Men’s
health refers to health issues specific to human male anatomy. These
often relate to structures such as male genitals, and conditions related
to or caused by male hormone (testosterone).
When providing health care to a man, a
doctor always has it in mind that beyond curing a man’s illness is the
improvement of the quality of his life.
Men’s health has become a major public
health issue because of the challenges associated with their health
which include the lack of awareness and understanding of the health
issues they face.
Men don’t openly discuss their health and
how they are feeling. They are reluctant to take action when they don’t
feel physically or mentally well. They can engage in risky activities
that threaten their health, and they usually don’t carry their partners
along.
Worse still is the fact that stigma surrounds men’s health, which is also a challenge in itself.
Ten common men’s health issues seen in
daily clinical practice include erectile dysfunction, low sperm count,
zero sperm count, hernia, urethritis, epididymoorchitis, prostatitis,
male menopause, benign prostate enlargement (BPH) and prostate cancer.
Others are premature ejaculations, testicular torsion, and undescended testes.
A patient of mine who was on honeymoon
had told his wife a few days after their wedding that he had to get to
the bank, only for him to be in the hospital to complain about inability
to have erection!
He got married about five days before
coming to the hospital. He said the wife saw her menstrual period on
their wedding night and that seeing the blood had affected him such that
he could not have an erection. He said the situation persisted till
after the wife’s menstrual flow ceased on the third day. This is a case
of erectile dysfunction.
He was confused and came for
consultation. He was counselled, treated and was asked to come for
follow-up. He was helped with medications.
However, he refused to show up for
further monitoring; and when the hospital staff called to remind him of
his appointment, he told them that the drug he was given was effective
and that he would not be honouring the follow-up appointment.
Another patient had said a friend told
him that erectile problems during honeymoons were spiritual and that he
did not need medical intervention.
Greater percentage of men may be helped
via medications, even while there is no harm for tackling the problems
spiritually via prayers, counselling and support.
Erectile dysfunction (ED), commonly
called impotence, is defined as the inability to achieve or maintain an
erection sufficient for satisfactory sexual performance. It often causes
serious distress, prompting men to seek medical attention they may not
otherwise seek.
Erectile dysfunction is the most common
sexual problem in men. The incidence increases with age and affects up
to one third of men throughout their lives.
It causes a substantial negative impact
on intimate relationships, quality of life, and self-esteem. History and
physical examination may be sufficient to make a diagnosis of ED in
most cases, while few may require test.
However, problems affecting men’s health extend far beyond erectile dysfunction and other commonly recognised men’s illnesses.
A couple who was receiving treatment for
infertility had come for review of their result at the hospital. The
nurse, on dropping the card on the doctor’s table, told the doctor that
the man requested that his wife must not know the outcome of the sperm
count. The nurse then left the consulting room.
The doctor stood up to welcome the
couple, but the wife was already at the door with the husband. The
doctor had asked the wife if she wouldn’t mind if he disclosed the
result to the husband alone. The wife objected. She said they were in
the clinic together to know the outcome of the result. The doctor held
the result, fidgeting. The wife was already asking what the sperm count
result and motility were, and whether the result was good or bad.
The doctor tried to be diplomatic by
telling them it was not too good. The woman had asked again about what
was not good there. The young doctor had told them to see the medical
director the following morning to allow for more time for explanation
and counselling. The truth is that the man had a zero sperm count but
did not want it disclosed to the wife!
About one in 10 men will have an abnormal
result on the first sperm (semen) test, but this does not always mean
they have a ‘true’ abnormality. So, if the results of the first semen
test are abnormal, the test should be repeated.
Ideally, this repeat test should be done
three months after the first, but if it looks as though the sperm count
is very low or no sperm at all, it should be repeated as soon as
possible.
The import of this piece is to increase
the need for men to seek medical care, especially in health issues that
are specific to men and also to carry their partners along because some
forms of therapies may directly or indirectly come from the woman.
The young man told me that he had ED, He had gone
to a doctor who requested for several tests but due to the high cost of the
test he went to a drug store. In the drug store he was shown a machine, a
computer scanner.
He placed his thumb on the scanner and he was told
the computer concluded he had a low sperm count.
He had a
prescriptions of testosterone, human menopausal gonadotropin (HMG) ,Ofloxacin
and sildenafil citrate.
I had told him to go back to his doctor that all
the drugs from the drug store are special drugs, that some may be harmful on
the long term and may be associated with irreversible side effects like prostate
cancer.
I had
written in the last piece that whenever managing men’s health
issues, a doctor always has it in mind that beyond curing a man’s illness is
the improvement of the quality of his life and not harming the person involved.
Men with
ED should be considered for a general medical checks including cardiovascular
risk screening because studies have shown that men with ED have a significantly
greater likelihood of having angina, myocardial infarction, stroke, transient
ischemic attack, congestive heart failure, or cardiac arrhythmia compared with
men without ED.
Men with
ED also have a 75 percent increased risk of peripheral vascular disease.
Because
most men are asymptomatic before an acute coronary syndrome, ED may serve as a
pointer for discussions on promotion of cardiovascular risk factors and
modification.
Risk Factors
Obesity
nearly doubles the risk of ED
The risk
of moderate or total ED is almost double in men who smoke compared with
nonsmokers
Prevention
Patient
education should be aimed at increasing exercise, losing weight to achieve a
body mass index (BMI) less than 30 kg per m2, and stopping smoking.
Treatment
When
there is no obvious medical etiology for ED, psychosocial factors should be
explored.
The
potential clue that psychosocial factors may be a cause is that a man is able
to achieve normal erections and orgasm through masturbation or sex with a
partner other than the “index case” partner with whom he has erectile
dysfunction (e.g., a spouse with whom there is substantial conflict).
Psychosexual
therapy aimed at improving relationship difficulties may help to improve sexual
dysfunction in men.
Psychosexual therapy plus medications had more
successful outcomes.
Some
whose erectile dysfunctions are due to uncontrolled Diabetes mellitus
,uncontrolled high blood pressure may get out of ED by having these conditions
controlled.
Some whose
ED are due to effects of certain drugs should have those drugs reviewed by
their doctors.
In some
cases, education about medical and psychosocial etiologies of ED in conjunction
with physician reassurance/counseling may prove adequate to restore normal male
sexual function.
If a man is experiencing signs and symptoms that might be
the result of a low testosterone level that include: Fatigue, Weakness, Depression,
Sexual problems, it is good to consult a doctor. He or she can evaluate
possible causes for the way you feel and explain treatment options.
In conclusion, the other men’s condition like Benign
Prostrate Hypertrophy (BPH) and prostrate cancer causes a variety of "gentlemen's problems", chief among which
is difficulty in urinating or the need to urinate frequently and constipation.
Whether the prostate is growing benignly or
malignantly, a test for prostate specific antigen in the blood - the PSA test -
can reveal much about the health of this organ.
A manual examination by a doctor can be helpful too,
of course, although less likely to be attractive to the patient.
I intend to write on Benign Prostrate Hypertrophy (BPH) and prostrate
cancer in the month of April. Plan is also on the way to
do a prostrate screening for men over 45 in conjunction with an NGO.
........concluded.
Bell’s
palsy is a condition that causes temporary weakness or paralysis of the
muscles on one side of the face. It is the most common cause of facial
paralysis.
