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STDS in men: Common infections and facts

 Common types of STDs in men include Chlamydia, gonorrhea, Trichomonas, and


genital herpes.
 Some of the most common STDs in men may not produce signs or symptoms.
 When present, signs and symptoms of STDs can be genital lesions or sores (as with
herpes or HPV), urethritis (with gonorrhea or Chlamydia), or systemic symptoms that
affect the entire body (such as HIV).
 STDs in men can be caused by bacteria, viruses, or parasites.
 Treatment for STDs in men is generally directed toward the causative organism. For
example, STDs caused by bacteria are typically curable with antibiotics.
 Some STDs, like herpes and HIV infection, persist for life.
 Early diagnosis of STDs as well as counseling about STDs and risks of spread can
help avoid spreading the infections to others.
 Zika virus also can be transmitted through sexual contact.

What are sexually transmitted diseases (STDs)?

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 and can be spread by infected people even when they are not
aware they have the infection.

Who is at risk for STDs?

Anyone who engages in any kind of sexual activity is at risk for STDs. The only way to
completely 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) have released a report that
estimates that 20 million new STD infections occur each year. People aged 15 to 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.

What causes STDs in men?

 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.

What are the signs and symptoms of STDs in men?

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In men, STDs can be grouped into three categories:

 STDs that predominantly cause genital lesions (sores or abnormalities on the genital organs)
 STDs that predominantly cause inflammation of the urethra (urethritis)
 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, or ulcers. STDs that cause urethritis cause early signs and symptoms often
associated with a urinary tract infection, including a painful or burning sensation during
urination and discharge from the urethra.

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

List of STDs in men

There are a variety of STDs that can affect sexually active men. The following list describes
the signs, symptoms, and treatments for STDs in men.

1. Chlamydia

Chlamydia is a bacterial infection that is common in young adults who are sexually active. 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.

2. Gonorrhea

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 usually causes symptoms, when
present, about 4 to 8 days after infection. Gonorrhea can also cause infection in the rectum
and in the throat. Moreover, it is possible for gonorrhea to spread within the body, causing
symptoms like rash and joint pain. Antibiotics, such as cefixime 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.

3. Trichomoniasis

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.

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4. HIV

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. There are no specific symptoms that 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 progression of the illness.

5. Genital herpes
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, the HSV
type 1 (HSV-1) causes cold sores around the mouth, while the HSV type 2 (HSV-2) causes
genital herpes, but both types of HSV are capable of infecting the genital area. As with some
other STDs, it is possible to be infected with HSV and not have signs or symptoms, or to
have very mild symptoms. Even when symptoms have occurred in the past, it is possible to
transmit the infection during any time 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.

HSV infection is not curable and persists for life. The infection has the potential to cause an
outbreak at any time, although affected people vary in terms of the number and severity of
outbreaks. Antiviral medications can shorten the severity and duration of an outbreak. For
people who have very frequent outbreaks, antiviral medications are often recommended as
ongoing therapy to suppress the virus.

6. Genital warts (HPV)

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 chances 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.

7. Hepatitis

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 the HIV virus. HBV may not cause symptoms, but it causes symptoms of
acute hepatitis in about 50% of infections. The primary danger with HPV 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% to
85% of people infected) develop chronic infection with the possibility of liver damage. There
is also no vaccine available against HCV.

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8. Syphilis

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 to 90 days after infection and resolves after 3 to 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.

9. Zika virus

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.

Which specialties of doctors treat STDs in Men?


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.

How are STDs in men diagnosed?

Many STDs are diagnosed based upon the 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 identification of the organism. A
number of different tests are available for STDs in men that are based either upon detection
of the surface proteins of the organism or of the genetic material of the organism. These
methods are more commonly used than the culture to identify sexually transmitted infections.

What is the treatment for STDs in men?

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STDs caused by bacteria -- chlamydia, gonorrhea, and syphilis -- are typically curable with
antibiotics. Trichomonas infection can also be cured with effective medications that eliminate
the parasite.

Viral STDs may resolve on their own, such as 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. HBV and, to a greater extent, HCV infections may persist and
develop into 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 the condition. HSV infection persists for life,
although antiviral drugs can help reduce the severity and frequency of outbreaks.

What is the prognosis for STDs in men?

When untreated, some otherwise treatable STDs can spread throughout the body, causing
serious consequences. 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 HCV and HBV to a lesser extent can
cause liver damage that sometimes progresses to liver failure. Herpes infection persists
throughout life, with the possibility of future outbreaks of the illness.

Can STDs in men be prevented?

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 risk of exposure to infections. Early diagnosis and
recognition of infections as well as counseling about STDs and risk can help avoid further
spread of infections.