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Men’s Health
DR.MOHD ISMAIL BIN MOHD TAMBI
CONSULTANT CLINICAL ANDROLOGIST
WELLMEN CLINIC
DAMAI SERVICE HOSPITAL
JALAN IPOH
KUALA LUMPUR
HP:012-9138424
E-mail: [email protected]
Definition
Men’s health is defined as the holistic
management of health conditions and risks
that are most common or specific to men in
order to promote optimal physical,
emotional and social health.
While male sexual health is important, men’s
health goes beyond sexual and reproductive
health.
Rationale
 Men less healthy than Women
 Die 6 years earlier 76.6 vs 82.6
 Early years and older age group
 Deaths in Men at age 25-30 due to high risk
activities.
 25 - 44 year olds death from external
causes
○ Intentional self harm
○ Transport deaths
○ Work related deaths
 Medical consultations trends
 40% Male vs 60% female
Rationale
 Health seeking behaviour
 Self reliance to spurious health products
 Seeking treatment on the sly, local traditional
therapies.
 Misplaced macho attitude, seeking medical
treatment is not ‘manly’
 Burden of disease
 Smoking 12% vs 7% in women
 Males more likely to drink daily compared to women
 More likely to use illicit drugs
 More likely to be involved in unsafe sex and
exposure to STI/HIV-AIDS
Cause for Gender based Health
• Urgent need for gender specific health care for men as
men have intentionally put women and children as the
principal recipients of health care, leaving them with
nothing to hold on to.(akin to sinking of the Titanic
where women and children survives leaving the men
sinking to their death!)
• The life-expectancy of men is shorter than women
across both developed and developing countries by an
average of 3.9 years.
Cause for Gender based Health
• Most causes of death in men such as cardiovascular
disease, injuries, road traffic accidents, cancers,
violence, war, infectious diseases (including
HIV/AIDS) and chronic obstructive pulmonary
diseases are not male-specific and they are
preventable or amenable to early intervention
• Further analysis on six of these, accidents and their
adverse effects, suicide, cancers, cardiovascular
diseases, injuries, and chronic liver diseases among
middle age adults in the major continents of the
world has noted that men stand a higher risk of
premature death than women.
The Malaysian Cause
• In Malaysia, the difference in the average life
expectancy between men and women is similar to
the global pattern. The life expectancy in Malaysia
was about 72 years for men and 76 years for
women in 2013(WHO).
• The common causes of death in Malaysian men
are similar to the Global trends with
cardiovascular disease, pneumonia/influenza and
transport accidents being the top three.
The Malaysian Cause
• Men in Malaysia also suffer high prevalence of many
chronic disorders and health risk factors. In the 2006
national health morbidity survey, the high prevalent
health morbidities include hypertension (33.2%),
hypercholesterolemia (18.6%), diabetes (12%), and
smoking (46.4%).
• The prevalence of male-specific disorders was also
high. Among other male-specific conditions, twothirds of men aged 40 and above have moderate to
severe erectile dysfunction, 19-29% have moderate to
severe lower urinary tract symptoms.
Men’s Health Network
The Challange
• Male attitude of associating health problems as a
weakness rather the reasons to seek medical
assistance.
• Associating macho and ‘dare to do’ as a glory rather
than bad attitude or risk taking behavior that may land
them in trouble like getting into accidents, fights,
trauma and sexual infections
• Men are more likely to be both the perpetrators of
violence and its victims
Men’s Health Network
Men’s Health : The Facts
Men’s Health Network
Current State of Men’s Health
Life Expectancy At Birth, 2007
80.7
80.4
80
77.9
77
75.3
75.8
70.2
75
70
65
60
All
All
Females
All Males
White
Females
Black
Females
White
Males
Black
Males
• Men are half as likely to see a health care provider for a
physical exam as women.
• Men are more likely to be uninsured than women.
• Men are dying at higher rates than women for 9 of the
top 10 causes of death.
Men’s Health Network
Current State of Men’s Health
Males
Females
Heart
Cancer
Stroke
CLRD[1]
Accidents
Alzheimer's
Diabetes
237.7
217.5
42.5
48
55.2
18.5
26.4
154
151.3
41.3
36
25.8
24.9
19.5
Flu/Pneumonia
Kidney
Septicemia[2]
Liver
Suicide
Homicide
Males
19.3
17.8
12.1
12.7
18.4
9.6
Females
14.2
12.5
10.2
5.9
4.7
2.5
[1]
[2]
Chronic Lower Respiratory Disease
Blood infections
Top 10 causes of death for 2007, age adjusted, with death from diseases of
the liver, suicide, and homicide also illustrated.
Deaths: National Vital Statistics Reports web release; vol 58 no 19. Final data for 2007. Xu JQ,
Kochanek KD, Murphy SL, Tejada-Vera B. Hyattsville, Maryland: National Center for Health Statistics.
Released May, 2010.
Men’s Health Network
What Does this Mean for Women and
Families?
• At birth, there are 71.7 boys for every 76.4 girls.
• By age 40, there are 77.8 women than 74.3 men.
• Retirement [1]
– In the early retirement years (65+), there are men to
women ratio of 0.79
– More than half the elderly women living in poverty were
not poor before their husbands died.
[
Men’s Health Network
Diet and Nutrition
“You are what you eat”
• Over 43 percent of Malaysian are overweight or obese.
• Malaysian ranked the 6th highest obesity rate in Asia.
• Obesity in Men is less when compared to women but
the incidence of Diabetes, Cardiovascular
Complications like hypertension and IHD is more in
men because of poor compliance in medical treatment.
Men’s Health Network
• Leading killer of men and women
among all ethnic groups.
• Approximately one in three adult
men have some form of
cardiovascular disease.
Per 1,000 Person Years
Cardiovascular
Disease
80
70
60
50
40
30
20
10
0
74.4
65.2
59.2
21.4
10.1
20.0
8.9
4.2
45-54
55-64
65-74
75-84
85-94
Age
Men
Women
Incidence of CVD by age and sex. Source: NHLBI
45
41.9
40
Per 1,000 Person Years
• A man suffering from
cardiovascular disease may have
Erectile Dysfunction (ED) as a
symptom.
40.2
34.6
32.7
35
30
25
22.3
20
14.8
15
10
5
9.2
4.7
0
65-74
75-84
85+
Age
Men
Women
Incidence of heart failure by age and sex. Source: NHLBI
Men’s Health Network
Diabetes
Diabetes is a leading cause of heart
disease, strokes, kidney failure,
blindness and amputations.
•
Diabetes affects the body’s ability
to turn food into the energy it needs
to function..
•
People with diabetes are more than
2X as likely to develop heart
disease or die from a heart attack.
•
People diagnosed with diabetes
have medical expenditures that are
2-3 times higher than patients
without diabetes.
•
A man suffering from diabetes may
have Erectile Dysfunction (ED) as a
symptom.
Men’s Health Network
Cancer
• Over the course of a lifetime, 1 in 2 men and 1
in 3 women will get cancer.
• Prostate cancer in Malaysia is 3.16 at 100,100
population being the the most common
reproductive cancer.
• Cancer can strike anyone, at any age, but the
majority of cases happen to men 55 and over.
Men’s Health Network
Prostate Health
•
BPH (prostate enlargement)
– A progressive condition which leads to:
•
•
•
•
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–
–
–
•
frequent urination,
decreased urine stream,
difficulty or pain while urinating, or
a feeling of incomplete emptying of the bladder
Affects half of men over age 50
Affects about 90% of men by age 80
Less than 50% of those men are diagnosed
Less than 20% of men are being treated
Prostate Cancer
– Prostate cancer is the most common cancer in American men
• Younger men may be more likely to have an aggressive form of prostate cancer
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–
–
–
•
1 in 6 men born today will be diagnosed in their lifetime
More than 215,000 men are diagnosed each year
Approximately 30,000 men die of prostate cancer each year.
African-American men are at increased risk
Prostatitis
– Inflammation of the prostate that may be caused by an infection
Men’s Health Network
Prostate Cancer
Race
Rate [1]
Deaths [1]
White (includes Hispanic)
21.8
23,202
White Non-Hispanic
21.9
21,732
White Hispanic
18.8
1,334
Black (includes Hispanic)
51.1
4,698
Hispanic (any race)
18.4
1,373
Amer. Indian/Alaskan Native (includes Hispanic)
14.7
104
Asian or Pacific Islander (includes Hispanic)
9.7
368
[1] Annual Death Rate over rate period, deaths per 100,000 (95% Confidence Interval)
[2] Deaths per Year over rate period
Men’s Health Network
Testicular Cancer
• Testicular Cancer is the most common form of
cancer of men between the ages of 15-39.
• Risk Factors include:
– Undescended testicle(s), even if corrected
– Family history
– White Men are more likely to get Testicular Cancer than Hispanic,
Asian-American, and African-American men
• Testicular cancer is less common among older and middle aged
men.
Men’s Health Network
Sexual Health
• Your sex life is a reflection of your overall health – the healthier
you are, the better it will be.
• Erectile Dysfunction (ED)
– Caused by heart disease, diabetes, certain medications, lifestyle, or
other problems.
• 4 million Malaysian men experience ED
– Lifestyle, Cardiovascular Disease and Diabetes
• Sexually Transmitted Infections (STIs / STDs)
– The more sexual partners you have, the greater your risk of getting
an STI.
Mental Health
• Mental health is the psychological well-being
and satisfactory adjustment to society and to
the ordinary demands of life.
• Stress – Anxiety – Depression
• Factors Affecting Your Mental Health
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Death of a loved one
Divorce or separation
Loss of employment
The birth of a child
Being diagnosed with a serious illness
Moving to a new job or home
Natural disasters
Your genes (some issues are hereditary)
Men’s Health Network
Why Don’t Men Make Doctor Visits?
• Socialization plays a major part in men’s decisions to frequent
their physician.
• Big boys don’t cry
• Work obligations
• Lack of health insurance
• Some men decide they will wait as long as possible before visiting
a doctor in hopes of getting better
.
• The biggest obstacle?
– Not making their health a top priority!
Men’s Health Network
Steps to Live a Longer and
Healthier Life
Men’s Health Network
Prevention
Among men, more than one-half of
premature deaths are preventable.
• Get an Annual Health Exam – Visit your
healthcare provider each year.
• Know Your Numbers – PSA – Cholesterol –
Glucose – Blood Pressure.
– Keep your own records. Do not rely on your health care
provider to say you are “okay” – Ask about your #s and keep
them in your records.
• Make Prevention a Priority – detect problems early.
• Ask Questions – it’s your body.
• Start Early – Don’t wait until you’re 50 to have your first health
exam since high school/college.
• Take advantage of free community health screenings or
employer offered health services and benefits.
• Involve your family in your health.
• Be a role model for your children.
Men’s Health Network
Diet and Nutrition
Over 60 percent of adult American
men are overweight.
 The only truly effective way to lose weight is to reduce the number
of calories you eat and get more exercise.
 Eat fruits, vegetables, whole grains, and fat-free or low-fat milk
and milk products.
 Eat lean meats, poultry,
fish, beans, eggs, and nuts.
 Limit intake of saturated fat,
trans fat, cholesterol, salt,
and added sugars.
Men’s Health Network
Exercise and Fitness
• Before starting any exercise program, talk it over with your
health care provider for guidance.
• Start off easy – you may only be able to do five minutes per
day.
• Gradually increase your workout capacity until you’re up to
20 minutes or more per day.
• Exercise at least two times per week.
• Any kind of activity – even mowing the lawn, washing your
car, or walking the dog is better than none.
Men’s Health Network
Cardiovascular Disease
• Cardiovascular disease is a blanket term that includes three
major types of diseases: hypertension (high blood
pressure), coronary heart disease, and stroke.
• Take these simple steps to protect yourself
– Have regular physicals
– Lose weight and choose a healthier lifestyle
– Get into a regular exercise routine
– Limit your alcohol and caffeine intake
– Reduce stress
– Quit smoking
Men’s Health Network
Diabetes
Diabetes is a leading cause of heart
disease, strokes, kidney failure,
blindness and amputations.
• There is no cure for diabetes, however it can be managed
and treated and about 90 percent of the time, diabetes can
be prevented before it starts.
• Keys to prevention and treatment
– Lose weight
– Get more exercise
– Control your blood pressure
– Eat a healthy, balanced diet
Men’s Health Network
Cancer
• What you can do
– Recognize the risk factors – smoking, family history, 55
or older, or cancer in the past.
– Early detection – notify your doctor if you notice
anything unusual or abnormal.
– Reducing the risk – no tobacco, eat a healthy diet and
stay active,.
Men’s Health Network
BPH (prostate enlargement) is the most frequent
prostate condition in men 50+.
Prostate Health
Prostate Cancer is the #1 cancer in men.
• Early detection is the key
• Prostate Cancer
– Get a baseline prostate exam at age
WomenAgainstProstateCancer.org
40, or earlier.
– Consult your health care provider
about yearly exams after age 40.
– Have regular safe sex.
– Ask your health care provider about
other prevention tips.
• BPH (benign prostatic hyperplasia)
– Progression can be slowed or stopped if treated early
• Prostatitis
– There are a number of treatment options.
Depression
Depression is under-diagnosed in men. Men are over
four times more likely than women to commit suicide.
• With proper diagnosis and treatment, the vast
majority of men with depression can be helped, and
will go on to lead normal, happy lives.
• Depression in men is under-diagnosed
– Doctors are more likely to diagnose depression in women compared
with men
• Treating depression starts with yourself
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Get some exercise – 20-30 minutes per day
Spend some time with other people
Do something you enjoy – even if you have to force yourself
Don’t make any decisions now – wait till you feel better
Prioritize – what needs to be done on any given day?
Set realistic goals
Be patient with yourself
Coping with Stress / Anxiety
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Exercise, especially aerobic exercise
Eat healthy foods
Don’t self-medicate
Ease up on caffeine
Get some sleep—8 hours a night
Take deep breaths
Relax and have some fun!
See a Trend ?
• We have found that the best approaches to
helping men lead a healthier and fuller lifestyle consist of a few
simple steps:
– See your doctor regularly – Ask questions!
– Eat a healthy diet rich in fruits, vegetables, whole grains, and
low-fat foods
– Exercise for 20-30 minutes a day, 3-5 days/week
– Protect yourself from the sun
– Maintain a healthy weight
– Get a ―good night’s sleep‖
– Manage your stress
– Get help if you need it !
Men’s Health Network
Awareness
• Men’s Health Month
– June each year in relation to Father’s Day
– National Men’s Health Week
• International Men’s Health Week
• Prostate Cancer Awareness
– September each year
Movember November Movement
Men’s Health Network
Movember Foundation
Every November, men around the world participate in
Movember, a movement to grow facial hair for the month
to raise awareness on men's health issues