The following are some of the symptoms or problems you may be concerned about. There are tests and treatments available for the vast majority of them.
This is often caused by a sexually transmitted infection such as Chlamydia or the non-specific urethritis (NSU) group of bacteria. Some of these include bacteria such asmycoplasma and ureaplasma, and screening tests for these have only recently become available recently in the UK. Fortunately, The Doctors Laboratory is now able to offer them to you through our sexual health clinic.
Gonorrhoea is a less common cause of discharge, but an important one, and can be simply tested by a urine test or another painless sample.
If an infection is diagnosed, then a short course of antibiotics, usually tablets, will resolve most discharges.
Again, this may be a symptom or sign of infection, and all of the above bacteria can contribute to it.
Epididymitis or orchitis (inflammation of the epididymis or the testicle) may be caused by Chlamydia or the NSU group of bacteria. The epididymis is a curved structure behind the testicle and consists of a long narrow tube. It stores sperms that have been maturing.
An examination and urine test will help to diagnose this condition. Effective treatment will often be in the form of antibiotics, taken by mouth for two weeks or more.
Commonly, men also develop other types of swelling in the scrotum, such as cysts. These lumps are usually separate from the testicle itself and may be in the epididymis. They are often smooth and not painful. A gentle examination may be all is that’s needed for the diagnosis, although an ultrasound test can be useful too. As they are harmless, they are often best left alone.
The most common, but important, cause for these is genital warts (caused by HPV, the Human Papillomavirus) which is one of the most frequently diagnosed sexual infections in the UK. They tend not to disappear spontaneously, and may grow in size and number. Although often soft and pink, they may be firm or darkly pigmented in many men.
Treatment of genital or anal warts is often possible by way of a cream or paint, or by the doctor performing cryotherapy, in the form of a very cold spray (which freezes the warts).
However, there are many harmless causes of lumps around the genital area, and an examination may allow us to reassure you that no treatment is needed, and that you are not infectious.
One of the important causes of this is genital herpes, caused by Herpes Simplex Virus Type 1 or 2 (HSV), and it can affect the genitals and the area around your anus (even if your sexual experience has only been with women).
An examination and tests will be needed to confirm the diagnosis.
As you may be infectious to your sexual partners during the time the spots are present, and sometimes for longer, you will be given advice about this.
Fortunately there are effective treatments for attacks of herpes, which may last from 5 to 14 days if not treated. You may be prescribed a short course of antiviral tablets, for example, which will resolve the lesions (sores).
However, genital (or peri-anal) herpes may recur in the future, as HSV can lay dormant (inactive) for many years, in the nerves close to the spinal cord. So you will be given full information regarding how to manage any future episodes, including strategies for reducing their frequency.
On the other hand there are other less worrying causes of painful sores on the penis or scrotum, such as simple infection of the oil glands (follicles). This condition can often be diagnosed with a quick examination. These spots often cure themselves and your doctor can reassure you.
This common condition often results in irritation or burning under the foreskin, or over the end of the penis (sometimes called the helmet, or glans). Your skin may look red, and there may be a discharge like cottage cheese under the foreskin. Men who are circumcised are less likely to be affected by thrush.
Thrush (candidiasis) is caused by excessive growth of the yeast fungus Candida albicans, and is not a sexually transmitted condition. This yeast lives harmlessly on the penile skin and is normally kept under control. However, if conditions change you can develop the signs and symptoms described above.
Thrush can usually be diagnosed by a quick examination by the doctor, or a painless sample can be taken with a small swab stick rolled gently over the affected parts.
The skin of your penis, scrotum, and groins and around your anus is quite sensitive to dryness and friction. So if you use too harsh a shower gel, or are frequently rubbing this area, the skin becomes dry, flaky and even inflamed. The resulting rash is called eczema, and is itchy, red and often sore—it sometimes known as dermatitis.
Treatment will include a discussion with you about more suitable agents for you to use in the shower or bath, ways to prevent irritation of the area, and possible prescription of a cortisone-based cream to use for up to a month or more.
his rash is not easy for a patient to diagnose for himself, as there are many similar, but important, conditions that it can resemble. For example, the rashes of psoriasis, contact dermatitis and fungal infection have different causes and so need specific management. Consequently a careful examination by your doctor will be needed so that the correct diagnosis can be made, and the best treatment prescribed.
Most men at varying stages of their life have difficulty getting satisfactory erections (erectile dysfunction, or impotence) but some help can invariably be offered. The condition may have multiple factors contributing to it, so each patient needs specific advice and management—it can, of course, have a marked effect on your well-being, self esteem and relationships.
The consultation may entail a general examination, and a careful search for problems in the blood circulation (cardiovascular system) and the presence of, say, diabetes, low hormone levels and depression. As your current sexual circumstances will also be important, we will discuss your own unique situation with you in confidence.
Your physician will be able to advise you whether tablets such as sildenafil (Viagra) would be safe and effective, and prescribe them if appropriate. Occasionally, other specialists such as an andrologist may be recommended if your circumstances require it.
On the other hand, many men, often when they quite young, experience too rapid an orgasm. This is often calledpremature ejaculation. This can be an embarrassing condition to disclose, even to a doctor, but we promise to listen sympathetically and confidentially to your circumstances. If you have a regular partner, you will be aware that she (or he) may be distressed by this, just as you are.
Fortunately, there are often useful strategies and treatments to overcome this condition, and you can expect to usefully lengthen the time that you can enjoy having intercourse before climaxing.
As well as having tests to exclude any sexual infections, treatment may be offered in the form of medication, or by involving your partner in “couples therapy”, where you are trained (as a couple) to help prolong your intercourse through simple techniques. We would find accredited professional therapists for this at a place and time convenient for you.
Many of our patients are feeling perfectly healthy and would simply like a sexual health screen to make sure you have no infections (STDs).
If this is the case, you are most welcome to book in for a consultation with our physician, who will tailor your tests to your needs and circumstances. These are likely to take the form of urine test and blood tests, and we will arrange to have your results given to you as rapidly as possible, hopefully within the same day, and certainly within the week.
Your consultation would include an examination if you would like this, at no extra charge.
You may wish to take advantage of one of the preventive vaccines such as against Hepatitis B (Engerix) or HPV , the wart virus (Gardasil). You should discuss with your physician whether one of these might be useful for you in reducing your future risk of contracting one of these STDs.