Men, sex and reproductive health

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There are many men's health issues that can impact on sexual relationships and sexual and reproductive health. These include safe sex, prostate and testicular cancer and sexual dysfunction.

Are you in good (sexual) health?

Good sexual health means more than being 'good in bed' and reaching orgasm ('coming') every time you have sex. Looking after your sexual health includes having safe sex, having sexual health checkups and being open about sexual and reproductive health issues with your partner.

Relationships

Being sexually healthy includes having equal, caring relationships where partners:

• talk openly about feelings
• respect each other's bodies and values
• make decisions together
• are honest and caring
• are not used or abused

Everyone has the right to say no to sex. Forcing someone to have sex is a crime called rape or sexual assault.

Let's face it. Most people like a partner who is willing to listen to them when they say whether or not they want sex,what feels good and what is OK sexually. Honest communication can build trust and intimacy, key building blocks to a healthy sexuality. 

Showing your partner you are willing to take responsibility for contraception and/or safe sex is a good place to start.

Safe sex

Having safe sex means that when you have sexual intercourse you take steps to reduce the risk of:

• sexually transmitted infections (STIs) like genital herpes, genital warts, chlamydia, gonorrhoea, hepatitis B, syphilis and HIV (the virus that leads to AIDS)
• unintended pregnancy

It's up to both partners in a sexual relationship to take steps to have safe sex.

Only condoms help protect against both unintended pregnancy and STIs. If you're using another form of contraception you may also need to use condoms to help protect against STIs

A vaccination is available to protect against hepatitis B.

Sexually transmitted infections - what is the risk?

Assessing your risk of STIs is not always easy. Your level of risk depends on both you and your partner(s) and your past and present sexual behaviour: 

• the sexual partners you have both had
• if you have casual partners (now or in the future)
• if you or your partner injects drugs

There can also be a small risk in sharing sex aids (e.g dildos or vibrators).

To reduce your risk you and your partner need to talk honestly with each other about your relationships. Getting tested for STIs at the start of a sexual relationship is important, but ongoing assessment is also needed.

Many people in a long-term relationship might stop having safe sex. If one of you then has sex outside the relationship, it might increase the risk of STIs for you and your long-term partner.

What are the signs and symptoms of STIs?

Some general symptoms in men may include:

• discharge from the penis
• sores or blisters on the penis, pubic area or around the anus
• lumps on the penis, pubic area or around the anus
• frequent urge to urinate ('wee')
• pain or burning while urinating
• pain in the scrotum

Some STIs do not show any symptoms. That means a person can have an STI and pass it on without knowing it. Some STIs can cause long-term problems like infertility, illness or even death.

People who have anal sex can get STIs in the rectum (back passage).

They may have:

• pain in the rectum
• discharge from the rectum

(note that some of these symptoms have other causes - they do not necessarily mean you have an STI)

If you think you may have an STI or are at risk of an STI, have a sexual health check-up as soon as you can.

If there is an infection you can get the best available treatment and advice on how to stay healthy. Early detection and treatment helps to reduce possible longer term problems. It also reduces the chance of you giving it to others.

Some infections may appear to go away, but actually stay in the body. They may cause problems later on. They can be given to any person you have sex with. Some STIs can be passed from a pregnant woman to her baby or cause infertility in women.

Your doctor, Family Planning Queensland (FPQ) clinic or sexual health clinic can help you with check-ups and treatment.

Contraception - what's in it for me?

Contraception means preventing pregnancy and is the responsibility of both people involved in a sexual relationship.

There are a number of different kinds of contraception. Not all are OK for everyone. Using a type you are both happy with means you and your partner will be able to relax and enjoy sexual intercourse, without the worry of an unintended pregnancy.

When choosing contraception you may need to think about:

• how effective it is
• your lifestyle
• how easy it is to use
• side effects
• cost and how to get it
• reversibility
• protection against STIs

The effectiveness of all contraception depends upon correct and consistent use. To make sure you have enough information to choose the method that suits you and your partner best, talk to FPQ or your doctor.

Testicular cancer

Testicular cancer can develop in either one of a man's testicles. It is more common in men aged between 18 and 40, but can occur at any time after the age of 15.

Symptoms include:

• swelling of the testicle or change in size or shape
• sensation of heaviness of the testes
• pain (a dull ache) or discomfort of the testes

Testicular self-examination (TSE) will help you to find any changes. Early detection and treatment will increase the chance of a full recovery.

Prostate cancer

The prostate is a small walnut-shaped gland that helps make seminal fluid (a fluid which forms part of semen). It is found below the bladder in men.

Common health problems with the prostate are prostate enlargement (in older men), prostate inflammation and prostate cancer

A common symptom of both prostate cancer and other prostate conditions is problems urinating. Symptoms should be discussed with a doctor to decide if further testing is needed.

For more information about these cancers, or about TSE contact the Queensland Cancer Fund or FPQ.

What is sexual dysfunction?

Sexual dysfunction is a condition that stops a man or woman from experiencing sexual activity to his or her full potential. Men and women of all ages may experience sexual dysfunction.

There are four sexual dysfunctions that might be experienced by men:

1. Premature ejaculation - reaching orgasm and ejaculating (coming) too quickly, either before or very soon after a man enters his partner.
2. Retarded ejaculation - able to obtain an erection but unable to ejaculate.
3. Limited or no sexual desire - leads to an inability to experience sexual arousal (erection).
4. Erectile difficulty (ED) (impotence) - inability to get or keep an erection despite normal sexual arousal.

Causes of erectile difficulty (ED)

Several hundred thousand men in Australia are affected by ED. It can occur at any age but is more common as men grow older. 

Some causes of ED are:

• diabetes
• heart disease
• prostate cancer
• damage to blood vessels due to high blood pressure, high cholesterol, long-term heavy
• alcohol use or smoking
• multiple sclerosis (MS), spinal injury and pelvic surgery
• relationship problems
• depression and anxiety
• medications
• stress or fatigue

Treatments for erectile dysfunction

If you think the ED is related to issues such as stress, relationship problems, anxiety or self-esteem, try to sort out these problems first or perhaps try counselling.

If counselling is not helpful, there are medical treatments available such as:

• drugs such as Sildenafil (Viagra)
• self-injection therapy
• hormonal treatments
• penile implant surgery - involves inserting a permanent inflatable rubber rod in the penis

Contact FPQ or your doctor for more information or advice.

What health and relationship services are available for men?

Some of these services provide referrals to appropriate services. Check your phone book to find the service nearest you.

• Family Planning Queensland Clinics
• Sexual health clinics 
• Queensland Cancer Fund - Cancer Helpline 13 1120
• Relationships Australia
• Men's Infoline 1800 600 636 for information, counselling and referral
• Lifeline 13 11 14
• Centacare (relationship counselling and courses)
• Men's counselling services
• Men's Health and Wellbeing Association
• Sexual Assault Counselling Service (SACS)
• Vietnam Veterans' Association
• Gay support services

Australian Men's Health Websites

• http://access.health.qld.gov.au/hid/MensHealth/index.asp
• www.andrologyaustralia.org 

Disclaimer

Family Planning Queensland (FPQ) has taken every care to ensure that the information contained in this publication is accurate and up-to-date at the time of being published. As information and knowledge is constantly changing, readers are strongly advised to confirm that the information complies with present research, legislation and policy guidelines. FPQ accepts no responsibility for difficulties that may arise as a result of an individual acting on the advice and recommendations it contains.