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Health condition · Clinically reviewed

Male STIs, explained plainly - testing, treatment and prevention.

Many sexually transmitted infections in men cause no symptoms at all. Regular testing and prompt treatment are what actually protect you and your partners.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against BASHH, NICE and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance including updated chlamydia treatment, resistance-aware gonorrhoea therapy and PrEP.

Key facts

Male STIs at a glance.

The essentials, in plain English - what to test for, how it’s tested, and how it’s treated in the UK today.

  • What it covers

    The infections most likely to affect men - chlamydia, gonorrhoea, syphilis, herpes, HPV, HIV, NGU and trichomonas.

  • Often silent

    Many STIs in men cause no symptoms at all - regular screening matters more than waiting for signs.

  • First-line test

    A first-catch urine NAAT for chlamydia and gonorrhoea is quick, accurate and needs no swab for most men.

  • Resistance watch

    Gonorrhoea antimicrobial resistance is rising - treatment and test-of-cure protocols are updated accordingly.

  • Prevention

    Condoms, regular screening, PrEP for HIV and partner notification all reduce transmission substantially.

  • Where to go

    A specialist GUM or sexual health clinic offers free, confidential testing and treatment across the UK.

Why this guide matters

Silent infections, real consequences.

Most STIs in men are curable or manageable once found. The three points below shape everything else on this page.

  • Absence of symptoms is not absence of infection

    Chlamydia, gonorrhoea, HIV and trichomonas frequently cause no symptoms in men - screening finds what waiting for signs would miss.

  • Resistance is changing treatment

    Rising antimicrobial resistance in gonorrhoea means single-dose ceftriaxone and test-of-cure protocols matter more than ever.

  • Prevention works alongside treatment

    Condoms, PrEP and partner notification cut transmission - treating one infection without addressing exposure risks reinfection.

How the diagnosis is made

From first visit to a confirmed diagnosis.

The steps a UK GUM or sexual health clinic will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Sexual history

    Number and gender of partners, condom use and MSM status shape which tests are offered and how urgently.

  2. 02

    Assessing

    Symptom review

    Discharge, dysuria, ulcers, rash, testicular pain or none of the above - each points down a different path.

  3. 03

    Confirming

    First-catch urine NAAT

    The first-line test for chlamydia and gonorrhoea - simple, sensitive and does not need a swab in most men.

  4. 04

    Confirming

    Swab for culture if symptomatic

    Urethral or throat/rectal swabs allow culture and sensitivity testing, important given rising gonorrhoea resistance.

  5. 05

    Confirming

    Syphilis serology

    Treponemal and non-treponemal blood tests confirm infection and stage, and track response to treatment.

  6. 06

    Confirming

    HIV test with consent

    Offered as part of a full screen or opt-out testing - a rapid result with same-day support if positive.

  7. 07

    Protecting

    Partner notification

    Contact tracing so partners can be tested and treated, preventing reinfection and onward spread.

Typical timeline: same-day testing, results and treatment for most bacterial STIs.

Symptoms

What male STIs actually look like.

Discharge, ulcers and testicular pain are the classic signs - but no symptoms at all is just as common. And the features that mean it’s time to escalate.

  • Urethral discharge

    Clear, cloudy or yellow discharge from the tip of the penis - classic for chlamydia, gonorrhoea and NGU.

  • Dysuria

    Burning or stinging on passing urine - often accompanies discharge but can occur alone.

  • Genital ulcers or sores

    Painful vesicles and ulcers suggest herpes; a single painless ulcer suggests primary syphilis (chancre).

  • Rash and systemic symptoms

    A non-itchy rash on the trunk, palms or soles with fever and malaise points to secondary syphilis.

  • Testicular or scrotal pain

    Epididymitis - often linked to untreated chlamydia or gonorrhoea - causes unilateral pain and swelling.

  • Warts or skin lumps

    Small, fleshy genital or perianal growths - the visible sign of certain HPV strains.

  • No symptoms at all

    Many men with chlamydia, gonorrhoea, HIV or trichomonas feel completely well - this is the norm, not the exception.

  • Red flag - severe pain or systemic illness

    Severe testicular pain, high fever or a widespread rash needs same-day assessment.

Treatment

How male STIs are treated in the UK.

Infection-specific antibiotics or antivirals, resistance-aware dosing where it matters, and partner treatment to prevent reinfection.

  • Chlamydia

    Doxycycline 100mg twice daily for 7 days is now first-line under updated BASHH guidance; azithromycin is an alternative where doxycycline is unsuitable.

  • Gonorrhoea

    A single intramuscular dose of ceftriaxone, chosen with resistance in mind - test of cure is important given rising antimicrobial resistance.

  • Syphilis

    Intramuscular benzathine penicillin, with the dose and number of injections depending on the stage - managed by a specialist GUM service.

  • Genital herpes

    Aciclovir or valaciclovir shortens episodes; suppressive daily therapy is offered for frequent recurrences.

  • HPV / genital warts

    Topical treatments, cryotherapy or excision for warts - see our dedicated HPV guide for vaccination and prevention.

  • HIV and PrEP

    Antiretroviral therapy for those diagnosed, and PrEP for those at ongoing risk of acquiring HIV - see our PrEP clinic page.

  • Non-gonococcal urethritis

    Mycoplasma genitalium and other causes are treated according to sensitivity results, since resistant Mycoplasma is increasingly common.

  • Trichomonas

    A short course of metronidazole clears infection - often picked up incidentally as men are frequently asymptomatic carriers.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

A GUM or sexual health clinician knows your history and can tell you which parts apply to you. If in doubt, get tested.

  • BASHH. UK national guidelines for the management of chlamydia, gonorrhoea, syphilis and genital herpes.

  • NICE. Sexually transmitted infections: condoms (PH52) and related clinical knowledge summaries.

  • UK Health Security Agency. STI surveillance data and antimicrobial resistance reports.

  • BHIVA. British HIV Association guidelines on treatment and PrEP.

Red flags

When it needs urgent attention.

Most male STIs are manageable in a sexual health clinic. These are the situations that aren’t - and where urgent or same-day care is needed.

  • Severe epididymo-orchitis

    Marked testicular swelling, fever and severe pain need same-day assessment to rule out torsion and start treatment early.

  • Suspected testicular torsion

    Sudden, severe one-sided testicular pain is a surgical emergency until proven otherwise - go straight to A&E.

  • Disseminated gonococcal infection

    Joint pain, skin lesions and fever alongside gonorrhoea suggest spread beyond the genital tract - needs urgent specialist care.

  • Neurosyphilis or ocular syphilis

    Visual change, confusion or neurological signs in syphilis of any stage need same-day specialist review.

  • Secondary syphilis rash

    A widespread rash with systemic symptoms should prompt urgent testing - untreated syphilis can progress to serious tertiary disease.

  • HIV seroconversion illness

    Fever, sore throat, rash and fatigue two to four weeks after a risk exposure can be acute HIV - test promptly, PEP may still be an option.

  • Recent high-risk exposure

    A condom failure or unprotected sex with an HIV-positive or unknown-status partner within 72 hours warrants urgent discussion about PEP.

  • Pregnant partner exposure

    Any STI diagnosis where a partner may be pregnant needs prompt joint management to protect the pregnancy.

  • Recurrent or treatment-resistant infection

    Symptoms persisting after treatment may indicate resistance, reinfection or a missed co-infection - always retest.

Living with it

Manageable and preventable, with the right habits.

Four things that make the biggest difference - regular screening, condom use, disclosing to recent partners and considering PrEP if you’re at ongoing risk.

A quiet reminder

Testing regularly is a normal part of a healthy sex life.

There is no shame in an STI test - it’s routine healthcare, and clinics see it every day.

  1. 01 Test

    Screen regularly, not just when symptomatic

    Annual screening - or more often with new partners or higher risk - catches silent infections before complications develop.

  2. 02 Protect

    Condoms reduce, not eliminate, risk

    Condoms are highly effective against chlamydia, gonorrhoea and HIV, and reduce but don’t remove herpes and HPV transmission.

  3. 03 Disclose

    Tell recent partners

    Partner notification through the clinic is confidential and stops the same infection bouncing back and forth.

  4. 04 Prevent

    Consider PrEP if at ongoing risk

    Daily or event-based PrEP substantially lowers HIV acquisition risk for men with ongoing exposure - ask your clinic if it suits you.

Frequently asked

Everything we get asked about male STIs.

Quick answers on symptoms, testing, resistance and prevention.

  • What are the most common STIs in men?

    Chlamydia and gonorrhoea are the most frequently diagnosed bacterial infections, alongside genital herpes, HPV/genital warts, syphilis, HIV, non-gonococcal urethritis and trichomonas. Many cause no symptoms at all.

  • Can I have an STI with no symptoms?

    Yes - this is common, not unusual. Chlamydia, gonorrhoea, HIV and trichomonas frequently cause no noticeable symptoms in men, which is why regular screening rather than waiting for signs is recommended.

  • What test do I need if I have no symptoms?

    A first-catch urine NAAT test covers chlamydia and gonorrhoea and needs no swab for most men. A full sexual health screen usually adds blood tests for syphilis and HIV.

  • Why has chlamydia treatment changed to doxycycline?

    Updated BASHH guidance moved doxycycline 100mg twice daily for 7 days to first-line for chlamydia, replacing single-dose azithromycin in most cases, based on evidence of better cure rates, particularly for rectal infection.

  • Is gonorrhoea becoming harder to treat?

    Antimicrobial resistance in gonorrhoea is a recognised and growing concern in the UK, which is why treatment now relies on a single dose of ceftriaxone chosen with resistance patterns in mind, and why a test of cure is recommended.

  • What should I do if I think I have been exposed to HIV?

    Contact a sexual health clinic, GUM service or A&E as soon as possible - post-exposure prophylaxis (PEP) can prevent infection but works best when started within 72 hours of exposure.

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