AS Covid-19 continues its devastating world tour, it can be easy to forget that there are other medical conditions that demand our attention. Today, the Express will focus on men’s health.
Here at home and on a global level the male mortality rate is higher than that of females. While there can be a biological explanation for this, men’s approach to health also plays a major role, says family practitioner Dr Visham Bhimull.
“Most men think that once they can live up to their roles in society, they are healthy. Such flawed thinking results in many men putting less priority on their health. It’s well known that the health seeking behaviour of men is very poor as compared to women. That has to do with ideas of masculinity and bravado and how males were brought up — to not express any sort of weakness. If you have a poor state of health it’s like you’re expressing that you’re weak as a male,” he said.
Bhimull shared six medical issues that are prevalent among men in T&T with the hope that it will encourage the male population to take a more active interest in their health.
Cardiovascular disease is the number one cause of death in T&T and around the world. It is also more common in men.
After the age of 40, men should have their cholesterol checked but if there is family history of heart disease then that puts one in a high risk group which requires earlier screenings. Controlling blood pressure, diabetes and cholesterol levels is also vital in order to lower one’s risk of heart disease.
“The advice is: if you smoke, stop and if you don’t smoke, don’t start. Increase your activity levels to 30 minutes a day, most days of the week. You significantly reduce your cardiovascular risks if you are more physically active,”said Bhimull.
This is an aggressive cancer. By the time symptoms are manifested, the cancer has already progressed and the prognosis is grim, said Bhimull. Tobacco smoke causes 90 per cent of all lung cancers, the remaining ten per cent would be based on a person’s environment; where a person lives and works. Quitting smoking at any age reduces the risk of lung cancer.
“Few preventative measures are effective or as challenging as the cessation of smoking. Some healthcare professionals make the mistake of just telling the patient to stop smoking. But it is a substance abuse issue. As such physicians may have to counsel the patient and talk them out of it. We must also bear in mind that as with all substance abuse problems there is a chance of relapse but that doesn’t mean there is no hope,”says Bhimull.
This is one of the most common cancers in men. Here in T&T, it leads cancer statistics in the population. Worldwide prostate cancer is the second type of cancer most frequently diagnosed in men.
This type of cancer is the result of the malignant transformation of certain cells of the prostate, a gland located underneath the urinary bladder in men While one in six men will be diagnosed with prostate cancer in their lifetime, the mortality rate is low because it is considered a slow growing cancer.
However some prostate tumours may be very aggressive and can extend to other organs which is why screening for prostate cancer which usually takes the form of the digital rectal examination is important, said Bhimull.
Depression and suicide
It was once thought that depression affects more women than men, but studies have shown that men are less likely to seek medical attention for their depression. This can be linked to the way one is brought up, said Bhimull. Some men were not taught how to express their emotions and feelings, when they later experience depression, it can lead to suicide. That may explain why there is a higher incidence of attempted suicide among women, but there is a higher incidence of actual suicides among men.
“Men tend to engage in risk seeking behaviours. What is worse is that men are less likely to seek help if they are depressed,”said Bhimull.
If one suffers from depression, Bhimull recommends seeking professional medical attention.
Diabetes is one risk factor for cardiovascular disease. Males born in the 2000s have an alarming one in three chance of developing diabetes in their lifetime as opposed to males born before 2000. Unhealthy lifestyles help feed the diabetes epidemic.
“Exercising for at least 30 minutes a day has been shown to reduce cardiovascular disease and can reduce the risk of diabetes by more than 50 per cent in men. An HbA1c test will determine whether a person is normal, prediabetic or diabetic and the person will be managed accordingly,” says Bhimull. Everyone, but especially men over the age of 40, should get an HbA1c test done, advises the physician.
Erectile dysfunction is a common type of male sexual dysfunction and can be a sign of serious health problems. Most are not aware that ED is linked with cardiovascular disease. In fact studies have revealed that many men with ED share the same risk factors with heart disease — high blood pressure, diabetes and high cholesterol levels. Erectile dysfunction remains a taboo topic, but it’s important to talk about it.
“Intimacy in relationships is important, therefore if there are issues with erectile dysfunction, it will affect relationships and compound the problem. This can result in infidelity and depression,” says Bhimull.
There are effective treatments. In some cases a regime of exercise and a good diet can even reverse the process, said Bhimull.
While public hospitals have advertised and hosted clinics designed for men, Bhimull doesn’t believe that it is enough. He is calling for public education programmes that target men and encourage them to be more proactive about their health and get screened.
“There should be a more active effort by public health and the Ministry of Health if we are to make any dent in these six conditions that are prevalent among men in T&T,” said Bhimull.