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Sexual Health after Prostate Surgery: Overcoming Challenges and Embracing Recovery

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Erena Pradhan, Consultant Urologist, MS, MCH

The Journey to Recovery

Prostate cancer treatments, especially the surgical procedure known as radical prostatectomy, have profound effects on a man’s sexual health. This operation can alter erectile function, ejaculation, and overall sexual contentment (Hyun 2012). Both patients and healthcare providers need to grasp the intricacies of sexual health following prostate surgery to tackle these challenges and discover successful recovery strategies effectively.

Sexual Health and Prostate Surgery

Radical prostatectomy, a gold standard method for treating localized prostate cancer, may cause a range of postoperative sexual health concerns. One of the most common issues is erectile dysfunction caused by damage to the nerves that control erections (Bratu et al. 2017). While nerve-sparing surgeries are designed to reduce this risk, they’re not suitable for everyone, and some men may face persistent erectile dysfunction that necessitates continued support for fulfilling sexual activity. (Cancer Research UK, 2023).

Post-surgery, men might also encounter ejaculation issues, most commonly retrograde ejaculation, which is caused by destruction of the natural mechanism of preventing the backflow of semen into the urinary bladder. Also in radical prostatectomy, lack of seminal fluid production, leads to what’s known as dry orgasms (orgasm without ejaculation), which can alter the physical sensation of climax (Koren & Koren, 2020). Additionally, the removal of the prostate gland can change sexual sensations during anal intercourse, potentially affecting sexual pleasure and intimacy, particularly in same-sex relationships. (Alexis & Worsley, 2018).

Pathways to Sexual Health Recovery

Addressing the sexual health challenges after prostate surgery involves a variety of strategies and interventions to aid patients in reclaiming sexual function and satisfaction. Penile rehabilitation programs are vital in fostering erectile recovery by preserving the oxygenation of penile tissue and muscle health, as well as aiding nerve healing. (Müller et al., 2008) (Elliott & Matthew, 2017)

Medical treatments, including oral medications like sildenafil and tadalafil, can improve blood flow to the penis, aiding in achieving erections. For cases where more conservative treatments don’t yield results, vacuum devices and penile implants provide alternative solutions for erectile dysfunction (Wang et al., 2023). These methods are geared towards restoring penile erection and enhancing sexual performance after surgery.

A Holistic Approach to Sexual Well-being: 

Confronting the sexual health changes following prostate surgery which is often an unspoken aspect demands a holistic strategy that considers both the physical and psychological facets of sexual wellness. With an understanding of the potential complexities introduced by prostate cancer treatments and the implementation of personalized recovery plans, patients can improve their quality of life and rediscover gratifying sexual experiences.

In summary, active management of sexual health problems after prostate surgery through counselling, rehabilitation, and medical treatments is crucial in aiding patients on their path to restoring sexual function.  Healthcare providers can combine their medical knowledge with comprehensive care practices to help individuals effectively navigate the complexities of sexual health following prostate cancer therapy.

REFERENCES

  1. Hyun JS. Prostate cancer and sexual function. World J Mens Health. 2012 Aug;30(2):99-107. doi: 10.5534/wjmh.2012.30.2.99. Epub 2012 Aug 31. PMID: 23596596; PMCID: PMC3623527.
  2. Bratu O, Oprea I, Marcu D, Spinu D, Niculae A, Geavlete B, Mischianu D. Erectile dysfunction post-radical prostatectomy – a challenge for both patient and physician. J Med Life. 2017 Jan-Mar;10(1):13-18. PMID: 28255370; PMCID: PMC5304365.
  3. Cancer Research UK. (2023). Sex and erection problems after treatment for prostate cancer. Retrieved from https://www.cancercenter.com/community/blog/2023/06/sex-after-prostate-cancer
  4. Koren G, Koren D. Retrograde Ejaculation-a Commonly Unspoken Aspect of Prostatectomy for Benign Prostatic Hypertrophy. Am J Mens Health. 2020 Mar-Apr;14(2):1557988320910870. doi: 10.1177/1557988320910870. PMID: 32146870; PMCID: PMC7065283.
  5. Alexis O, Worsley AJ. The Experiences of Gay and Bisexual Men Post-Prostate Cancer Treatment: A Meta-Synthesis of Qualitative Studies. Am J Mens Health. 2018 Nov;12(6):2076-2088. doi: 10.1177/1557988318793785. Epub 2018 Aug 16. PMID: 30112965; PMCID: PMC6199434.
  6. Müller, A., Tal, R., Donohue, J. F., Akin-Olugbade, Y., Kobylarz, K., Paduch, D., Cutter, S. C., Mehrara, B. J., Scardino, P. T., & Mulhall, J. P. (2008). The effect of hyperbaric oxygen therapy on erectile function recovery in a rat cavernous nerve injury model. The Journal of Sexual Medicine, 5(3), 562-570. https://doi.org/10.1111/j.1743-6109.2007.00727.x
  7. Elliott, S., & Matthew, A. (2017). Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics. Retrieved from https://pcscprogram.ca/wp-content/uploads/2022/01/Sexual-Recovery-after-Prostate-Cancer-Elliott-Matthews.pdf
  8. Wang CM, Wu BR, Xiang P, Xiao J, Hu XC. Management of male erectile dysfunction: From the past to the future. Front Endocrinol (Lausanne). 2023 Feb 27;14:1148834. doi: 10.3389/fendo.2023.1148834. PMID: 36923224; PMCID: PMC10008940.

Rezum Therapy: A Minimally Invasive Treatment for Benign Enlargement of Prostate

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Erena Pradhan, Consultant Urologist, MS, MCH

Introduction:

Benign Prostatic Enlargement (BPE) is a prevalent condition in men, characterized by bothersome urinary symptoms such as increased frequency, urgency, weak urine flow, and incomplete bladder emptying. While lifestyle modifications, dietary adjustments, and medication can help manage mild cases, individuals with more severe symptoms may find relief through surgical intervention. Among the traditional surgical options, transurethral resection of the prostate (TURP) is commonly employed, albeit with its associated risks, including bleeding, sexual dysfunction, and a prolonged recovery period [1].

A Less Invasive Option:

The Rezum System emerges as a promising alternative to conventional surgical methods. This innovative approach utilizes the application of thermal energy, in the form of steam, to target and treat the enlarged prostate tissue [2][3]. By delivering controlled bursts of steam directly to the prostate gland, Rezum therapy offers a minimally invasive solution that effectively alleviates urinary symptoms while mitigating the risks commonly associated with TURP, such as bleeding, ejaculatory dysfunction, and retrograde ejaculation [4]

How Rezum Works:

At the heart of the Rezum System lies a specialized device equipped with a small, flexible needle-like instrument. This instrument is inserted into the prostate tissue under direct visualization, allowing for precise delivery of thermal energy in the form of steam. The targeted application of steam induces localized tissue necrosis, leading to the gradual shrinkage of the enlarged prostate over time. Importantly, this targeted approach ensures the preservation of surrounding healthy tissue and structures, minimizing the risk of adverse effects commonly observed with conventional surgical methods [5].

What to Expect after Treatment:

 Patients undergoing Rezum therapy can anticipate a significant improvement in urinary symptoms, resulting in enhanced quality of life and restored urinary function. Clinical studies have demonstrated notable enhancements in urinary flow rates, reduction in post-void residual urine volume, and improvements in symptom scores following Rezum therapy. While some individuals may experience transient side effects such as temporary dysuria, urinary frequency, or urgency immediately post-treatment, these symptoms typically resolve within a few weeks and are generally milder compared to those observed following traditional surgical interventions [4].

Conclusion:

Rezum therapy represents a paradigm shift in the management of benign prostatic enlargement, offering a patient-centered, minimally invasive solution that effectively addresses bothersome urinary symptoms while minimizing the associated risks. By harnessing the therapeutic potential of steam, Rezum therapy exemplifies the advancements in medical technology and underscores the importance of individualized care in the field of urology [5][6].

REFERENCES

  1. Lee CL, Kuo HC. Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts. Ci Ji Yi Xue Za Zhi. 2017 Apr-Jun;29(2):79-83. doi: 10.4103/tcmj.tcmj_20_17. PMID: 28757771; PMCID: PMC5509197.
  2. McVary, K. T., Roehrborn, C. G., & Barkin, J. (2019). Rezūm Water Vapor Thermal Therapy for Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia: 4-Year Results from Randomized Controlled Study. Urology, 126, 171-179.
  3. McVary, K. T., Gange, S. N., Gittelman, M. C., Goldberg, K. A., Patel, K., Shore, N. D., … & Roehrborn, C. G. (2016). Erectile and ejaculatory function preserved with convective water vapor energy treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: randomized controlled study. Journal of Sexual Medicine, 13(6), 924-933.
  4. McVary, K. T., Rogers, T., & Roehrborn, C. G. (2016). Rezūm water vapor thermal therapy: practical guide for urologists and primary care physicians treating lower urinary tract symptoms secondary to benign prostatic hyperplasia. Therapeutic Advances in Urology, 8(3), 172-181.
  5. Dixon, C.M., Cedano, E., & Mynderse, L. A. (2018). Rezūm water vapor thermal therapy for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: A systematic review of the literature. Current Urology Reports, 19(6), 44.
  6. Roehrborn, C.G., Gange S.N., Shore N.D., et al.(2020). Five year results of the prospective randomized controlled Rezūm system study: Convective radiofrequency thermal therapy for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia.Journal of Urology ,203(5),1042-1050.

Revolutionizing Prostate Cancer Treatment: The TULSA-Pro Procedure

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Erena Pradhan, Consultant Urologist, MS, MCH

Prostate Cancer:

Prostate cancer is the leading cause of cancer death and the second most common non-cutaneous cancer in males worldwide which is a significant health concern (Abudoubari et al., 2023). Wang et al. (2022) found in their study on global prostate cancer incidence and mortality that a total of 1 414 259 new cases of prostate cancer and 375 304 related deaths were reported in 2020 globally.  There are marked variations in the rate of prostate cancer in different populations worldwide which suggests its genetic predisposition (Tzelepi et al, 2022). Apart from that, age, family history, ethnicity, and tobacco smoking are additional risk factors (Berenguer et al.2023). Most of the prostate cancers identified currently are asymptomatic. Diagnosis in these cases is based on elevated prostate-specific antigen (PSA) level, digital rectal examination (DRE), and prostate biopsy. Localized and advanced diseases can cause urinary retention, blood in the urine (hematuria), blood in semen, and pelvic discomfort, back pain, weight loss (Peters et al.2023)

Recent Advances in Prostate Cancer:

The treatment landscape for prostate cancer has seen remarkable progress in recent years. Standard treatment for localized prostate cancer includes active surveillance, radical prostatectomy, and radiation therapy with or without hormonal therapy. New therapies targeting the disease’s resistance to conventional treatments are emerging. One such advancement is a therapy that combines an experimental drug, AZD5069, with enzalutamide, a hormone therapy, showing promising results in shrinking tumors and reducing PSA levels (Guo et al.2023). Another breakthrough is the development of 177 Lu-PSMA-617, a targeted radioligand therapy that delivers radiation directly to cancer cells, demonstrating effectiveness in controlling advanced prostate cancer (Sartor et al.2021)

The TULSA-Pro Procedure:

TULSA-Pro stands for Transurethral Ultrasound Ablation. It is one of the focal ablative therapies for localized prostate cancer which is minimally invasive, providing proper oncological outcome with preserving urinary continence and erectile dysfunction due to nerve sparing.

Procedure:

TULSA procedure is performed in 1.5 Tesla MRI with the patient under general anesthesia. An ultrasound applicator is placed in the prostatic urethra to deliver the focused waves to ablate the cancerous tissue sparing the healthy tissue and a rectal cooling device is placed adjacent to the prostate. Both devices are irrigated with water for thermal protection of the rectum and urethra. MRI shows real-time visual monitoring during the procedure. (Klotz et al.2021)

Post-Procedure Recovery:

Patients can be discharged the same day or can be admitted overnight. They benefit from shorter recovery times and fewer side effects like urinary incontinence and erectile dysfunction.

Clinical Evidence and Results Recent studies highlight TULSA-Pro’s effectiveness:

PSA Reduction: Studies report 75% decrease in PSA levels post-procedure, indicating effective tumor ablation (Peters et al.2023)

Preservation of Erectile Function: TULSA-Pro has been shown to minimize damage to neurovascular bundles, reducing the incidence of erectile dysfunction. (Klotz et al.2021)

Urinary Continence: Patients experience lower urinary leakage rates than traditional surgical treatments (Peters et al.2023).

Quality of life: IPSS urinary symptom score, quality of life score, and voiding/storage sub scores recovered to baseline 3 months post-procedure. Urinary continence and sexual function also recovered to baseline earlier than other measures ( Klotz et al.2021).

Advancements and Future Directions: The TULSA-Pro procedure is evolving, with advancements enhancing its precision and outcomes.

Conclusion

TULSA is a minimally invasive procedure that uses planar ultrasound energy with real-time MRI-based treatment planning, thermal dosimetry, and closed-loop temperature feedback for effective prostate cancer ablation.  It signifies a new era in prostate cancer treatment ongoing research promises to refine this innovative approach, broadening its adoption and benefiting patients and healthcare providers globally.

REFERENCES

  • Abudoubari, S., Bu, K., Mei, Y., Maimaitiyiming, A., An, H., & Tao, N. (2023). Prostate cancer epidemiology and prognostic factors in the United States. Frontiers in Oncology, 13. https://doi.org/10.3389/fonc.2023.1142976
  • Wang, L., Lu, B., He, M., Wang, Y., Wang, Z., & Du, L. (2022). Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019. Frontiers in Public Health, 10, 811044. https://doi.org/10.3389/fpubh.2022.811044
  • Tzelepi V. Prostate Cancer: Pathophysiology, Pathology and Therapy. Cancers (Basel). 2022 Dec 31;15(1):281. doi: 10.3390/cancers15010281. PMID: 36612276; PMCID: PMC9818719.
  • Berenguer, C. V., Pereira, F., Câmara, J. S., & Pereira, J. A. M. (2023). Underlying Features of Prostate Cancer-Statistics, Risk Factors, and Emerging Methods for Its Diagnosis. Current Oncology, 30(2), 2300-2321. https://doi.org/10.3390/curroncol30020178 this is for no .2
  • Peters, I., Hensen, B., Glandorf, J., et al. (2023). “First experiences using transurethral ultrasound ablation (TULSA) as a promising focal approach to treat localized prostate cancer: a monocentric study.” BMC Urology, 23, Article number: 1421
  • Guo, C., Sharp, A., Gurel, B., et al. (2023). Targeting myeloid chemotaxis to reverse prostate cancer therapy resistance. Nature, 623, 1053–1061. https://doi.org/10.1038/s41586-023-06696-z
  • Sartor, O., de Bono, J., Chi, K. N., Fizazi, K., Herrmann, K., Rahbar, K., Tagawa, S. T., & the VISION Investigators. (2021). Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. The New England Journal of Medicine, 385(12), 1091-1103. https://doi.org/10.1056/NEJMoa2107322
  • Klotz, L., Pavlovich, C.P., Chin, J., Hatiboglu, G., Koch, M., Penson, D., Raman, S., Oto, A., Fütterer, J., Serrallach, M., Relle, J., Lotan, Y., Heidenreich, A., Bonekamp, D., Haider, M., Tirkes, T., Arora, S., Macura, K.J., Costa, D.N., Persigehl, T., Pantuck, A.J., Bomers, J., Burtnyk, M., Staruch, R., & Eggener, S. (2021). Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer. Journal of Urology, 205, 769–779. https://doi.org/10.1097/ju.0000000000001362
  • Feigl, G. C., Heckl, S., Kullmann, M., Filip, Z., Decker, K., Klein, J., Ernemann, U., Tatagiba, M., Velnar, T., & Ritz, R. (2019). Review of first clinical experiences with a 1.5 Tesla ceiling-mounted moveable intraoperative MRI system in Europe. Bosnian Journal of Basic Medical Sciences, 19(1), 24-30. https://doi.org/10.17305/bjbms.2018.3777

The Semen Microbiome and Its Impact on Male Fertility

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert , M.D. (OB/GYN) 

 In 1981, Lynn Margulis published Symbiosis in the journal Cell Evolution, she proposed that life emerged not as the outcome of a competitive race but by interacting organisms joined together for a very specific order. Human body not only consist of trillions of cells but trillions of ancient species including bacteria and it may be surprising that the mitochondria that makes the energy for the body originated from an ancient bacteria and it retained its unique genome that is known as Mitochondrial DNA.

These microbiomes, occupies and live in a harmony in different part of the body and body fluids especially in  the gut, vaginal, and in the semen microbiome. These microbiomes involved in the health and well-being of humans.  Recent research has shed light on the significance of the semen microbiome and its potential influence on male fertility. This article aims to explore the latest findings on the semen microbiome and its relevance to male fertility, drawing from verifiable sources to provide a comprehensive understanding of this emerging field.

Understanding the Semen Microbiome

The semen microbiome, once thought to be microbe-free, has been revealed to host its own microbial community, akin to the microbiomes of the gut and vagina (Hill, 2021). This microbiome comprises a diverse array of microbes originating from various glands in the upper reproductive tract, as well as “drifter” bacteria from urine, the urethra, and potentially from a person’s blood or their sexual partners (Winters & Walsh, 2019). However, the impact of these individual species of bacteria on health has long been a mystery (Hill, 2021).

Recent Research Findings

A recent investigation conducted at the University of California, Los Angeles (UCLA) delved into the semen microbiome’s potential link to infertility, yielding insightful findings (Winters & Walsh, 2019). The study, published in Scientific Reports, identified a bacterial species, Lactobacillus iners (L. iners), associated with sperm motility issues in individuals experiencing infertility (Winters & Walsh, 2019). This microbe, commonly found in the vaginal microbiome, has been linked to impaired sperm motility, a key factor contributing to male infertility (Winters & Walsh, 2019).

The study involved the genetic sequencing of semen samples from 73 men, half of whom were fertile and the other half seeking fertility consultation due to issues such as lower sperm count or motility (Winters & Walsh, 2019). The researchers identified five common bacteria species in the semen microbiome, with high levels of L. iners correlating with impaired sperm motility in men experiencing infertility (Winters & Walsh, 2019). This discovery is significant as it suggests a potential link between the semen and vaginal microbiomes, indicating their influence on each other and their role in fertility (Winters & Walsh, 2019).

Implications for Male Fertility

The findings of this study have far-reaching implications for male fertility. With approximately 50% of infertility cases attributed to male individuals, understanding the role of the semen microbiome in infertility is crucial (Hill, 2021). The research paves the way for the development of targeted treatments aimed at rectifying issues with sperm parameters, potentially alleviating the burden of infertility for couples (Hill, 2021).

Furthermore, the identification of specific bacteria, such as L. iners, and their potential impact on sperm motility opens new avenues for exploring drug targets to address infertility (Hill, 2021). This could lead to the development of innovative treatments tailored to rebalance the semen microbiome, akin to current approaches used to treat bacterial vaginosis in the vaginal microbiome (Hill, 2021).

Future Directions and Implications for Clinical Practice

While the research on the semen microbiome and its connection to male infertility is still in its nascent stages, the findings have set the stage for future comprehensive investigations into the complex relationship between the semen microbiome and fertility (Winters & Walsh, 2019). These studies could potentially lead to the identification of new biomarkers for clinical laboratory testing, offering valuable insights for couples experiencing fertility issues (Winters & Walsh, 2019).

In conclusion, the emerging field of semen microbiome research has unveiled a new dimension in the understanding of male fertility. By shedding light on the role of the semen microbiome in influencing sperm parameters and male fertility, these findings have the potential to revolutionize the diagnosis and treatment of male infertility, offering hope to countless couples striving to conceive.

REFERENCES

  1. Hill, J. E. (2021). The Semen Microbiome: A New Contributor to Male Fertility? Scientific American.
  2. Winters, K., & Walsh, T. J. (2019). Microbial Communities in Semen Could Impact Fertility. University of California – Los Angeles Health Sciences.

Recent Advances in Male Infertility Research

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert , M.D. (OB/GYN) 

Infertility is a prevalent issue with an estimated 9% of couples worldwide experiencing fertility challenges, half of which are attributed to male factors 1 Revolutionary genetic studies like exploring the Y chromosomes sequencing (2)DNA fragmentation techniques as well as recent technological advances like ICSI procedures shed light on various causes and potential treatments for male infertility, offering hope for effected couples.

Challenges & Causes of Male Infertility 1,3,4

Male infertility can stem from a range of factors, including genetic mutations, lifestyle factors, medical illnesses, environmental exposures, and medications. Genetic variations have been identified as a leading cause of male infertility, with recent studies focused on deciphering these genetic markers to develop targeted therapies 1,3 4 . Additionally, oxidative stress has been recognized as a significant contributor to sperm DNA damage and impaired function, emphasizing the potential role of antioxidant supplementation in mitigating these effects 1, 3

Dr Hagai Levine, an epidemiologist at the Hebrew University of Jerusalem, and his colleagues published an analysis in 2017 and an update in 2022 , these two papers found about a 50 percent decrease in sperm concentration since 1970s. 5, 6. 

Furthermore, the decline in sperm count is paralleled by declines in testosterone and increases in testicular cancer and male genital anomalies.

Treatment Approaches 1,3,4,7

Oxidative damage of sperm DNA is positively linked with oligoasthenoteratozoospermia (OAT), and male infertility. The antioxidants are being explored worldwide to combat OAT, sperm DNA fragmentation and reactive oxygen species. Recent prospective, double-blind, randomized, placebo-controlled multi centre trial by Patki et al was conducted in 300 sub-fertile males (25-45 years) has explored the use of antioxidants with a proprietary formula of micronutrients, essential amino acids, antioxidants, and vitamins such as coenzyme Q10, L-carnitine, L-arginine, L-glutathione, vitamins like C, E, B6, B12, B1, A, D, ginseng extract, lycopene, folic acid along with elemental zinc, iron, copper selenium, manganese. Subjects were randomised in either the antioxidant blend treatment group or placebo group, assessed changes in sperm count, motility, normal morphology, semen volume, and percent DFI before and after treatment (90 days). Study results confirmed the well-researched fact of antioxidants being effective to reduce oxidative stress and thus improve sperm DNA integrity and also improved semen parameters in males aged 40 and above.

Furthermore, advancements in reproductive technologies, including intra cytoplasmic sperm injection (ICSI), have significantly enhanced fertilization rates, especially in cases where traditional IVF methods may not be successful 1, 3

Role of Varicocelectomy and Testicular Sperm Extraction 1,3

Conventional male reproductive surgeries, such as varicocelectomy and testicular sperm extraction (TESE), have been studied to broaden their indications for addressing male factor infertility. Varicocelectomy, in particular, has shown improvements in semen parameters, including sperm concentration and motility, following repair 12

Infertility Evaluation & counselling. 3

The American Urological Association (AUA) and American Society for Reproductive Medicine (ASRM) have provided guidelines for the diagnosis and treatment of male infertility, emphasizing the importance of a thorough evaluation to identify potentially treatable causes 3. Moreover, male infertility risk factors, reproductive history, and medical interventions that may impact fertility should be carefully assessed during the evaluation process 3. ASRM/AUA guidelines recommend Clinicians should advise couples with advanced paternal age (≥40) that there is an increased risk of adverse health outcomes for their offsprings. 8

Future Directions and Considerations

Efforts to understand the molecular and genetic factors responsible for spermatogenesis and fertilization are ongoing, offering the potential for improved outcomes in male factor infertility 1,3 . Additionally, the use of assisted reproductive technologies, such as intrauterine insemination (IUI) and in vitro fertilization (IVF), remains crucial in overcoming various causes of idiopathic infertility 3, 4

In conclusion, recent advances in male infertility research have provided valuable insights into the causes and potential treatments for this prevalent condition. By focusing on genetic variations, oxidative stress, and innovative treatment approaches, researchers aim to improve fertility outcomes for affected individuals. 

REFERENCES

  1. Boivin J, et al. “International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care.” Hum Reprod. 2007.
  2. Nature ,Vol 621 14 September 2023.
  3. Smits RM, et al. “Antioxidants for male subfertility.” Cochrane Database Syst Rev. 2019.
  4. Schlegel PN, et al. “Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II.” Fertil Steril. 2021.
  5. Human Reproduction Update, Volume 23, Issue 6, November-December 2017,
  6. Human Reproduction Update, Volume 29, Issue 2, March-April 2023
  7. Transl Clin Pharmacol. 2023 Mar;31(1):28-39
  8. https://www.auanet.org/documents/Guidelines/PDF/Male-Infertility-Guideline.pdf

Mental health for men

Mental health is an important aspect of overall wellbeing, yet it is often overlooked, particularly among men. Men are often expected to be tough, stoic, and unemotional, which can make it difficult for them to seek help when they are struggling with mental health issues. In this article, we will explore the unique challenges that men face in regards to mental health and offer tips and resources for coping with stress, anxiety, and depression.

Challenges Men Face

There are several challenges that men face when it comes to mental health. One of the main challenges is societal expectations. Men are often expected to be strong and not show weakness, which can make it difficult for them to seek help when they are struggling with mental health issues. Men may also feel like they are not supposed to talk about their feelings or emotions, which can lead to feelings of isolation and loneliness.

Another challenge that men face is the stigma surrounding mental health. Many men may feel ashamed or embarrassed to admit that they are struggling with mental health issues, as there is often a perception that mental health problems are a sign of weakness or inadequacy. This stigma can prevent men from seeking help and can exacerbate their symptoms.

Tips for Coping with Mental Health Issues

If you are a man who is struggling with mental health issues, it is important to know that you are not alone and that there are resources available to help you. Here are some tips for coping with mental health issues:

Talk to someone: It can be difficult to talk about your feelings and emotions, but it is important to remember that you don’t have to go through this alone. Talking to a friend, family member, or mental health professional can help you to process your feelings and get the support you need.

Practice self-care: Taking care of yourself is an important part of maintaining good mental health. This can include getting regular exercise, eating a healthy diet, getting enough sleep, and engaging in activities that you enjoy.

Seek professional help: If you are struggling with mental health issues, it is important to seek professional help. A mental health professional can provide you with the tools and support you need to manage your symptoms and improve your mental health.

Connect with others: Connecting with others who are going through similar experiences can be a great way to get support and feel less alone. Consider joining a support group or reaching out to a mental health organization for resources.

Resources for Men’s Mental Health

There are many resources available to help men who are struggling with mental health issues. Here are some organizations and resources that you may find helpful:

Movember: Movember is an organization that focuses on men’s health issues, including mental health. They provide resources and support for men who are struggling with mental health issues.

HeadsUpGuys: HeadsUpGuys is a website that provides resources and support for men who are struggling with depression. They offer information about symptoms, treatment options, and coping strategies.

The Samaritans: The Samaritans is a mental health organization that provides support and resources for people who are struggling with mental health issues. They offer a helpline that you can call if you need support.

Men’s Health Forum: The Men’s Health Forum is an organization that focuses on men’s health issues, including mental health. They provide resources and support for men who are struggling with mental health issues.

In conclusion, mental health is an important aspect of overall wellbeing, and it is important for men to prioritize their mental health. If you are struggling with mental health issues, it is important to know that you are not alone and that there are resources available to help you. By talking to someone, practicing self- care, seeking professional help and connecting with others, men can take steps towards improving their mental health and overall wellbeing. It is important to remember that seeking help is a sign of strength, not weakness, and that taking care of your mental health is just as important as taking care of your physical health.

REFERENCES

Maintaining a healthy lifestyle

Maintaining a healthy lifestyle is essential for everyone, regardless of gender. However, men often neglect their health, leading to several health problems. Healthy habits like regular exercise, healthy eating, stress management, and preventative health measures like regular check-ups and screenings can help prevent many health issues in men. In this article, we will discuss these healthy habits and the benefits of preventative health measures under men’s health.

Regular Exercise:

Regular exercise is crucial for maintaining good health. It not only helps to keep the body fit but also reduces the risk of various health conditions such as heart disease, diabetes, and obesity. Men should aim for at least 30 minutes of moderate-intensity exercise most days of the week. Some good options include brisk walking, jogging, cycling, swimming, and weightlifting. Exercise can also help to relieve stress and improve mental health.

Healthy Eating:

A healthy diet is crucial for maintaining good health. Men should aim to eat a balanced diet that includes plenty of fruits, vegetables, whole grains, lean protein, and healthy fats. It is also essential to limit the intake of processed foods, sugary drinks, and alcohol. Men should aim to drink at least 8-10 glasses of water a day to stay hydrated. A healthy diet can help to maintain a healthy weight and reduce the risk of various health conditions, including heart disease, high blood pressure, and type 2 diabetes.

Stress Management:

Stress is a part of life, but prolonged stress can lead to various health problems. Men should aim to manage their stress levels by practicing relaxation techniques such as deep breathing, meditation, and yoga. Regular exercise and a healthy diet can also help to reduce stress levels. It is also essential to prioritize self-care activities such as spending time with loved ones, pursuing hobbies, and taking breaks when needed.

Preventative Health Measures:

Preventative health measures such as regular check-ups and screenings are essential for maintaining good health. Men should aim to schedule regular check- ups with their healthcare provider, even if they feel healthy. These check-ups can help to detect health problems early, when they are more treatable. Men should also discuss their family health history with their healthcare provider, as certain conditions may be more common in some families.

Screenings such as blood pressure checks, cholesterol tests, and prostate cancer screenings are also essential for maintaining good health. Men should discuss the appropriate screening schedule with their healthcare provider based on their age, family history, and other risk factors.

Benefits of Maintaining a Healthy Lifestyle:

Maintaining a healthy lifestyle can have numerous benefits for men. It can help to prevent various health conditions, improve mental health, and increase longevity. It can also help to boost energy levels, improve sleep quality, and enhance overall quality of life. By making healthy choices, men can not only improve their own health but also set a positive example for their families and communities.

Maintaining a healthy lifestyle is essential for men to lead a long and healthy life. Regular exercise, healthy eating, stress management, and preventative health measures can help prevent various health conditions and improve overall health. By making small changes to their lifestyle, men can improve their health and set a positive example for others. Men should prioritize their health and well-being by making healthy choices and scheduling regular check-ups and screenings with their healthcare provider.

Common men’s health issues

Men’s health issues have gained increasing attention in recent years, with more research focused on conditions that disproportionately affect men. Prostate cancer, erectile dysfunction, and male pattern baldness are among the most common men’s health issues. In this article, we will discuss the causes, symptoms, and treatments for these conditions, as well as recent research findings related to men’s health.

Prostate Cancer

Prostate cancer is the most common cancer in men, with over 191,000 new cases diagnosed in the United States each year. The prostate is a small gland located near the bladder and is responsible for producing seminal fluid.

Causes: The exact cause of prostate cancer is unknown, but age, family history, and race are all risk factors. Men over the age of 50 are at an increased risk for developing prostate cancer, and African American men have a higher incidence rate compared to men of other races.

Symptoms: Early stage prostate cancer may not produce any symptoms. As the cancer grows, common symptoms can include difficulty urinating, frequent urination, and blood in the urine.

Treatment: Treatment options for prostate cancer include surgery, radiation therapy, chemotherapy, and hormone therapy. The best course of treatment will depend on the stage and severity of the cancer.

Erectile Dysfunction

Erectile dysfunction (ED) is a common condition that affects men of all ages. ED is defined as the inability to achieve or maintain an erection sufficient for sexual intercourse.

Causes: The causes of ED can vary, but common risk factors include age, diabetes, high blood pressure, and cardiovascular disease. Lifestyle factors such as smoking and excessive alcohol consumption can also increase the risk of ED.

Symptoms: The primary symptom of ED is the inability to achieve or maintain an erection. Other symptoms may include decreased sexual desire or difficulty achieving orgasm.

Treatment: Treatment options for ED include oral medications, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), as well as vacuum devices and penile injections. In severe cases, surgery may be recommended.

Male Pattern Baldness

Male pattern baldness is a common condition that affects up to 70% of men by the age of 70. It is characterized by hair loss on the top of the head and a receding hairline.

Causes: The exact cause of male pattern baldness is unknown, but genetics and hormones are thought to play a role. Testosterone, the primary male hormone, is converted into dihydrotestosterone (DHT), which can cause hair follicles to shrink and eventually stop producing hair.

Symptoms: The primary symptom of male pattern baldness is hair loss on the top of the head and a receding hairline.

Treatment: Treatment options for male pattern baldness include medications such as minoxidil (Rogaine) and finasteride (Propecia), as well as hair transplant surgery. Lifestyle changes such as reducing stress and improving diet and exercise habits may also help to prevent or slow down hair loss.

Recent Research Findings

Recent research has provided valuable insights into the causes and treatments of common men’s health issues. Some of the recent findings related to these conditions include:

Exercise may lower the risk of prostate cancer – According to a study published in the Journal of Urology, regular exercise may help to lower the risk of developing prostate cancer.

Cognitive behavioral therapy may help treat ED – According to a study published in the Journal of Sexual Medicine, cognitive behavioral therapy may be an effective treatment for ED in men who do not respond to medication.

Platelet-rich plasma therapy may help treat male pattern baldness – According to a study published in the Journal of Cutaneous and Aesthetic Surgery, platelet-rich plasma therapy may be an effective treatment for male pattern baldness by promoting hair growth nd thickening existing hair.

New targeted therapies for prostate cancer – Recent research has led to the development of new targeted therapies for prostate cancer, including immunotherapy and gene therapy, which show promising results in clinical trials.

Advanced imaging techniques for prostate cancer diagnosis – Advanced imaging techniques such as multiparametric magnetic resonance imaging (mpMRI) and positron emission tomography (PET) scans are being used to improve the accuracy of prostate cancer diagnosis and guide treatment decisions.

In conclusion, men’s health issues such as prostate cancer, erectile dysfunction, and male pattern baldness are common conditions that can significantly impact a man’s quality of life. While there is still much to be learned about the causes and treatments of these conditions, recent research has provided valuable insights that may help to improve diagnosis, treatment, and prevention. By staying informed and taking proactive steps to maintain good health, men can reduce their risk of developing these conditions and ensure a healthy and happy life.

REFERENCES

  • American Cancer Society. (2021). Key Statistics for Prostate Cancer. Retrieved from https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html
  • Mayo Clinic. (2021). Erectile Dysfunction. Retrieved from https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms- causes/syc-20355776
  • American Hair Loss Association. (2021). Men’s Hair Loss. Retrieved from https://www.americanhairloss.org/men_hair_loss/
  • Rieken, M., Kluth, L. A., Xylinas, E., et al. (2016). Association of diabetes mellitus and hypertension with the risk of prostate cancer detection in a biopsy-naive screening cohort of men: results from the prostate cancer prevention trial. BJU International, 118(3), 460-467.
  • Wilt, T. J., Brawer, M. K., Barry, M. J., et al. (2013). The Prostate Cancer Intervention Versus Observation Trial: VA/NCI/AHRQ Cooperative Studies Program #407 (PIVOT): design and baseline results of a randomized controlled trial comparing radical prostatectomy to watchful waiting for men with clinically localized prostate cancer. Contemporary Clinical Trials, 36(1), 63-81.
  • McVary, K. T. (2013). Erectile Dysfunction. The New England Journal of Medicine, 369(24), 2379-2387.
  • Valente, D. S., Tizziani, V. A., Borges, M. C., et al. (2019). Cognitive behavioral therapy versus tadalafil 5 mg daily for the treatment of erectile dysfunction: a randomized pilot study. The Journal of Sexual Medicine, 16(11), 1803-1811.
  • Dhurat, R., Sukesh, M., Avhad, G., et al. (2014). A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. International Journal of Trichology, 6(1), 6-11.
  • Goren, A., Shapiro, J., Roberts, J., et al. (2015). Clinical utility and validity of minoxidil response testing in androgenetic alopecia. Dermatologic Therapy, 28(1), 13-16.
  • Høyer, S., Kjær, A., Kristensen, H., et al. (2016). Advanced imaging techniques for prostate cancer: magnetic resonance imaging and positron emission tomography/computed tomography. Current Opinion in Urology, 26(5), 449-455.
  • Higano, C. S. (2018). Understanding treatments for bone loss and prostate cancer: role of denosumab. Urologic Oncology, 36(6), 313-321.
  • Anandappa, G., Jones, A., Scott, K., et al. (2020). Development of a genetically engineered vaccinia virus for prostate cancer gene therapy. Journal of Medical Virology, 92(5), 565-576.

Sexual health for men

Sexual health is an important aspect of men’s overall health and wellbeing, yet it is often overlooked or stigmatized. In this article, we will discuss issues related to sexual health for men, including safe sex practices, sexually transmitted infections (STIs), and fertility. We will also explore recent research findings in these areas.

Safe Sex Practices

Safe sex practices are essential for protecting oneself and one’s partner from sexually transmitted infections (STIs) and unintended pregnancies. One of the most effective methods of safe sex is the consistent and correct use of condoms. Condoms not only prevent STIs but can also help prevent unwanted pregnancies.

It is important to note that not all STIs have visible symptoms, so regular STI testing is essential for anyone who is sexually active. Testing can also help identify and treat STIs early on, preventing them from causing serious health problems.

Sexually Transmitted Infections (STIs)

STIs are infections that are spread through sexual contact. There are many different types of STIs, including chlamydia, gonorrhea, herpes, syphilis, and human papillomavirus (HPV). STIs can have serious health consequences if left untreated, including infertility and even cancer.

Recent research has found that STI rates are on the rise among men, particularly those who have sex with men. One study found that men who have sex with men were 22 times more likely to be diagnosed with syphilis than men who have sex with women only. Another study found that young men aged 15-24 had the highest rates of chlamydia and gonorrhea.

Fertility

Fertility is another important aspect of men’s sexual health. Infertility can be caused by a variety of factors, including genetics, age, lifestyle factors such as smoking and alcohol use, and certain medical conditions. Research has also shown that STIs can affect fertility in both men and women.

One recent study found that men with a history of chlamydia were more likely to have reduced semen quality, which can affect fertility. Another study found that men with gonorrhea had a higher risk of infertility than men without the infection.

Resources for Sexual Health

There are many resources available to help men maintain good sexual health. Here are some organizations and resources that you may find helpful:

Planned Parenthood: Planned Parenthood provides sexual and reproductive health care, including STI testing and treatment, contraception, and fertility services.

CDC: The Centers for Disease Control and Prevention (CDC) provides information about sexual health, including safe sex practices and STI testing.

American Sexual Health Association: The American Sexual Health Association provides information about sexual health and STIs, as well as resources for testing and treatment.

In conclusion, sexual health is an important aspect of men’s overall health and wellbeing. Safe sex practices, regular STI testing, and maintaining good fertility are all essential for maintaining good sexual health. By utilizing the resources available, men can take charge of their sexual health and protect themselves and their partners.

REFERENCES

  • Centers for Disease Control and Prevention. (2021). Sexual Health. https://www.cdc.gov/sexualhealth/index.html
  • Glick, S. N., Morris, M., Foxman, B., Aral, S. O., & Manhart, L. E. (2012). Association between sex partner change among men who have sex with men and higher incidence of sexually transmitted infections: A systematic review and meta-analysis. Sexually Transmitted Diseases, 39(4), 274-281.
  • Petersen, E. E., Kent, C. K., Montoya, J. A., & Klausner, J. D. (2007). Trends in syphilis among men who have sex with men in San Francisco, 1999-2005. Sexually Transmitted Diseases, 34(11), 836-839.
  • Satterwhite, C. L., Torrone, E., Meites, E., Dunne, E. F., Mahajan, R., Ocfemia, M. C., & Weinstock, H. (2013). Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2008. Sexually Transmitted Diseases, 40(3), 187-193.
  • The American Sexual Health Association. (2021). About ASHA. https://www.ashasexualhealth.org/about-asha/
  • Tu, W., Gao, L., Jing, J., Hu, T., Lei, H., & Li, X. (2013). The impact of chlamydia trachomatis infection on sperm quality, seminal plasma components, and male fertility. Spermatogenesis, 3(3), e25146.
  • Yin, Y. P., Chen, S. C., Wang, H. C., Huang, W. L., Li, H. P., & Chen, X. S. (2013). Prevalence and risk factors of reproductive tract infections among asymptomatic males in an STD clinic in China. The Journal of Sexual Medicine, 10(3), 839-846.

Aging and men’s health

As men age, they face a variety of physical and mental health challenges that can impact their quality of life. In this article, we will address some of the common issues that men may face as they age, including mobility limitations, cognitive decline, and chronic disease management. We will also explore recent research findings in these areas.

Mobility Limitations

Mobility limitations are a common challenge that many older men face. Age- related changes in the body, such as decreased muscle mass and strength, can lead to difficulties with balance, coordination, and mobility. These changes can increase the risk of falls and injuries, which can have a significant impact on overall health and wellbeing.

Recent research has found that regular exercise can help improve mobility in older men. One study found that a structured exercise program can help improve muscle strength, balance, and gait speed in older men, reducing the risk of falls and improving overall mobility.

Cognitive Decline

Cognitive decline is another common challenge that many older men face. As we age, changes in the brain can lead to difficulties with memory, attention, and decision-making. These changes can impact daily life and make it difficult to maintain independence.

Recent research has found that regular physical activity can help improve cognitive function in older men. One study found that older men who engaged in regular physical activity had better cognitive function than those who were sedentary. Other studies have found that engaging in mentally stimulating activities, such as reading or puzzles, can also help improve cognitive function in older adults.

Chronic Disease Management

As men age, they are at an increased risk for chronic diseases such as diabetes, heart disease, and cancer. These conditions can have a significant impact on overall health and wellbeing, and managing them effectively is essential for maintaining a good quality of life.

Recent research has found that lifestyle changes, such as maintaining a healthy diet and engaging in regular exercise, can help prevent and manage chronic diseases in older men. One study found that men who followed a healthy lifestyle, including regular exercise and a healthy diet, had a lower risk of developing chronic diseases such as heart disease and diabetes.

Resources for Aging Men’s Health

There are many resources available to help older men maintain good physical and mental health. Here are some organizations and resources that you may find helpful:

National Institute on Aging: The National Institute on Aging provides information and resources on healthy aging, including tips for maintaining physical and mental health.

AARP: AARP provides resources and support for older adults, including information on health and wellness, caregiving, and financial planning.

Eldercare Locator: The Eldercare Locator can connect older adults and their caregivers with local resources, including health care providers and support services.

In conclusion, aging can present a variety of physical and mental health challenges for men. By staying active, engaging in mentally stimulating activities, and managing chronic diseases effectively, older men can maintain good health and wellbeing. By utilizing the resources available, men can take charge of their health and enjoy a good quality of life as they age.

It’s important to note that men may also face unique challenges when it comes to aging and mental health. For example, older men may be more likely to experience social isolation, which can lead to depression and other mental health issues. It’s important for men to maintain social connections as they age, whether through friends, family, or community organizations.

Additionally, men may be less likely to seek help for mental health issues than women. This can be due to social stigmas surrounding mental health, as well as the belief that seeking help is a sign of weakness. It’s important for men to understand that seeking help is a sign of strength and can lead to improved mental health and overall wellbeing.

In conclusion, addressing the physical and mental health challenges that men may face as they age is crucial for maintaining a good quality of life. Regular exercise, engaging in mentally stimulating activities, and managing chronic diseases effectively can all help to improve health and wellbeing in older men. By utilizing the resources available and seeking help when needed, men can take charge of their health and enjoy their golden years to the fullest.