Beyond the Basics: What Every Man Should Know About Women's Sexual Health

Five Common Preventable STI That You Need To Understand

If, like me, you are a man who grew up in the 80s or 90s, you probably associate the term “STD” with HIV/AIDS, syphillis, gonorrhoea and herpes. Unless you were having sex with prostitutes or other men, you probably didn’t give much thought to these issues either. After all, the incidence of HIV among straight women was vanishingly small, and the risk of catching anything else was low enough to take your chances in the heat of passion and deal with consequences later. We used condoms more out of fear of unwanted pregnancy than STI!

If we’re being honest, that risk assessment is reasonable from the perspective of a man. Of the infections you’re most likely to encounter, most are curable and have no lasting effects on men if treated promptly. Many are even asymptomatic, or have such mild symptoms as to go unnoticed in men.

Unfortunately, many of these same conditions that we men might trivialise can cause serious and lasting complications for women. Furthermore, it is actually possible to develop some STIs even if both partners have passed STI screening!

How did you go?

<5: I trust you’ve enjoyed a life of celibacy thus far!

<12: Not bad, but read on to learn more…

<20: You must be well-read or well-travelled!

20+: Greetings, doctor! Feel free to correct any errors in the comments!

Here’s a list of the most common 20 STI in the Western world according to ChatGPT:

1. Human Papillomavirus (HPV)

2. Chlamydia

3. Gonorrhea

4. Herpes Simplex Virus (HSV)

5. Syphilis

6. Human Immunodeficiency Virus (HIV),

7. Trichomoniasis

8. Hepatitis B

9. Hepatitis C

10. Mycoplasma genitalium

11. Bacterial Vaginosis

12. Pubic Lice (Crabs)

13. Scabies

14. Candidiasis (Yeast Infection)

15. Molluscum Contagiosum

16. Lymphogranuloma Venereum (LGV)

17. Ureaplasma urealyticum

18. Shigella

19. Enterococcus faecalis

20. Group B Streptococcus (GBS).

STI vs STD: What’s the Difference?

We tend to use these abbreviations interchangeably, but technically:

• STI: Sexually Transmitted Infection

• STD: Sexually Transmitted Disease

Not all infections lead to disease. E.g. you can be infected with, and become a carrier of HPV without actually developing genital warts.

Establish Your Sexual Health Baseline

If you have had new sexual partners since your last STI screen, or you’ve never had a screen, book in for one now! A simple blood test will provide peace of mind both to you and your partner that allows you to enjoy intimacy without the niggling concern of STI. I’m somewhat ashamed to admit that I had my first STI screen in my forties, despite having had several partners in my twenties and thirties. Misplaced shame or embarrassment, combined with a typical male attitude to avoiding doctors unless seriously ill, led to twenty years of wilful ignorance. Thankfully the screen came back negative! Be a better man. Get your baseline now!

A word of caution on STI screens:

Speak to your doctor about what infections are included - and perhaps more importantly excluded - in the test you take. E.g. HIV is not part of the standard test panel in many locations.

Understand These Five STIs - Even in a Monogamous Relationship

Every man who enjoys sex with women should be aware and understand the following conditions!

Photo by Dainis Graveris on Unsplash

HPV

These days health guidelines recommend vaccinating boys and girls against HPV before they become sexually active. In our day, no vaccine existed, so we remain more at risk than younger generations. HPV is a virus that causes genital warts and also increases the risk of cancers of the penis, cervix, vagina, anus, and throat. Men can carry HPV without symptoms and continue to infect their sexual partners. I know a man who lost his wife to cervical cancer, remarried, and his second wife died the same way. Coincidence???

Chlamydia

Another STI that frequently remains undetected in men, Chlamydia can have serious implications for women. Problems such as pelvic inflammatory disease caused by Chlamydia can cause fertility problems and chronic pelvic pain. Fun fact: Chlamydia carries the blame for endangering koala populations in Australia. Don’t fuck koalas.

Herpes Simplex Virus (HSV)

Do you know the difference between love and herpes? Herpes lasts forever! <I know, lame joke!> But seriously, there is no cure for herpes, and more than half the world’s adult population likely carries some form of the virus! Many carriers only discover they have HSV-2 (the variant commonly responsible for genital infection) after diagnosis of infection of their sexual partner, or in the case of women, diagnosis of infection of a newborn baby! In other words, you don’t need to have open lesions to transmit herpes, so it’s a condition you absolutely want to know about if you or your partner carry it! Read more about it here: https://en.wikipedia.org/wiki/Herpes_simplex#Pathophysiology

Urinary Tract Infections

An often overlooked advantage of having a penis is the added length of the urinary tract which keeps the opening of the urethra away from infection! UTIs occur when bacteria enters the urethra and multiplies, travelling upstream towards the bladder, and ultimately the kidneys. Left untreated, UTIs can cause serious organ damage. Fortunately the severe pain of a UTI will usually lead the patient to seek prompt treatment, and a UTI will usually clear up quickly with a course of suitable antibiotics.

Since a woman’s urethra nestles in the warm moist folds of the vulva just beneath the clitoris, its location is ideal to accumulate and incubate any foreign bacteria introduced during foreplay or sex. This is what makes it so easy to contract a UTI even though neither partner is carrying an existing STI. Dirty hands or nails, or cross-contamination of normal bacteria from other parts of the body (yours, hers, or someone else’s!) can quickly multiply to problematic levels in this environment.

To minimise the risks of causing UTI:

• Keep your fingernails trimmed and clean and wash your hands thoroughly before sex or foreplay

• Ensure anything that comes in contact with your partner’s vulva is clean - toys, hands, penis, etc.

• If indulging in any sort of anal play, be extra careful to avoid transferring bacteria between anus and vagina. Condoms and careful hand washing between orifices are non-negotiable!

• Your partner hopefully already knows this, but urinating immediately after sex helps to flush the urethra and maintain an acidity level that discourages bacterial infection.

Bacterial Vaginosis - aka BV

BV is a relatively common condition that results from an imbalance of the natural bacteria normally present in the vagina. It typically results in abnormal discharge and fishy odour, which in serious cases can be detectable at a distance and is usually quite repugnant. Whilst not strictly an STI (it can develop for other reasons), the exchange of bacteria and elevation of pH within the vagina due to the alkalinity of semen are common causes in sexually active women.

If your partner has a tendency to develop BV, you can minimise the risk by using condoms and/or withdrawing prior to ejaculation. On the other hand, if you and your partner prefer the intimacy of unprotected sex, pharmacies usually stock over-the-counter products which she can apply after sex to restore the acidity and preserve the balance of her vaginal biome.

The most awkward aspect of BV is the case where a woman fails to recognise that she suffers from it, thinking that vaginal odour is normal. This situation requires a delicate conversation. Proceed with caution - women can be extremely self-conscious about their genitals, and provoking her insecurity might spell an end to your sex life for the foreseeable future! This is another great reason to normalise matter-of-fact communication about sex early in the relationship. The following article might help you in this regard:

Remember:

Just because we and our partners might be at an age where pregnancy is less of a risk, STI is still a serious and avoidable concern. Condoms prevent more than pregnancy, and there’s no shame in using them.