Sex can be pleasurable and fun—but you’ve got some work to do before you get busy.
“Men need to do two things: be proactive and protective by taking care of themselves, and in so doing, taking care of their sexual partners,” says Bill Owen, M.D., internal medicine physician and certified HIV specialist at Sutter Pacific Medical Foundation.
Here’s how to cultivate a healthy, enjoyable sex life.
Face it: If you have sex with others, you’re at risk for sexually transmitted diseases (STDs). At least 20 million new STD infections—including herpes, human immunodeficiency virus (HIV), hepatitis A and B, human papillomavirus (HPV), syphilis, chlamydia and gonorrhea—occur every year in the United States. Among other outcomes, they increase your risk for certain cancers and infertility.
So don’t get caught unprepared. “Protective sex, aka sex with condoms, is an excellent way of protecting against STDs,” Dr. Owen says.
Get vaccinated for hepatitis A and hepatitis B. It also wouldn’t hurt to get a vaccine for meningitis, which can spread through close contact such as kissing; you’re at higher risk if you’re a college or grad student, a man who has sex with men (MSM) or a California resident.
“We also have a vaccine for HPV, human papillomavirus, but it’s currently very underutilized,” says Dr. Owen. (Learn more in “Why Your Preteen Needs the HPV Vaccine.”
Also consider an anal pap smear, comparable to a woman’s cervical pap smear, which many doctors recommend for MSM and particularly for those who have a history of anal warts or who are HIV positive.
Make a call if you experience painful urination, pelvic pain, sores in your mouth and unexplained flu-like symptoms or swollen lymph glands. A rash, sores, warts, swelling, pain or discharge from the genital or anal areas could signal an STD infection.
If you get a STD diagnosis, tell your sexual partner(s); they’ll need treatment too.
Even without symptoms, “if you’re sexually active, you should get tested at least once a year,” Dr. Owen says. “And if you’re very sexually active, especially with different partners, my rule of thumb is that you consider being tested as often as every three months.”
Talk to your doctor about pre-exposure prophylaxis, or PrEP, if you’re at risk for HIV, the virus that causes AIDS:
A landmark 2011 study of 2,500 HIV-negative, gay and bi men and women found that in those who regularly took a treatment called Truvada, HIV infection rates dropped 92 percent—and those who took it daily showed an astonishing 99 percent protection against HIV.
“The medication is good enough that basically it functions in the zone of a vaccine,” says Dr. Owen. “If you take it every single day, day in and day out, you have an extremely high chance of not getting HIV.”
In 2012, the FDA approved the treatment, nicknamed PrEP, in combination with safer sex practices, for HIV prevention. However, “like the HPV vaccine, a lot of people who could benefit from this treatment aren’t taking it,” Dr. Owen says. He points to a 2016 study estimating that this daily drug could prevent more than one-third of new HIV cases in MSM during the next decade.
If you go with PrEP, you’ll need to take it every day; inconsistent use lowers the protective effect and may lead to developing a drug-resistant HIV strain. You’ll also need to see your doctor every three months for a follow-up.
Did you know that testicular cancer is the most common cancer in men younger than 35? So start self-exams early. Check your testes and scrotum once a month while showering, or make it a more pleasant experience by asking your partner to help.
Be honest with your doctor if you experience mood problems, such as depression or anxiety. “I try to assess that all the time, as well as drug dependencies and substance abuse, all of which affect men’s emotional well-being,” Dr. Owen says.