家庭时要考虑到自己的年龄，就像许多女性已经做的那样。

“Fertility is a team sport,” Dr. Chen said. “And men have increasingly more to do with outcomes than what we previously thought.”

陈说：“生育是一项团队运动。男性对结果的影响比我们此前想象的要大得多。”

… and so can other lifestyle factors.

其他生活方式因素也是如此。

Smoking, alcohol consumption and nutrition also play a large role in sexual function. A high-fat, high-sugar diet results in an increase in certain chemicals — known as reactive oxygen species — that cause wear and tear on cells, including those within the testes. Dr. Carroll pointed out that the Mediterranean diet, which includes foods with higher levels of antioxidants, was associated with healthier sperm.

吸烟、饮酒和营养在性功能中也扮演着重要角色。高脂肪、高糖的饮食会导致体内某些化学物质——即活性氧——增加，造成包括睾丸内细胞在内的细胞磨损与老化。卡罗尔指出，包含较高水平抗氧化剂食物的地中海饮食与更健康的精子相关。

Obesity is another important risk factor, said Dr. Channa Jayasena, a reproductive endocrinologist at Imperial College London. Fat cells produce an enzyme called aromatase, which converts testosterone to estrogen. Lower testosterone makes it harder to maintain an erection and slows sperm production. Every inch increase in a man’s waistline has been associated with an approximately 3 percent drop in sperm concentration, according to a study from the Harvard T.H. Chan School of Public Health. Numerous studies have shown that weight loss programs can raise sperm count in obese people.

伦敦帝国理工学院的生殖内分泌专家查纳·贾亚塞纳博士表示，肥胖是另一个重要的风险因素。脂肪细胞会产生一种名为芳香化酶的酶，它会将睾酮转化为雌激素。较低的睾酮水平使得维持勃起变得更加困难，并减缓精子的生成。根据哈佛大学陈曾熙公卫学院的一项研究，男性的腰围每增加一英寸，精子浓度就会下降约3%。多项研究表明，减重计划可以提高肥胖人群的精子数量。

Experts also said to avoid testosterone therapy unless you have a medical test confirming that you have a deficiency.

专家们还表示，除非你有医学检测证实自己存在睾酮缺乏，否则应避免接受睾酮补充疗法。

“It’s marketed to younger men as, ‘If you want big muscles, if you want erections that will last forever, if you want to look like a real man, then take testosterone,’” Dr. Modgil said. Yet few are aware that it can also interrupt sperm production and potentially reduce fertility.

莫德吉尔说：“向年轻男性推销补剂时常说，‘如果你想要大块肌肉，如果你想要永不消退的勃起，如果你想看起来像个真正的男人，那就补充睾酮吧。’”然而很少有人意识到，它还会打断精子的生成，并可能降低生育能力。

Exercise in moderation while trying to start a family.

在尝试要孩子期间，运动要适度。

Regular physical activity can enhance your fertility, but avoid extreme training regimens if you are trying to conceive.

定期的身体活动可以增强你的生育能力，但如果你正在备孕，请避免过度的训练计划。

Some evidence suggests that high-intensity exercise can cause a stress response that interrupts testosterone production, reducing sperm production, Dr. Carroll said. Pushing the body to its limits may also increase the production of the chemicals that damage DNA, he said.

卡罗尔说，一些证据表明，高强度的运动可能会引发应激反应从而打断睾酮的生成，降低精子的产生量。他表示，将身体推向极限还可能增加破坏DNA的化学物质的产生。

Cycling may come with additional risks, Dr. Bole said. “You get scrotal compression for a long period of time, and you have tight clothing, which has the potential to elevate the temperature of the testes.” Short recreational rides aren’t likely to do much harm, she added, but longer training might cause problems.

博莱表示，骑自行车可能会带来额外的风险。“你的阴囊会长时间受到挤压，加上穿着紧身衣物，这有可能升高睾丸的温度。”她补充道，短暂的休闲骑行不太可能造成太大危害，但较长时间的训练可能会引发问题。

That doesn’t mean you have to give up your bike touring. But if you are concerned about your fertility, practice more moderate exercise, Dr. Carroll said. Keep in mind it takes about two months for newly produced sperm to fully mature, so don’t expect lifestyle changes to have an immediate effect.

这并不意味着你必须放弃骑车旅行。但卡罗尔表示，如果你担心自己的生育能力，请进行更适度的运动。请记住，新产生的精子需要大约两个月的时间才能完全成熟，因此不要指望改变生活方式会立即见效。

Squeamishness is the enemy of health.

害羞是健康的敌人。

Experts said that a reluctance to discuss their private parts can prevent men from visiting a urologist and being screened for things like testicular cancer.

专家表示，不愿讨论隐私部位可能会阻碍男性寻求泌尿科医生的帮助，并进行针对睾丸癌等疾病的筛查。

“When caught early it has nearly a 98 percent cure rate,” said Dr. Juan Andino, a urologist at UCLA Health who urges men to make a habit of checking their anatomy regularly.

加州大学洛杉矶分校健康中心的泌尿科医生胡安·安迪诺博士敦促男性养成定期检查生殖器的习惯，他说：“发现得早，治愈率接近98%。”

One common reason some men avoid screening is the size or shape of their penis, experts said. These worries can contribute to anxiety, depression and sexual dysfunction. In extreme cases, they can become a form of body dysmorphia that significantly impairs daily life, Dr. Carroll said.

专家表示，部分男性避免筛查的一个常见原因是他们阴茎的大小或形状。这些顾虑可能会加剧焦虑、抑郁和性功能障碍。卡罗尔表示，在极端情况下，它们可能会演变成一种严重损害日常生活的躯体变形障碍。

He noted that pornography can set unrealistic standards that leave many people feeling inadequate. It often reassures men, Dr. Carroll said, to know the average erect length is smaller than many assume: around 5.2 inches.

他指出，色情内容会设定不切实际的标准，让许多人感到自卑。卡罗尔说，当了解到平均勃起长度比许多人想象的要短——大约在5.2英寸（约13.2厘米）左右时，通常能让男性感到安心。

He also warned against treatments claiming to enhance penis size and said simply trimming pubic hair could leave some men feeling more confident.

他还警告不要使用声称能增大阴茎尺寸的治疗方法，并表示仅仅修剪阴毛就能让一些男性感到更有自信。

Remember that your urologist has seen it all before, Dr. Ziegelmann said. And a frank conversation can go a long way to assuaging fears.

齐格尔曼表示，请记住你的泌尿科医生早就见怪不怪了。而一次坦诚的交流，在打消顾虑方面可以起到很大作用。