Sunday July 10, 2011

Health watch for men

Stories by AUDREY EDWARDS
audee@thestar.com.my

CHRISTOPHER, who is in his early 50s, is quite a health buff. He exercises up to five times a week, preferring brisk walking, cycling and swimming.

He also undergoes yearly health checks to keep track of the usual “suspects”, including blood glucose and cholesterol.

“I don't want to get into trouble' when I grow old,” he says about his health regime.

Christopher watches his diet although he does cave in occasionally when it comes to dessert. He says exercising helps him to maintain his weight and also keeps him alert, especially at work.

This manager is among droves of Malaysian men who keep a close watch on their health.

But there are still pockets of men who do not give a toss about it, as highlighted by healthcare specialists and Health Minister Datuk Seri Liow Tiong Lai.

Indeed, Malaysians are ticking the wrong boxes when it comes to health conditions such as diabetes, obesity and hypertension.

Health Minister Datuk Seri Liow Tiong Lai recently rang the alarm bells again, pointing out that 60% of Malaysians are overweight and that our country ranks sixth in the list of Asian countries with the highest percentage of obese adults.

Diabetes among those aged 30 and above in 2006 had risen by 80% in 10 years and hypertension had also gone up by 40% for the same period. Some 70% of all patients in government health clinics had non-communicable diseases (NCD) while 20% were admitted for the condition.

On top of the broad spectrum of diseases that both men and women have to grapple with, men have illnesses they need to get a firm grip on, including prostate cancer, andropause, erectile dysfunction (ED) and premature ejaculation (PE).

“When it comes to health problems, men wait to be sick before they see a doctor,” observes consultant urologist Datuk Dr Sahabudin Raja Mohamed, adding that regular check-ups are advisable for those aged 50 and above.

This includes undergoing prostate evaluation, colonoscopy, gastroendoscopy and checks for ED (if there are symptoms), diabetes and cardiovascular diseases.

At 50, a man would normally begin exhibiting ED symptoms but ED could start earlier in the coming generations if men do not start taking better care of themselves, including watching their body weight, he warns.

“Obesity is setting in earlier these days, in puberty even. This could lead to ED and it does not look good for the population,” he adds.

He proceeds to list out the various unhealthy habits, such as inactivity due to hours spent in front of the computer and lack of exercise.

“Boredom and depression can set in,” he warns.

Currently, about 20% of men with ED come forward for treatment, he says, adding that many of them do so because their partner or wife asked them to do so.

Treatment for ED, he emphasises, is more than just “dishing out” pills. It also encompasses the psychological and sociological problems. This sees the partner being present during counselling sessions to discuss the issues linked to the problem.

And although a modern lifestyle has led to NCD being the leading cause of death, he adds that men are also more educated and enjoy a higher economic standing. Changes in attitudes have led to different desires and awareness.

The setting up of one-stop men's health clinics, he adds, is important to test and diagnose for illnesses specific to the gender.

The clinic would also provide health promotion such as behaviour modification in diet, exercise, mental acuity, quitting smoking and alcohol, disease prevention and normalisation and curative care for conditions such as prostate cancer, incontinence, enlarged prostate, sexual dysfunction and osteoathritis.

Men's health clinics, he emphasises, help to ensure care and protection of elderly males towards enhancing their well-being.

It will also help them to continue to be active and productive in national development and be self-reliant.

On the subject of andropause, Dr Sahabudin says symptoms include reduced potency and libido, increased fatigue, decreased muscle strength, prostate gland hypertrophy, bone fractures and signs of feminisation.

The reduction in serum testosterone leads to muscle weakness, increased risk for falls and diminished performance of daily living skills.

He says that between 6% and 12% of men aged between 40 and 70 show clinical signs and symptoms associated with low testosterone levels with specific symptoms being Type 2 diabetes, coronary heart disease and osteoporotic fractures.

“Symptoms which alert the general public include reduced or complete loss of libido, tiredness, unexplained fatigue, sexual dysfunction and depression,” he adds.

Some of the symptoms and signs that are suggestive of androgen deficiency are lower sexual libido and activity, spontaneous erections, very small or shrinking testes, hot flushes, sweats and breast discomfort.

Metabolic syndrome, meanwhile, plagues 33.3% of men with a three-fold increased risk of cardiovascular events and five-fold increased risk of diabetes, he adds. There is also a two-fold risk of ED.

A risk factor in 55.4% of men turns out to be physical inactivity, he says.

Malaysian Medical Association president Dr Mary Cardosa says there is always a need for doctors to be aware of diseases in which specific groups, both men and women, are more vulnerable.

“But we need to look at health overall and not just concentrate on one or two diseases,” she adds.

Dr Cardosa emphasises the need for a healthy Malaysian population, regardless of gender.

“For women's health, the emphasis is always on reproductive health and osteoporosis but there are other health issues as well, such as heart disease (which is always thought of more as a man's disease),” she says.

“Similarly, for men's health, the emphasis is always on sexual health but other aspects such as stress and depression (which is thought of more as a woman's problem) need to be looked into.”

When it comes to undergoing tests, she says it should be done when indicated either because of symptoms that a patient has or because it is recommended.

“Today, there are many clinical practice guidelines to inform both the medical profession as well as the public about what is appropriate and what is not,” she says.

“The patient can ask the doctor why such and such a test is necessary to avoid unnecessary tests (and charges).”

Fomca secretary-general Mohd Sha'ani Abdullah, meanwhile, says that while it is the norm of those above age 40 to undergo regular health check-ups, it is inadvisable to sign up for packages offered by unscrupulous parties.

The solution is to obtain a check-up at government hospitals, he suggests.

“There are some who take out advertising and offer free services such as health talks or check-ups. But when you go there, you sit through a marketing talk and are enticed to sign up. Your credit card is normally used and sometimes when difficulties arise, you can face difficulties in cancelling it,” he warns.

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For many men, health takes a back seat

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Sunday July 10, 2011

Health watch for men

Stories by AUDREY EDWARDS audee@thestar.com.my

Stories by AUDREY EDWARDS
audee@thestar.com.my