Men’s Wellness
The journey of a male from his teens to andropause is accompanied with multiple biological and psychological changes. Often, these changes may be associated with health disorders . It is thus vital to have a checkup done regularly to diagnose the same
Common Health Problems in Men
| Chronic non – communicable diseases | It is estimated by Ministry of Health (MOH) that 73 percent of Malaysians die of non- communicable diseases with majority of them being the male population. These non communicable diseases include coronary artery disease (heart attack), Diabetes, stroke, high blood pressure etc. |
| Prostate problems | Prostate cancer is the 4th most common cancer diagnose in man in Malaysia. Benign prostatic hyperplasia is a non- malignant enlargement of the prostate gland , and commonly occurs in male after the age of 40 years old due to changes in the balance of sex hormone. |
| Erectile Dysfunction (ED) | Although the majority of men affected by ED are elderly, younger men are not exclusively exempted. In Malaysia, data collected to date are for men above 40 years of age, and it showed a higher prevalence among men above 60 years of age. |
Prostate Cancer
Prostate cancer is one of the most common types of cancer in men. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.
Risk Factors
Age. The risk of prostate cancer increases with age, especially after age 50. More than 80% of prostate cancers are diagnosed in men who are 65 or older.
Race/ethnicity. Black men have a higher risk of prostate cancer than white men. They are also more likely to develop prostate cancer at an earlier age and to have more aggressive tumors that grow quickly.
Family history. Prostate cancer that runs in a family, called familial prostate cancer, occurs about 20% of the time. This type of prostate cancer develops because of a combination of shared genes and shared environmental or lifestyle factors.
Screening For Prostate Cancer
| Digital rectal exam (DRE) | During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of the gland, you may need further tests. |
| Prostate-specific antigen (PSA) test | It’s normal for a small amount of PSA to be in your bloodstream. However, if a higher than normal level is found, it may indicate prostate infection, inflammation, enlargement or cancer. |
| Ultrasound & prostate biopsy | If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. Prostate biopsy is often done using a thin needle that’s inserted into the prostate to collect tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present. |
Symptoms of Prostate Cancer
Prostate Cancer can be asymptomatic in the early stage.
- Trouble urinating
- Decreased force in the stream of urine
- Blood in semen
- Discomfort in the pelvic area
- Bone pain
- Erectile dysfunction
Certain Factors Affect Prognosis
(Chance of Recovery) & Treatment Options
The prognosis (chance of recovery) and treatment options depend on the following:
- The stage of the cancer (level of PSA, Gleason score, grade of the tumor, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the body).
- The patient’s age.
- Whether the cancer has just been diagnosed or has recurred (come back).
Treatment options also may depend on the following:
- Whether the patient has other health problems.
- The expected side effects of treatment.
- Past treatment for prostate cancer.
- The wishes of the patient.
Benign Prostatic Hypertrophy (Enlarged Prostate)
Benign prostate enlargement (BPE) is the medical term to describe an enlarged prostate, a condition that can affect how you pass urine. BPE is common in men aged over 50.
Symptoms of Benign Prostate Enlargement
The prostate is a small gland, located in the pelvis, between the penis and bladder. If the prostate becomes enlarged, it can place pressure on the bladder and urethra (the tube through which urine passes). This can affect how you pee and may cause:
- Difficulty to initiate pee
- A frequent need to pee
- Difficulty fully emptying your bladder
- In some men, the symptoms are mild and don’t need treatment. In others, they can be very troublesome.
Cause of Benign Prostate Enlargement
The cause of prostate enlargement is unknown, but it is believed to be linked to hormonal changes as a man gets older.
The balance of hormones in your body changes as you get older and this may cause your prostate gland to grow.
Diagnosing Benign Prostate Enlargement
- Patient history and physical examination, which includes a digital rectal examination (DRE). In DRE the doctor inserts a gloved finger into the rectum and presses on the prostate gland to check for enlargement.
- Uroflowmetry – Tests to measure the rate of urine flow and measurement of retained urine within the bladder.
- Urine tests and cultures.
- Prostatic specific Antigen (PSA)
- Ultrasound Pelvis
Treatment of Benign Prostate Enlargement
- Treatment may be unnecessary for mild symptoms.
- Excess alcohol or fluid intake, especially at night, should be avoided.
- Medication such as Proscar (finasteride) to shrink the prostate or drugs that relax smooth muscle tone in the prostate (alpha-blockers).
- Heat treatment (the application of heat to prostate tissue) can be used to alleviate symptoms of BPH.
- Removal of excess tissue from an enlarged prostate via transurethral resection of the prostate (TURP) is the most common surgical treatment.
- Surgical removal of obstructing prostate tissue via an abdominal incision may be necessary when the prostate is unusually large.
Erection Dysfunction
What is Erectile Dysfunction?
Erectile dysfunction, commonly known as impotence, is the inability to achieve or maintain an erection adequate for satisfactory sexual performance. It may occur at any age but becomes increasingly more common as men grow older.
What Causes Erectile Dysfunction?
- Emotional and psychological difficulties such as guilt or anxiety.
- Conditions that affect the brain and decrease the libido (sex drive), including depression or schizophrenia; use of drugs that act on the central nervous system (sedatives, antidepressants, some antihypertensive, antipsychotic, and alcohol); and chronic illnesses such as heart, lung, kidney, or liver disease, and certain types of cancer.
- Hormonal disturbances that decrease the libido, including diminished testosterone levels, elevated prolactin (due to a pituitary tumor) and hyper- or hypothyroidism.
- Brain disorders (that do not affect libido but have neurological consequences that affect sexual functioning), including brain tumor and stroke.
- Spinal cord disorders, such as multiple sclerosis or spinal cord trauma.
- Damage to the peripheral nerves due to diabetes mellitus or pelvic surgery for disorders such as prostate cancer or rectal cancer.
- Medications that can sometimes cause sexual dysfunction, including anticholinergics, antihistamines, beta-blockers (and other kinds of antihypertensives), and long-term use of nicotine.
- Peripheral vascular disease (impaired blood flow to the extremities and the penis).
- Fatigue.
- Advancing age.
How To Treat Erectile Dysfunction
- Avoid nicotine, alcohol, and other drugs.
- Your doctor may change your prescriptions if a medication has caused erectile dysfunction.
- Psychological counseling may be recommended when erectile dysfunction has an emotional or psychological cause.
- Testosterone injections or skin patches are given if blood testosterone levels are low.
- Hyperthyroidism or hypothyroidism is treated if necessary.
- Bromocriptine therapy is given to correct elevated prolactin levels.
- Three oral medications are currently available for treating erectile dysfunction: Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil).