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Men's Health Comes out of the Closet
By Dr. Andrew Ember
Men's Health ne thing is certain:  Menís Health has finally "come out of the closet."

Whatever favourite news media you follow regularly, you cannot escape the constantly increasing interest and coverage of menís health issues.  Well known celebrities are talking about the successful treatment of their impotence or their prostate cancer or the hormones that they are taking to combat their male menopause.  Younger men are devoting greater personal resources to maintaining optimal physical and mental function and the best possible appearance.

There is no doubt that gay men have been at the leading edge of this gaining movement - to keep healthy, fit and look the part.

Erectile Dysfunction

Since the release of Viagra by the Pfizer Pharmaceutical Company, a great deal of health focus has been on erectile dysfunction or ED,  the new term for impotence.  Doctors have long been aware of the various health conditions, such as diabetes and hyper-cholesterolemia, which cause early hardening of to the penis resulting in ED.  However, we have only become aware recently that smoking is a significant risk factor for ED.  Health authorities in many locations, such as California, are currently mounting public awareness campaigns aimed at smokers in an attempt to prevent ED.

Smoking is a significant risk factor for ED
As for therapy, Viagara can effectively treat 60% of men with ED.  For the remaining 40%, other proven effective medical therapies are available, such as  intra-urethral pellets of the medication Alprostadil or somewhat more complicated penile injections with the same drug.

Spurned on by the business success of Viagra, the pharmaceutical industry is rushing to put other simple oral therapies on the market with such drugs as apomorphine and phentolamine in the pipeline.  The new reality is that no one needs to suffer from erectile dysfunction any longer.

Prostate Cancer

Less well known have been the advances in the diagnosis and treatment of prostate cancer, the most common cancer of men over the age of 50.  This decade saw the development of the blood PSA test, which is sensitive in picking up prostate cancer even before symptoms develop or before it can be detected by physical examination.  Although the test is not perfect because results can be elevated with benign conditions such as prostatic enlargement, infection or inflammation, the blood PSA test has boosted important chances for early detection.  All men over age 50, and men over age 40 with a family history of prostate cancer should have regular PSA tests along with a digital rectal examination.  There is no question that early detection means greater chances of a cure with simpler treatments which have less unwanted side effects.

Male Menopause

Effective treatment can now be offered for male menopause
Finally, no article on Menís Health would be complete without mentioning new developments in the diagnosis and treatment of male menopause, aptly called andropause.  This common condition is distinguished by a decrease in the level of bioavailable testosterone, a form of the male hormone which could not easily be detected until very recently.  Men with andropause experience the gradual onset of decreased vigour, muscular strength, depressed mood and irritability, and a tendency to gain fat around the belly.  Low sex drive with or without ED also occurs.  The diagnosis of the condition requires a careful medical history, physical examination and laboratory tests.

Effective treatment can now be offered, with testosterone injections or tablets under careful medical monitoring. Further advantages of the treatment include the prevention of osteoporosis and the reduction of certain cardiovascular risks.  Men with andropause can now regain a sense of well being and appearance of youthfulness.

As the octogenarian comedian George Burns put it:  "You canít help getting older, but you sure donít have to get old."

Science is at an encouraging pace of discovery and development in the area of Menís Health.  Since reaching the year 2000, we can be reassured that the man of the New Millennium is both healthier and youthful.

Menís Health has not only come out of the closet - it has come of age.

Dr. Ember practices medicine at University of Ottawa Health Services  Tel: 564-3950