Sexually Transmitted Diseases/something or it's irritation


QUESTION: I've been having regular unprotected and sometimes protected sex with my girlfriend of one year. She's only had sex with one other guy in her life so I don't think she's got anything since it has been almost 3 years. Well my penis hurts when I pull back my foreskin and it hurts when I touch the head. It has little red spots on the head and a few thin abrasions on the body of the penis. My testicles feel swollen and once again penis feels sensitive as hell. Not sure if it is irritation or some disease. Last time I had sex was 3 days ago and shit got worse. I'm 20.

ANSWER: Hello Cesar,
Looks like you have balanitis, an infection of the underside of the foreskin and glans (head) of the penis from one or more things. The most common cause is a skin infection from yeast, which may cause redness, swelling, and pain.  Your may try using an antifungal cream such as terbenefine (Lamisil), miconazole (Micatin), tolnaftate (Tinactin), or something prescribed like ketoconazole (Nizoral) or nystatin (Mycostatin).  Until effectively treated, avoid anything that causes such pain. Not all infections are considered "sexually transmitted" but they are more "sexually mediated"-- friction injures the skin and opportunistic skin fungi such as yeast can cause the malady.

Good luck!

---------- FOLLOW-UP ----------

QUESTION: Umm I tried several things including rubbung garlic on it and umm I don't know what is going on. I did go to the doctor they said it was balanitis and gave me Nizoral. I don't know if this is how it should be looking.

Hello Again, Cesar,
I am not aware of the home "remedy" of garlic to treat fungal infections causing balanitis. Nizoral cream is a good antifungal that you must use at least twice daily for a week or two. The other over-the-counter medications  mentioned above may also be used. Give it a week or two after treatment to then examine and reassess.

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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