Deal with syphilis and other venereal disease
Male sexual health is important: be in control
- venereal disease, STI and STD all mean the same thing
- practice safe sex and address possible infection immediately
- confidential testing and advice for STDs
Dr Morton's Test Kit© for all 4 major STIs
Male sexual health covers sexually transmitted infections and diseases of the testes, prostate and penis
Male sexual health receives much less publicity and attention than female sexual health. Interestingly, the same applies to male mental health. Unless you are having monogamous sex with a similarly monogamous partner who is free from sexually transmissible diseases, you are at risk. The number of new cases of gonorrhoea and syphilis is increasing rapidly in the UK.
All STIs are transmitted by unprotected oral, anal or vaginal sex.
Chlamydia is the commonest sexually transmitted disease in the UK. Gonorrhoea is the second commonest with approximately 20,000 new cases per year. This number is rising. Chlamydia testing at universities and through other national initiatives has been highly successful, but the same does not apply to syphilis, gonorrhoea, HIV/AIDS (human immunodeficiency virus), herpes and genital warts, all of which are on the increase. Hepatitis B is also sexually transmitted, but infection in the UK is more commonly through intravenous drug use.
The number one message is that people having sex in which there is risk should use condoms. Failing that the most important advice is to get tested and treated as quickly as possible. It is very difficult to distinguish between genital ulcers and penile discharge due to one STI or another, so do not try. Either send for a home test kit such as
Syphilis and gonorrhoea are bacterial infections which are treatable with antibiotics. There is an increasing problem with antibiotic resistance in the treatment of gonorrhoea.
HIV, genital herpes, genital warts and hepatitis B are caused by viruses. Some viruses can be treated with antiviral agents. The outlook for people with HIV has improved beyond recognition over the last 20 years with antiviral triple therapy, as well as the fact that people have beome much more inclined to get themselves tested rather than ignore possible infection.
Vaccines are available to protect against hepatitis B and human papilloma virus, which causes genital warts.
A major role of GUM clinics is contact tracing. If you feel you have put someone else at risk, suggest they be tested too.
What is syphilis?
Syphilis is a bacterial infection (caused by Treponema pallidum) which has 3 phases:
The primary disease is characterised by an ulcer on the genitals. It is described as a ‘punched out’ ulcer or sore. It will usually heal by itself in 2 – 6 weeks. You are very infectious when it is there. Left untreated the next (secondary) phase features a non-itchy skin rash and a sore throat, sometimes with a fever and headache, which again will subside on their own. You are still very infectious during this phase.
Still untreated, tertiary syphilis can arise years later and is famous historically for causing the death of monarchs, artists, composers and other well-known characters ranging from Al Capone to Paul Gauguin, who died with syphilitic dementia. Other organs such as the heart can be damaged.
Syphilis is diagnosed by a blood test and sometimes from a swab taken from an ulcer.
Treatment is with penicillin.
Syphilis is one of the infections which is screened for during early pregnancy, as it can be passed onto the unborn baby causing serious mental retardation, blindness and heart problems. These things can be prevented by giving antibiotics to the mother.
Gonorrhoea (caused by Neisseria gonorrhoea bacteria) is often called ‘clap’ or ‘drip’. It is the second most common sexually transmitted disease with 30,000 new cases in the UK in 2013. One in 10 men have the disease but no symptoms, but it usually causes pain on passing urine (cystitis), discharge from the penis and painful swollen testicles. Following oral sex it can cause a sore throat and swollen glands in the neck. It is very infectious. Current best practice treatment is a single intramuscular injection with an antibiotic called ceftriaxone together with a single oral dose of azithromycin. It is also treated with ciprofloxacin or azithromycin. Unfortunately, antibiotic resistance is an increasing problem and it is sensible to be tested properly so as to be certain that you are given the right antibiotic. Like chlamydia, it is a serious cause of female infertility so the importance of contact tracing and honesty cannot be over-emphasized. Walk-in GUM clinics offer a great service.
Genital warts are caused by certain types of human papilloma virus (HPV). They are small itchy raised bumps on the penis or around the anus. Other types of HPV cause cancer of the cervix in women and cancer of the mouth and throat in men who have oral sex. Hopefully the introduction of HPV vaccine in schools (currently only for girls but planned for boys as well) will lead to a reduction of HPV related disease in both sexes.
Warts are treated by painting them with acid, freezing (cryotherapy) or burning them (cautery).
HIV / AIDS
Over 35 million people in the world live with HIV. HIV is most common in gay men and intravenous (IV) drug users. The prevalence varies enormously in different parts of the world, with the southern half of Africa having the highest number of infected people. HIV can be transmitted by a blood transfusion of unscreened infected blood or by infected needles, but is mainly transmitted by sexual acts of any variety. Being tested no longer prejudices a life assurance or health insurance policy. Treatment is with triple antiviral therapy. Complications arise through loss of immune cell function leading to increased vulnerability to infections and to developing cancers such as Kaposi's sarcoma. This tumour is caused by a variety of the herpes virus which is usually dealt with by the body's immune system. When immunity is weakened, it can cause tumours to develop in various organs. On the skin these are raised purplish lumps.
All pregnant women in the UK are offered screening for HIV.
Hepatitis B is another highly contagious viral infection which is transmitted via blood and other bodily fluids. It is much commoner in certain parts of the world, particularly the Far East, than it is in the UK. Apart from acute illness it can lead to chronic liver infection and even to liver cancer. Women are screened during early pregnancy and their babies are protected against infection with an injection of immunoglobulin at birth and then an active immunisation programme.
Urinary tract infection
Urinary tract infection is relatively uncommon in men but it does occur.
Fungal or yeast infection of the groin is particularly common in hot moist climates. This causes redness and itching in the groin and on the scrotum and penis, and is commonly called "jock itch".
- discharge from the penis
- soreness or pain during sex
- pain and swelling of the testicles
- small lumps on the penis or around the anus
- fever and general aches and pains
- skin rash
- pain when urinating which is called dysuria
- blood in urine
- itching and redness around the groin and scrotum
There is really no way of distinguishing one type of infection from another and indeed people who have caught one venereal disease may have caught others. If there is any possibility of infection, it is important to be safe and get tested.
When you should contact a doctor
If you are unsure about symptoms and what to do and need advice or reassurance
You should be tested either at your local GUM clinic or your GP. Alternatively send for
Our doctors screen the
Do not delay in getting tested and seeking treatment. Be honest and thorough about informing your partner about the need for testing.
It is not unreasonable to take treatment for chlamydia if you have been exposed. Azithromycin 1g taken as a single dose is recommended, and is contained in
If you are prone to herpes cold sores when you go in the sun, or get recurrent genital herpes, you should obtain
With Dr Morton’s – the medical helpline© you can email or phone our doctors at any time for more information, reassurance or advice.