About one-third of the cases of sterility are related to fertility issues in men. STDs are the most common preventable causative factor of male sterility.
Common STDs that cause male sterility are Neisseria Gonorrhoeae, HIV, Chlamydia Trachomitis, and Ureaplasma. However, the data on the effect of these infections on male fertility is quite limited.
In addition to the physical effect of STDs on males, the psychological effect of these can affect a male’s libido and harm male sexual health.
The impact of STDs on male fertility is also strongly dependent on their prevalence. For example, it is quite uncommon in developed countries but in developing countries of Southeast Asia and Africa, it has a huge disease burden.
What are STDs and how do they affect male fertility?
STDs or Sexually Transmitted Diseases are diseases that are transmitted from one partner to another through oral, vaginal, or anal sex. In men, STDs have different mechanisms to impair fertility such as damage to the sexual organs, damage to reproductive cells via inflammatory mediators, obstruction in the reproductive tract, and binding to sperms and rendering them useless.
As a significant portion of sterility problems is related to male fertility issues, it is crucial to recognize common sexually transmitted infections, their causative agents, and ways to prevent and treat them.
In men, N. Gonorrhea can impair fertility by various mechanisms. Firstly, it can cause urethral stricture or narrowing of the urethra. Secondly, it can cause inflammation of the urethra, epididymis, and testicles. All of these pathological changes finally lead to impairment of testicular function in a few years. If not treated on time, the gonorrheal infection can lead to scarring and permanent obstruction, and damage to the epididymal canal.
Most male patients with gonorrheal infection are asymptomatic. But when present the common symptoms include greenish-yellow or whitish discharge from the penis, pain in the penis, burning sensation during urination, swollen glands, swollen testicles, fever, etc. The symptoms can occur as late as 30 days from having unprotected sex.
The human immune deficiency virus adversely affects the functional capacity of the seminal vesicles and prostate glands which leads to a drastic decrease in the amount and quality of sperm. The more severe the immune deficiency, the worse the sperm quality.
HIV also complicates the process of having children or fertility treatment. It is because treating physicians want to first prevent the transmission of the virus from one partner to another during the process of treatment. Having said that it doesn’t mean that people with HIV can’t have kids, there are medical treatment options such as semen washing that can make conceiving children in parents with HIV much safer.
The evidence on how herpes affects male sterility is limited. But some studies suggest that it reduces the sperm count and affects the ability of the body to produce sperm. But more research is needed on this topic.
Syphilis which is caused by Treponema Pallidum doesn’t directly cause a major impact on male fertility, the inflammation caused by it in the epididymis, however, can lead to obstruction in the transportation route of sperm.
Although the research on how Chlamydia affects male sterility is inconclusive. It is suggested that it does so by causing urethritis and epididymitis in males.
Some studies have indicated that Chlamydia infection is associated with decreased sperm motility in males. Some studies also suggest chlamydia causes malformation in the structure of the sperm cells.
Common symptoms of chlamydia infection in the male are watery discharge from the penis, pain in the penis, swollen testicles, burning sensation during urination, rectal discharge or pain, etc.
Ureaplasma, which is also a bacteria is believed to affect sperm motility and DNA condensation. It can have an unfavorable effect on the sperm chromatin which carries the genetic material and hinder embryonic development.
Trichomonas Vaginalis a protozoan was more abundantly found in the semen of infertile men but its direct relation to male infertility is a subject of further research.
Most STDs affecting male fertility can be treated. Gonorrhea and Chlamydia can be easily treated with antibiotics. HIV although not curable can be managed well with modern antiviral drugs.
Importance of timely testing
As STDs are a preventable cause of male sterility it is of utmost importance for males of reproductive age to get tested if they have had unsafe sex. It helps to detect the disease early and treat it effectively. It also reduces the risk of transmitting it to the partner. Furthermore, if caught and treated on time, irrevocable damage to the male reproductive system can be prevented.
Read Also: STDs You May Need To Test Yourself For Today
Also, chronic and inadequately treated infections are more related to male sterility than acute infections. With proper and timely testing, doctors can detect such cases and treat them which can prevent pathological damage to the male reproductive organs.
Avoiding STDs that cause male sterility
The best way to prevent STD-related sterility is to practice safe sex by using a condom and getting tested and treated on time every time after having unprotected sex. Timely treatment can prevent extensive and permanent damage to the reproductive system and its effect on sperm motility, quality, and transport.
Many types of organisms can cause STDs and sterility in men such as viruses, bacteria, protozoa, etc. Common mechanisms include reduced sperm count, decreased motility, and poor quality caused by the inflammation of the epididymis, testicles, prostate gland, and obstruction of the sperm transport system.
These STDs can go several years unnoticed because many have mild or no symptoms. So, it is very important to screen them regularly for STIs, especially in men who have unsafe sex frequently and have multiple partners.
- Bezold G, Politch JA, Kiviat NB, Kuypers JM, Wolff H, Anderson DJ (2007) Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia. Fertil Steril 87: 1087– 1097.
- Eley A, Pacey AA, Galdiero M, Galdiero M, Galdiero F (2005) Can Chlamydia trachomatis directly damage your sperm? Lancet Infect Dis 5: 53– 57.
- Brookings C, Goldmeier D, Sadeghi-Nejad H. Sexually transmitted infections and sexual function to male fertility. Korean J Urol. 2013;54(3):149-156. doi:10.4111/kju.2013.54.3.149