Sexual health is often reduced to two questions: “Can I perform?” and “Do I have an STI?” Both matter, but neither gives you the full picture of your reproductive health.
You can have normal erections and a healthy sex drive while having a low sperm concentration or reduced sperm motility. You can also have no obvious symptoms and still have a sexually transmitted infection. Meanwhile, a home sperm test can tell you useful things about semen quality, but it cannot diagnose an STI, check your hormones or explain every possible cause of fertility problems.
So what should UK men actually be checking? Here is the practical version.
First: sexual health and fertility are connected, but they are not the same
Sexual health covers your physical, emotional and social wellbeing in relation to sex. That includes consent, relationships, contraception, STI prevention and testing, sexual function and access to support. Fertility is more specific: it concerns your ability to contribute to a pregnancy.
There is overlap. Some infections can affect the reproductive tract, certain medical treatments can affect sperm production, and difficulties with erections or ejaculation can make conception harder. But no single check covers everything.
A useful approach is to think in five areas: STI status, semen quality, testicular health, sexual function and general health.
When did you last have an STI check?
Many STIs can cause few or no symptoms. That means feeling well, having no discharge and being in a relationship do not automatically confirm that you are infection-free.
Consider an STI test if you have had sex without a condom with a new or casual partner, if a partner has received a positive result, if you have symptoms, or if you simply do not know your current status. NHS sexual health services are free and confidential, and many areas offer home sampling as well as clinic appointments.
Seek medical advice promptly if you notice pain when urinating, unusual discharge, sores, rashes, testicular pain or swelling. Do not wait for Sexual Health Week—or for symptoms to disappear on their own.
Important: A semen analysis or home sperm test does not screen for chlamydia, gonorrhoea, HIV, syphilis or other STIs. Those require the appropriate sexual health tests.
Do you know anything about your semen quality?
Semen analysis is the main first-line test used to assess male-factor fertility. It examines characteristics of the semen and sperm rather than judging fertility from how semen looks.
Useful measurements include:
- Sperm concentration: how many sperm are present in each millilitre of semen.
- Motility: the proportion of sperm that are moving and how they move.
- Semen volume: the amount of fluid in the sample.
- Total motile sperm count: an estimate combining volume, concentration and movement.
- Morphology: the shape of sperm, which is normally assessed as part of a full laboratory semen analysis.
No single number provides a final fertility verdict. Semen parameters naturally vary, and pregnancy also depends on timing, the reproductive health of both partners and other biological factors. An unexpected result should be interpreted in context and may need repeating.
If you are testing at home, follow the product instructions carefully and use a comparable abstinence period each time. Read ExSeed’s guide to male fertility tests, costs and preparation before collecting a sample.
Have you checked for changes in your testicles?
Knowing what is normal for you makes it easier to notice a change. Pay attention to a new lump, swelling, persistent ache, a feeling of heaviness, or a clear change in size or shape.
Most changes are not testicular cancer, but they still deserve medical assessment. ExSeed’s guide to testicular pain, lumps or swelling explains the fertility context and the limits of sperm testing.
Contact your GP if you find a lump, swelling or persistent change. The NHS advises that sudden, severe testicular pain needs urgent assessment because testicular torsion can threaten the blood supply to the testicle.
A self-check is not a fertility test. It is simply a way to notice changes that need professional attention.
Has anything changed with erections, ejaculation or sex drive?
Erections, ejaculation and libido are not reliable measures of sperm quality. However, persistent erection problems or changes in ejaculation can still be worth discussing with a GP or sexual health professional.
Possible contributors include stress, relationship pressure, medication, alcohol, diabetes, cardiovascular problems, hormonal conditions and mental health. The aim is not to self-diagnose, but to recognise when a temporary issue has become an ongoing pattern.
Get advice if difficulties are persistent, distressing, painful, accompanied by other symptoms or affecting your relationship or plans for a family.
Are your general health checks up to date?
Reproductive health does not sit in isolation. Smoking, heavy alcohol use, obesity, poorly controlled diabetes, some medications, anabolic steroids and testosterone therapy can all be relevant to fertility or sexual function.
That does not mean every lifestyle choice directly determines a semen result. It means your wider health history belongs in the conversation. Depending on your age and circumstances, useful checks may include blood pressure, weight, diabetes risk and a medication review with a clinician.
If you take testosterone or anabolic steroids and want children now or in the future, speak to a qualified clinician. External testosterone can suppress the hormonal signals needed for sperm production; ExSeed’s guide to TRT and male fertility explains why sperm testing may matter. Do not stop prescribed treatment without medical advice.
When should you consider checking your fertility?
You do not need to wait until there is a crisis. A fertility check may be useful if:
- You and your partner are preparing to try for a baby and want a baseline.
- You have been trying without success.
- You have a history of testicular injury, undescended testicles, chemotherapy, pelvic surgery or certain infections.
- You use or previously used testosterone or anabolic steroids.
- You have concerns about ejaculation, testicular changes or semen quality.
- You want to track sperm health after making sustained lifestyle changes.
The NHS generally advises speaking to a GP after one year of regular unprotected sex without pregnancy. Seek advice sooner if the female partner is aged 36 or over, or if either partner already has a reason to be concerned about fertility.
What can an at-home sperm test tell you—and what can’t it tell you?
An at-home semen test can provide a private, convenient first look at selected semen parameters. The ExSeed Home Sperm Test assesses sperm concentration, motility, semen volume and total motile sperm count and allows men to track results over time.
It cannot confirm that you are fertile or infertile, screen for STIs, assess sperm morphology in the same way as a full laboratory analysis, check your hormones or diagnose the cause of an unexpected result.
A home test should not delay a GP or clinic appointment when you have symptoms, risk factors or ongoing difficulty conceiving. Read when a urologist may become part of a male fertility assessment.
For a broader explanation of available tests, the measurements they include and their limitations, read ExSeed’s guide to male fertility test types, costs and reliability.
The simple checklist
- STI status: test according to your sexual history, not just your symptoms.
- Semen quality: consider analysis if you are planning a family or have concerns.
- Testicular changes: know your normal and get new changes assessed.
- Sexual function: seek support for persistent or distressing changes.
- General health: review lifestyle, long-term conditions and medication with a clinician.
- Communication: include your partner without turning fertility into a search for blame.
The takeaway
Good sexual health is not one test and it is not one number. It is a combination of informed choices, appropriate screening, attention to changes in your body and honest conversations with your partner and healthcare professionals.
Sexual Health Week is a useful prompt—but you can start at any time. Check what is relevant to you, understand what each test can and cannot tell you, and ask for support when something does not feel right.
Frequently asked questions
Does normal sexual performance mean I am fertile?
No. Libido, erections and ejaculation do not reliably indicate sperm concentration, motility or other semen parameters. Read how to tell if a man is fertile or infertile for a clearer explanation of what testing can and cannot show.
Does a sperm test check for STIs?
No. A sperm test or semen analysis is not an STI screen. Use an NHS sexual health service or another appropriate testing provider for STI testing.
When should a man have a semen analysis?
It may be appropriate when a couple has difficulty conceiving, when there are known fertility risk factors or when a man wants an informed baseline. ExSeed’s male fertility testing guide compares the main options, while a GP or fertility professional can advise on clinical testing.
Can one semen result confirm infertility?
No. Semen quality varies, and an individual result needs context. An unexpected result may need to be repeated and discussed with a healthcare professional. This is why a result should be treated as information rather than a permanent fertility verdict.
Where can I get sexual health testing in the UK?
NHS sexual health and genitourinary medicine services provide confidential testing and advice. Availability differs by area, so use the NHS service finder or contact your GP.
