2023-12-11 04:59:12
At the moment, Movember has spread throughout the world, and thanks to its characteristic mustaches and the support of institutions, men and women who join the program, greater visibility has been achieved for diseases that, despite their high prevalence, still suffer from social stigma. . In no country in the world do men live longer than women.
A combination of genetic and social factors contribute significantly to men’s health. The early evolution of men’s health has arguably occurred over the past 40 years, with concrete initiatives since the 1980s to address cardiovascular disease and sexual health.
In addition to being physically different from women, men are influenced by social class, education and work, factors that significantly affect their health outcomes.
Andrology, everything you want to know about sexual health
Andrology, a branch of urology, is responsible for the study, exploration and treatment of any aspect related to sexual function and the male reproductive system.
The main pathologies treated by an andrologist include erectile dysfunction, Peyronie’s disease (curvature of the penis), ejaculation disorders, hormonal problems in men, male infertility, and sexually transmitted diseases (STDs).
Juan Ignacio Martínez-Salamanca, founder and medical director of Lyx Instituto de Urología, associate physician of Urology at the Iron Gate Hospital, explains to ABC the most common pathologies in andrology according to age. It stands out that, in young people between 20 and 40 years old, alterations in the ejaculation process, fertility problems, psychological erectile dysfunction and sexually transmitted diseases are observed.
In those over 40 years of age, cases of erectile dysfunction of organic origin, Peyronie’s disease and hormonal alterations such as testosterone deficiency are more common. Erectile dysfunction is one of the most important pathologies within andrology and is classified into two types: organic and psychogenic.
Organic erectile dysfunction occurs when there are underlying medical problems that justify the difficulty in achieving an satisfactory erection, such as cardiovascular, neurological diseases or diabetes, he explains. On the other hand, psychogenic dysfunction is due to psychological causes, either due to problems outside the sexual sphere, such as anxiety or depression, or related to physical appearance, attraction or sexual relations.
Regarding Peyronie’s disease, this expert assures that it is an acquired disorder characterized by symptoms that affect the penis, such as pain, curvature, shortening, narrowing and deformities.
Martínez-Salamanca emphasizes that Peyronie’s disease “is not cancerous, is not contagious, nor is it caused by any known communicable disease.” Currently, there are various treatments, from medications to surgery, to address these pathologies.
Advises that men go to the urologist once a year after age 40 or sooner if they have had more than 5 different sexual partners per year.
In recent years, there has been a progressive increase in cases of sexually transmitted infections.
According to Dr. José Joaquín Hernández Roca, head of the Internal Medicine service at the Hospital Vithas Madrid Arturo Soria«adolescent males begin an intimate relationship earlier than they did 15 or 20 years ago, often with insufficient information about STDs and influenced by imported models of pornography consumption that increase the risk not only of STDs but also, and We will see it in the future, in mental health diseases.
On the other hand, Hernández Roca highlights that “the approval of the vaccine against human papillomavirus has changed the panorama of sexually transmitted infections in European territory. For this reason, vaccination against HPV is recommended systematically in children between 11 and 12 years old.
Hernández Roca adds: “It is also recommended in the population under 26 years of age not vaccinated in childhood and should be considered in those under 45 years of age also if they have not been vaccinated in said period, as well as in patients with immunosuppression, including HIV positive patients.” .
“Men have to lose respect to show weakness”
Being a man can make it difficult to recognize and identify mental health problems, according to Dr. Lidia Gayubo, assistant to the Psychiatry Service of the Puerta de Hierro University Hospital. Values traditionally associated with masculinity still persist, such as the tendency not to express emotions or the fear of showing weakness or vulnerability.
The expert highlights the need to break down these barriers and promote the idea that men should also take care of their mental health, talk about it and lose the fear of showing weakness. “Although diseases such as depression affect women more, suicide rates in men are higher,” she points out.
Dr. Gayubo comments that “current models of mental health care seek to understand suicide from a multifactorial perspective, considering biological, psychological and triggering factors.”
The disorders that initially affect men the most are anxiety, which is a relatively stable problem between the ages of 35 and 84; followed by depressive disorder, whose most common symptom is sleep disorder; and finally psychosis and dementia.
«Mental disorders associated with urological cancer may appear in the diagnosis and/or treatment phase. Many depressive moments that arise are usually associated with urine loss and sexual impotence » points out Ángela Palao from the Psychiatry and Mental Health Service of the Hospital La Paz.
For Palao “you have to ask for help when symptoms such as irritability, social isolation, loss of desire to do pleasant activities appear, and of course when the feeling of frustration and helplessness associated with the ideation of death and suicide appear.”
Detection of prostate, testicular and penile cancer
In Spain, more than 35,000 new cases of prostate cancer per year, being the third cause of death from cancer in men. Early detection is essential, since in most cases, this disease does not present symptoms.
Currently, it is recommended to make the first determination of PSA (a marker in the blood) at age 50 and earlier to age 45 in case of a family history of prostate cancer.
The incidence of testicular cancer in Spain is 1,510 cases estimated for 2023, with the peak incidence occurring in an age range between 15 and 35 years.
Regarding possible warning signs, Dr. Estefanía Linares, specialist in Uro-oncology at Hospital La Paz, points out: “the increase in consistency and painless growth should alert any man to consult with a primary care doctor or urologist.”
In the case of penile cancer, we are talking about a less common tumor, with about 300 cases a year in Spain, which places us as one of the countries with the highest incidence of this type of tumor in Europe. Regarding the warning signs,
Linares comments: «it is detected under suspicion by physical examination with the appearance of a lesion that does not completely heal. In the case of this tumor, Linares points out «There is a close relationship with HPV infection (human papillomavirus) which is a precursor for the development of these tumors in men, as is the case with HPV in cervical cancer in women.
La Paz Hospital organizes two annual days dedicated to the detection of prostate cancer, during which any man from the age of 40 can have a blood test done, without an appointment, that will be useful for early diagnosis.
Hypertension and obesity, pending issues
Cardiovascular diseases especially affect the male population. “We are immersed in a true obesity pandemic and it is largely a consequence of the fact that the food industries have led us to convince ourselves that unhealthy foods are not unhealthy,” observes José Joaquín Hernández Roca, Head of the Internal Medicine Service at he Vithas Madrid University Hospital in Arturo Soria.
«Diabetes is the disease that grows the most and the best thing is to prevent it. To achieve this, healthy nutrition based on a Mediterranean diet, doing moderate physical exercise, not smoking and drinking alcohol moderately, is the best medical prescription that doctors can prescribe because obesity is closely associated with its development,” adds Dr. Hernández Roca. .
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