Under the Covers with Men’s Sexual Health Issues

male sexual health

Addressing Men's Health: Overcoming Stigma and Embracing Solutions

Despite the rising conversation around women’s health, a Google search for men’s health yields a mere fraction of the results. With 152 million hits for women's health and only 22.3 million for men's health, this disparity raises important questions: Is this a sign of societal bias, or does it reflect a reluctance among men to discuss their health issues, even in the digital age?

Consultant urologist and andrologist Dr. Ivor Cullen, from University Hospital Waterford, emphasizes the importance of men being proactive about their health, particularly when it comes to issues like infertility and sexual dysfunction. He argues that many health concerns, often perceived as embarrassing or distressing, have multiple solutions—solutions that men should be aware of and seek help for.

Male Infertility: A Revolution in Treatment Options

While female fertility often takes center stage in discussions about reproductive health, male infertility has seen significant advances. In recent years, the field of male fertility has witnessed a revolution, offering new possibilities for men who may have struggled with conception. Dr. Cullen stresses that infertility isn’t just a female issue, with male factor infertility contributing to approximately 50% of infertility cases.

For many men with suboptimal semen analysis—whether due to low sperm count, poor motility, or abnormal sperm shape—there are now more treatment options than ever before. These include lifestyle changes like stopping frequent sauna visits or supplementing with zinc and folic acid, as well as medical and surgical interventions.

One common condition that can lead to male infertility is a varicocele, a varicose vein in the spermatic cord that can increase testicular temperature and hinder sperm production. Fortunately, this condition can often be treated surgically, improving sperm quality.

Erectile Dysfunction: Beyond the "Little Blue Pill"

Erectile dysfunction (ED) affects about half of all men at some point in their lives, and for some, it may be a temporary issue. However, for others, ED can persist and may require more advanced treatment. While medications like Viagra can work for many, Dr. Cullen points out that for those who don’t respond to these treatments, surgical options like inflatable penile prosthesis implants are now available.

These implants, which involve a hydraulic pump inserted into the scrotum, offer a permanent solution to ED and can provide men with functioning erections suitable for penetrative intercourse. Dr. Cullen has noted that while this option is available in Ireland, it remains underutilized due to a lack of awareness among both patients and healthcare providers.

Addressing Peyronie’s Disease: Curved Penis Solutions

Peyronie’s disease, characterized by a significant curve in the penis due to abnormal scar tissue, affects 4-8% of men and can make intercourse difficult or impossible. While mild curvature is common, problematic cases involve curves greater than 30-45 degrees. Dr. Cullen highlights that treatment options, including surgeries to straighten the penis or inject enzymes to dissolve the scar tissue, can help many men regain sexual function.

However, as with other health issues, men often avoid seeking help for what they perceive as embarrassing problems. This reluctance can negatively impact their relationships and mental health. Dr. Cullen encourages men to recognize that these issues are common and treatable, and seeking medical advice can lead to significant improvements.

The Role of Andrology in Men's Health

Andrology, a specialized branch of medicine focusing on male reproductive and sexual health, is often underrepresented in Ireland. Dr. Cullen, who has trained extensively in this field, believes that more focus is needed on male-specific health concerns, especially as men live longer. With the aging population, there’s an increasing need to address conditions like late-onset hypogonadism—sometimes referred to as the "male menopause"—which affects many older men.

Symptoms of low testosterone, such as erectile dysfunction, fatigue, and psychological distress, can be effectively treated with testosterone replacement therapy. However, Dr. Cullen emphasizes the importance of lifestyle changes, weight management, and addressing comorbid conditions before turning to hormone therapy.

Encouraging Men to Seek Help

Ultimately, the key to improving men’s health lies in increasing awareness and reducing the stigma surrounding conditions like erectile dysfunction, infertility, and sexual dysfunction. Men need to feel comfortable seeking help from healthcare professionals, whether it’s to discuss fertility issues, sexual health concerns, or the physical and psychological challenges associated with aging. By being proactive about their health, men can access a wide range of medical, surgical, and lifestyle interventions that can greatly improve their quality of life.

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