Why Can Andrology Symptoms Come and Go? What to Track Before a Medical Visit

Andrology-related symptoms can come and go because sexual function, urinary patterns, and pelvic or testicular discomfort can vary with health, medicines, stress, sleep, and the situation in which a symptom occurs. Fluctuation alone does not identify the cause. A short, factual record of what happened, when it happened, how long it lasted, and what else was going on can help a clinician decide what to evaluate. Do not wait to keep a diary if you have a red flag such as sudden severe testicular pain, inability to urinate, blood in your urine, or an erection lasting four hours or more.

“Andrology” broadly refers to health concerns involving male reproductive and sexual function. People may use it to describe erection or ejaculation changes, reduced sexual desire, fertility concerns, testicular or pelvic pain, or urinary symptoms. These symptoms can overlap, and the same symptom can have several possible explanations. The goal of tracking is to give the clinician a clearer timeline—not to diagnose yourself.

Why might a symptom improve and then return?

Different symptoms respond to different circumstances

An occasional erection difficulty is not automatically the same as a persistent erection problem. NIDDK notes that erectile dysfunction (ED) can mean being able to get an erection sometimes but not every time, or one that does not last long enough for sex. Stress, anxiety, mood, relationship context, sleep, health conditions, and some medicines may be relevant, but noticing that a symptom happened on a stressful day does not prove stress caused it.

For example, someone might notice erection changes mainly after several nights of poor sleep, but also have an episode when well-rested. That pattern is useful to share; it does not rule out a physical contributor. Record what occurred and the context without deciding on a cause.

Pain and urinary symptoms can naturally fluctuate

Some chronic pelvic pain conditions include symptoms that come and go. NIDDK describes chronic prostatitis/chronic pelvic pain syndrome as potentially involving pain in the lower abdomen, perineum (the area between the scrotum and anus), penis, scrotum, or lower back, along with urinary urgency or discomfort during or after ejaculation. These symptoms can overlap with other conditions, so a pattern alone cannot confirm prostatitis.

Urinary frequency and urgency can also vary with fluid intake, timing, and other circumstances. A bladder diary can help show how often you urinate, what you drink, and whether leakage or urgency occurs. Track these details as observations, rather than testing yourself by deliberately changing fluids or stopping medicines.

Medicines, health changes, and treatment can matter

Prescription and over-the-counter medicines, vitamins, and supplements may be relevant to sexual or urinary symptoms. So can a recent illness, a new diagnosis, surgery, or an injury. Do not stop or change a prescribed medicine on your own; record its name and when it was started or changed, then ask the clinician whether it could be connected.

A symptom returning after treatment also deserves a factual note: what treatment you used, when you used it, whether it helped, and when the symptom returned. Do not take someone else’s medication or add an unverified supplement as a test. Treatment choices depend on the person and the cause.

What should you track before the appointment?

You do not need a complicated spreadsheet. A few brief entries over several days—or notes about earlier episodes if the issue is urgent or infrequent—are often more useful than trying to record every sensation. Include:

• The main symptom. Describe it in plain terms: difficulty getting or keeping an erection, lower desire, pain, a change in ejaculation, urinary urgency, a weaker stream, or a testicular lump or swelling. Note whether it is new, recurring, or changing.
• Timing and duration. Record the date, time, how long it lasted, how often it happens, and whether it is improving, worsening, or unchanged. Note whether it wakes you at night or affects work, sleep, exercise, or sex.
• Location and severity. For pain, mark the location and describe the quality (for example, aching, burning, or sharp) and intensity in a consistent way. Note whether it spreads, follows urination or ejaculation, or began after an injury.
• What happened around it. Note sleep, stress, recent illness, physical activity, alcohol or other substances, fluid intake, and any situation that seems to precede or ease the symptom. These are clues, not proof of a cause.
• Urinary details. If relevant, record how often you urinate, nighttime trips, urgency, leakage, pain or burning, stream changes, and whether you feel your bladder emptied. A simple drink-and-urination log can help with urinary concerns.
• Sexual and reproductive details. If relevant, note changes in erection, desire, ejaculation, orgasm, pain during or after sex, and fertility goals or concerns. If you are seeking fertility care, note how long you have been trying and any prior testing. You can write this privately and share only what is relevant to your care.
• Medicines and health history. Bring a current list of prescriptions, nonprescription medicines, vitamins, supplements, and doses if known. Include recent changes, chronic conditions, prior procedures, and relevant family history.

A useful entry might read: “Tuesday, 7 p.m.: sudden urge to urinate twice during a 30-minute meeting; no pain; woke once overnight; started a new medicine last week.” Avoid conclusions such as “this must be my prostate.” The clinician can interpret the pattern alongside your history, examination, and any tests.

What will the clinician ask or check?

For erection concerns, NIDDK says clinicians may ask about medical, sexual, and mental health history, medicines and supplements, sexual desire, erections, ejaculation, and emotions. They may perform an exam or order tests depending on the situation. For pelvic pain or urinary symptoms, the clinician may ask about pain location, stream changes, fever, urinary infections, and symptom duration. Bring your notes, but do not worry if you cannot answer every question precisely.

You can help the conversation by opening with the main change: “This began about three weeks ago; it happens two or three times a week and lasts about an hour.” Then share what affects daily life and what worries you most. Ask what symptoms should prompt urgent care, what tests are being considered, and when to follow up if the problem continues.

When should you seek care sooner?

Seek emergency care now for sudden, severe pain in a testicle, particularly with nausea, vomiting, or abdominal pain. Testicular torsion is one possible cause and needs rapid assessment; do not wait to see if a diary reveals a pattern.

Get urgent medical care if you suddenly cannot urinate at all, have blood in your urine, or have painful, frequent, urgent urination together with fever or chills. An erection lasting four hours or longer also needs emergency care. If a symptom feels severe or rapidly worsening, use your local emergency service even if it is not listed here.

For a new testicular lump, swelling, persistent pain, repeated blood in semen, discharge, or ongoing urinary or sexual changes, arrange a prompt appointment even if the symptom is intermittent. A symptom that disappears is still worth discussing if it returns or affects your life.

Common assumptions to avoid

• “It comes and goes, so it cannot be medical.” Fluctuation does not rule a health issue in or out. Record the pattern and discuss recurring symptoms with a clinician.
• “It happened during stress, so stress must be the cause.” Stress can be relevant, but timing alone does not establish causation. Include physical symptoms, medicines, sleep, and health changes in your notes too.
• “A symptom diary will tell me what condition I have.” A diary provides context; diagnosis may require a history, examination, urine or blood tests, or other evaluation. Use it to prepare for care, not replace it.
• “I should wait until I have several weeks of data.” Do not delay urgent care for sudden severe pain, inability to urinate, blood in the urine, fever with urinary symptoms, or a prolonged erection. Seek care first and bring whatever notes you already have.

Reliable medical references

• NIDDK: Symptoms and causes of erectile dysfunction
• NIDDK: Diagnosis of erectile dysfunction
• NIDDK: Prostatitis symptoms and when to seek medical care
• NIDDK: Urinary retention
• NHS: Testicle pain and emergency symptoms
• NHS: Priapism and prolonged erections
• Urology Care Foundation: Overactive bladder diary
• NHS: Testicle lumps and swellings