Male Yeast Infections: A Hidden Health Concern

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Q: I am in a monogamous relationship and have an ongoing problem. Every time I have vaginal intercourse with my wife the head of my penis begins to itch. This lasts for several days. It is sometimes accompanied by non-painful white dots that appear around the head of the penis. My doctor said it might be a yeast infection and gave me some ointment that seems to help. But this problem comes back and I can't shake it. Is there another way to prevent this from happening?

A: The best way to prevent this from occurring is to re-examine the facts. Since you were diagnosed with a yeast infection, it's possible your wife also has an infection. In that case, timing is everything and you would both need to be simultaneously treated. If not, the yeast infection may cycle back and forth between yourself and your wife. This would help to explain why your symptoms continue to reappear after vaginal intercourse.

Other causes

There may be other reasons for your symptoms. For example, do you use a condom containing a spermicidal lubricant? If so, the ingredient may be causing a chemical irritation to the head of your penis, triggering the itching and temporary skin changes you have described. Also, if you are uncircumcised and have poor personal hygiene, symptoms such as you have experienced may develop. Needless to say, it is possible your original diagnosis may need to be reconsidered. It's best for you and your wife to have thorough medical evaluations by your personal physicians.

Diagnosing the problem with your doctor

Fortunately, you are in a monogamous relationship and don't need to worry as much about multiple partners with the potential for a myriad of sexually transmitted illnesses. However, it's important to communicate with your wife about your symptoms. The two of you are a team, and what affects one partner may affect the other. That said, your physician will likely need you to answer these questions:

How long have you (and your wife) been in a monogamous relationship?
Have you (or your wife) been previously diagnosed with a sexually transmitted illness?
Have many lifetime sexual partners have you had, and did you always use protection?
What are your current symptoms (rash, blisters, discharge, itching, pain, redness or inflammation of the foreskin)?
Where do the bumps appear (on the head of your penis, along the shaft, other areas of your body including your groin and anal region)?
How long do they last (hours, days, weeks)?
When do they occur (after intercourse, after urinating, on a random basis)?
What type of sexual activity triggers the symptoms (vaginal, oral, anal)?
Are you circumcised or uncircumcised?
Do you use a condom and if so, is it of latex or non-latex material?
Does your wife douche (can lead to a chemical irritation on the skin)?
Does your wife have any vaginal symptoms (unusual discharge, odor, pain with intercourse)?
Do you (or your wife) have any current medical concerns such as diabetes or an immune system disorder? (Both increase the risk for yeast infections.)
Have you or your wife been on a prolonged course of antibiotics (which may contribute to a yeast infection)?

Next, your physician will complete a focused examination of your penis, meatus (opening where urine flows out), foreskin, scrotal sac and surrounding regions, checking for redness, ulcerations, evidence of lice or scabies, swelling of the skin, as well as for any tender or painful areas. If a wound, blister or discharge were present, a sample of the fluid or tissue may be sent to the laboratory for evaluation. The following conditions will be considered in your diagnosis:

Yeast or bacterial infection
Contact or irritant dermatitis from soap, ingredients in the spermicidal jelly or douche, condom
Local allergic reaction affecting the skin
Non-cancerous skin conditions such as psoriasis
Sexually transmitted illness
Skin cancer (uncommon)

It will also help if you can point to the areas where your symptoms occur. For instance, those bumps you feel may actually be normal pearly penile papules. These are basically "hair follicles" without the hair, are more common in men who are uncircumcised, and are usually located along the rim of the head of the penis.

If it turns out you do have a genital yeast infection, both you and your wife may benefit from treatment. Other helpful measures include the following:

Keep your genital area clean and dry
If you are uncircumcised, it is also important to clean and dry the area under the foreskin
Use mild and unscented soap
Use some absorbent powder (cornstarch) if you tend to perspire heavily in that area

Second opinion

From the description of your symptoms, including the diagnosis by your doctor, it sounds as though your concerns are more bothersome than serious. I say this because your itching tends to go away in a few days (whether it is treated or not), you have no pain, ulcerations or discharge, and the skin around the affected area is not red or inflamed.

However, descriptions are no substitution for a full examination by a physician. And, since your symptoms continue to return, it may be time for a second opinion with a specialist such as an urologist or dermatologist.

For further information, please check out the American Academy of Family Physicians as well as Urology Health.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)