Why we need to talk about men’s health
Conversations around men’s health are changing. Gone are the days when we were limited to only discussing prostate problems or sexual function. In today’s world, men are being increasingly encouraged to talk about all aspects of their health – from physical to mental to emotional. As such, we must take an holistic approach to men’s health.
ADAM questionnaire (Androgen Deficiency in the Aging Male)
The ADAM questionnaire is a useful screening tool to see if you might suffer with low testosterone. If you answer “yes” to questions 1 or 7, or three or more of the below questions, we suggest that you might need a testosterone blood test – contact us to book your consultation.
- Do you have a decrease in libido (sex drive)?
- Do you have a lack of energy?
- Do you have a decrease in strength and/or endurance?
- Have you lost height?
- Have you noticed a decreased “enjoyment of life”?
- Are you sad and/or grumpy?
- Are your erections less strong?
- Have you noticed a recent deterioration in your ability to play sports?
- Are you falling asleep after dinner?
- Has there been a recent deterioration in your work performance?
HEALTH AND WELLBEING
Men’s Health and Wellbeing refers to the concept of treating the patient as a whole. We live in a hectic world where time is short, and as such, for many men, their personal health becomes compromised due to time commitments In terms of physical checks, we take note of your lifestyle – including your diet, activity levels and alcohol intake – as well as your medical history, weight and height. We will take your blood pressure, measure your cholesterol, undertake a urine test for diabetes or kidney problems; we will also test your vision and your lung function – and may even undertake an ECG to check for heart problems or a chest X-Ray if you are a smoker. In terms of mental health, we appreciate the impact that modern life has on our ability to cope. Sadly, it can still be quite hard to get men to talk their doctor about their anxieties or mental health concerns. We provide a quiet and confidential environment that gives you time to explore and discuss any concerns you may have, without feeling pressured or judged. Just as physical health is important to address in men, mental health is just as important too.
What is testosterone deficiency?
Male testosterone deficiency has been dubbed the “male menopause”, or “manopause”, and is a pathological process that occurs as a result of decreasing amounts of testosterone. Men need testosterone for many aspects of healthy living. It is the male sex hormone, responsible for men’s facial hair, increased muscle mass, sexual function and pubic hair growth. But it is also much more. It provides men with drive, energy, motivation, protects them heart disease and brittle bones. For a long time testosterone deficiency has often been seen as a normal part of the ageing process, and, as such has been dismissed by patients and doctors alike. However, it is now estimated that it could affect more than 1 in 10 men over 40.
What are the symptoms of testosterone deficiency?
Patients often complain of decreased sex drive, erectile dysfunction, depression, fatigue, and loss of muscle mass. In addition, testosterone deficiency is also associated with the development of obesity, diabetes, osteoporosis, and memory problems.
Who gets it?
As men age, they all drop their testosterone levels, and as a result, age is one of the most important contributing factors in looking at causes of testosterone deficiency. However, just because we get older does not mean this drop in testosterone should not be treated. In addition to age, there are many medical conditions that also cause low testosterone, including:
- High blood pressure
- High cholesterol
- Asthma or chronic obstructive pulmonary disease
- Liver disease
- Obstructive sleep apnoea
- Kidney disease
Despite its prevalence and relative ease to diagnose, testosterone deficiency remains largely under investigated or treated in the UK, or worldwide. Testing is done by simple blood tests and, in many cases, treatment can be started quickly.
What is the treatment?
Treatment options include gels, injections, or tablets, and patients can often feel the benefits within four weeks of starting treatment. If you think you might be suffering from low testosterone, or would like to find out more, please contact Dr Jeff Foster.
PROSTATE AND ERECTILE DYSFUNCTION
Prostate health and Erectile dysfunction are key areas of men’s health that many men still feel embarrassed to discuss.
Approximately half of all men aged 40-70 will suffer with some degree of erectile dysfunction (ED). Causes of ED are widespread, and include
- Heart disease
- High cholesterol
- Testosterone Deficency
- High blood pressure
- Parkinson’s disease
- Certain prescription medications
- Peyronie’s disease — development of scar tissue inside the penis
- Alcoholism and other forms of substance abuse
- Sleep disorders
- Some prostate treatments
- Psychological factors, anxiety, or depression.
Sexual function is not something that should stop just because we get older. ED can also be a marker of other diseases so it is important not to ignore the symptoms.
What treatments are available?
Viagra is not always the first line treatment for ED. The most important aspect to treating and improving ED is finding the cause. Once this is addressed, there are specific medications, (including viagra), that may improve erectile function. There are also longer acting medications, or similar medications to viagra that act in a slightly different way. In most cases, ED is easily treatable. However, where medications or lifestyle changes do not work, we work closely with local Urology specialists who will be able to offer advice or more advanced treatment options.
There are around 130 new cases of prostate cancer every day in the U.K. However, more than 84% of men will survive for 10 or more years under current treatment regimes. The key to beating prostate cancer, is catching it early. Symptoms of prostate disease include:
- Poor urinary flow
- Hesitating starting
- Going more frequently
- Feeling as if you have not emptied completely
- Dribbling afterwards
- Blood in the urine
- Ejaculation pain
It is important to stress, however, that not cases of prostate disease mean prostate cancer. Many other conditions can mimic prostate cancer including a large prostate, infection of the prostate, narrowing of the tube we urinate out of, and even diabetes. Investigations include blood tests, examinations and scans as necessary. However, the most important message on this page is to not ignore your symptoms. Prostate cancer has a much better chance of being treated successfully if it is caught early. Do not ignore the symptoms as it might just save your life. If you think you might have prostate symptoms or are worried about erectile dysfunction, either book an appointment to see us or contact us.
Should I have a PSA screening test?
There is currently no national screening process for prostate cancer. This means, we currently rely on a combination of symptoms, PSA testing, and physical examination, to see if you should be referred for biopsy/imaging. The problem comes with the fact that many prostate cancers are asymptomatic until the late stages, which poses the question “should patients with no symptoms be screened with a PSA test?”. Overall, the evidence is mixed. The PSA result has both false positives and negatives, can result in needless testing, but more worryingly, false reassurance. The best advice is to see your doctor and discuss the pros and cons of having the test. There are several interesting and practical ways prostate cancer might be screened for in the near future, but for now it is far more complex then a “yes” or “no” test.