Why are there little bumps on my penis?

Dear Dr Ren,

I’ve had these awful little bumps on my penis since I was about 20 and I hate them. I’ve noticed them on other guys too, but nobody ever talks about them. What’s up with this?

And while I’ve got your ear about completely embarrassing problems, should I be worried if there’s blood in my cum? It only happened once, but it concerns me.

Nervous Below the Belt

Dear NBB,

Yes, it is true that you can ask me questions that relate to physical as well as relationship issues. However, let me make this disclaimer: I am not medically trained. I encourage you to see your healthcare professional about any symptoms that concern you.

The bumps on your penis probably fall under the category of normal variation.

They are probably benign papules that require no treatment. Papules themselves can be divided into types, the most common being hair follicles and sebaceous (sweat) glands, pearly penile papules, and Fordyce spots.

But odd little growths on your genitals could also be ulcers, plaques, or warts. These are more serious and must be assessed by your doctor and treated medically.

As for the blood in your semen (hematospermia), most men report no previous genitourinary symptoms. In other words, it happens out of the blue. It tends to occur between the ages of 15 and 75, usually in the late 30s. We don’t know exactly what causes it, though it seems to result from inflammation of the urethra, prostate, and/or seminal vesicles.

Sometimes rough sex can break little blood vessels that bleed into the semen. Frightening though it can be, it is very rarely associated with anything serious. Still, if it occurs more than one time, or if you find blood in your urine as well, have your doctor assess the situation.

So you see, there are a number of reasons you could worry, but most of them don’t require it. It is always a good idea to check with your care provider if something happens to your body that mystifies and concerns you. It makes good sense, too, to arrive at the medical office somewhat informed and prepared with questions.

Human bodies have enormous variations, all within normal range. Still, some of those oddities signal disease and must be attended to medically. Don’t panic, but educate yourself.

Given our poor record of sex education and our embarrassment about discussing sexual topics, we have a mix that guarantees a society confused and silenced about physiology. We must each be responsible for the body we own and care for it properly.

Once you have determined that you are healthy, consider the ripple effect this worry may have on you. You mention, for instance, that you’ve noticed similar bumps to yours on other men, yet you didn’t speak of them. What a wasted opportunity! Oh, I understand it, and I think it’s sad.

We have been so sold on our culture’s impossible standards of beauty that a scarce few of us believe we measure up, leaving most of us to fumble about with other imperfect specimens. It distracts us from the thrill of our sexual encounters and tempts us to doubt our desirability as romantic or sexual partners. All that happens even before we get our pants off and start worrying about the bumps on our dicks!

We all want to be attractive to others and we all fear rejection, which can tempt us to hold back in significant circumstances. Yet we know it is the bold suitor who succeeds in most romantic situations. Would you turn down someone who makes you feel like a million bucks because of bumps? Probably not.

Confidence is the key to allure and attraction. Remember the old adage about loving someone warts and all? When you know you are loveable, you need not worry about your bumps. When you are falling in love, you’ll think his bumps are adorable, or at least not a buzz-kill.

What is important is that we focus on the pleasure and function of our genitals. You are wise to ensure you are healthy, but that done, concentrate not on skin-deep details but rather on the thrill and connection possible when your physical and emotional systems are firing in concert.

If it works and it feels good, isn’t that enough? Isn’t that, in fact, what makes the earth move?

Dr Pega Ren is Daily Xtra’s queer- and kink-friendly sex therapist, specializing in relationship and sexual issues. To learn more about her and the work she does, or to book a session, visit her website at smartsextalk.com.

Have a question for Dr Ren? Send an email to asktheexpert@dailyxtra.com.

This column was originally published on Jan 4, 2006 under the name, “Spotted Dick No Cause For Panic.”