STDs in Men

Sexually transmitted diseases often have specific symptoms in men. 

Sexually transmitted diseases (STDs) are infections transmitted during sexual contact. STDs are often referred to as sexually transmitted infections (STIs). STDs can be transmitted during any type of sexual activity.

Some STDs can be cured with a course of antibiotics, while others persist and are not curable. Some STDs may cause debilitating signs and symptoms, while others may be present without causing symptoms at all. Many STDs do not cause notable signs or symptoms so a person can have one and not know it, and consequently, spread the infection to others.

Common types of STDs in men include the following:

• Chlamydia
• Gonorrhea
• Trichomoniasis
• HIV
• Genital herpes
• Hepatitis B and C
• Syphilis
• Zika virus

Some of the most common STDs in men may not produce signs or symptoms.

Chlamydia is a bacterial infection that is common in sexually active young adults. It is caused by the bacterium Chlamydia trachomatis. Both men and women can be infected, and many of those infected do not have any signs or symptoms.

When it does cause symptoms in men, symptoms of urethritis are the most common. It can also cause infection of the epididymis and testes. Chlamydia infection can be cured with antibiotics such as azithromycin. However, reinfection can occur, especially when sex partners of an infected person are not treated.

Like chlamydia, gonorrhea is a bacterial infection that may not always cause signs and symptoms and can remain undiagnosed. Also similar to Chlamydia, gonorrhea can cause urethritis in men, leading to burning or pain on urination and discharge from the urethra.

Gonorrhea is caused by Neisseria gonorrhoeae bacteria, and when symptoms do occur, they develop about 4-8 days after contracting the infection. Gonorrhea can also cause infection in the rectum and the throat. Moreover, gonorrhea can spread within the body, causing symptoms like rash and joint pain.

Antibiotics, such as cefixime (Suprax) are typically used to treat gonorrhea, although other antibiotics have also been used. Treatment is often given that is also curative for Chlamydia infection, since these two infections frequently occur together.

Trichomoniasis is a sexually transmitted infection caused by the Trichomonas vaginalis parasite. Most women and men who are infected do not have symptoms, and as with chlamydia and gonorrhea, may not know they are infected. When the infection does cause symptoms, it typically results in urethritis, with itching or burning and discharge from the urethra.

Trichomonas infection can be cured with a single dose of antibiotic medication. Metronidazole and tinidazole are antibiotics commonly used in the treatment of trichomonas infection.

The human immunodeficiency virus (HIV) is perhaps the most feared STD. Infection with the HIV virus can occur during sexual contact, by sharing needles, or from an infected pregnant woman to her baby. The virus ultimately causes dysfunction of the body's immune system at a later time point. The average time from infection to immune suppression is 10 years.

No specific symptoms signal HIV infection, but some people develop fever and a flu-like illness 2 to 4 weeks after they have contracted the virus. Once immune suppression is present, serious complications like unusual infections, certain cancers, and dementia may develop. Numerous medications are available to help affected people manage the infection and delay or prevent the progression of the illness.

The herpes simplex viruses (HSVs) cause painful blistering sores on sexually exposed areas of the body. They can be transmitted during any type of sexual contact. Typically, HSV type 1 (HSV-1) causes cold sores around the mouth, while HSV type 2 (HSV-2) causes genital herpes, but both types of HSV are capable of infecting the genital area. Like some other STDs, it is possible to become infected with HSV and have very mild symptoms or none at all. Even when symptoms have occurred in the past, it is possible to transmit the infection during any period in which symptoms are not present.

The lesions caused by HSV typically take the form of painful blisters that eventually open, forming ulcers, and then crust over. In men, the sores can be found on the penis, scrotum, buttocks, anus, inside the urethra, or on the skin of the thighs. The first outbreak of HSV infection may be more severe than subsequent outbreaks and can be accompanied by fever and swollen lymph nodes.

Hepatitis is inflammation of the liver. Hepatitis B and hepatitis C are two viral diseases that can be transmitted by sexual contact. Both the hepatitis B virus (HBV) and hepatitis C virus (HCV) are transmitted by contact with the blood of an infected individual or by sexual activity, similar to HIV.

HBV may not cause symptoms, but it causes symptoms of acute hepatitis in about 50% of infections. The primary danger with HBV infection is that around 5% of those infected progress to have long-term liver damage, or chronic hepatitis B. People with chronic hepatitis B are at increased risk for the development of liver cancer. There is a very effective vaccine available for the prevention of hepatitis B. Treatment of acute hepatitis involves supportive care and rest, although those with chronic hepatitis may be treated with interferon or antiviral medications.

Unlike HBV, HCV is rarely transmitted by sexual contact and is usually spread by contact with the blood of an infected person. Still, it is possible to transmit this virus as a result of sexual contact. Most people infected with HCV have no symptoms, so a delayed or missed diagnosis is common. In contrast to hepatitis B, most people with HCV infection (75%-85% of people infected) develop chronic infection with the possibility of liver damage. There is also no vaccine available against HCV.

Human papillomavirus infection (HPV) is a very common STD. Different types of HPV exist and cause different conditions. Some HPVs cause common warts that are not STDs, and other types are spread during sexual activity and cause genital warts. Still, other types are the cause of precancerous changes and cancers of the cervix in women.

Most people with HPV infection do not develop genital warts or cancers, and the body is often able to clear the infection on its own. It is currently believed that over 75% of sexually active people have been infected at some point in life. When HPV causes genital warts in men, the lesions appear as soft, fleshy, raised bumps on the penis or anal area. Sometimes they may be larger and take on a cauliflower-like appearance.

There is no cure for HPV infection, but it often resolves on its own. Treatments to destroy or remove genital warts are also available. Vaccines are available for boys and girls that confer immunity to the most common HPV types.

Syphilis is a bacterial infection caused by Treponema pallidum bacteria. If not treated, the disease progresses through three phases and can also persist in a latent state. The initial manifestation is a painless ulcer known as a chancre at the site of sexual contact. The chancre develops 10-90 days after infection and resolves after 6 weeks.

Syphilis can be treated with antibiotics, but if this first stage is untreated, secondary syphilis can develop. In secondary syphilis, there is spread of the disease to other organs, causing various symptoms that can include skin rash, swollen lymph nodes, arthritis, kidney disease, or liver problems. After this stage, some people will have a latent infection for years, after which tertiary syphilis develops. Tertiary syphilis can cause different conditions including brain infection, the development of nodules known as gummas, aortic aneurysm, loss of sight, and deafness. Fortunately, syphilis is curable with proper antibiotic treatment.

The Zika virus has been associated with birth defects in babies born to infected mothers. Transmission of Zika virus occurs among humans by the bite of an infected vector mosquito. However, sexual transmission of the Zika virus is also possible, and an infected individual may spread the virus to his or her sex partners.

STDs can be caused by different kinds of microorganisms, including viruses, bacteria, and parasites.

• Sexually transmitted viral infections include human papillomavirus (HPV), human immunodeficiency virus (HIV), herpes simplex virus (HSV), hepatitis B and C, and human herpesvirus-8 (HHV-8).
• Sexually transmitted bacterial infections include syphilis, gonorrhea, and chlamydia.
• Trichomonas is an example of a sexually transmitted infection caused by a parasite. Infestations with parasitic bugs, such as lice or scabies, can also be transmitted by close contact and may be acquired during sexual activity.
• Humans contract the Zika virus through the bite of an infected vector mosquito, and the Zika virus can be transmitted to others through sexual contact.

Anyone who engages in any kind of sexual activity is at risk for STDs. The only way to eliminate the risk of acquiring an STD is abstinence from sexual activity. The use of latex condoms during sexual contact can greatly reduce the chances of contracting many STDs, but no method is completely safe.

The U.S. Centers for Disease Control and Prevention (CDC) has released a report that estimates that 20 million new STD infections occur each year. People ages 15-24 account for about half of those newly infected. Young men and young women are about equally affected.

According to the CDC, sexually active gay, bisexual, and other men who have sex with men (MSM) are at greater risk for acquiring STDs. In addition to an increased risk of syphilis, over 50% of all new HIV infections occur in MSM.

In men, STDs can be grouped into three categories:

1. STDs that predominantly cause genital lesions (sores or abnormalities on the genital organs)
2. STDs that predominantly cause inflammation of the urethra (urethritis)
3. STDs that cause symptoms and signs throughout the body (systemic STDs)

Some of the STDs that cause local lesions or urethritis, including gonorrhea and syphilis, can also cause damage to other organs and spread within the body if not treated.

Depending upon the exact infection, STDs that cause genital lesions may cause:

• Genital warts
• Painful blisters
• Ulcers

STDs that cause urethritis cause early signs and symptoms often associated with a urinary tract infection, including:

• Painful or burning sensation during urination
• Discharge from the urethra

The section below reviews the specific signs and symptoms of eight common STDs.

Healthcare professionals that help diagnose and treat STDs in men may include:

• STDs in men may be treated by primary care practitioners, including internists and family practitioners.
• Urologists are physicians with specialized training in conditions involving the male reproductive system, and they may be involved in the care of STDs in men.
• For certain STDs, other specialists, including gastroenterologists (hepatitis) or immunologists (HIV) may be consulted.

Many STDs are diagnosed based on clinical history and characteristic physical findings. Herpes and syphilis are two conditions that can produce identifiable signs and symptoms.

Often the diagnosis of an infection depends upon the identification of the organism. Several different tests are available for STDs in men that are based either on the detection of the surface proteins of the organism or on the genetic material of the organism. These methods are more commonly used than the culture to identify sexually transmitted infections.

The treatment for STDs in men depends on the type of infection, which may include:

• STDs caused by bacteria - Chlamydia, gonorrhea, and syphilis - are typically curable with antibiotics.
• Trichomoniasis can be cured with effective medications that eliminate the parasite.
• Viral STDs may resolve on their own, such as genital warts (HPV) infection. There is no treatment for HPV infection, although it commonly does not cause problems.
• Genital warts can be treated by destruction and removal.
• The hepatitis B virus (HBV) and, to a greater extent, the hepatitis C virus (HCV) infections may persist and develop into a chronic infection. Antiviral drugs and interferon may be used to manage these long-term infections, but they do not cure the infection.
• Likewise, HIV treatment drugs can manage the infection, but they do not cure it.
• The herpes simplex virus (HSV) infection persists for life, although antiviral drugs can help reduce the severity and frequency of outbreaks.

STDs caused by bacteria are typically curable with antibiotics while some STDs, like herpes and HIV infection, are not curable and persist for life.

When untreated, some treatable STDs can spread throughout the body, causing serious consequences, such as:

• Gonorrhea and syphilis are examples of treatable conditions that can cause serious consequences if not treated.
• HIV infection causes immune suppression that can lead to death from cancers or rare infections, although treatments are available to postpone or delay the immunosuppressive actions of the virus.
• Both hepatitis B and C can cause liver damage; however, they may cause liver damage that sometimes progresses to liver failure.
• Herpes (HSV) infection persists throughout life, with the possibility of future outbreaks of the illness; however, there is no cure.
• Herpes (HSV) infection persists throughout life. There is no cure.

Certain tips may help prevent you from getting an STD, such as:

• Using condoms can help prevent the transmission of many STDs, but no method of prevention is 100% safe. Sometimes, STDs may affect areas not ordinarily covered by a condom during sexual activity.
• Prevention can also be difficult because many people will not show specific signs or symptoms of an STD even though they may be infected.
• While abstinence from sexual activity is the only absolute way to prevent STDs, limiting the number of sexual partners can help reduce the risk of exposure to infections.
• Early diagnosis and recognition of infections as well as counseling about STDs and risk can help avoid the further spread of infections.