Patient: My grandfather came to me asking for help. He is embarrassed to visit his female PCP. He has gout for years and has been put on a new medication for it. He is also regularly taking medication (beta-blocker?). In the last few months he has has discoloration in his nail beds and some finger pain, similar symptoms to Reynauds. Now he has come to me saying that off and on throughout the day, his penis shrinks very small and causes pain. He pointed out that it gets down to the size of the first to knuckles of his pinky. When it shrinks like this it causes him pain and makes it difficult to urinate. Later it will go back to normal and the pain is gone. He wants to know if this is a side effect of one of the 2 medications, or if adding another medication is the only option. He is 65 years old and otherwise in good active health.