Problems down there? Here are 14 potential reasons why

NOTE: This article/page uses the terms ‘male/man/men’ and/or ‘female/woman/women’. Please note, this is in reference to the sex assigned at birth.

Whether it’s frequent itching, an unusual pain or something that just doesn’t feel quite right, not knowing what’s going on down there can sometimes make us feel a little uncertain.

But caring for our intimate health and hygiene is just as important as anywhere else on our bodies, so it’s always worth getting checked out if you spot anything out of the ordinary. Here, we’ve put together some common problems down there and what might be causing them.

• Benign prostatic hyperplasia

• Balanitis

• Phimosis

• Endometriosis

• Erectile dysfunction

• Jock itch

• Pelvic inflammatory disease (PID)

• Pelvic floor strength

• Premature ejaculation

• Sexually transmitted infections (STI)

• Thrush

• Urethritis

• Urinary tract infection (UTI)

• Vaginal dryness

1. Benign prostatic hyperplasia 

Also known as an enlarged prostate, this condition typically affects older men, usually over the age of 50. While the cause isn’t fully understood, it’s thought that hormonal changes may cause the prostate gland to grow. 

The prostate is a small gland that’s located in the pelvis between the penis and bladder. If the prostate becomes enlarged, it can place pressure on the bladder and the urethra (the tube that urine passes through). Because of this, it may cause symptoms like:

• Difficulty starting to pee

• A frequent urge to pee

• Feeling like you can’t fully empty your bladder

If you notice any of the above symptoms, speak to your GP. If your GP confirms that you have benign prostatic hyperplasia, it isn’t usually anything to worry about and symptoms are often mild. They may advise trying some simple lifestyle changes such as exercising regularly and minimising your caffeine intake. For moderate to severe symptoms, your GP may recommend certain medication to help reduce the size of the prostate.

2. Balanitis

This is a condition where the head of the penis becomes swollen, itchy and sore. It can also look a little red, but this may be less obvious on darker skin tones. You may also experience:

• Pain when peeing

• A thick discharge from under the foreskin

• Bleeding around the foreskin

• An unpleasant smell

• Difficulty pulling back the foreskin

If you have any of these symptoms it’s important to make an appointment with your GP to find out what’s causing it. Some of the possible causes include:

• Not washing the penis properly

• A tight foreskin (phimosis)

• Soaps, shower gels or condoms irritating the skin

• Thrush

• A sexually transmitted infection (STI) such as gonorrhoea or chlamydia

Balanitis can usually be treated with a steroid cream or ointment, an antifungal treatment if it’s caused by thrush, or antibiotics if it’s a bacterial infection, which your GP may prescribe.

3. Phimosis

Also referred to as a tight foreskin, phimosis normally occurs in babies and young boys but it can affect adults, too.

The foreskin is the thin sheath of skin that covers the end of the penis. If this becomes tight, it’s difficult to pull it back from the end of the penis. This isn’t usually a cause for concern unless you experience other symptoms such as:

• Swelling and tenderness

• Pain when peeing or a weak flow

• Blood in your pee

• Frequent urinary tract infections (UTIs)

• Painful erections

• An unpleasant smell, bleeding or thick discharge from under the foreskin – these are signs of an infection (balanitis)

If you experience any of these, it’s important to speak to your GP for advice and appropriate treatment.

4. Endometriosis

Affecting one in 10 women in the UK, endometriosis is a long-term condition where tissue that’s similar to the womb lining starts to grow in other places, such as the ovaries, fallopian tubes, bowel and bladder. It can cause symptoms such as:

• Pain in your lower tummy or back (pelvic pain) – usually worse during your period

• Painful, heavy or irregular periods

• Period pain which stops you doing your normal activities

• Pain during or after sex

• Pain when going to the toilet during your period

• Feeling sick, being constipated or having diarrhoea during your period

• Difficulty getting pregnant

• Tiredness

If you’re experiencing symptoms, speak to your GP for advice and next steps. You may find it helpful to keep a diary to track of any symptoms throughout your cycle.   

You can find out more about this condition in our endometriosis article.

5. Erectile dysfunction

Erectile dysfunction (ED) is a term used to describe the difficulty of getting and keeping an erection long enough to have sex. It’s very common, particularly in men over 40, and is usually nothing to worry about.

Most men are likely to experience ED at some point in their life. Sometimes, it can be a short-term condition, caused by a number of things including:

• Feelings of stress

• Tiredness

• Drinking too much alcohol

• A side effect of certain medicines

But if it keeps happening or happens often, it may be caused by a condition such as high blood pressure or high cholesterol, diabetes, depression or anxiety or hormone problems.

Depending on the cause, you may still be able to get an erection at other times, such as when you wake up in the morning. You may find that making simple lifestyle changes may help, but if it’s happening regularly or you’re concerned, make an appointment with your GP to find out what’s going on.

You can find out more about this condition on our Erectile Dysfunction Health Hub.

6. Jock itch

Common in athletes, jock itch (medically known as tinea cruris), is a fungal skin infection that causes redness and itching. It’s often harmless but as the fungi thrives in moist areas, it’s more common in areas like the groin and inner thighs. It may be shaped like a ring and cause the following symptoms:

• Red or brown sores which may have blisters or pus-filled sores around the edge

• Itchiness and redness around your groin area, such as your inner thighs and bottom (the genitals are not usually affected)

• Scaly and flaky skin on your inner thighs

Usually, things like exercising, walking and wearing tight clothing or underwear can make the symptoms of a groin infection worse. A combination of thoroughly washing and drying the affected area, wearing loose cotton clothing and changing clothes every day can help, as well as some over-the-counter antifungal creams.

If you’re experiencing any of the above symptoms, make an appointment with your GP for advice and to find out what treatment’s available.

7. Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is an infection which can affect the womb, fallopian tubes and ovaries. In most cases, PID is caused by a bacterial infection that’s spread from the vagina or cervix to the reproductive organs. While there are many different types of bacteria than can cause PID, it’s typically caused by a sexually transmitted infection (STI), such as chlamydia.

PID doesn’t usually cause any obvious symptoms but one notable symptom is pain around the pelvis or in the lower tummy. Most other symptoms are mild and may include:

• Discomfort during sex that’s felt in the pelvis

• Pain when peeing

• Bleeding between periods and after sex

• Heavy and painful periods

• Unusual vaginal discharge, particularly if it’s yellow, green or it smells   

In rare cases, some people may become very ill and experience:

• Severe pain in the tummy

• A high temperature

• Feeling and being sick

If you experience symptoms of PID or are concerned you may have PID, it’s important to visit your GP or a sexual health clinic. If you have severe pain, you should contact your GP urgently or go to A&E.

8. Pelvic floor strength  

The pelvic floor muscles sit at the base of your pelvis and are responsible for supporting the bladder, bowel, uterus and vagina. You can feel them working if you imagine trying to stop yourself from peeing.

Strengthening your pelvic floor muscles can help with urinary incontinence, help provide support for pelvic organ prolapse, as well as making sex feel better, too. To get you started, why not try doing some Kegel exercises to help contract and relax the pelvic floor muscles?

9. Premature ejaculation

Premature ejaculation (PE) is when a man can’t control ejaculation and comes quicker than they would like, usually within the first minute or two during sex.

Generally speaking, there are two types of premature ejaculation:

• Primary – where you’ve always had the problem (often triggered by psychological experiences)

• Secondary – where you’ve recently developed the problem (this can be a mix of psychological and physical causes such as drinking too much alcohol)

It’s important to note that premature ejaculation is only an issue if it’s bothering you or a partner – if you’re happy with your sex life then there’s no need for treatment. However, if it’s impacting you, there are a few self-help techniques you can such as:

• Masturbating a couple of hours before sex

• Using a thick condom to help reduce sensation

• Taking a deep breath during sex to help delay ejaculatory reflexes 

If you’d like to consider seeking treatment, you may want to try the Boots Online Doctor Premature Ejaculation Treatment service* for advice and, if appropriate, treatment.

You can find out more about premature ejaculation in our article.

10. Sexually Transmitted Infections (STIs)     

An STI is a sexually transmitted infection that can be passed from one person to another through unprotected sexual contact, usually vaginal, anal or oral sex.

You can have an STI without knowing as some don’t always have symptoms. The only way to know is to get tested. However, some common STI symptoms to look out for include:

• Unusual discharge

• Pain when weeing

• Lumps or skin growths around the genitals

• A rash

• Unusual vaginal bleeding

• Itchy genitals or anus

• Blisters, sores and warts around the genitals or anus

• Warts in the mouth or throat, although this is very rare

It’s important to go to a sexual health clinic if:

• You have symptoms of an STI

• A sexual partner has symptoms of, or is confirmed to have an STI

• You’re worried after having sex without a condom

• You’re pregnant with symptoms of an STI

If you suspect you have an STI, do not have sex, including oral sex, without using a condom until you’ve had a check-up with your GP or at a sexual health clinic. They’ll ask a few questions and carry out some tests, providing you with next steps if any of the results come back positive.

You can also find out if you have an STI, such as chlamydia and gonorrhoea, by using the Boots Online Doctor STI Home Test Kit** – there’s one for men and one for women, too. If any results from the test kits are positive, you can access treatment for certain STIs through Boots Online Doctor.*

You can find out more about STIs in our article.

11. Thrush

Thrush is a common yeast infection that affects both men and women and is caused by the yeast, candida. Although it’s usually harmless, it can be uncomfortable and may keep coming back. It’s important to note that it’s not an STI, but it can be triggered and passed on during sex.

Common thrush symptoms in women include:

• White vaginal discharge (often like cottage cheese), which doesn’t usually smell

• Itching and irritation around the vulva and vagina

• Soreness and stinging during sex or when you wee

Common thrush symptoms in men include:

• Irritation, burning and redness around the head of the penis and under the foreskin

• A white discharge (like cottage cheese)

• An unpleasant smell

• Difficulty pulling back the foreskin

Thrush can also affect other areas of the skin, including the armpits, groin and between the fingers.

It’s important to see your GP if:

• You have symptoms of thrush for the first time

• You have thrush and are under 16 or over 60

• Thrush keeps coming back (more than four times in 12 months)

• Treatment for thrush isn’t working

• You have thrush and are pregnant or breastfeeding

• You have thrush and a weakened immune system

Thrush can usually be treated with an antifungal treatment in the form of tablets or a cream, like the Boots Pharmaceuticals Thrush 1% w/w Cream (contains clotrimazole, always read the label). Symptoms of thrush should clear up within seven to 14 days of starting treatment.

You can take a look at our Women’s Thrush Health Hub and our article on male thrush for more information. 

12. Urethritis

Urethritis occurs when the tube that carries wee from the bladder out of the body (urethra) becomes inflamed and irritated. It’s often caused by an STI so it’s important to get it treated to avoid spreading it to others. It doesn’t always have symptoms but some can include:

• Pain or a burning sensation when you pee

• White or cloudy discharge from the vagina or penis

• An irritated or sore tip of the penis  

If urethritis is caused by an STI, it usually takes a few days or weeks for symptoms to show after having sex. If you’re worried about your symptoms and you think you may have urethritis or an STI, speak to your GP or visit a sexual health clinic.

13. Urinary Tract Infection (UTI)

Urinary tract infections (UTIs) are common in women and affect your urinary tract which includes your bladder (cystitis), urethra (urethritis) or kidneys (kidney infection). Although they can be painful, an uncomplicated UTI in a woman isn’t usually a cause for concern. Symptoms generally pass within a few days with self-care measures and can be treated with a short course of antibiotics, if appropriate.

Symptoms of a UTI may include:

• Pain or burning when peeing

• Needing to wee more often than usual during the day and night

• An urgent need to wee

• Wee that looks cloudy

• Blood in your pee

• Lower tummy pain or pain in your back

• Feeling like you can’t fully empty your bladder

• A slightly high temperature

It’s important to speak to your GP if you’re experiencing symptoms of a UTI and:

• They’re severe or getting worse

• They don’t improve after a few days

• You get UTIs often

• They come back after treatment

Get urgent medical attention or call NHS 111 if you have a UTI and:

• A very high temperature and feel hot and shivery

• A very low temperature below 36°C

• Are confused or drowsy

• Have pain in your lower tummy or in your back

• Have blood in your pee

If you have a UTI (also known as cystitis), you’re a woman aged 16 to 64 and you live in England, you may be able to access treatment, including prescription treatment, from a pharmacist in your local Boots Pharmacy via the NHS Pharmacy First Service^ without needing to make an appointment. 

14. Vaginal dryness

Vaginal dryness affects many women at some point in their life and can cause some of the following symptoms:

• Itching or soreness in or around the vagina

• Pain or discomfort during sex

• Needing to wee more often than usual

• Recurring UTIs

If you’re experiencing these symptoms, they may put you off having sex. However, there are a few things you can do to help relieve vaginal dryness such as using water-based lubricants before sex, using unperfumed soaps around your vagina and trying vaginal moisturisers, specifically designed for vaginal dryness.

Vaginal dryness can be caused by a number of things, including:

• The menopause

• Breastfeeding

• The contraceptive pill or some prescription medication, such as antidepressants

• Having your womb removed (a hysterectomy)

• Having cancer treatments, such as chemotherapy

We’d recommend making an appointment with your GP if any of the following apply:

• You’ve had vaginal dryness for a few weeks and self-help techniques aren’t working

• Vaginal dryness is impacting your daily life

• You have unusual discharge or are bleeding from your vagina

• You’re bleeding after sex or in between periods

You can find more information on vaginal dryness in our article.

Self-care for down there

Now you’re familiar with the above intimate health conditions, it’s time to turn your attention to the things you can do to help care for down there. Whether it’s how best to wash your genitals or choosing the right underwear, it’s important to keep on top of your intimate health and be aware of any changes. Looking for more tips? Take a look at our guide for women’s intimate health.

Next steps

If you’re experiencing any symptoms of the above conditions or you’re worried about something out of the ordinary, speak to a pharmacist or make an appointment with your GP to get checked out.