Time to Talk: Breaking the Silence on Men’s Health

by Men's Health | Oct 1, 2024 | Health

The doctor’s office is definitely not a place where we men like to spend our time. You’ll rather find us around a flickering fire, steak sizzling on the grill, sipping slowly on home-brewed beer. After all, we were taught to be rough and tough, bite our lips and wear the breadwinner badge with pride, right?

Vasectomies, erectile dysfunction, depression and prostates are definitely not topics for discussion! The Boks and the next hunting trip in the Bushveld are at the top of the conversation menu. However, this is where stereotypes and healthcare end up in a highly contested scrum.

Despite the fact that men on average die five years earlier than women, get sick at a younger age and have a greater risk of chronic diseases, research shows that up to 65% of men wait until the last minute to seek medical advice. According to the fairer sex, we are also the fussiest patients.

Ten Things To Consider

According to Johan Viljoen, Head of Stakeholder Engagement at Medihelp, preventive care is vital. “For men specifically, this includes, among other benefits, a blood sugar, blood pressure and cholesterol test; body mass index (BMI) measurement; tetanus, Pneumovax and flu vaccination; a bone mineral density test; a prostate examination; a consultation with a dietician; and back and neck treatment to prevent spinal surgery.”

Here are ten things men should pay attention to:

1. Excess Baggage

Excess weight increases your risk for diabetes, heart disease and stroke. BMI is commonly used to calculate body fat based on your height and weight, and is an indicator of whether you are overweight or at risk of developing obesity.

A BMI score of 18,5 to 24,9 indicates a healthy weight; between 25 and 29,9 indicates being overweight; and 30 or higher may indicate obesity. However, according to experts, BMI is not the be-all and end-all. The distribution of fat in the body is more important than the amount of excess baggage you carry.

For this reason, your waist circumference is often considered a better risk predictor than BMI. More fat around your waist is associated with a higher risk for cardiovascular disease, type 2 diabetes and cancer, among other things.

2. Curb Cholesterol

Experts recommend that men over the age of 35 have their cholesterol tested every five years. If you smoke, suffer from diabetes, have a BMI of more than 30, and have a family history of heart disease and stroke, you should visit the doctor’s office regularly from the age of 20.

A cholesterol test (a blood test that gives readings in milligrams per decilitre of blood or mg/dL) will show the following levels: high-density lipoprotein (HDL) or good cholesterol; low-density lipoprotein (LDL) or bad cholesterol; and triglycerides, a type of fat. High triglyceride levels are linked to metabolic syndrome, which increases your risk for heart disease, diabetes and stroke.

A healthy total cholesterol level is less than 200 mg/dL, and a triglyceride level below 150 mg/dL is considered normal.

3. Be the Boss of Your Blood Pressure

Blood pressure is the pressure your blood places on the walls of your arteries while your heart beats. Blood pressure readings have two numbers, for example 122/79 mm Hg (we pronounce it “122 over 79”). The description at the end stands for millimetres of mercury.

According to the South African Heart and Stroke Foundation, high blood pressure or hypertension is the cause of one in two strokes and two out of every five heart attacks in the country. One in three South Africans has high blood pressure.

If your blood pressure is within normal limits, you only need to have it tested every two years. Normal blood pressure is less than 120/80 mm Hg. Symptoms of high blood pressure include severe headaches, chest pain, dizziness, difficulty breathing, nausea and vomiting, blurred vision or other visual changes, anxiety, ringing in the ears, nosebleeds, and abnormal heartbeat.

4. Bittersweet Blood Sugar

Although anyone can develop diabetes, there are symptoms that are unique to men. These include erectile dysfunction, reduced muscle mass, genital thrush, frequent urination, fatigue, blurred vision, thirst and an increased appetite.

A blood sugar test measures the amount of glucose in a drop of blood and is done by pricking the finger. People without diabetes usually have 72 to 140 mg of glucose per decilitre (mg/dL) of blood. People with diabetes have a blood glucose or sugar level of about 80 to 180 mg/dL. A blood sugar test should form part of your routine doctor’s visits. If high or low blood sugar is measured, more frequent testing will be recommended.

We distinguish between hypoglycemia or low blood sugar (70 mg/dL or less) and hyperglycemia or high blood sugar (more than 180 mg/dL). Low blood sugar can lead to seizures and even a coma, and high blood sugar can lead to neuropathy (nerve damage) as well as heart, kidney, and eye diseases.

5. Skincare Not Just for Women

The South African sun is scorching and men tend to shy away from sunscreen and moisturiser. According to the South African Cancer Society, we have one of the highest rates of skin cancer (also called melanoma) in the world. Next to prostate, colorectal and lung cancer, it is the most common cancer in South African men.

Monthly self-examination is important to find any irregularities such as moles on your skin. Men should apply sunscreen to their face, neck, arms, lips and ears daily; replace their razor blade regularly; use a face wash that suits their skin type (sensitive, oily, dry, normal, or combination); and use a good moisturiser. It will help keep wrinkles and age spots at bay.

6. Cancer Champion

If you’re over 50 and haven’t been tested for colorectal cancer, now is the time. If you have a family history of this, you should be tested much earlier. Common symptoms include diarrhoea, constipation, blood in the stool, abdominal pain, unexplained weight loss, fatigue, and low iron levels.

A colonoscopy is painless and only takes about 15 to 20 minutes. This test can detect colon cancer early and precancerous growths can be removed before they become malignant.

7. Prostate Predicament

According to the National Cancer Registry, prostate cancer is the most common type of cancer in men. Although more cases of prostate cancer are diagnosed every year because more men get tested earlier and more often, this early testing, diagnosis, and treatment leads to a much lower death rate.

If the prospect of a digital rectal exam (the frightening finger test or DRE) makes you want to run for the hills, fear not. This is only one of the tests for prostate cancer. Others include:

Prostate-specific antigen (PSA) blood test: Blood is drawn and tested for PSA levels. PSA is a protein secreted by the prostate. High levels of PSA can indicate inflammation or enlargement of the prostate, benign growths, urinary tract infection, or cancer. A PSA of between 0 and 4 nanograms per millilitre (ng/ml) is considered normal, but a score of 2,5 in men in their forties, 3,5 in men in their fifties, and more than 4 in men in their sixties may indicate malignancy.
Biopsy: If abnormalities are found in the PSA score and/or DRE, a needle biopsy is done using a rectal sonar under local or general anaesthesia. The tissue is examined histologically and tested for possible cancer.
Other tests include a CT scan of the bowels and pelvis to determine the spread of the cancer (metastasis – spread through the blood) to other organs and/or an MRI scan of the skeleton to detect metastasis to the bones.

8. Vasectomy Worries

South Africa has a very low vasectomy rate with few men choosing this permanent contraceptive route. However, a vasectomy is a small operation of about 30 minutes, done in a urologist’s office or a day clinic. The patient can decide between general or local anaesthesia.

Although most men are back at work within a day and experience only moderate pain and swelling, any rolling in the hay should be put on ice for at least 7 days. Once the doctor has confirmed that your swimmers’ chance of Olympic gold is over, things can return to normal.

After a vasectomy, the body still produces semen, but without sperm. This should not affect your normal sexual functioning – you can still have an orgasm and ejaculate. However, a vasectomy does not protect you from sexually transmitted diseases.

9. Male Menopause (Excuse Me?)

Although the medical community is still reluctant to use the term “male menopause”, doctors believe that the physical and emotional changes in men in their late forties and early fifties extend far beyond just a decrease in testosterone (andropause) or a midlife crisis. The fact that male menopause is not used as a medical term does not mean that it doesn’t exist.

In addition to a decreased sex drive and erectile dysfunction, there are other symptoms that are common in men at this age, including:

Mood swings and irritability;
Loss of muscle mass and a reduced ability or desire to exercise;
Reduced bone density (which can lead to fractures);
Weight gain and the development of a “beer belly” or larger breasts;
A general lack of enthusiasm and energy;
Insomnia or fatigue; and
Poor concentration and short-term memory.

Testosterone replacement can help address hormone deficiency and alleviate symptoms. However, maintaining a healthy lifestyle is still the best starting point. This includes eating healthily, exercising regularly, getting enough sleep, and reducing your stress by making time for relaxation.

10. Mental Health

The lack of frank conversations about mental health and the stigma attached to it is a big concern, especially among men. For many men, anxiety and depression about everything from money matters to work pressure and health concerns are struggles they face in silence, often to the detriment of themselves and their loved ones.

According to the South African Association of Psychiatrists, South Africa ranks among the top ten countries with the highest suicide rates, with 23,5 suicides per 100 000 people. Of the 13 774 suicides reported in South Africa in 2019 (the latest available figure), 10 861 were men. According to the South African Depression and Anxiety Group, there are ten suicide attempts for every suicide case in South Africa.

Figures on depression and anxiety are scant because men either don’t want to talk about it or feel ashamed, and on the other hand because they feel they can handle it themselves, don’t want to be a burden, or don’t have the courage to speak to someone.

The only way to bring about change is to talk openly about this, ask for help and learn to spot the signs. Although professional help is critical in dealing with depression and anxiety, the following coping mechanisms may be of value in the short term:

Relaxation techniques: Visualisation, breathing exercises and meditation help you feel calmer and more relaxed.
Be active: Exercise is the best medicine thanks to the endorphins released by the brain. You don’t have to run a marathon, get some fresh air and walk around the block.
Limit alcohol intake: High-risk behaviour is often a symptom and a consequence of depression. Alcohol may seem like the ideal escape, but it’s a depressant that will only make you feel worse.
Friends and family: Interaction with friends and family can help alleviate feelings of loneliness. It is important to surround yourself with people who care for and love you. Find a confidant with whom you can share your true feelings without feeling judged.
Get creative: Take on something that challenges you, whether it’s a new hobby, learning to play an instrument or a new language – anything that stimulates your brain to form new neurological paths.
Take the leap: Do something you’ve always dreamed of. Travel to an exotic destination, bungee jump or start writing that book.

The fact that we men neglect our well-being deserves a red card. Let’s talk frankly for a change about everything from prostate exam fears to mental health. Come on Tiger, you owe it to yourself and your loved ones.

**MH Partnership