Men’s Health
Introduction
Sexual health is important for a man’s wellbeing, whether you’re trying to prevent pregnancy and sexually transmitted infections or you’re worried about erectile dysfunction or other problems related to men’s sexual health. This means enjoying the sexual activity you want, safely, without causing you or anyone else any suffering including physical, mental, emotional or financial distress.
A Healthy Sex Life
A healthy sex life means something different to everyone. There is no set amount of sex you should have. Everyone’s libido is different.
A healthy sex life is about understanding your body, communicating with partners, and practising safer sex to protect against STIs and unplanned pregnancy.
Good sexual health requires regular STI testing and reducing risk by practicing safer sex. Regular testing will make sure STIs are quickly diagnosed and treated. You can get tested at a sexual health clinic. This is a confidential service and no one is told of your visit or what tests and treatment you receive.
If you have any concerns or changes, support is available and it’s always okay to ask for help.
STIs
STIs are passed from person to person via bodily fluids such as vaginal fluids, semen (cum), ejaculate and/or pre-ejaculate, blood, anal mucosa and even via genital to genital skin contact. Most do not survive for long on other surfaces but sex toys can also pass STIs from person to person if you don’t clean them or cover them with a condom after someone else has used them. You can get some STIs from oral sex and some can affect your eyes.
How do I know if I have an STI
- Discharge from the penis
- Pain or burning when you pee
- Pain or bleeding during sex
- Itches, rashes, sores, lumps or blisters on genitals or near the back passage
- Pain in the testicles
Some infections don’t have any symptoms, so if you have had sexual contact and not had a sexual health check up then get a check at your local sexual health clinic.
If You Have Sex With Women
Contraception
Preventing unplanned pregnancy and reducing the spread of STIs is a shared responsibility for men who have sex with women. Understanding contraceptive options for women is important and men can play a supportive role in choosing contraception with their partner. The options for men are currently male condoms and male sterilisation/vasectomy.
STIs
STIs are passed from person to person via bodily fluids such as vaginal fluids, semen (cum), blood or even via genital to genital skin contact. Most do not survive for long on other surfaces but sex toys can also pass STIs from person to person. You can get some STIs from oral sex and some can affect your eyes.
How do I know if I have an STI
- Discharge from the penis
- Pain or burning when you pee
- Pain or bleeding during sex
- Itches, rashes, sores, lumps or blisters on genitals or near the back passage
- Pain in the testicles
Some infections don’t have any symptoms, so if you have had sexual contact and not had a sexual health check up then get a check at your local sexual health clinic.
If you have sex with men
Vaccination; Gonorrhoea, Hepatitis A, Hepatitis B, Human Papilloma Virus (HPV) and Mpox
How can I get a vaccination?
In sexual health we do not offer vaccinations to everyone. The decision to offer you a vaccination depends on who you have sex with, your gender and age. We follow directions from the Scottish Government’s Chief Medical Officer.
Often you will be offered vaccinations as part of your appointment with us. We only offer vaccination in the sexual health department if you are at sexual risk of an STI.
You don’t have to accept any vaccination if you don’t think it’s right for you.
Vaccination to help protect against Gonorrhoea
The 4CMenB vaccine (usually used to reduce risk of meningococcal infection) has been shown to protect against gonorrhoea in around 30-40% of cases. The most effective protection is still consistent condom use.
The sexual health team will assess your risk when attending for prevention initiatives appointments such as PrEP and they will offer you vaccination against other STIs if you are eligible
Read more here: Vaccination to help protect against gonorrhoea | NHS inform
Leaflet: Protect yourself against gonorrhoea: Get the meningococcal B (Men B) vaccine
Hepatitis A and B vaccination
Hepatitis A infection is uncommon in the UK. The virus is spread in the faeces (poo) of an infected person.
The Hepatitis B virus is carried in blood, semen and vaginal fluids. One way it can be transferred is through sexual intercourse with an infected person without a condom.
Hepatitis vaccination is now offered to those who are eligible when attending sexual health for other appointments, for example PrEP.
Hepatitis B vaccine is now part of the childhood vaccination schedule. Only those born after 2017 will have received hepatitis B vaccination.
We usually give Hepatitis B vaccine in combination with Hepatitis A vaccine to reduce the number of injections you need to have.
If you are looking for a vaccination due to other reasons such as work or travel please visit the following website: Vaccines – NHS Ayrshire & Arran (nhsaaa.net)
Human Papilloma Virus (HPV) vaccination
Infection with HPV makes you more likely to develop certain types of cancers and warts. HPV is spread through skin to skin contact; usually intimate sexual contact. One of the best ways to protect yourself from HPV infection is to get the vaccine.
The HPV vaccine is now available for men through sexual health clinics. If you are eligible when attending for an appointment we will offer you the vaccine. You have to be aged 45 years or under and sexually active with other men and not already had the vaccine or unsure if you have received this.
Mpox (monkeypox)
Mpox is a rare viral infection. The risk of mpox in Scotland currently remains low. Anyone can get mpox. However, most recent cases across Europe and the UK have been among gay, bisexual and other men who have sex with men (GBMSM). Tips on how to reduce your risk of infection can be found here. The sexual health team will assess your risk when attending appointments for other prevention initiatives such as PrEP and will offer you vaccination if you are eligible.
PrEP
PrEP stands for Pre-Exposure Prophylaxis.
HIV PrEP is a medicine that stops you getting HIV. You don’t have to take PrEP every day for it to work. PrEP can be taken in different ways to suits your needs. Most people take PrEP as a small pill which is easy to take. Most people don’t get any side effects from PrEP pills.
See below for PrEP frequently asked questions.
PEPSE
Post-exposure prophylaxis after sexual exposure (PEPSE) is a treatment that can prevent HIV infection after the virus has entered a person’s body. Men who have sex with men are at high risk of HIV. This medication is often recommended if you are a man who has condomless sex with another man.
PEPSE should be taken as soon as possible, but it can be taken up to 72 hours after exposure. The earlier it is taken the more effective it is.
If you think you may have been exposed to HIV you can reduce your risk of becoming infected by taking post exposure prophylaxis (PEP) which is a short course of medication.
If you think you have been exposed to HIV you may be eligible for post-exposure prophylaxis after sexual exposure (PEPSE), a short course of medication which can reduce your risk of becoming infected.
Ayrshire and Arran’s sexual health services are continuing to provide PEPSE for sexual exposure to HIV. Please call us on 01294 323226. We will ask you some questions to find out if PEP is suitable for you and arrange an appointment if required.
If the sexual health department is closed please attend the Accident and Emergency department at;
- University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE or
- University Hospital Ayr, Dalmellington Rd, Ayr KA6 6DX
- Regular family doctors (GPs) do not prescribe PEP
HIV-Post Exposure Prophylaxis and PrEP – Sexual Health Ayrshire
Click here for community language access information.
Doxy PEP
DoxyPEP is a way of taking an antibiotic called doxycycline that can prevent you from getting syphilis and chlamydia. Click the links below for more information.
DoxyPEP | Terrence Higgins Trust
STIs and STI Testing
STIs are passed from person to person via bodily fluids such as vaginal fluids, semen (cum) and ejaculate and/or pre-ejaculate blood or even via genital to genital skin contact. Most do not survive for long on other surfaces but sex toys can also pass STIs from person to person. You can get some STIs from oral sex and some can affect your eyes.
How do I know if I have an STI
- Discharge from the penis
- Pain or burning when you pee
- Pain or bleeding during sex
- Itches, rashes, sores, lumps or blisters on genitals or near the back passage
- Pain in the testicles
Some infections don’t have any symptoms, so if you have had sexual contact and not had a sexual health check up then get a check at your local sexual health clinic.
Good sexual health requires regular testing and practicing protected sex. Regular testing will make sure STIs are quickly diagnosed and treated. You can get tested at a sexual health clinic. This is a confidential service and no-one is told of your visit or what tests and treatment you receive.
PrEP FAQs
What does taking PrEP involve?
Taking a pill, usually daily, and regularly getting tested for HIV and other sexually transmitted infections. Before starting PrEP, it is important that you know your HIV status.
Who is PrEP for?
There are strict criteria around eligibility for PrEP which you can discuss with your health professional at Sexual Health Services.
Is PrEP safe?
Yes – the drug approved for use as PrEP, Truvada, is used as treatment for HIV and was selected for use as PrEP because of its low side effect profile.
There is significant evidence indicating that side effects are infrequent, mild and
temporary.
Some people report side effects such as nausea, headaches, dizziness and vomiting. These can be short term or more persistent.
There is a small risk of kidney function or bone mineral density depletion so these are
monitored in all patients.
If you are worried about any of these side effects, you can discuss them with your healthcare provider.
Does PrEP mean I can stop using condoms?
You should NOT stop using condoms just because you are using PrEP.
PrEP does not prevent transmission of other sexually transmitted infections and having other sexually transmitted infections increases your risk of getting HIV.
PrEP is not intended as a replacement for condoms and they are still an integral part of the HIV and sexual health response.
Where can I get PrEP?
PrEP will be available in sexual health clinics throughout Scotland from approximately July 2017. However you can act now to get ready and keep preventing HIV transmission by getting in touch with your local sexual health service; getting tested for HIV; stocking up on condoms and water based lube.
Coercion and Violence
1 in 6 men have had unwanted sexual experiences. This can include emotional manipulation, controlling behaviour, threats, financial control, or physical harm. Men may feel pressure to stay silent due to stigma, fear of not being believed, or concerns about appearing weak. It’s important to acknowledge that abuse can happen to anyone. This can cause problems, even many years later. You don’t have to just live with it. There are things you can do and people who can help.
Useful links:
ManKind Initiative – Supporting Male Victims of Domestic Abuse
Domestic Abuse Helpline for Men | Men’s Advice Line UK
Erectile Dysfunction or Impotence
Erectile dysfunction is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have it to some degree and it can be linked to a range of factors such as stress, anxiety, physical health conditions, lifestyle habits, or relationship concerns.
Testicular Self Examination
Testicular self examination helps find cancer at an early stage and saves lives. Testicular cancer affects a man’s testes or ‘balls’. Although testicular cancer is not that common, it is the most common cancer to affect young men and occurs most often between the ages of 19 to 44 years old. Most importantly, detected early enough it is almost always curable.
Prostate
Prostate problems are very common in older men. The most common symptoms caused by prostate problems are:
- Increased urinary frequency and urgency
- Frequent night-time wakening to empty the bladder
- Hesitancy – with weak flow of urine
- Flow of urine is slow, incomplete, painful or burning
- Straining or dribbling at end of urination
- Blood in the urine
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