It is important that men are aware of the signs and symptoms of common STIs as they are less likely than women to get tests for these infections. With early treatment, people with STIs have an excellent outlook.
In this article, we look at some of the most common STIs in men and discuss the signs and symptoms, prevention methods, and available treatment options.
Signs and symptoms of STIs in men
Not all STIs have visible symptoms.
According to the World Health Organization (WHO), people around the globe contract more than 1 million STIs every day.
In some cases, an STI does not cause any visible symptoms, so it is possible to have one without knowing it. People can also mistake any symptoms that do develop for those of other conditions.
Below, we discuss the most common STIs and the signs and symptoms that may occur in men.
Chlamydia is a bacterial STI that an infected person can pass on by having anal, oral, or vaginal sex without a condom. Men can get chlamydia in the urethra, rectum, or throat.
People refer to chlamydia as a "silent" infection because people are often unaware that they have it. The majority of chlamydia infections in men do not cause any symptoms, but some men can develop symptoms several weeks after infection.
Common signs and symptoms of chlamydia in the urethra in men include:
- discharge from the penis
- pain when urinating
- burning or itching around the opening of the penis
- pain and swelling in one or both testicles
Chlamydia infections in the rectum are less common, but they do occur. Although these infections usually have no symptoms, they can cause:
- rectal pain
On rare occasions, chlamydia can infect the epididymis, which is the tube that carries sperm from the testicles to the vas deferens. This can cause:
- in rare cases, fertility issues
Healthcare providers usually collect urine samples to test for chlamydia in men, but they may use a cotton swab to get a sample from the urethra instead.
Curing chlamydia with oral antibiotics is relatively straightforward. Treatment consists of either a single dose or a 7-day course of an antibiotic. Repeat infections are common, so it is wise to get another test for chlamydia after completing treatment.
Herpes is an infection with the herpes simplex virus (HSV). There are two types of herpes simplex virus that affect different parts of the body:
- Herpes simplex virus type 1 (HSV–1), also called oral herpes, causes cold sores in and around the mouth.
- Herpes simplex virus type 2 (HSV–2) almost always spreads through sex without a condom and causes genital herpes.
Many people who have herpes will not have any symptoms, and those who do may have a difficult time identifying them.
Symptoms typically appear 2–12 days after infection. Sometimes herpes blisters are so mild that they can resemble insect bites, ingrown hairs, or razor burn.
Common signs and symptoms of herpes in men include:
- painful blisters or open sores in or around the mouth
- blisters on the genitals, rectum, buttocks, or thighs
- tingling, itching, or burning sensations of the skin around the blisters
- sore muscles in the lower back, buttocks, and upper legs
- loss of appetite
Healthcare providers can use the following tests to help diagnose herpes:
- Polymerase Chain Reaction (PCR) test. This test examines the individual's DNA to see if they have herpes. It can be useful when people do not have any visible symptoms.
- Blood tests.
- A cell culture. Healthcare providers use this test when someone has visible sores around their genitals. The test involves collecting a sample of the fluid inside one of the sores.
There is no cure for herpes, and people may experience recurrent outbreaks over time. Treatments focus on managing the symptoms and extending the time between outbreaks.
A doctor may prescribe antibiotics to treat gonorrhea.
Gonorrhea is an infection with the bacterium Neisseria gonorrhoeae. Gonorrhea can affect the urethra, rectum, or throat. People can transmit these bacteria through vaginal, anal, or oral sex without a condom.
Most men who have gonorrhea show no symptoms. When gonorrhea in the urethra does cause symptoms, these usually appear 1–14 days after infection.
Common signs and symptoms of gonorrhea in men include:
- painful urination
- white, yellow, or gray discharge from the urethra
- pain in the testicles
- itching and soreness in the anus
- painful bowel movements
- bloody discharge from the anus
Healthcare providers can treat gonorrhea with antibiotics. The CDC recommend dual therapy with ceftriaxone and azithromycin. Medication will stop the infection, but it will not repair any damage that the disease causes.
Healthcare providers are becoming increasingly concerned about the rise of antibiotic-resistant gonorrhea, which will make successful treatment much more difficult, if not impossible.
Bacteria are also responsible for syphilis, which people transmit through vaginal, anal, or oral sex without a condom.
Men who have sex with men (MSM) have a higher risk of contracting syphilis. Almost 70 percent of primary and secondary syphilis diagnoses in 2017 were in MSM.
Syphilis is also known as "The Great Pretender" because its symptoms can resemble those of other diseases. Symptoms usually appear 10–90 days after infection, with 21 days being the average.
The symptoms of syphilis progress in stages known as primary, secondary, latent, and tertiary. Each stage has its own unique set of symptoms that can last for weeks, months, or even years.
The symptoms of primary syphilis include:
- a small, firm sore where the bacteria initially entered the body, usually on the penis, anus, mouth, or lips
- sores can also appear on the fingers or buttocks
- swollen lymph nodes in the neck, groin, or armpits
Secondary syphilis can cause the following signs and symptoms:
- skin rashes on the palms of the hands or soles of the feet
- large gray or white lesions in the mouth, anus, armpit, or groin
- a sore throat
- swollen lymph nodes
- hair loss
- muscle aches
The latent, or "hidden," stage of syphilis, during which there are no visible symptoms, can last for several years.
Tertiary syphilis is very rare. It can cause severe health complications that affect multiple organ systems. The symptoms of tertiary syphilis include:
Healthcare providers are likely to run blood tests or examine some of the fluid from a sore to check for syphilis.
A healthcare provider may recommend an antibiotic called benzathine benzylpenicillin to treat primary, secondary, and early latent syphilis. People who are allergic to penicillin will need to use a different antibiotic, such as doxycycline or azithromycin.
Although antibiotics will prevent the infection from progressing, they cannot repair any permanent damage resulting from the infection.
Human Papillomavirus (HPV)
Men and boys under 26 years of age can have the HPV vaccination.
Human Papillomavirus (HPV) is a group of related viruses, comprising more than 150 strains.
HPV is one of the most common STIs. According to the CDC, HPV mainly affects people in their late teens and early 20s.
Most men who contract HPV never develop symptoms, but some may notice symptoms several months or even years after the initial infection. The most common symptoms of HPV in men are warts in the mouth or throat and genital warts, which are small bumps around the penis or anus.
HPV is unusual among STIs as there is a vaccine that can prevent it.
In fact, there are two FDA-approved HPV vaccines, which are called Gardasil and Cervarix. These vaccines are effective against HPV types 16 and 18, which are high-risk strains because they are responsible for causing certain types of cancer.
The CDC recommend that children aged 11 to 12 years old receive the HPV vaccine to protect them against complications of the infection.
The CDC also recommend that older boys and men up to the age of 26 get the HPV vaccine if they did not receive a vaccination when they were younger.
At present, there is no routine screening to check men for HPV, and there are no reliable HPV tests. However, a healthcare provider may be able to make a diagnosis based on any genital warts that are present.
Most cases of HPV resolve without treatment and do not cause any health complications. However, if HPV does not go away and a person does not receive treatment, it can cause health problems, including certain types of cancer.
There is no approved treatment for HPV, but it is possible to treat the symptoms and complications. For example, men can use topical and oral medications to treat genital warts.
Human immunodeficiency virus (HIV)
Human immunodeficiency virus (HIV) is a virus that attacks the body's immune cells.
HIV spreads through contact with infected bodily fluids, such as semen, vaginal fluids, and blood. Having sexual intercourse without a condom is the most common method of transmission.
Many people who have HIV will experience flu-like symptoms within 2–6 weeks of infection. Common signs and symptoms of HIV in men are:
- a sore throat
- a body rash
Other symptoms may include:
- joint and muscle pain
- swollen lymph nodes
- nausea and vomiting
There is no cure for HIV, but healthcare providers can prescribe effective treatment to prevent symptoms, transmission, and progression to stage 3 HIV, which is also called acquired immunodeficiency syndrome (AIDS).
Healthcare providers use antiretroviral therapy (ART) to treat HIV. ART reduces the amount of HIV in the blood and other bodily fluids.
When people take these medications according to the directions, they eliminate the risk of transmitting the disease to other people. When HIV is undetectable, it is not transmittable, meaning that it cannot pass from one person to another.
With the treatments that are currently available, it is rare for HIV to develop into AIDS.
Hepatitis is inflammation of the liver, which often occurs due to a viral infection. One of the most common hepatitis viruses is the hepatitis B virus (HBV). HBV can spread between people in blood, semen, and other bodily fluids.
Healthcare providers will classify an HBV infection as either acute, meaning that it is temporary and will last for a few weeks, or chronic, in which case it will be a severe and lifelong condition.
Hepatitis B signs and symptoms include:
- loss of appetite
- abdominal pain
- muscle and joint pain
- jaundice, which causes dark urine and a yellowing of the skin
Hepatitis B is preventable. As with HPV, there is a vaccination available that protects against hepatitis B. The World Health Organization (WHO) recommend at least three doses of the hepatitis B vaccine for all infants.
Healthcare providers will look for signs of liver damage, such as jaundice. Some tests that can help diagnose hepatitis B include:
- blood tests
- liver ultrasound
- liver biopsy
There is currently no treatment available for acute hepatitis B. However, people can use medications for chronic hepatitis B, and scientists are developing new medications.
People who have chronic hepatitis B will need regular medical checkups for signs of liver disease.
Many men who contract an STI do not have any symptoms, which means that the actual number of STI cases is likely to be much higher than the number of cases that healthcare providers see.
With treatment, men with STIs have a good outlook. However, infections can become chronic, lifelong conditions if they do not receive treatment.
Men can prevent STIs by using condoms during sex. It is also possible to prevent some STIs with vaccinations.
Men who are sexually active should ensure that they have tests for STIs. The early detection of these infections will allow quicker treatment and stop men from spreading infections to others.