Heath & Beauty - Free Fitness Library
Men - the weaker sex
By Dr. R E Lister
During a recent discussion at my sports club on the relative health status of men and women I asked how many of the mixed group could tell me what a gynaecologist did. They were all familiar with the term; but when asked to define the job of an andrologist only one out of the twenty knew (and this was only because she had a classical education). As everybody in the group knew a gynaecologist specialises in women's diseases whereas they were unaware that an andrologist is a specialist in men's diseases. This ignorance of men's disease issues reflects a lack of awareness both at the individual level and that of society. Gynaecology is a recognised speciality within the NHS with thousands of practitioners and it's own Royal College (largely consisting of men) but the number of specialist andrologists in the NHS can be counted on the fingers of both hands. It might be concluded from this situation that men are healthier than women, but this is not the case. Men are twice as likely as women to die before the age of 65, the most productive part of their life, and their life expectancy at 72yr. is six years shorter than that for women. Many of the diseases that contribute to the imbalance in life expectancy are a consequence of unhealthy life styles and are in part avoidable or preventable. The big three killers of men in their prime are heart disease, stroke and cancer and are linked to poor diet, smoking, excessive drinking and lack of exercise all of which are under the control of the individual. A change to a healthier lifestyle and the early detection of incipient disease can result in a significant improvement in men's life expectancy and general health.
As women visit their GPs twice as often as men this may be taken as an indication that women are less healthy than men but the real reason is that men are much more likely to face up to changes in their health status than are women. A recent MORI poll found that 21% of men were reluctant or unwilling to visit their GP even though they may show well-marked symptoms that if diagnosed could result in prompt treatment and prevent a fatal outcome. Men tend to be much less knowledgeable about their body and it's functions. This is particularly noticeable with regard to their reproductive organs, the reason for this is largely cultural; women visit their GP more frequently and read about their health in magazines, newspapers and from leaflets produced by the Health Education Council and others that they pick up from their GP's surgery. Men traditionally show a lack of interest in their health and frequently deny symptoms of disease in the mistaken belief that a stiff upper-lip can be the cure for most illnesses. However there are signs that the situation may be changing, two magazines devoted to men's health have recently appeared on the bookstalls and it hoped that they will go some way towards bringing the message of disease prevention to men. In view of men's traditional disregard of health issues it may be that the best course is for women to buy these magazines and insist that their menfolk read them. The level of men's ignorance about their body and it's function was revealed in a recent MORI poll that found that two thirds of the men questioned were ignorant of the exact location and function of the prostrate gland. This contrasts with women of whom almost half were aware of it's position. The majority of men know that a poor diet high in fat is linked to heart disease and that smoking can lead to lung cancer and aware of the major signs of these diseases but few are familiar with the internal anatomy and signs and symptoms of diseases of the male reproductive gland.
The Prostrate Gland
This is a walnut sized gland at the base of the bladder that produces
most of the fluid that makes up the bulk of the seminal fluid. For reasons
yet unknown it tends to become enlarged with age and presses on the
nerves from the bladder inducing more frequent and difficult urination
and difficulty in emptying the bladder completely. This condition known
as benign prostatic hypertrophy or, more commonly BPH, affects about
60% of men over sixty. While it may cause discomfort and possible embarrassment
it is not life threatening and can be controlled by drugs or in more
severe cases by a minor operation. Any persistent difficulties in urination
should be investigated medically without delay as the initial symptoms
of BPH are also those of prostrate cancer, a much more serious condition
and the fourth most common cause of cancer in men in UK. There are about
14,000 new cases of prostrate cancer reported each year in Britain with
only a third of the men with a positive diagnosis surviving for more
than five years. This figure could be halved if earlier regular checks
and earlier diagnosis could be achieved. In the USA, where prostrate
examinations are routinely performed on most men over 40, tow thirds
of the men diagnosed with the disease survive for more than five years.
Women can play a part in minimising the toll of this disease by encouraging
their partners to have regular checks for this condition if they show
any of the above symptoms. This practice could lead to a very real reduction
in the number of avoidable deaths from this form of cancer.
The Testicles
These paired organs, also called the testes, produce sperm and the male
hormones, in particular testosterone, that influence the development
of the secondary physical sex characteristics and the masculine psyche.
The commonest disease of the testes is cancer and this occurs most frequently
in men between the ages of twenty and forty. About 1,400 new cases of
this form of cancer are reported each year causing an estimated 130
deaths annually, fortunately, it is the form of cancer with probably
the highest cure rate of all; if caught in it's early stages almost
100% of cases can be cured by drugs or surgery or a combination of both.
The best form of early detection is to look for swelling in each testicle,
the presence of a small pea-sized lump on the otherwise smooth surface
of the testicle, or any unexpected or persistent testicular pain. Many
women regularly examine their breasts for signs of early cancer although
the chances of early detection by this means is quite low because by
the time the lumps are felt the cancer maybe well established. BY contrast
testicular cancer is easily detected at an early stage but is frequently
missed as few men actually perform regular self-examination. Perhaps
the answer to early detection of testicular cancer is for the man to
have his partner regularly examine his testes and in return for him
to examine his partners breasts. This suggestion is less flippant than
it may seem as the incidence of testicular cancer is at it's peak between
twenty and thirty, this coincides with maximal sexual activity in men
and with the time when denial of illness is commonest and concern for
mortality at a minimum. Testicular cancer tends to be confined to one
organ and if surgical removal is essential this need not affect sexual
performance or it's enjoyment.
Impotence
Impotence is the inability in a man to complete sexual intercourse successfully.
It can be due to psychogenic or physiological factors or often a combination
of both. In some men hormonal disturbances can induce both impotence
and sub-fertility. The major factor in impotence is due to problems
with initiating and sustaining an erection, this may be exacerbated
by ejaculatory failure. Treatment of this condition demands a full case
history and will usually involve attention to both physical and emotional
factors. Modern treatment methods can utilise both drug therapy and
psychological methods and usually are effective. Treatment should be
undertaken by specialists in the field and the results tend to be better
when both partners are actively involved in the treatment process. Infertility
and sub-fertility may accompany impotence but the two conditions are
usually not linked.
Infertility
Total infertility is the inability to reproduce and is usually a medical
disorder, it may be due to a number of organic causes. In men it may
be due to an inability to produce visible sperm or insufficient amount
to fertilise an egg due to ejaculatory failure. In cases where couples
are unable to conceive it is just as important for the man to have his
fertility status determined as for the woman. Many of these fertility
problems can be tackled by surgical procedures, hormonal re-balancing,
artificial insemination or as a last resort in vitro fertilisation (IVF).
Sub-Fertility
This is a common condition in which the physiological system is functional
but is not in perfect working order. This state can occur in both men
and women, in men the testes are producing sperm but the sperm quality
may be low and the chance of successful fertilisation is reduced. In
recent years there has been a considerable increase in the prevalence
of sub-fertility in men. The rate of this reported increase has accelerated
over the last two decades and does not appear to be matched by a corresponding
increase in female sub-fertility. This is causing concern as the consequences
of a major increase in the prevalence of male sub-fertility may have
a serious impact on the population growth and economic activity. The
increase in sub-fertility in men does not appear to be due to a single
causative factor but is the result of a number of influences coming
together to affect men of fathering potential particularly in the industrialised
nations. This suggests that there may be a link with the changes in
lifestyle that have occurred over the last few decades. Various scientists
have suggested a range of potential factors that may be causing this
change but there is no general agreement amongst them as to a single
probable cause. It is likely that a number of factors that alone may
not prove to be very important, are acting together in an additive fashion
to give rise to a significant hazard that shows up as an overall increase
in sub-fertility. The female hormones knows as oestrogens can inhibit
sperm production leading to infertility or sub-fertility depending on
the level of exposure, they are used medically to suppress sperm production.
Synthetic oestrogens are a major constituent of the majority of oral
contraceptives and are used in agriculture to boost growth in farm animals
and can enter the food chain via meat or milk.
Other synthetic chemicals that are used in the production of plastics and as chemical preservatives have chemical structures that are similar to oestrogens and can mimic their effect in the body. These can enter the food chain or contaminate the drinking water and even though they may be present in only minute quantities there is a strong suspicion amongst some scientists that this may be a major factor in causing sub-fertility in men. Heavy metals such as lead and mercury may enter the body through the food chain or less commonly as a result of atmospheric pollution. These elements are harmful to dividing cells and can be lethal to cells at high levels and impair fertility at lower levels but their adverse effects can be counteracted by the element of selenium.
Carcinogens, pesticides, some drugs and many types of radiation can lead to the production of free-radicals in the body. In many cases the body itself may produce free-radicals to fight off infection. In a recently reported Canadian study free-radicals were detected in the semen of 40% of infertile men but none were found in normal men. A general deficit of essential nutrients may also lead to sub-fertility but some nutrients are vital for the production of healthy sperm. Recent studies in the US have shown that zinc is vital for sperm production, even short term zinc depletion can lead to a rapid loss in fertility in young men.
To insure against these potential adverse environmental effects on reproduction it is a wise policy to take a daily high-quality antioxidant nutrition supplement that will counter the damaging effect of free-radicals together with a zinc and selenium that can counter the presence of heavy metals. An effective supplement containing antioxidant vitamins with Zinc and Selenium is Bio-Selenium + Zinc produced by Pharma Nord (UK) and available from your local pharmacy or health food shop. Should you have difficulty in obtaining this product or any of their wide range of dietary supplements write to Pharma Nord, (UK) Ltd, Spital Hall, Morpeth, NE61 3PN or phone them free on 0800 591 756.
For more information on the diseases mentioned above and the many others that men are heir to, the interested reader should read "The Which Guide to Men's Health" published by the Consumers Association at £9.99.