There have been many discussions surrounding mental health, mental illness, and the need for increased awareness. However, as many as 40% of men will avoid discussions about their mental health. In Canada alone, 75% of all suicides are men. Globally, a man will die from suicide every minute.
As for why men won’t talk about mental health, the reasons vary. Some want to try to deal with it on their own, they don’t want to be a burden on anyone else, while others say they’re simply too embarrassed and afraid to admit they need the help. In addition, there’s also the negative stigma that still surrounds mental illness to this day despite a great deal of progress being made in effort to end the stigmatization, which also causes people to shy away from having open and honest discussions with their friends, family members, and healthcare providers. Still, that shouldn’t stop you from reaching out for support if you need it, as it’s not a sign of personal weakness. Just as you would take care of every other aspect of your health, such as a broken bone or an infection, your mental health matters just as much and needs to get the same level of attention and care.
The most common types of mental illness that affect men include anxiety, stress and depression. Causes include everything from pressure at work, financial difficulty, or other underlying health problems – while mental illness can also be caused by genetics. Substance use also often co-occurs in men with mental illness, and men are also much more like to engage in substance abuse than women. When you ignore the signs of depression, the condition will only worsen, as will things like substance abuse and other erratic, impulsive behaviours. Mental illness can also have a negative effect on your sleep. In fact, as many as 90% of men with mental health issues say they have trouble sleeping – and that lack of sleep can cause a wide range of problems, including such as lack of clarity, and increased irritability. If you’re having difficulty falling or staying asleep, Dr. Ghahary recommends finding something you can do to help you relax. A great way to lower your heart rate and calm both the mind and body, thus making it easier for you to sleep, is to practice deep breathing techniques. It’s also not uncommon for a mental illness, such as depression, to decrease your appetite. By eating less, you may actually be depleting your energy, so you should try to get something nutritious in your system, even if it’s something as simple as raw fruits or vegetables. Keep in mind that while some individuals won’t eat when they’re feeling anxious, stressed or depressed, other will turn to food to help them cope – and they’re often the wrong ones (i.e. sugary sweets, carbohydrates), so always make healthy choices. When a man is feeling depressed, they will also be less likely to want to engage in physical activity. Many studies have shown physical activity to improve the mood and relieve stress, not to mention its many other health benefits – and while it may be hard to get or stay motivated, you should try to include some type of physical activity into your daily routine.
Personal relationships can also suffer as a result of mental illness, as men also tend to withdraw from friends and family. However, this may actually make one feel more depressed. Being social when you’re depressed might seem nearly impossible, but it is your social connections that can actually help you fight off a mental illness like depression. It can also help boost your self-esteem, and have an overall positive impact on your mind.
While it can take courage to step up and ask for help, know that it can be done. For more information on how mental illness affects men and what you can do to take action, visit www.headsupguys.org.
While an embarrassing topic of discussion and therefore one that many men will often try to shy away from having, erectile dysfunction (also referred to as ED, sexual dysfunction, impotence, and male erectile disorder) affects more than 50% of males between the ages of 40 and 70, making it a much more common problem than you might think.
Characterized as the inability to achieve or maintain and erection, ED occurs when something blocks the brain-nerve-blood vessel process that the body goes through in order to develop an erection. The brain controls the what we see, hear, feel, think, and smell, while the nerves pass those signals from the brain to your body, following the opening of blood vessels to allow blood flow to the male genitalia (also known as the penis.) More often than not, the most common reason that these processes are blocked is due to a chronic health condition; including everything from cardiovascular disease to diabetes, metabolic syndrome, MS (multiple sclerosis), thyroid disorders, hormonal disorders, spinal cord injuries, Parkinson’s disease, history of stroke, as well as any previous trauma to the genital area. It’s also possible to develop erectile dysfunction as a result of taking certain medications. For example, use of non-steroidal anti-inflammatory drugs (NSAIDs), anti-depressants, and medications used to treat high blood pressure. In addition, one can also develop ED if they have previously received or are receiving treatment for cancer – such as chemotherapy or radiation therapy. Furthermore, certain psychological conditions (such as depression, anxiety, stress, and relationship issues) and lifestyle habits (such as whether you’re a smoker, drink excessive amounts of alcohol, are overweight or obese) could also potentially increase a male’s risk of developing ED.
Along with being unable to sustain an erection, ED can have a significant impact on a male’s self-esteem. In addition, it can also have a negative effect on relationships, causing one or both parties of a relationship to want to withdraw from being physically intimate with each other, to causing problems with communication. It may also cause a man’s partner to feel as though an affair is taking place or as if they aren’t good enough – when in reality, a man will usually shy away from intimacy as they do not want to let their partner down. Having erectile dysfunction is never anyone’s fault and therefore it should not be taken personally. Because of this, it’s essential that couples keep their lines of communication open and talk about it. The less it is talked about, the more likely it is to have a negative impact on a relationship as a whole. In some cases, couples can also benefit from couple’s counselling to help with that communication. If a male has ED, then couples are also less likely to engage in intimacy – but this doesn’t necessarily have to be the case, as there are many other ways in which couples can maintain their closeness.
If you happen to be a male and any have concerns about your sexual health, such as with erectile dysfunction, it’s always important that you address these concerns with your physician. Not just for reassurance, but to make sure the cause of your erectile dysfunction isn’t due to a serious or underlying health problem. If your health is the cause, then that’s all the more reason why it’s so crucial to speak with your physician about those concerns you have regarding sexual health – because the quicker something is addressed, the quicker you will be on your way to resolving it.
When it comes to treating ED in particular, making certain changes to one’s lifestyle can cause an improvement (such as quitting smoking, avoiding alcohol, and losing weight.) There are also many medications that physicians are able to prescribe patients to help increase blood flow and improve erectile dysfunction – including sildenafil (commonly known as Viagra), tadalafil (Cialis), and vardenafil. Family physicians like Dr. Ghahary typically recommend that first-time users of these medications try the initial dose on their own to ensure that it does what it’s supposed to do. In addition, these medications tend to work better when taken on an empty stomach and approximately one hour before sexual intimacy. Also, be aware that these medications come with side effects, including upset stomach and facial flushing; while less common side effects can include light sensitivity and temporarily blurred vision. In the event that this medication causes you to have an erection lasting longer than four hours, you should seek medical attention.
First founded by Australia’s Travis Garone and Luke Slattery in 2003, the Movember Foundation has gone on to become one of the world’s most prominent leaders in raising awareness on men’s health, including prostate cancer, testicular cancer, and even men’s suicide, for the last 14 years. As part of Movember, men are encouraged to grow moustaches in the month of November, with the foundation’s goal being to “change the face of men’s health.” Individuals and organizations are also strongly encouraged to host fundraisers for men’s health. You can find a variety of fun and interactive fundraising tips by clicking here.
For whatever reason, men are much more hesitant than women when it comes to being proactive about their health and seeing their family physician for regular checkups – something that Dr. Ghahary suggests people do on a yearly basis regardless of how healthy they may be feeling. Our culture teaches men to be self-reliant, and as a result they tend to ignore certain health concerns they may have, only going to the doctor when the situation reaches an emergency level or when it is too late for treatment to be effective. Because of this, the average life expectancy of a male is between 5 and 6 years less than that of a female. Therefore, Movember isn’t just about growing a moustache; it’s also about opening dialogue and teaching men that their health shouldn’t be ignored. When it comes to discussing health, men should not only reach out to their family physician’s office and book an annual exam, but they should also talk about their health amongst friends. Sometimes having that dialogue can help encourage others to be just as proactive about their own health, too. In fact, it can be life-saving.
It’s also important to know the numbers. You’re at an increased risk of developing certain health conditions depending on your age. For example, by the age of 50, it’s recommended that men begin screening for prostate cancer. If you have certain risk factors of developing prostate cancer (i.e. if you’re of African or Caribbean descent, or if your father or brother has had prostate cancer) then you should start the screening as early as age 45. For younger men, testicular cancer can also be a concern. It can occur as early as age 15, all the way through age 40 or later. Just as women do self-exams for breast cancer, men can also do self-exams for testicular cancer. Testicular Cancer Canada offers a self-examination guide via their website which can be found at www.testitcularcancer.ngo. If you notice any tenderness, lumps or other abnormal growths, then you should inform your physician immediately. Other warning signs of testicular cancer can include back pain, as well as pain in the abdomen or groin. Men who are sexually active should also make healthy decisions, such as practicing safe sex and being tested for sexually transmitted diseases – especially if they have multiple sexual partners. 1 in 2 sexually active individuals will be diagnosed with at least one STD in their lifetime, and the number of STDs being diagnosed are already on the rise at alarming rates in North America.
Lastly, all individuals, including men, should make sure they’re getting regular physical activity and eating healthy. Whether it’s going for a walk or jog, biking to work instead of driving, or working out at the gym – the more exercise you get, the better you will feel. The same goes for the food you eat. For increased energy and to prevent diseases, it’s recommended that men intake their whole grains as well as consume more fruits and vegetables.
Infertility, which is defined as the inability to conceive after one year of regular, unprotected intercourse, is something that is much more common than you might realize. In fact, 1 in every 6 couples in Canada experience problems with fertility; and, if you’re not directly impacted by fertility problems, then you most likely know someone who is or has been affected by it in the past.
There are many reasons why couples may have trouble conceiving, and those reasons differ between males and females.
When it comes to women and infertility, age can play a significant role. A woman’s fertility can decline by as much as 40% in her early 30s, and declines even further by the time they reach the age of 40. Different types of medical conditions can also cause issues with fertility in females; the most common conditions being PCOS (polycystic ovary syndrome) and endometriosis. PCOS is a condition that causes an imbalance in hormones and results in menstrual and ovulation cycles becoming disrupted. In addition to infertility and menstruation irregularity, PCOS can also cause other symptoms, including excess weight, excess hair, as well as acne. As many as 30% of women who are infertile also suffer from polycystic ovary syndrome. Endometriosis is a very common condition that occurs in women. With endometriosis, the tissue that lines the uterus (also known as the endometrial tissue) winds up growing in other areas of the body, such as the pelvis. This tissue then gets trapped, resulting in inflammation and the formation of scar tissue which can cause the pelvic structures to stick together, and can also cause damage to the ovaries and blockages to the fallopian tube, which prevents fertilized eggs from travelling to the uterus, thus affecting implantation. Aside from infertility, some common symptoms of endometriosis include painful periods, excessive bleeding, pain with intercourse, and severe pelvic pain. Weight can also cause issues with fertility. For example, if a woman is underweight and has a low percentage of body fat, they can develop issues with ovulation. Similarly, being overweight can also cause the same problems. In this case, it’s important to try and maintain a healthy weight. However, sometimes as much as a 5% change in weight can be enough to improve a woman’s chances at becoming pregnant (as long as there are not other contributing factors.) If a woman has had a sexually transmitted infection that has gone untreated, this can lead to a condition known as PID – also referred to as pelvic inflammatory disease. In many cases, an STI will not necessarily cause symptoms, meaning you are less likely to get tested and seek out treatment. However, if you have unprotected sex or have had multiple sexual partners, then it’s important to be tested for any potential STDs/STIs. Stress and poor diet have also been linked to infertility in females.
Males can also have problems with fertility. Contributing factors that can make a male infertile include excessive alcohol use, drug use, tobacco use, certain environmental toxins, as well as health problems like kidney disease, mumps, or issues with hormones. Men can also develop fertility problems from certain medications they may be taking, and if they’ve undergone treatment for cancer (such as chemotherapy or radiation.) Like women, age can also play a role. Fertility in males tends to start to decline after age 40, and sperm quality decreases. This not only makes it harder for their partner to conceive, but also increases the risk of miscarriage.
In order to determine whether or not you have fertility problems, a number of different tests can be done. For women, these tests often consist of things such as pap smears (to check for things like cervical cancer or other problems that could prevent pregnancy), urinalysis, transvaginal ultrasound, and surgical procedures like a laparoscopy or hysteroscopy. Blood tests can also be ordered to check a woman’s follicle-stimulating hormone levels. For men, tests can consist of a physical examination, hormone evaluation, sperm and semen analysis, as well as a blood test known as an anti-sperm antibody test. Getting these tests done will help your healthcare providers determine the root cause of your infertility issues.
There are many different ways in which infertility issues can be treated in both men and women, including with medication, assisted reproductive technology, and artificial insemination. In some cases, these treatment methods may be combined. Assisted reproductive technology is done by removing eggs from a woman’s body, mixing them with sperm to create embryos, then placing those embryos back in the woman’s body. IUI (intrauterine insemination) and IVF (in vitro fertilization) are also two common methods used for fertility treatment. During IUI, concentrated and processed sperm is directly inserted into a woman’s uterus. This is a method that is timed with a woman’s ovulation and can be performed as much as twice per day. IVF, which is considered to be one of the most common and most successful methods of fertility treatments, includes the stimulation of ovaries and egg retrieval. Those eggs are then fertilized in a laboratory, and the resulting embryos are then transferred into the uterus.
It is important to note that issues with infertility can have a major psychological impact on couples. If you are struggling with infertility, remember to pay close attention to your own mental health as well as the mental health of your partner, and take the steps that you need to take in order to help yourself and your partner get through this challenging time – whether it’s having an open dialogue with each other, discussing infertility with close friends or family members, seeking help from a therapist, or even practicing calming exercises such as meditation or yoga.
• An estimated 21,300 men (58 per day) were diagnosed with prostate cancer.
• An estimated 4,100 men (11 per day) died from prostate cancer.
• An estimated 1 in 7 men will develop prostate cancer in their lifetime.
• An estimated 1 in 29 men will die from prostate cancer.
• Prostate cancer is the most common cancer among Canadian men.
• Prostate cancer is the 3rd leading cause of death for Canadian men.
The prostate is a walnut-sized gland that is located just below the bladder and in front of the rectum, and it is part of a male’s urinary and reproductive system. The prostate is responsible for making prostatic fluid that mixes with sperm and different fluids to make semen. When a male develops prostate cancer, it begins in the cells of the prostate, but can metastasize to other areas of the body. As mentioned, prostate cancer is quite common, but many men may not even realize they have it as it does not typically present with any signs or symptoms in its early stages, which is why screening is so important – not just for this, but for many other types of cancers and health conditions.
If you are over the age of 50, Dr. Ali Ghahary recommends speaking with your family physician about whether or not you would make a good candidate for early testing for prostate cancer. There are two types of tests that are typically performed as part of the screening process for prostate cancer; a test known as a digital rectal examination (DRE) and a test known as a prostate-specific antigen test (PSA).
DRE test vs. PSA test
The digital rectal examination (DRE) test is the most common way for a physician to test a patient for prostate cancer, in which they will feel around the peripheral zone (the area closest to the rectum) for any lumps or abnormal changes to the prostate – including the shape, size, and consistency. If the prostate is normal and cancer-free, it should feel smooth and rubbery.
The prostate-specific antigen (PSA) test is a type of blood test that measures the amount of prostate-specific antigen in the patient’s blood. This test can help a physician detect problems with the prostate that they may not have been able to detect during a DRE. That being said, it’s not always a definitive test for detecting prostate cancer. You can have high PSA levels from issues aside from prostate cancer, including prostatitis, as well as another condition known as benign prostatic hyperplasia. While these two conditions can be deemed serious, they are typically non-life threatening.
Prostatitis vs. Benign Prostatic Hyperplasia Prostatitis is an extremely painful condition that causes inflammation of the prostate and can sometimes be caused by not just inflammation itself, but also by infection. There are four types of prostatitis that an individual can be diagnosed with: acute bacterial prostatitis, chronic bacterial prostatitis, non-bacterial prostatitis, and prostatodynia. You have a much higher risk of developing prostatitis if you have an infection, have undergone surgical procedures (such as a biopsy of the prostate) or have a catheter, or have unprotected sex and expose the prostate to sexually transmitted diseases/infections. Other risk factors include having a history of urinary tract infections, bladder obstruction, or inflammation-causing trauma resulting in nerve damage to the pelvic area. Signs and symptoms of prostatitis include everything from blood in the urine or semen, pain/burning during urination, trouble passing urine, painful of difficult ejaculation, pain in the genitals, lower abdomen, groin or lower back, pain or a sensation of pressure in the rectum, as well as sexual problems, and even fever, chills and body aches. Prostatitis can be diagnosed through a DRE, though your physician may also order a series of other tests, including blood tests (the PSA test, as mentioned, as well as a complete blood count), and urinalysis. Treatment can include antibiotics (if a bacterial infection is present) as well as muscle relaxers (to decrease bladder contractions), and alpha-blockers.
Benign Prostatic Hyperplasia occurs when the prostate becomes enlarged due to an overgrowth of cells in the prostate’s transition zone, which is located just around the urethra. It is non-life threatening, non-cancerous, and unlike prostate cancer it cannot metastasize. Almost all men will experience prostate enlargement by the age of 70. In addition to aging, other risk factors of BPH include abdominal obesity and lack of physical activity. BPH can come without symptoms, or it can come with symptoms including difficult passing urine or urinary frequency, urinary incontinence, inability to fully empty the bladder (which can potentially lead to UTI’s and/or bladder stones), as well as blood in the urine. BPH can be diagnosed through a series of tests including the aforementioned DRE, blood tests, urinalysis, as well as a general physical exam. You may also require imaging tests (such as an x-ray or ultrasound), a cystoscopy, or even a biopsy in the event that your doctor cannot make a diagnosis. In many cases, patients with BPH will be asked to wait and see if their symptoms worsen or decrease, while treatment can also include drug therapy (such as alpha-blockers, muscle relaxers, and 5-alpha-reductase inhibitors) in addition to making certain lifestyle changes.
STDs – also known as Sexually Transmitted Diseases – are on the rise in North America, with the United States at the forefront of an alarming rate of diagnosed cases of chlamydia, syphilis, and gonorrhea, this according to a new government analysis. The National Coalition of STD Directors says the country is in the middle of a public health crisis.
Many of the Sexually Transmitted Diseases we hear about are transmitted through coming into contact with bodily fluids. These fluids can include those that are vaginal, semen, or even blood. They can also be contracted through contact with mucous membranes or skin that is infected (i.e. mouth sores.) A person is exposed to these fluids through having sexual contact (such as vaginal, anal, or oral sex) with someone who is already infected with an STD.
Among the rising rates of STDs, the CDC says that gonorrhea seems to be growing at a much more rapid rate compared to other sexually transmitted diseases. There are an estimated 80 million new cases of gonorrhea diagnosed each year on a global scale, and just under 1 million diagnosed each year in the United States (and cases diagnosed jumped by as much as 67% last year.) It’s also on the rise in Canada…and while this particular infection was once easily treated with antibiotics, it’s now starting to become resistant to them. It might seem like a small number, but as many as 5% of gonorrhea samples were found to be resistant to Azithromycin (Zithromax), a common antibiotic used to cure the bacterial infection, along with resistance to other antibiotic treatment. Because of this, gonorrhea is considered a much more complex condition to treat, which could lead to a multitude of problems without an effective remedy. These problems include chronic pain (such as pain in the abdomen or pelvis), an increased risk of contracting and/or transmitting HIV, ectopic pregnancy, stillbirth, as well as affect a couple’s ability to get pregnant at all.
One of the biggest reasons why the health industry may be seeing such a rise in this and other sexually transmitted diseases could be due to a lack of sexual education and the fact that many patients either don’t know they need to ask to be screened for STDs, or because they feel too embarrassed to ask, leaving many cases undiagnosed, thus increasing the risk of those who are already infected potentially spreading the infection on to other sexual partners, and the vicious cycle continues. Another reason that cases of gonorrhea go undiagnosed is because symptoms are sometimes absent; and without symptoms, this can be sometime that is easy for individuals to overlook or not think twice about. However, when symptoms do occur, they can include the following:
SYMPTOMS IN MALES:
• Urethral discharge that resembles pus and is white, yellow or green in colour
• Discharge, bleeding or pain when passing stools
• Painful urination
• Frequent urination
• Pain in the scrotum or the testicles
• Swollen lymph nodes
• Red, swollen and/or warm and painful joints
SYMPTOMS IN FEMALES:
• Pain during sexual intercourse
• Bleeding after sexual intercourse
• Vaginal discharge that is green or yellow in colour
• Painful urination
• Frequent urination
• Vulvar swelling
• Bleeding unrelated to menstrual cycles
• Heavier periods
• Abdominal or pelvic pain
To avoid the development and spread of gonorrhea, you should always practice safe sex by using condoms, and also get tested regularly for this and other sexually transmitted diseases. To learn more about the prevention of other sexually transmitted diseases such as chlamydia, genital herpes and HPV, click here.
Men’s Health Month, an initiative first started by congress in 1994, is now recognized worldwide throughout the month of June via various educational health programs, health fairs, outreach activities, and even in the media. The main focus of Men’s Health Month is to not only heighten the awareness of some common (and less common) health concerns for men, but it’s also about the prevention, early detection, and treatment of certain illnesses, disorders and diseases that men can be faced with.
As a family physician, Dr. Ali Ghahary encourages men to see their doctor for regular physical examinations. Typically, patients (both males and females) will see a physician once per year for a full check-up. By going for annual exams, this allows you and your doctor to discuss any concerns you might have with your health, as well as making any necessary updates to your medical file. Your vital signs, such as blood pressure, heart rate, respiratory rate, and temperature are also checked, and you will also undergo head/neck, abdominal, and neurological examinations. For men, an annual exam can also include a testicular exam, prostate exam, and hernia exam, which are done to check for things like testicular and prostate cancer. While the thoughts of these exams can be uncomfortable, embarrassing, and maybe even downright scary for some, it’s important to remember that they are being done for your own benefit.
There are certain guidelines that Dr. Ali Ghahary and healthcare professionals across Canada, the United States, and the world, suggest men between the ages of 18 and 39 follow when it comes to health screening. Things like blood pressure and cholesterol screening should be checked every 3 to 5 years. If you have a history of high blood pressure yourself, or if there is a history of high blood pressure in your family, then it’s suggested that you have it checked every year. If your systolic number (the top number) is over 140 or the diastolic number (the bottom number) is over 90, you should book an appointment with your family doctor as soon as possible. There are also other underlying medical conditions that may require you to have your blood pressure levels checked more frequently. Click here to learn more about blood pressure and what you can do to avoid the risk of developing hypertension, and click here to find out how you can control your cholesterol. It’s also recommended that you keep your immunizations up to date. By age 19 you should have a tetanus shot, followed by a tetanus-diphteria booster every 10 years. Learn more about which vaccinations you need by visiting immunizebc.ca.
Another recommendation is that men between the ages of 45 and 49 have a baseline PSA test to check for prostate cancer. If your PSA level is above 3 ng/mL, your doctor may recommend having a biopsy done of the prostate. If your level is between 1 and 3 ng/mL, you should be going for a PSA test every 2 to 4 years. If you are at risk of developing or have a family history of prostate cancer, screening can be done as early as age 40. You can learn more about this particular test, including how it’s administered, by visiting prostatecancer.ca. Men should also be screened for colorectal cancer. While women can also develop this type of cancer, it tends to be more common in males than females.
When it comes to your health, it’s important to be pro-active. Certain illnesses often have no symptoms until the illness has reached a late stage, which is why it’s so crucial to see your physician for regular examinations. This way you are able to live a much healthier, longer life. If you don’t have a family physician, you can also see a doctor at any walk-in clinic. At Brentwood Medical Clinic in Burnaby, Dr. Ali Ghahary is available to see patients on a walk-in basis every Monday, Wednesday, Friday and Sunday. For clinic hours, visit brentwoodwalk-inclinic.com.
For a list of common health concerns for women, click here.