Gender and its Impact on Men’s Health

2nd Year Sex, Gender and Medicine Seminar

Rob McLachlanRob McLachlanDeputy Director of EndocrinologyDeputy Director of Endocrinology

Monash Medical CentreMonash Medical Centre

AustraliaAustralia

Since mid-1980s, gender-based inequalities in health of women have been acknowledged by policy makers and health service planners

Only in recent years that inequalities in health outcomes for men have received attention

Gender differences in healthGender differences in health

Gender Health perspective – where are the men?

Andrology = the study of health matters that Andrology = the study of health matters that relate to being male – relate to being male –

Reproductive Reproductive

Non-reproductiveNon-reproductive CVS diseaseCVS disease lifestyle/behaviours lifestyle/behaviours

Limited prevalence men’s reproductive health data available (AIHW report: Reproductive Health Indicators in Australia, 2002)

Men’s health policy at State level is variable

Government policyGovernment policy

Consequences Limited community awarenessLimited community awareness

Limited GP access - availability of ‘Well Men’s’ Limited GP access - availability of ‘Well Men’s’ approach cw womenapproach cw women

Doctors are male- healthy or otherwiseDoctors are male- healthy or otherwise Patients are male – single or partneredPatients are male – single or partnered

Vulnerable to exploitative commercial ‘Men’s Vulnerable to exploitative commercial ‘Men’s Health’ clinicsHealth’ clinics

What is the formal status of andrology at the governmental, or educational level?

Andrology Australia – funded by Andrology Australia – funded by Communicable Communicable Disease and Health Protection Branch of Dept Health Disease and Health Protection Branch of Dept Health (in the HIV/Hepatitis section). What the……??(in the HIV/Hepatitis section). What the……??

World Health Organization – Gender = womenWorld Health Organization – Gender = women

Only one Prof. of Andrology in AustraliaOnly one Prof. of Andrology in Australia

No specific Australia curricula in andrology - teaching No specific Australia curricula in andrology - teaching fragmented between urology, internal medicine fragmented between urology, internal medicine endocrinology and O&Gendocrinology and O&G

Men use health services at a lower rate

Men experience higher rates of CVS and cancer

Men die 5 years earlier than women

Men experience higher rates of accidents and injuries, including suicide

Gender differences in healthGender differences in health**

A variety of risk behaviours contribute to poorer A variety of risk behaviours contribute to poorer health statushealth status

Reproductive disorders are common

prevalence with age

Significantly effect quality of life

Does Society educate and ‘allow’ boys and men to seek help?

Are medical staff ready to listen?

Do doctors feel comfortable with issues?

Male health issuesMale health issues

Approx. 50% of Australian men may experience some type of prostate problem at some stage of their life

Prostate diseases:- Benign enlargement - Prostatitis (inflammation of the prostate)- Cancer (10,055 new cases and 2,644 deaths

recorded, AIHW 1997)

Compare community-medical recognition with that of female breast disease

Prostate diseaseProstate disease

One in 200 men under 60 years

Klinefelter’s syndrome 1:650 males – 75% escape diagnosis lifelong

– diagnosis 10 seconds

- effects of this neglect

?Education of boys/men

?Education and willingness of doctors to assess

Androgen DeficiencyAndrogen Deficiency

The inability to achieve and/or maintain an erection that allows sexual intercourse.

About 30% of men over age 50 have erectile dysfunction (impotence)

Marker of underlying heart disease and diabetes

Effects quality of life and relationships

Why is ED hilarious - ? fear ?embarrassment

Erectile DysfunctionErectile Dysfunction

In Australia 550 new cases annually

Peak ages of 18 and 39 years, it is the second most common cancer in Australia

Why do some men present late with obvious mass?

Testicular CancerTesticular Cancer

Affects about one man in 20

40% of infertile couples using IVF

Infertility major stress

Fertility = virility

Anger- guilt – relationships - coping

Male InfertilityMale Infertility

Andrology Australia (Australian Centre of Excellence in Male Reproductive

Health) aims to enhance the reproductive health of males by

programs focusing on community and professional education and research

For more information visitwww.andrologyaustralia.org