H

hematospermia BLOODin the SEMENthat may be
apparent with EJACULATION. Trauma and INFECTION
are the main causes of hematospermia. SEXUALLY
TRANSMITTED DISEASES (STDS), notably GONORRHEA
and CHLAMYDIA, are common infections that irritate
and inflame the URETHRA, often causing bleeding
into both the URINE(HEMATURIA) and the semen as
either passes through the urethra to leave the
body. Less common causes of hematospermia
include bleeding disorders (health conditions or
medication induced); severe HYPERTENSION (high
BLOOD PRESSURE); and, in men over age 50, PROSTATE
CANCER. Diagnostic and therapeutic efforts focus
on identifying and treating the underlying cause.
See also EPISTAXIS; URETHRITIS.

hot flashes Sudden episodes of flushing and
sweating that occur with the fluctuating HORMONE
levels that precede MENOPAUSEor as a consequence
of HORMONE THERAPY such as to treat HORMONE-
DRIVEN CANCERS. Though researchers do not know
the precise mechanisms of hot flashes, they
believe the sudden drops in ESTROGENSaffect the
thermoregulatory centers in the BRAINthat cause
the body to function as though it must reduce
body temperature. SKINflushing and sweating are
among the methods the body uses to accomplish
such reduction. Hot flashes associated with
menopause improve and usually go away when
the body’s estrogen levels stabilize.
Lifestyle measures to mitigate the discomfort of
hot flashes include dressing in layers to allow
rapid cooling, drinking cool fluids at the onset of a
hot flash, minimizing CAFFEINEconsumption, and
avoiding foods that are high in tyramines, includ-
ing red wine, aged cheese, smoked meats, and
concentrated yeasts such as miso. Medical treat-
ments for hot flashes include selective serotonin

reuptake inhibitor (SSRI) medications, a classifica-

tion of antidepressant medication that appears to

reduce the frequency and intensity of hot flashes,

or short-term hormone replacement therapy

(HRT). Alternative and complementary

approaches to relieve hot flashes include ACUPUNC-

TUREand botanical remedies such as BLACK COHOSH

and SOY.

See also ANTIDEPRESSANT MEDICATIONS; MEDICINAL

HERBS AND BOTANICALS; PREMATURE OVARIAN FAILURE

(POF).

hydrocele A fluid-filled growth, similar to a cyst,

that develops in the SCROTUM. Most hydroceles are

congenital (present at birth) and occur as a result

of incomplete closure of the channel through

which the testicle descends from the abdomen to

the scrotum. The defect allows peritoneal fluid to

seep from the abdominal cavity into the scrotum.

A congenital hydrocele, also called a primary

hydrocele, appears as a variable and usually pain-

less enlargement of the scrotum. The size of the

enlargement may fluctuate with changes in

abdominal pressure, increasing with activities such

as bearing down (Valsalva maneuver), coughing,

sneezing, or, in infants, vigorous crying. Sec-

ondary hydrocele may develop after viral INFECTION

(more common in children) or trauma to the scro-

tum.

The preliminary diagnosis of hydrocele is clini-

cal, based on the scrotum’s transluminency. In this

simple test the doctor holds a bright, focused pen-

light against the side of the scrotum. When the

cause of scrotal swelling is hydrocele, the light

passes uniformly through the tissues of the scro-

tum. Most other causes of scrotal swelling are not

transluminent. An OPERATIONto repair a primary

hydrocele is the treatment of choice; surgical

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