In almost every corner of the world, we realise that men have a shorter life span than women as they deal with inferior health conditions, which is quite concerning. Urologic and cardiac conditions make up a significant portion of men’s health issues. Innovative and coordinated programs from Governmental and non-governmental organizations are the need of hour to improve men’s health. This month is all about Men’s health and raising awareness about health care for men.
Men are prone to many health-related problems. The most common health-related issues in men are metabolic syndrome, sexual dysfunction, lower urinary tract symptoms due to prostate enlargement and cancers of the prostate, penis and testis.
Metabolic syndrome is a combination of dyslipidemia, diabetes mellitus, hypertension and obesity. In addition to its association with increased cardiovascular disease risk metabolic syndrome in men is linked to specific health issues including lower urinary tract symptoms, impotence, hypogonadism and genitourinary cancers (kidney, bladder and prostate). The novel strategies to treat this syndrome have centred around a healthy and balanced diet, regular exercise, lipid-lowering drugs (statins), strict blood sugar control and testosterone therapy in specific cases.
It is an organic or psychological problem that prevents a man from getting sexually satisfied. It can affect men of all ages and is most common in older men. The most common types of male sexual dysfunction are ejaculation disorders, erectile dysfunction and inhibited sexual desire, which can be corrected by the treatment of their underlying causes.
Types of male sexual dysfunction:
Physical causes of male sexual dysfunction are – Smoking, alcoholism, low testosterone levels, use of antidepressants, diabetes and hypertension.
Psychological causes of male sexual dysfunction are – Work-related stress and anxiety, concern regarding sexual performance, marital problems, depression and effects of past sexual trauma.
Erectile dysfunction is the inability to reach and/or maintain an erection adequate for satisfying sexual intercourse.
Premature ejaculation (PE): PE is classified as lifelong (primary) and acquired (secondary). Lifelong PE is a syndrome characterized by early ejaculation at nearly every intercourse within 30-60 seconds in the majority of the times (80%) or between 1-2 minutes (20%), with every or nearly every sexual partner and from the first sexual intercourse onwards. Acquired PE is seen at some point in life, is often situational with the previous history of normal ejaculation experiences.
PE is associated with negative psychological consequences including distress, and frustration which may affect the quality of life, partner relationship, self-esteem and self-confidence.Patients with PE are advised to consult a urologist as it is a treatable condition. Psychosexual education and pharmacotherapy can cure PE in the majority of patients. Various drugs like serotonin reuptake inhibitors, local anaesthetics, and PDE5 inhibitors are used to treat PE.
Delayed ejaculation (DE): Also called as impaired ejaculation, it is a condition in which an extended period of sexual stimulation is required by a man to reach the sexual climax and release semen from the penis (ejaculate). In some cases with delayed ejaculation, the man is unable to ejaculate at all. DE can be a temporary or a lifelong problem and is mostly caused due to certain chronic health conditions, surgeries and medications. Treatment for delayed ejaculation depends on the underlying cause. It is a normal situation for men to have delayed ejaculation from time to time. Delayed ejaculation is only a problem if it’s ongoing or causes stress for either of the partners.
Low libido: It can be described as a decreased interest in sexual activity. It is common for a man to have a low sex drive, and libido levels can vary through life. It is a common thing to have different interests than your partner and a low libido for a long time period can cause concern for some people as it can be an indicator of an underlying health condition.
The most potential cause of a low libido in a man can be the male hormone in men called testosterone, which is produced by the testicles. This hormone is responsible for the bone mass, muscle build up and for the stimulation of sperm production. These testosterone levels play an important role in the sex drive and the normal levels can vary. A man is said to have low levels of testosterone when the levels are below 300ng/dl and a decreased level means a decreased desire for sex. This decreased level of testosterone can happen with age and a decreased level can lead to a decreased libido.
What are UTIs?
UTIs are mostly common in women, but men can get them too. In men, these may develop in the urethra (the tube that runs from the opening at the tip of the penis to the bladder), bladder, the prostate or kidney. They mainly occur when the bacteria builds up along the urinary tract. They can be mostly cured with antibiotic drugs.
Symptoms of UTIs:
Causes of UTIs
UTIs are mostly caused by the bacterium E.coli, which gets into the urinary tract through the urethra or through the bloodstream. In some men enlargement of the prostate gland which is present near the urinary bladder can cause obstruction at the bladder neck and causes difficulty in passing urine. The bacteria which are normally flushed out, usually gain a foothold causing the infection.
Some other causes of urine infection are:
UTIs can be diagnosed mainly with symptoms including the past history of any of them. A urine sample is collected to check for pus cells and bacteria and their presence confirms a UTI.
It is always important to stay hydrated and to reduce the chances of bacteria invading the urinary tract to prevent a UTI.
Male pattern baldness can be described as the typical hair loss itself as a receding front hairline, hair loss from the crown portion of the scalp or a combination of both. It is the most common type of hair loss in men. It is also called androgenic alopecia. It is said that male pattern baldness is associated with male sex hormones called androgens which have many functions including hair growth.
What causes male pattern baldness?
Genetics or family history of baldness is one of the causes of male pattern baldness.
Inherited baldness usually has no side effects but sometimes this can have more serious causes like certain medications, cancer, thyroid issues and steroids. It is always advisable to consult a doctor if there is hair loss after taking a new medication or if it’s accompanied by other health problems.
The pattern of hair loss helps the doctor in diagnosing male pattern baldness followed by a medical history and a physical exam to rule out some health conditions.
This kind of baldness usually starts in teenage years , but is more common in adult men and increases as they age. Genetics plays an important role as men who have relatives with this kind of baldness are at higher risks.
Male pattern baldness cannot be prevented and can only be managed, as it is said that stress causes hair loss by an increase in producing the sex hormones in the body. Stress can be managed by certain relaxing activities like walking, listening to soothing music and entertaining oneself.
Prostate and testicular cancer are specific for men as these organs are seen only in males.
Prostate Cancer: Prostate cancer usually occurs in men above 50 years of age. The disease is usually asymptomatic in the early stage. Hence screening is advised to diagnose the disease in an early curable stage. Cancer confined to the prostate can be cured by robotic-assisted surgery.
Generally, prostate cancer screening is suggested for men who are between the ages of 55 to 69. Some men who belong to a higher risk zone for prostate cancer should eventually consider screening immediately between 40-45 years of age. This group covers American African men, men with a close relative (father, brother or son) who has had prostate cancer.
Testicular Cancer: Testicular cancer can attack males at any age, but mostly it is found in men aged between 15 to 44 years.
If found early, it can be cured. Testicular cancer is highly chemotherapy-sensitive and can be cured even if diagnosed at an advanced stage. To identify this cancer early, men are encouraged to learn about the early signs of the disease, learn how to do a testicular self-exam and talk with a new or changed lump, swelling or pain in the area.
Benign enlargement of prostate and prostatitis are the non cancerous prostate related problems seen in men.
Benign prostatic enlargement is usually seen after 50 yrs of age. An enlarged prostate can obstruct the urinary passage and can lead to a myriad of voiding and storage symptoms like a slow urinary stream, hesitancy, straining at urination, frequency, urgency and frequent nighttime urination. Men with these symptoms are advised to consult a urologist. Urologists, after a physical examination and necessary investigations, will prescribe treatment based on the severity of the problem. Mild disease is treated by some lifestyle changes and disease of moderate severity needs drug therapy. Patients with severe urinary symptoms due to benign prostatic obstruction usually need minimally invasive surgery.
Prostatitis: Inflammation of the prostate gland is called prostatitis. It could be an acute inflammation called acute prostatitis which usually presents with fever, lower abdominal pain and burning micturition. Antibiotics and anti-inflammatory drugs are the mainstay of therapy in this condition.
Chronic prostatitis could be bacterial or nonbacterial. Patients with this problem have long-standing symptoms like- burning micturition, pelvic pain and quality of life issues. Antibiotics, anti-inflammatory drugs, and alpha-blockers are used to treat this condition. The condition has a waxing and waning pattern of occurrence.
Mental health issues including anxiety, depression and suicide are increasingly prevalent in men and are concomitantly being underdiagnosed. Compared to women, men are at 4 times higher risk for suicide. Opioid abuse is also a major health-related crisis commonly seen in men.
Men need to take charge of their health and it is important at any age. Regular health checkups and a urologist consultation will prevent serious health problems and many of these can be cured at an early stage. Statistically, men pay less attention to their health and are always busy building their careers and achieving their goals in today’s competitive world. It is always advisable to ensure care throughout the lifespan and have a healthy lifestyle.
| CHECKUPS & SCREENING | WHY? | WHEN? |
| Physical Exam | Preventive care for total health | Annually |
| Testicular Exam | Screens for Testicular cancers | Annually, during a physical exam or right away you find limps during self-exam. |
| Blood Pressure | Screens for Hypertension (high blood pressure) | Annually or as directed by your doctor |
| Cholesterol | If hugh, can lead to heart disease | Every 5 years or as directed by your doctor |
| Prostate- Specific Antiget (PSA) test | Screens for Prostate cancer | African American men or men with a family history are at a high risk of developing Prostate Cancer. Consider talking with your doctor at the age of 45 about whether Prostate Cancer screening is right for you. |
| A1C Test | Screens for high blood sugar levels | If you have a family history, are overweight, or have personal concerns, talk to your doctor about screening for this condition. |
About Author –
Dr. V. Surya Prakash ,Consultant Urologist, Laparoscopic, Robotic & Transplant Surgeon
MS (Gen Surgery), FRCSED, M.Ch(Urology), DNB(Urology), D.Lap
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