Why, when some men catch a cold, do they make it out to be something more serious – suggesting pneumonia or bronchitis? And yet when they’re really sick, they ignore the symptoms, minimise their discomfort and avoid the doctor?
Ahead of Men’s Health Week, which starts on June 13, Dr Johnathan Chow Jun-fung, doctor-in-charge of the men’s health service of Hong Kong’s Family Planning Association, explains that men are often perceived as the stronger sex, a view “further burdened by cultural norms of masculinity, braveness, and self-dependence”.
They’re expected to “man up”, or ignore health concerns. Some men say they are afraid of learning what might be wrong, and they feel vulnerable and uncomfortable during examinations. And this often prevents them from seeking necessary care.
Men’s life expectancy is universally shorter than that of women – one in five men dies before 65; 75 per cent of premature deaths from heart disease are in men; 67 per cent of men are overweight; middle-aged men are twice as likely to have diabetes as women; four out of five suicides are men.
In addition, men are more likely to smoke, eat and drink more, including eating too much meat and not enough fruit and vegetables.
They are also more susceptible to illness on account of “the different interplay of biological factors, including differences in hormones, genetics and metabolism, which increase men’s predilection for developing life-threatening chronic diseases such as coronary artery diseases, stroke, and liver diseases at an earlier age”, Chow says.
That’s why, he stresses, “it’s crucial for men to take action as early as possible; avoidance won’t make the problem go away and it could harm the individual in the long run”.
What complaints force men to see their doctor?
Chow says the most common issues he sees “include sexual dysfunction problems, including erectile dysfunction (ED), premature ejaculation (PE) and low sexual desire; sexually transmitted disease screening; male sterilisation; lower urinary tract symptoms – especially associated with benign prostate hypertrophy, subfertility and genital dermatosis (skin lesions) and pain”.
Erectile dysfunction is defined as the inability to achieve a sustained erection for intercourse. It can affect men at any age, with increasing prevalence and severity in advanced age.
A 2017 population survey by the Family Planning Association of Hong Kong among women of reproductive age showed the prevalence of erectile dysfunction in their partners was around 4.8 per cent.
Chow says the proportion of patients consulting for erectile dysfunction has gradually risen, from 18.4 per cent in 2016 to 21.4 per cent in 2021. Patients as young as 18 may seek help.
Erectile dysfunction is often a crucial indicator of something bigger and more serious: atherosclerosis – the thickening or hardening of arteries, diabetes, hypertension and high cholesterol – another risk factor for the development of cardiovascular disease which could lead to potentially fatal consequences such as heart attack or stroke.
That’s why it’s so important men don’t ignore what may on the surface manifest as a glitch in their love life.
Premature ejaculation is just that – ejaculation that happens too soon or too fast. In his practice, Chow says six to seven per cent of his patients have this complaint. And while it might be embarrassing to talk to your doctor about it, it’s not uncommon, and the prognosis for a positive outcome is good.
So how can we encourage the men we love to seek care – especially when something has apparently gone wrong in a private part of their body?
“Partners are encouraged to be empathetic, compassionate and judgment-free. With regards to PE and ED, which are the most commonly encountered sexual dysfunction problems in our clinic, we encourage men to bring their partner with them to a consultation to enable a mutual learning opportunity. The more their partners know, the better they are prepared to help,” says Chow.
“It’s important for men to understand that ED and PE are not a reflection of their masculinity and that the relationship is just as valued. By reassuring them that these are common problems, couples can stay positive about these treatable conditions given the array of available treatments.”
Men still show reluctance to be screened for sexually transmitted infections – or STIs. But they need to have it to avoid passing one along. Men and women should be tested with every new partner, especially because some infections, such as chlamydia, can be asymptomatic and lead to complications such as chronic pain and infertility even in men.
Men’s do-it-yourself body check
Here’s a list of steps men can take to assess their own health condition, courtesy of the UK-based charity Men’s Health Forum.
1. Keep an eye on your pulse rate
You can take your pulse with two fingers on your wrist. Know your resting pulse rate and understand the difference between that number and when you exercise and – crucially – the time it takes to return to resting rate. A high resting heart rate is indicative of poor fitness levels as is a heart rate that remains elevated minutes after exertion.
2. Be honest about how much excess weight you’re carrying – especially around your middle
Measure the belly at the widest point – usually at belly button level. If the number is more than 94cm (37 inches), you’re probably overweight, which predisposes you to risk of cardiovascular disease, diabetes and even cancer.
If the number is greater than 101cm, you’re considered obese and need to speak to your doctor, as the risk of all of the above rises with the number on the tape measure.
3. Notice change in how you look or feel
Look in the mirror. Are any moles changing shape or bleeding? Any lumps? Are you suffering any breathlessness or unexplained pain, especially in the chest area? A persistent cough? Blood where you don’t expect to see blood – in your saliva, in the toilet bowl? Any change in bowel movements?
These may mean nothing. Or they could be a marker of something really serious. See your doctor anyway.
4. Monitor your bathroom breaks
How often are you having to pee? Does it flow easily? Are you waking up to pee more often at night?
Peeing more often or difficulty peeing could be a symptom of prostate enlargement, which is not necessarily a sign of prostate cancer. But it could be, so get it checked. Peeing often in large amounts is a pointer for diabetes.
5. Check your blood pressure
Be aware of what the healthy range is and work to get there. That might be by losing weight or decreasing your salt intake. High blood pressure, hypertension, puts you at risk for many ailments, including stroke.
6. Give your testes a good feel in the shower from time to time
Any lumps? Testicular cancer is more common in young men, in their 20s to mid-30s. Caught early, it’s highly treatable.
- Samaritans of Singapore: 1-767
- Singapore Association for Mental Health: 1800-283-7019
- Care Corner Counselling Centre (Mandarin): 1800-353-5800
- Institute of Mental Health's Mental Health Helpline: 6389-2222
- Silver Ribbon: 6386-1928
- Shan You Counselling Centre (Mandarin): 6741-0078
- Fei Yue’s Online Counselling Service: www.eC2.sg