Men's sexual health conditions

Condition guides

• Erectile Dysfunction

  Erectile dysfunction (ED) is the repeated difficulty getting or keeping an erection firm enough for satisfying sex. Occasional difficulty is common and not a diagnosis; ED describes a pattern that persists for several months and bothers the man or his partner.

• Premature Ejaculation

  Premature ejaculation (PE) means ejaculation that happens sooner than a man and his partner would like, often within about a minute of penetration, that he feels unable to delay, and that causes distress. It is the most commonly reported male sexual complaint.

• Low Libido

  Low libido means a persistently reduced interest in sex that the man himself finds unwelcome, distinct from a quiet week after a stressful stretch or a late night at work. It differs from erectile dysfunction, which is a difficulty with the physical response rather than the wish for sex, though the two often travel together. A single dull month is not a diagnosis; the pattern over time matters more than any one occasion.

• Nightfall

  Nightfall (nocturnal emission) is an involuntary release of semen during sleep, usually noticed on waking, and unrelated to anything the man chooses to do. It is one of the most common and least discussed parts of male sexual development, most frequent in the teenage years and less frequent, but not abnormal, in adult men. On its own it is not an illness and needs no treatment.

• Dhat

  Dhat refers to the belief, and the distress that comes with it, that a man is losing an excessive or harmful amount of semen — in urine, through nocturnal emission, or without any clear reason — and that this loss is weakening him. It is recognised in psychiatry as a pattern of physical and emotional symptoms built around that belief, most often described by men from South Asian backgrounds, though similar concerns have been reported elsewhere^[1]. The distress is real even where the physical belief behind it is not medically accurate, and both deserve to be taken seriously.

• Low Sperm Count

  Low sperm count, or oligozoospermia, means a semen sample has fewer sperm than the World Health Organization's lower reference limit — about 15 million sperm per millilitre, or 39 million in the whole sample^[1]. It is one of several things a semen analysis measures alongside motility and shape, and a single low reading is usually repeated a few weeks later before it is treated as a real finding.

• Azoospermia

  Azoospermia means no sperm at all can be found in the ejaculate, confirmed on at least two occasions by examining a spun-down (centrifuged) semen sample under a microscope^[1]. It is not the same as a low count — the finding changes how the work-up proceeds, and in many men it does not mean the testes have stopped making sperm altogether.

• Male Infertility

  Male infertility means a couple has not conceived after a year of regular, unprotected sex, and a semen analysis or examination has found a problem on the man's side — in count, motility, shape, or the way the ejaculate reaches the vagina at all. It is assessed and managed as one half of a couple's fertility, alongside the woman's own evaluation, not on its own.

• Phimosis

  Phimosis is a foreskin that cannot be pulled back fully over the glans. In young boys this is usually a normal stage that loosens with growth; in an adult man it usually means the tissue has thickened or scarred, and a first visit looks for a cause rather than treating the tightness alone.

• Peyronie's Disease

  Peyronie's disease is a curve or bend in the erect penis caused by a fibrous plaque, a patch of scar-like tissue that forms inside the sheath which normally lets the shaft fill and straighten evenly. It usually develops gradually over months, sometimes with pain early on, before the curve settles into a stable shape.

• Retrograde Ejaculation

  Retrograde ejaculation happens when semen travels backward into the bladder at the moment of orgasm instead of leaving through the tip of the penis, because the valve-like muscle at the bladder neck does not close properly. The orgasm itself usually still feels normal, but the man notices little or no fluid coming out, and cloudy, sperm-containing urine afterwards; it is not painful and does not affect erections directly, though it can affect fertility.

• Gynaecomastia

  Gynaecomastia is the enlargement of the glandular tissue in a man's breast, caused by an imbalance between oestrogen and testosterone acting on that tissue, and is not the same as the fatty enlargement seen with weight gain. It commonly appears in newborn boys, again during puberty, and again in older age, and in most of these settings it settles by itself without treatment.

• Low Testosterone

  Low testosterone (male hypogonadism) means the testes make less of the hormone than a man's body needs, confirmed by a blood test rather than by symptoms alone. Symptoms overlap many other conditions — reduced sex drive, tiredness, low mood, fewer morning erections, loss of muscle bulk — so a diagnosis needs both a low reading and a matching symptom pattern, not either one by itself.

• Varicocele

  A varicocele is an enlargement of the veins that drain the testicle, similar to a varicose vein elsewhere in the body, most often on the left side because of how that vein joins the kidney vein. Many men have one and never notice it; in others it is found during a fertility work-up or shows up as a dull ache or heaviness in the scrotum, especially after standing for long periods.

• Hydrocele

  A hydrocele is a build-up of clear fluid in the thin sac that normally surrounds a testicle, producing a soft, usually painless swelling on one or both sides of the scrotum. It can be present from birth, when it is common and usually closes on its own, or appear later in life, sometimes after an injury, an infection, or — rarely — alongside a testicular tumour that needs to be ruled out.

• Sexually Transmitted Infections

  Sexually transmitted infections (STIs) are infections passed on through vaginal, anal or oral sex. Some, such as chlamydia, gonorrhoea and syphilis, are bacterial and are treated and cleared with the right antibiotic; others, such as genital herpes and HIV, are viral and are managed with ongoing treatment rather than cleared completely. Many cause no symptoms at first, which is why testing rather than waiting for symptoms is how most are found.

• Psychosexual Disorder

  Psychosexual disorder is an umbrella term for sexual difficulties that arise mainly from psychological causes — performance anxiety, relationship strain, past experience or how a man thinks about sex — rather than from a physical problem with blood flow, nerves or hormones. It can show up as difficulty with erections, rushed or delayed ejaculation, or reduced interest, and it commonly overlaps with a physical cause rather than replacing it. The label describes where the difficulty mainly comes from, not how serious it is.