Most men are notoriously bad at having a check up with their GP, even if it's to discuss a sore back or the flu. There's even less chance of men talking to a doctor about their sexual health worries.

This may be one of the reasons why more men are contracting sexually transmitted infections (STIs). The latest figures reveal some male STI rates have risen by 40 per cent in a year.

"Traditionally, men have abdicated responsibility for their sexual health," says Dr Peter Johnson of Marie Stopes International Australia's reproductive health centre in Sydney.

Women are seen as primarily responsible for childbearing and contraception and men think if their partners are screened regularly, they'll know if anything is wrong.

"I think, despite the bravado, the average male is quite insecure. Men invest so much of their masculinity in their sexual performance and potency and they're uncomfortable talking about their sex lives."

In an effort to provide information, let's take a closer look at some of the most common male sexual health issues and what can be done about them.

Chlamydia
Chlamydia is a bacterial infection contracted through sexual intercourse - either penile/vaginal sex or penile/anal sex. More than 50 per cent of people have no symptoms. In some cases Chlamydia leads to inflammation of the urethra that causes a burning sensation when men urinate, and discharge from the penis. If a woman has Chlamydia it can lead to infertility and ectopic pregnancies.

In 2004, Marie Stopes International Australia says 14,606 men were diagnosed with this STI with those aged 15 to 29-years-old most at risk. In the same year 21,509 women were also diagnosed with Chlamydia. Chlamydia is a notifiable condition and must be reported to health authorities by health workers. Those figures are an increase on 2003 but this may be due to the availability of a new and simple urine test that can now more easily diagnose Chlamydia.

Women tend to be detected more often than men because they are more likely to undergo other medical examinations that reveal the infection, for example, during a Pap smear. But health authorities believe rates of infection for both sexes are similar.

"The most effective protection against Chlamydia is using a condom. If you're not in a long-term monogamous relationship, condoms are essential," says Dr Johnson.

Chlamydia can be detected with a urine sample and is treated with a single dose of antibiotic tablets. The infection clears in two to three days.

Gonorrhoea
"Gonorrhoea is more prevalent in men who have sex with men and in men who have casual partners. You can also be at risk of gonorrhoea if you have sex overseas and don't use a condom, particularly in South-East Asia," says Dr Katerina Lagios, director of Sexual Health Services at Westmead Hospital's Parramatta sexual health clinic in NSW. "It's more easily transmitted than chlamydia but you'll usually know you have it."

Gonorrhoea is a bacterial infection and there is a high chance of transmission. Symptoms usually show within three to nine days and include discharge and pain when urinating. One of the possible long-term effects is arthritis; in women, long-term effects include pelvic inflammatory disease and infertility.

Gonorrhoea can be detected through a sample of discharge or a urine test. It can be treated with penicillin or a single antibiotic injection. In 2004 the number of men diagnosed with gonorrhoea was 4964 - a significantly higher number than the 2224 women infected.

syphilis
This is another bacterial infection you can contract from sexual contact - including non-penetrative sex. Usually the syphilis bacteria are found in a painless ulcer and if your sexual partner has a break in their skin and comes into contact with that ulcer, syphilis can transfer. The newly-infected person then forms an ulcer at the point of contact - it can be the penis, mouth, throat. This heals but the person is still infected.

The syphilis bacteria can affect the penis, skin, mucous membranes, heart, blood vessels and brain. In extreme untreated cases, syphilis can cause serious health complications and even death. Syphilis is diagnosed via a blood test and is treated with antibiotics. In 2003, 1132 men were diagnosed - almost double the number of women with the infection.

erectile problems
"Erectile dysfunction is more common as men get older and it can also be caused by depression, fatigue, stress and worry. Certain medical conditions such as diabetes, high cholesterol, hypertension, blood vessel diseases and the effects of smoking and alcohol can also lead to erectile dysfunction," says Dr Caroline de Costa, co-author with Dr Michele Moore of Dick: A Guide To The Penis For Men And Women (Allen & Unwin).

"Medication such as Viagra can help," says Dr de Costa, "but men must see their doctor first because erectile dysfunction can be an indicator of underlying health problems."

The Medical Journal of Australia has reported that about one million Australian men suffer erectile problems. Drugs can help and so can some surgical techniques and gadgets such as a vacuum pump.

premature ejaculation
Every man experiences this problem at least once in his sexual life, though most probably wouldn't admit it.

"Over-excitement and anxiety can cause this," says Dr Lagios. So can past furtive sexual experiences associated with guilt or fear of being discovered. These memories can cause men to be unable to hold back their orgasm.

Experts recommend that couples look for other ways of sexual enjoyment, taking the focus off penetrative sex. This can ease the pressure on the male.

"Look at how sex is happening in your relationship and find other ways of getting comfortable," says Dr Lagios. "Then practise techniques of squeezing the penis and then stopping so you learn control. Build up to penetrative sex slowly."

herpes
About one in six people in Australia have herpes, a viral infection which can be asymptomatic. "It's a recurrent infection. It stays in your system although it settles down after the first few years," says Dr Lagios.

Typical signs of a herpes infecto are flu-like symptoms followed by localised tingling and pain and blisters that ulcerate. These can appear on the penis, mouth, anus, throat or vagina.

"Cold sores are a herpes virus so if you have oral sex with someone who has a cold sore, you can be infected," says Dr Lagios.

Using condoms can help prevent infection. Researchers are also working on developing a vaccine for herpes. Babies can die from a neonatal herpes infection so inform your GP if you've had genital herpes and are pregnant.

testicular cancer
About 580 cases of testicular cancer are diagnosed each year in Australia. It occurs when the cells within the testes grow and divide abnormally and a tumour develops. Andrology Australia states that if discovered early, 90 per cent of cases can be cured.

Men aged between 18 and 39 are most likely to develop testicular cancer; in this age group it's the second most common cancer. Symptoms include a lump in a testicle, an enlargement or shrinking of a testicle, or pain in the scrotum.

Treatment usually involves the removal of the affected testicle and maybe radiotherapy or chemotherapy. This doesn't affect sexual function but men should talk to their specialist about storing sperm first.

"It's important to examine your testes and scrotum, to get to know how the area feels and see your doctor if you detect any changes," says Dr Lagios.

sex appeal
Marie Stopes International Australia has launched the Sex Appeal to raise funds to promote and provide sexual and reproductive health services in under-developed countries. For more information see www.mariestopes.org.au

find out more

• The Andrology Australia website is a useful resource for men's health matters.

Visit www.andrologyaustralia.org

• For a list of the Marie Stopes International Australia centres in Australia, call 1800 003 707 or visit the website, www.mariestopes.org.au