Men who are sexually attracted to men can face health concerns that differ from those of straight men. They should understand these health issues and take steps to stay healthy.

For example, gay men who are socially ranked can become anxious about competing with each other for status and sex. In addition, they can be prone to body-consciousness that leads to eating disorders.

1. Sexual Arousal

Sexual arousal is the biological experience of feeling turned on. It is a different experience from sexual desire or libido, which refers to a general interest in sexy things.

When sexual arousal is activated, your heart rate and blood pressure increase. Your clitoris and vagina become swollen. Your nipples may also become fuller or erect. Your body may also begin to sweat. These changes occur whether or not you have an orgasm.

Researchers don’t know exactly what causes sexual arousal, but they do know that certain brain structures are active during this time. They include the nucleus accumbens, cingulate cortex and orbitofrontal cortex (dACC). These regions are involved in reward processing and complex cognitive functions such as decision-making. In addition, arousal triggers the release of hormones that make you feel excited and hungry.

2. Emotional Arousal

Sexual minorities can become tripped up by compare-and-despair anxieties, particularly as social media tools like Instagram and Grindr quantify their physical appearance with brutal accuracy. These can contribute to body consciousness, eating disorders, and even the use of anabolic steroids.

When anal stimulation causes an erection, it’s difficult to distinguish whether you feel love or adrenaline. It’s no wonder that many men (and almost all teenage boys) have had experiences of unwanted or unintentional arousal.

In an experiment called the Love Bridge study, researchers set up two groups of men to walk on a series of bridges. Some of them were told about the arousal they were experiencing; others weren’t. The result was that the men who were informed about their arousal had no trouble identifying and labeling it as such, but the men who were misinformed struggled to do so. They couldn’t figure out whether they were feeling euphoria or fear, and as a consequence were less likely to interpret their experience as pleasurable.

3. Physical Arousal

Although the words arousal and desire are often used interchangeably, they’re two distinct concepts. Desire has to do with emotionally wanting to have sex, and arousal has to do with the physiological changes in your body (e.g., increased heart rate, genital swelling and engorgement, blood flow to the genitals, an erection, and more).

Physical arousal is managed by the brainstem, the oldest part of the brain that manages wakefulness and basic bodily functions. It’s characterized by the feeling of warmth or heat, tingling and your blood pounding. When a man becomes sexually aroused, the penis gets an erection because two spongelike tubular spaces inside the shaft are engorged with blood.

Having trouble with sexual arousal usually means you’re having problems with either physical or subjective arousal. Having limited subjective arousal and excitement typically accompanies lack of physical response, but you can have one problem without the other.

4. Social Arousal

Gay men can be especially hard on each other. Their culture is intrinsically status-conscious, and men often compare themselves to their peers for sex, status, income, and physique. This can trigger a vicious mental compare-and-despair loop that leads to body dissatisfaction, eating disorders, and the misuse of anabolic steroids. A new study published in the Journal of Personality and Social Psychology shows that this comparison can also lead to heightened cardiovascular stress responses.

Researchers used a lab experiment to measure cardiovascular responses and self-reports of arousal in gay participants. They found that when people perform a novel task in front of others, their hearts race faster than when they do the same thing alone. This is called social facilitation and is consistent with Zajonc’s drive theory. However, the perception of other people is not necessary to induce the effect. This suggests that other factors are involved, such as arousal enhancement. A similar result was found in a follow-up supplemental experiment.