As a doctor with a sexology expertise, Massimo is in the unique position in New Zealand to be able to offer both pharmacological treatments and sexual counselling, combining both approaches to reach the maximum results. His special interest in sexology is men's sexual rehabilitation, particularly when first-line approaches like erectile dysfunction drugs taken on-demand have not worked. What you can expect from a medical sexology consult: During the first appointment Massimo will take a detailed history of your problem and of your sexual development from adolescence to the current time. An examination could be indicated and a chaperone will be provided if you wish. Massimo will likely request some blood tests (hormonal panel including testosterone levels, etc.). At the follow-up visit, feedback regarding the test results will be provided and Massimo will make a management plan with you. This might include medications (according to the issue: drugs exist for erectile dysfunction and premature ejaculation; testosterone supplementation might be indicated for male hypogonadism in specific circumstances and in the absence of contraindications), suggestions to your GP regarding how to optimise your overall health or how to modify other treatments you might be taking, specific sexual therapy exercises to do at home, alone or with your partner, or a definite number (generally 8 to 12) of weekly counselling sessions. Massimo is able to refer you to a sex therapist for those if you wish (a sex therapist is generally not a doctor), or he could provide the sessions himself if you prefer so, also via telehealth for your convenience.

Massimo follows the WPATH SOC v8 and as such always prescribes gender-affirming hormonal therapy in the context of a multidisciplinary approach including a psychosocial assessment undertaken by a clinical psychologist. He is happy to direct patients to a psychologist in Tauranga with proven experience and skills in performing WPATH assessments. Alternatively, patients are welcome to submit, prior to their first consult, assessments done by other mental health professionals for Massimo to review. Massimo only sees gender-diverse patients who are older than 16.

Under his double expertise in infectious diseases and sexual health, Massimo is happy to see people who are experiencing recurrent UTIs.

Urethritis is not a diagnosis, it is the term used to describe an inflamed urethra. It can be caused by STIs, other infections, or non-infective causes. Urethritis can occur after unprotected vaginal, anal and oral sex. Symptoms Symptoms of urethritis include discharge, pain passing urine, or just an uncomfortable feeling in the urethra. Urethral irritation Sometimes men experience urethral irritation when no inflammation or infection is present. This is usually short-lived and may be due to strong urine, other general illness, allergy (e.g. to spermicide) or topical irritants (e.g. soap).

They are simply too many to be listed. Over his 30+ years' career Massimo has dealt with most of them, including but not limited to viral hepatitis, malaria and other tropical parasitoses, tuberculosis (including latent TB diagnosed during an occupational health screening) and other mycobacterioses, and post-surgical infections (including prosthetic infections, for example hip & knee joint replacement infections).

Syphilis used to be uncommon in New Zealand but is now on the rise. It can be very serious if left untreated. The bacteria Treponema pallidum enter the body through tiny breaks in the skin or through the linings of the body cavities i.e. vagina, anus, mouth. Syphilis is almost always acquired by sexual contact. This disease is detected by a blood test. Massimo is happy to see applicants to Immigration NZ who have tested positive during the immigration medicals and who require a certificate for the clearance of their medicals.

Gonorrhoea is caused by a bacteria (Neisseria gonorrhoeae) infecting the mucous membranes (linings) of the male urethra, female cervix and sometimes the eye, rectum or throat. Gonorrhoea is transmitted by having vaginal, anal or oral sex with someone who has the infection. An infected mother can pass the infection on to her baby at birth.

Chlamydia is caused by the bacteria Chlamydia trachomatis. It is a very common infection of the mucous membranes (linings) of the male urethra, female cervix and sometimes the eye, rectum or throat. Chlamydia is transmitted by having vaginal, anal or oral sex with an infected partner. A mother may pass the infection on to her baby at birth, causing the baby to develop eye or lung infections.

It is a relatively new agent causing mostly persistent or recurrent urethritis in men. It responds to very few antibiotics and can become even more resistant to antibiotics following previous suboptimal treatments.

Bacterial Vaginosis (BV) is also known as non specific vaginitis or Gardnerella vaginitis. BV is caused by overgrowth of bacteria that normally live in the vagina. However, evidence is growing that BV can affect both partners and be passed to and from during sex. The results of a large study in Melbourne offering treatment for the partners of women with BV are due in 2024 and could radically change the way we consider and manage BV.

Candidiasis, or thrush, is caused by an overgrowth of a yeast (a type of fungus) called Candida albicans. It is not caught or transferred by sexual activity. Candidiasis can be triggered by: • Antibiotics • Diabetes • Pregnancy • Severe infections • Hypersensitivity (allergy) • Dermatitis or ulcers • Scratching • Tight clothing.

Trichomoniasis is caused by a small parasite called Trichomonas vaginalis. The infection is most common amongst sexually active females between 16 – 35 years. It is caught during sexual contact with an infected person. Trichomonas can be called ‘Trich” for short (sounds like trike).

Crabs (Phthirus pubis) are very small insects which can infect and cause itching in the genital area. Crabs are not the same as the lice found in the scalp. Crab lice are common and can be transmitted by close bodily contact.

Genital herpes is a common infection caused by a virus called herpes simplex. You can get genital herpes by having genital skin contact (vaginal, oral or anal sex) with someone who has the infection.

Genital warts are caused by infection with human papilloma virus (HPV) and appear as small lumps in the anal and genital areas. HPV is different from the virus that causes warts on the hands or other areas of the body.

Molluscum contagiosum is caused by a virus and is seen as small lumps with waxy, white centres. They are commonly found on the genital area, thighs or lower abdomen. Molluscum contagiosum is spread by close bodily contact, on clothing or bedding or from one part of the body to another by scratching. Sexual partners will not necessarily become infected.