Understanding Sexually Transmitted Infections in Men

A sexually transmitted infection (STI) is any infection transmitted through sexual contact, which may not always involve full intercourse. Both men and women are susceptible to the same range of STIs, but the way these are present in men and women can vary. Importantly, many STIs show no symptoms, making regular testing crucial, especially with new or multiple partners. Regular screening ensures that men are not unknowingly infected and do not pose a risk to their partners.

Because STI is a blanket term for a wide range of different infections, including viruses, bacteria, and parasites, each STI presents with different symptoms and each will require a different kind of test. For STIs like genital ulcers, lumps, or rashes, a physical examination at a sexual health clinic (GUM clinic) is recommended. Other STIs, especially those without symptoms, can be detected through urine tests, blood tests, or swabs. One Day Tests offers self-tests for various infections, typically using PCR tests to identify genetic material from different infections.

Chlamydia

Chlamydia is one of the infections that can be tested by PCR testing. It is one of the most common STIs in the UK. It is particularly common in men and women under the age of 25 and the NHS recommends that sexually active people in this age group get tested annually for chlamydia and after any episode of unprotected sex with a new or casual partner.

About 50% of infected men will show no symptoms of chlamydia but the infection may cause burning during urination, discharge from the urethra, or anus, and pain and swelling in the testicles. Untreated, chlamydia can eventually cause long-term damage to the testicles which can impact male fertility, but the most feared complication of chlamydia is Pelvic Inflammatory Disease in women which often leads to fertility problems. It is for this reason that men mustn’t transmit chlamydia to women. Fortunately, chlamydia is usually very straightforward to treat with a short course of antibiotics.

Gonorrhoea

Gonorrhoea can also be identified with self-performed urine or swab testing. Similarly to chlamydia, it can cause discomfort during urination which is usually accompanied by discharge from the penis or anus. About 10% of people will experience no symptoms but these infections will still be picked up by testing. It is a bacterial infection and can also be treated with antibiotics.

Trichomoniasis

(Caused by the parasite Trichomonas Vaginalis) can cause no symptoms in up to half of people. When it does cause symptoms, men usually get discharge from the penis, pain on urination and irritation and swelling of the foreskin or the head of the penis. Trichomoniasis can be treated with a course of an antibiotic called metronidazole.

Mycoplasma Genitalum

Mycoplasma Genitalum is the last of the infections that can be picked up on a self-performed urine or swab sample. It is often not included in routine sexual health screenings although as many as 1 in 50 people may carry the bacteria. It often causes no symptoms and no lasting harm, but it can cause discharge, pain on urination, and testicular pain. Like the infections described above, it can be treated with antibiotics.

Blood borne viruses include HIV, hepatitis B and hepatitis C. Each of these is carried in the blood of those infected and can be transmitted by exposure to that blood, such as needle sharing or unsterilised tattoo equipment, or have been given a blood transfusion in a country that does not check for these infections in blood products. However, they can all also be acquired through sexual contact.

HIV

HIV is often the most feared STI due to its potential to cause serious, life-threatening complications if undetected and untreated. However, modern treatments have transformed the outlook for people with HIV, enabling them to live normal, long lives and reducing the likelihood of transmission. Early detection and treatment are crucial.

In the early stages, HIV may cause a brief flu-like illness, but it often remains symptomless for a long time while silently damaging the immune system, leading to AIDS. Blood tests for HIV typically check for HIV 1 (found worldwide) and HIV 2 (more common in West Africa). HIV has an incubation period of up to 90 days, so testing should be done (or repeated) 90 days after potential exposure.

Additionally, the P24 test detects a protein produced by the virus, which can be identified 2 to 3 weeks after exposure but usually disappears after 1 to 2 months. Ideally, an HIV test should include all three components for the most accurate results.

Hepatitis B

Hepatitis B primarily affects the liver and, while not common in the UK, is more prevalent in other parts of the world. Men who engage in sexual activity abroad are at a higher risk. Hepatitis B often presents no symptoms or only mild ones, such as abdominal pain, fever, fatigue, and jaundice (yellowing of the skin and eyes).

Most individuals recover from hepatitis B within 1 to 3 months. However, in some cases, the infection becomes chronic, potentially leading to severe liver damage and, ultimately, liver failure. If diagnosed with hepatitis B, antiviral treatments are available, typically under the care of a liver specialist.

Hepatitis C

Hepatitis C is similar in many respects to hepatitis B. It often causes no symptoms until late in the illness when significant liver damage has occurred which can take many years. Like hepatitis B, it can be treated with antiviral medication under the care of a liver specialist.

Syphilis

This is a bacterial infection that initially causes sores or lumps in the anogenital region and sometimes fever, swollen glands, or a rash on the palms and soles. These symptoms sometimes disappear on their own, but this does not mean that the infection has gone.

Before treatment was available, syphilis would often progress to cause severe complications and, ultimately, death. Thankfully it is now easily treated with antibiotics. There are several blood tests for syphilis. At One Day Tests, we test for ‘IgG’. This will tell you if you have ever had an infection, but not necessarily if you have a current infection. A positive result should therefore prompt some further investigations.

Herpes

Beyond the infections previously mentioned, some STIs are more challenging to diagnose with blood tests or swabs and require a medical professional's evaluation. Herpes is a prime example, caused by a virus similar to the one that causes cold sores around the mouth.

Herpes typically manifests as painful blisters, sores or ulcers around the genitals, especially during the first outbreak. These ulcers will eventually disappear but tend to recur periodically, with subsequent outbreaks generally becoming less severe and less frequent. While herpes can often be diagnosed through a physical examination, a special swab is ideal for confirming the infection, usually performed at a sexual health clinic. Although herpes cannot be cured, antiviral medication can reduce the duration and severity of outbreaks.

Parasitic infections, such as pubic lice and scabies, can cause severe itching. Scabies, in particular, is associated with a characteristic rash. Typically, these infections do not require diagnostic tests and are easily treated.

For many parasitic infections, the prognosis is excellent if treated promptly. As many of these infections cause few or no symptoms, regular screening is a prudent way to ensure everything is fine and to maintain peace of mind.

Maintaining sexual health is crucial for overall well-being. Regular screening for STIs can help detect infections early, ensuring prompt treatment and reducing the risk of complications. Whether you are experiencing symptoms or simply seeking peace of mind, One Day Tests offers comprehensive blood tests for men to meet diverse needs.