Key determinants of men's health
Factors that influence the behavior of men and their attitude to their health
The appearance of risks for men's health is also promoted by many additional factors, both directly and indirectly, through their influence on men's behavior and attitudes. This section examines how the following factors affect men’s health: biology and genetics, psychophysiology, ethnicity, socio-economic status, age, marital status, occupational hazards, unemployment, incarceration, public opinion about masculinity, social impact on men , media and advertising, medical knowledge.
Biology and genetics
Biology determines the development of a number of bands-specific health problems for men. For example, erectile dysfunction, which can be the result of significant emotional overload and interpersonal conflicts, is observed in almost half of men aged 40 to 70 years and more than half of them over 70 years. Biology is also caused by an increased risk of death in the male sex, which is already noted during intrauterine development. Despite the fact that after conception, there are 120-160 male for every 100 female embryos, by the time of birth the ratio drops to about 106 to 100. In addition, the lifespan for men and boys is higher than the risk of death from congenital anomalies. Although some studies have questioned the prophylactic role of estrogen in the development of ischemic heart disease, biologically determined estrogen deficiency in men may increase the risk of developing the disease by lowering their “good” cholesterol compared to women. Similarly, the enzyme monoamine oxidase, neuroregulators and hormones such as androgens and cortisol cause cravings for a variety of strong impressions and trials. Decades of research have revealed a link between such desires (which are much more common in men than in women) with high-risk driving, with high-risk sexual activity, alcohol use, drug addiction and smoking, as well as with extreme sports and criminal activity. Low levels of serotonin in the male brain may be responsible for expressing physical aggression more often. However, despite the fact that a number of biological factors mediate risks to men's health, studies show that the significance of biological factors in influencing gender differences in morbidity and mortality rates is relatively small.
Genetic factors also increase the risk for men. For example, in men with the presence of heart failure and prostate cancer in the family history, the risk of developing these diseases is significantly increased. The level of monoamine oxidase is also clearly determined genetically.
It is assumed that psychophysiological reactions to emotional stress (such as increased excretion of catecholamine, changes in heart rate and blood pressure) are associated with the risk of coronary heart disease. Research confirms that men recover more slowly after stress, which may partly explain the higher incidence of CHD among them and its more severe course. Reactivity of systolic blood pressure is also more pronounced in men than in women.
Activation of the autonomic nervous system and the subsequent response of the cardiovascular system are considered as one of the main mechanisms of the influence of stress on physical health. In addition, there is strong evidence of a link between stress and impaired functioning of the body’s immune system. And despite the fact that it is very difficult to directly identify or change the psycho-physiological reactions to emotional stress, it is relatively easy to correct the behavioral and situational factors that stimulate these reactions.
For our country, this factor is not very critical, but it should be noted that there are significant differences in mortality and morbidity rates among men of different ethnic groups. The difference between the life expectancy of African-American and white men in the United States even exceeds the difference between men and women in this indicator: African Americans die 7 years earlier than white men.
Numerous studies have shown that there is a clear relationship between poor health and low socioeconomic status (BOT). Men who are in economically unfavorable conditions often do not have separate housing, are more susceptible to involvement in the criminal environment, are more likely to be affected by harmful factors, receive insufficient medical information and are exposed to significantly more serious stress loads. However, the relationship between BOT and health is not limited to comparing only the very poor with the very rich. Among the majority of ethnic groups in the USA and Europe, differences in health status persist even with a relatively small difference in the socio-economic situation: the health of people with an average BOT is worse than that of people with a slightly higher BOT. In addition, with the improvement of socio-economic status, people's health usually also improves.
According to statistical studies conducted in the United States, the greatest gender disparity in the death rate is observed in the age group from 15 to 24 years. Three of the four deaths in this age group are deaths of men. Male adolescents receive 174% more injuries and are much more likely to be hospitalized for serious injuries than female adolescents. Fatal injuries (accidents, homicides, suicides) account for about 75% of deaths in this age group, and three out of four such deaths are men. Young men are significantly more likely than women to experience various occupational hazards. Male adolescents are also more likely to become infected with STIs. Most of these diseases and causes of death are preventable, as they result from unwillingness to lead a healthy lifestyle and risky behavior. Males, for example, begin to smoke, use alcohol and drugs at a younger age than adolescent girls. Among adolescents, the incidence of drug addiction and substance abuse is higher in males. In addition, the risk behavior that occurred during adolescence is very often the cause of illness, injury and death that occurs as early as adulthood.
Marital status is an important factor affecting health. Unmarried, widowed and divorced men have more serious risks than married men. In addition, they usually lead a less healthy lifestyle. For example, unmarried men drink and smoke more, eat less vegetables and fruits, they have more risk of getting an STI, they go to a doctor less often, they measure blood pressure less often, they are more susceptible to suicide. There was also evidence that a happy marriage has a positive effect on longevity. Moreover, evidence has recently been obtained that the correlation with mortality (and other risk factors associated with an unmarried position) is higher in men than in women.
Professions that men choose are often the most dangerous. Transport, energy, processing industry, construction - these are the activities that have the highest mortality rate from injury, and in all these sectors men are mainly involved in the workforce. Among police officers and rescuers, the absolute majority of those killed in the line of duty are men. However, injuries are only one of the causes of occupational morbidity and mortality. In the USA, for example, approximately 32 million workers in the workplace are exposed to one or more hazardous chemical compounds, in the Republic of Belarus it is difficult to obtain such statistical data. The five occupations that have the largest percentage of workers exposed to chemicals (in descending order): construction, agriculture, chemical industry, oil refining and forestry, and these are the activities that involve mostly men.
Unemployment is the cause of a number of negative effects on health. There is evidence that these negative effects are more pronounced in men than in women. The relationship between unemployment and psychological problems is much stronger among men. And the frequency of suicides associated with unemployment and periods of economic crisis is higher among men than among women. In several studies conducted among young people, it was found that unemployment or low wages are also risk factors for alcohol abuse, smoking, drug addiction, suicides and accidents, mostly among men.
Deprivation of liberty
More than 30 thousand people in Belarus are in state correctional institutions. Prisoners are at risk of contracting tuberculosis, hepatitis and HIV. The incidence of AIDS in prisons is 14 times higher than in the general population. The level of suicides in places of detention is also increased. The incidence of suicides among prisoners is several times higher than in the general population, and almost all cases of such deaths occur among men. Other factors that increase the health risks for prisoners include violence, prison health care, and poor nutrition. In Russia, for example, even taking into account the fact that there are more women than men in the state, men go to prison 10-12 times more often than women.
Public opinion about masculinity and social impact on men
Belarusians and Slavs in general are committed to the view that a man should be independent, self-confident, strong, healthy and strong. Men and boys are under strong social pressure to support these beliefs. Boys are more often the object of ridicule from their peers, and parents punish them for offenses more often and more severely than girls and less pay attention to atypical or non-stereotypical (in the opinion of society) behavior for a man, for example, for complaining of pain, crying or asking for help. The environment that surrounds men since childhood often contributes to the development of unhealthy forms of masculinity. For example, in many men's sports, aggression, health risks, and pain tolerance are reasonable and respected. From the moment of birth, parents and other adults bring up girls and boys in different ways, which has a serious impact on their health. Despite the fact that boys are at a relatively higher risk, there are still quite a few parents who care less about their sons' safety than daughters, which can contribute to the development of risky behavior in boys and the risk habit in the future. Compared to girls, boys are often less surrounded by warmth and care. Despite the fact that they are often more susceptible psychologically, boys are less expressing a feeling of sadness, but more - anger; they are perceived as physically stronger, they are raised more rigidly; they are attracted to more mobile and competitive games; they are more often punished physically. Boys are more likely to be abused both at home and outside. Boys are more often involved in such activities and they rotate in an environment that distances them from their parents and discourages the desire to seek help. Such an approach has a short-term and long-term impact on the health of men and boys. As noted earlier, compared with women, men are harder to express their emotions, more often they consider themselves immune to the risks caused by bad habits, show aggression and less often seek help.
Media and Advertising
A review of recent research shows that the media draws clear lines between the health and healthy lifestyle of men and women. For example, in television programs, overweight men appear on the screen three times more often than women with a similar problem. In television shows and movies, men appear to be seven times more likely to smoke than women. Two thirds of the roles associated with alcohol use are male, and in various media alcohol, courage and risk behavior are closely interrelated. Boys are 60% more likely than girls to be portrayed as exhibiting physical aggression, while men are more likely than women to use violence, which is usually taken for granted (this is confirmed, in particular, by the absence of any negative consequences associated with such behavior). Women are usually portrayed as being more at risk, weaker and unprotected, while men appear healthy and risk-tolerant despite their risky behavior. It was found that such a presentation of information adversely affects health. For example, there is a link between the violence seen on TV and the subsequent manifestation of aggression. In addition, showing the use of alcohol in films leads to a more favorable attitude towards alcohol in life. Studies show that many media publications exacerbate unhealthy and stereotypical gender behavior among men. Children's channels also, unfortunately, are more likely to show men and boys who show aggression than women and girls. Alcohol advertising is deliberately placed in magazines and television programs designed primarily for male audiences. Advertisers often show men performing dangerous and risky activities. Tobacco companies draw parallels between smoking and growing up.
Studies have shown that men have much less than women’s stock of knowledge about health in general, certain diseases such as cancer, STIs, coronary heart disease, and risk factors for their development. Lack of medical knowledge leads to a low level of appealability for medical care and to maintaining an unhealthy lifestyle, for example, prolonged exposure to direct sunlight, unprotected sexual intercourse, etc. Many men also lack knowledge about proper nutrition and nutrition. risk factors. The lack of medical knowledge among men is partly due to the lack of training programs for the male population in health care organizations, while similar programs for the female population have been developed and used for a long time. Health care The health care system and related health related areas have a significant impact on men's health. The following aspects of medical care are discussed in this section: the cost of medical services, the availability of medical care, the impact of medical institutions and scientific methodology, doctor-patient interactions, doctors' gender errors. Cost of medical services This factor has the greatest impact on the health of men in countries with paid and health insurance systems. In the Republic of Belarus, its influence is somewhat lower, but even here it must be taken into account, because, despite free medical care, a number of medical services, including diagnostic services, are paid in our country.
According to international studies, men spend less money on medical care than women, including on dental services and laboratory diagnostics, despite the higher risk of contracting STIs. And even when planning a vacation, men prefer the entertainment component rather than treatment, for example, in sanatoriums or health centers. Availability of medical care Men are significantly more likely than women to believe that getting medical care is quite difficult. One of the three men does not visit the doctor regularly. Men living in rural areas find it harder for them to get medical care than living in cities. Living in rural areas, however, does not explain the gender differences in the use of medical care. Among the rural population, men seek medical care less frequently than women. Many working men consider the problem of inaccessibility of healthcare organizations during off-hours and weekends, since most of them cannot afford to visit a doctor on weekdays because of employment. In addition, according to most men, a visit to a medical institution in the presence of, for example, queues may take an unreasonably long time.
Impact of the health care system and scientific methodology
The health care system and health-related organizations contribute to creating an opinion about a man as a healthy and trouble-free individual. Historically, heightened attention to the health of women, rather than men, was encouraged. For example, training in the field of oncological vigilance during the twentieth century was focused mainly on women. A number of scientific methodological factors and research methods also contribute to a wrong perception of men's health. For example, many studies on the use of behavioral health indices in determining the health status of men underestimate the importance of the influence of some factors (sleep time, appealability for medical care, etc.) on men's health, and many factors are not taken into account at all, although they appear in women's health studies. long ago.
During the reception, doctors spend significantly less time on men than women; besides, men usually get fewer appointments and procedures. They are less often given explanations, and these explanations are usually shorter than those given by women. Men also receive less information from doctors. Despite the fact that men tend to be more risky behavior and they are less likely to lead a healthy lifestyle, doctors during the reception less often talk with men about the risk factors and the need to avoid them. Also, men are less likely than women to teach self-examination techniques. In the US, for example, less than 10% of doctors talk about the need for self-examination for testicular cancer, while in 86% of cases, women receive recommendations for self-examination of the mammary glands.
Gender mistakes of doctors
Diagnostic and treatment decisions are influenced by the gender errors of doctors. For example, men are less likely to be diagnosed with mental disorders, they are more often recorded in women. So, perhaps due to the fact that depression is twice as common in women, psychiatrists are less likely to correctly diagnose depression in men. This may partly explain the increased incidence of suicides among men compared with women. Gender errors can also be attributed to prescribed drugs: men are less likely than women to be prescribed psychotropic drugs, but more often they are prescribed drugs with more pronounced side effects.
A review and brief explanation of the main factors affecting men's health can have practical applications in the field of health care, as they point to a number of problematic issues related to men's health. In order to preserve and promote the health of the male population, social and cultural changes, the promotion of gender medicine and the correction of professional medical views on men's health are necessary.
Despite the fact that in recent decades, a number of measures have been taken abroad and in the Republic of Belarus to solve this problem, statistical indicators of morbidity and mortality among the male population indicate the need for their improvement. The risks affecting the health of men are not reduced, therefore it is necessary to more actively introduce new methods, develop and scientifically substantiate new approaches to maintaining men's health. In addition, strategies for changing attitudes toward men's health should be directed not only at the physiology of the individual man, but also take into account the socio-cultural, psychological and behavioral factors that influence the male population as a whole. It is important to note that social, psychological, behavioral, biological and genetic factors do not arise and do not act in isolation, they are interrelated and can often stimulate each other. This multi-factor nature of risks and the complex interplay of factors suggest the need for a multidisciplinary approach to minimize their impact on men's health.
Multidisciplinary and interdisciplinary research is needed, based on which it will be possible to form action strategies. Despite the fact that over the past decade, interest in the issue of men's health has steadily increased throughout the world, there are relatively few objective data in this area. Both fundamental and applied research, as well as interdisciplinary interaction, are needed to create interactive models in the field of male behavior, health and disease. In turn, the creation of an interdisciplinary approach to the study of men's health requires the development of methodological foundations that take into account relevant factors, disciplinary differences in the assessment of results in the studied populations, in the methods used.
Most of the factors cited in the article are modifiable. Correction of them through training, changes in legislation or other scientifically-based methods can help improve the health of men. In addition, as noted above, many health-related attitudes and stereotypes of men (including risky behavior) affect not only themselves, but also other members of society. Therefore, the correction of these factors affecting men's health will not only improve the health of men, but also ensure the improvement of society as a whole.
However, there are not and cannot be simple and fast-acting means of improving men's health, we need long-term social and medical policies and systematic training of men to assimilate a variety of gender roles and minimize the social, psychological and medical risks associated with them.
It is important for a man to be healthy!
The average man knows very little and understands the problems associated with their own health. Men are not accustomed to complaining about the poor state of health, do not cry and do not sigh, believing that they are just tired. Here's a rest - and life will get better, they will be like cucumbers again.
Finding a normal wart on the penis, the man immediately goes to the doctor. However, a painless swelling on the testicles can grow to an impressive size, but is unlikely to cause the same concern. Almost all of these tumors are harmless, but still there is a chance that testicular cancer can develop - the most common malignancy in men from 15 to 34 years old. If you yourself have found something similar in yourself, consider yourself lucky, since almost 100% of testicular cancers detected at an early stage can be cured. With late detection, the prognosis is usually not as favorable.
Risk factors and prevention
Sex by itself and sexually transmitted diseases are not related to testicular cancer. In men born with undescended testes, the risk of cancer is ten times greater than the rest. Surgical correction does not reduce the danger, although it facilitates the detection of a tumor. Since only 10% of men with testicular cancer suffer from this congenital disorder, the rest are no less at risk. Men with testicular atrophy and those who have suffered mumps with subsequent testicular inflammation, orchitis, appear to be at greater risk. There is no way to prevent testicular cancer - the only defense is early detection - diagnosis. Blood tests and x-rays give nothing. Currently, doctors detect approximately 50% of testicular cancers during routine routine examinations or after the tumor begins to grow. This should not be, because every man is obliged to monitor their health and conduct self-examination monthly.
- The testicles should be about the same. If one of them is abnormally small, it is most likely atrophied after a long-standing infection.
- One testicle always hangs below the other. Otherwise you could not put your legs together. Inspect yourself monthly, but only in a warm place - in the cold scrotum strongly shrinks. Ideal to inspect while taking a bath or shower. Roll your testicles between your thumb and the rest of your fingers. They should be felt like a hard-boiled egg (without a shell, of course) about 3.5-4 cm in diameter; dimensions should not differ by more than 5-6 mm. If you have touched the testicles carefully, they should not hurt, so a clear pain during the examination should be considered as a deviation. Very few testicular neoplasms are malignant, but doctors treat and treat any of them as cancerous until they receive evidence to the contrary. Fortunately, an experienced urologist or surgeon can confidently diagnose most of the benign formations immediately upon examination in his office.
Men usually notice an inguinal hernia after lifting weights. With age, the likelihood of hernia formation increases, since a general weakening of the tissue leads to an increase in all openings and passages. Painless inguinal hernias are generally harmless, but in principle all hernias must be eliminated. If the slipped part of the intestine is strongly clamped by the edges of the hole (this is called pinching) and the blood supply to it is stopped, emergency intervention is required, as in this case, intestinal gangrene quickly develops. If you suspect a hernia or experiencing pain in the groin area that occurs during physical exertion and quickly disappears after the load is removed, be sure to consult a doctor even if no tumors are noticeable.
What does testicular pain mean?
Inflammation of the epididymis (epididymitis) is almost always observed only on one side. Usually the culprits are bacteria, as a rule, gonococci or chlamydia, causing, moreover, urethritis (inflammation of the urethra). The pain intensifies gradually, within one to three days. A man may notice other symptoms of infection of the urinary tract - fever, spontaneous urination or burning in the canal.
Sudden pain rather indicates a "twist" of the testicle. Torsion of the testicle, being a frequent illness in adolescence, is much less common in adults than inflammation of the epididymis, but with the appearance of pain, both possibilities should be considered. Do not show unreasonable "heroism" by postponing a visit to the doctor, as the twisted testicle dies after a few days.
The reasons. The testicles and ovaries begin to form from the same primitive tissue deep in the abdominal cavity of the embryo. In boys, the testicles descend into the scrotum gradually (so that they subsequently cool better, since the sperm dies at body temperature, and that is why men with undescended testicles are infertile). Each testicle hangs on the so-called spermatic cord, which includes the arteries, veins and nerves, as well as the ductus of the spermatic cord. This design allows the testicle to move back and forth, as well as within certain limits, to rotate around its axis, but sometimes it can turn to an excessively large angle and remain in this position. Typical torsion makes itself felt by sudden excruciating pain, often accompanied by vomiting. No one who has experienced this will linger with a visit to the doctor, but, unfortunately, in one third of cases, acute pain does not occur immediately, but increases gradually. Torsion blocks access of the blood to the testicle, therefore urgent intervention is required. If you experience severe pain in the testicles, consult a doctor immediately. Restoration of blood flow during the first 6 hours saves 80-100% of the sex glands. With a delay of up to 2 days, this figure drops to 20%.
Orchitis (inflammation of the testicles) is a fairly rare disease, with the exception of complications after mumps. Many adult patients are afraid of this diagnosis, believing that the complication will lead them to sterility (infertility). I explain that this happens, but less often than they think.
Cause. The mumps virus (mumps) usually affects the salivary glands of children, forming a strong swelling behind the lower jaw and causing fever and a general disease state that lasts about a week. The virus also infects other organs, among them the testicles most often (for unknown reasons). But this almost never happens before puberty. The usual course of the disease. Mumps in adults is no more severe than in children, and orchitis affects only 20 to 30% of cases. Only in 10% of these cases, the lesion of both testicles is detected.
Symptoms appear suddenly, on the third or fourth day after swelling of the salivary glands: the temperature rises sharply, and the testicles swell and become painful. The disease lasts a week or a bit less, and then (in about 50% of cases) the affected testicles shrink over the next two months. An atrophied testicle usually produces less sperm, but a man with one normal testicle does not lose fertility. Even bilateral orchitis does not necessarily lead to infertility if atrophy of both sex glands has not gone too far. There is no cure for this disease. Prevention. The mumps vaccine works very well. Adults who do not remember whether they have had mumps in childhood, it is better to be vaccinated.
The need for surgery
There are a number of diseases of the male urogenital system in which surgical intervention is indicated. In some cases (for example, in case of oncological diseases) such an intervention is strongly required, and in other cases it simply facilitates sex life and life in general.
Varicose veins of the spermatic cord and testicle - varicocele, one of the most frequent diseases, affects about 10-15% of all men. In most cases, the disease begins at puberty. If you take all men with infertility, then varicocele can be detected in 40% of them. Moreover, if we separately single out a group of men with so-called secondary infertility (that is, those men from whom previously women were pregnant but who currently cannot become fathers), then it turns out that 80% of such men have varicocele. The patient may feel pain in the testicle and heaviness in the scrotum. Expansion of blood vessels under the skin of the scrotum can be detected by a urologist during the initial examination. To clarify the diagnosis, most likely, you will need an ultrasound. Conducting a study of the level of sex hormones in the blood. Before starting treatment, on the basis of semen the doctor determines the severity of the disease.
It should be noted that varicocele is not always manifested by pain and a feeling of heaviness. Quite often, it is asymptomatic, and a man may not even suspect of its existence. Therefore, in cases where the wife’s pregnancy does not come for a long time, the husband should check with the doctor. However, one should not expect until a significant amount of time has passed and the man will understand that not everything is in order with his genital function. Ideally, varicocele should be detected and cured as early as possible. The lower the age of the man during the operation, the greater the chance of restoring his reproductive function. In addition, there is evidence that surgery improves spermatogenesis if less than 5 years have passed since the time of illness. The operation can be performed by various methods. All of them are quite well developed and do not cause difficulties. After surgery, the patient, as a rule, quickly recovers and as soon as the next day their hospital can be discharged.
Frequently, fluid accumulates in the scrotum, forming a solid rounded formation, located separately from the testicle and in front of it; large dropsy (hydrocele) may surround the testicle completely. Treatment with hydrocele is performed only surgically. The operation is performed under local or general anesthesia and lasts no more than 30 minutes. Two hours later, the patient is allowed to go home. Hydrocele is most common in men aged 20–30 years, but the disease can also be congenital. In newborns there are communicating dropsy of testicular membranes, which can pass on their own.
Timely consultation of the urologist will help avoid costly treatment, waste of time. Prevention will prevent the development of most urological diseases.