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Five men’s issues to watch - Medical Observer Feb 12th, 2014


WHAT'S ahead for men’s health? Here are five issues to watch as the year unfolds.

A focus on men’s health in Australia has been reinvigorated in recent years with the launch of the 2010 National Men’s Health Policy. But new issues continue to emerge, so it is important to remain vigilant in addressing areas of need. In particular, health issues facing younger males — including drugs in sport and pressures around body image — have gained growing media attention.


Sport

Until recently most us of may have thought the major male health issue around sport was participation levels. But 2013 was the year that performance-enhancing drugs and ‘supplements’ came to the attention of the mainstream media.

The health consequences of drugs in sport can get lost within the media hoopla and the drama of high-profile sports people implicated in these activities, plus the associated legal and sporting regulatory issues. And let’s keep in mind that what takes place in the elite levels of sport often propagates throughout the amateur ranks as well. The use and abuse of ‘recreational’ drugs and alcohol also has a long but not particularly glorious history in Australian sport. It will be interesting to observe how the major sporting codes will approach the use of social and performance-enhancing drugs in 2014 and beyond.

Body image

Recent evidence suggests that body image concerns are more prevalent in boys than previously thought, and that boys may manifest these concerns in a different manner to girls.

The finding that boys tend to be concerned about muscularity (rather than concerns about thinness observed in females) has significant implications for diagnosis and treatment of eating disorders in men and boys.

Dads get the blues too

Becoming a parent for the first time marks a major life milestone, and is also a time of significant lifestyle upheaval. Health professionals are beginning to recognise that the mother and the father both share the emotional and psychological impacts of new parenthood. Postnatal depression in men is now on the health agenda with support services being developed, albeit in the early stages.

Prostate cancer

Several promising new approaches to the diagnosis of prostate cancer are under investigation. While the venerable PSA is not likely to fall into disuse any time soon, we can look forward to a future where more specific markers for prostate cancer may play a role in diagnosis and management.

In the meantime, the use of the PSA test will continue to be a contentious issue, as will recommended treatment and management practices. Careful analysis of quality evidence must remain the cornerstone of this debate.

Erectile dysfunction

Erectile dysfunction (ED) is more than just old blokes worrying about their sexual performance. Men who experience ED face a higher risk of developing cardiovascular disease compared to men who do not. The degree of risk for a cardiovascular event after developing ED is said to be similar to that of current smoking or a family history of ischaemic heart disease.

While specific treatments to promote erectile function, usually starting with options such as PDE5 inhibitors, are effective, management of any identified cardiovascular disease or risk factors should follow a diagnosis of ED. It is hoped that awareness of the role of a man’s penis as a barometer for his overall health will become more widespread in 2014.

 

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