In many societies, the traditional stereotypes of masculinity, such as self-sufficiency, rigid gender roles, hypersexuality, aggression and control have become less prominent over time. Unfortunately, some of these notions persist and have led to a large barrier for men receiving the medical care and attention that they need. There is a general, remarkable disconnect between men and our health care systems. A 2012 World Heath Association study showed that men are more likely to die younger than women in every country surveyed (Weiner, Salib, 2020). A national poll completed by the Cleveland Clinic shows that over 70% of men would “rather do household chores, like cleaning the bathroom or mowing the lawn, than go to the doctor” and that “20 percent of men admit they have not been completely honest with their doctor before” (Cleveland Clinic, 2019)
Men’s health is a relatively new focus and historically has gotten very minimal attention. Increasing numbers of providers are focusing on creating practices that promote men’s health, but the definition of a men’s clinic continues to evolve over time (Houman, Eleswarapu, Mills, 2020).
https://us.movember.com/mens-health%20
Barriers to Treatment
Many conditions treated at a traditional men’s clinic are ones that individuals might not feel comfortable discussing with their primary care physician. Sometimes, these conditions carry stigma, such as weakness or helplessness, and individuals might try to ignore the problems rather
than seek treatment. Studies show that men are more likely to have lower levels of health literacy than women and are less likely to acknowledge illness and to seek treatment when ill (Key data: Understanding of health and access to services).
Common Conditions Treated
Men’s clinics provide men with care that could be compared to that of a gynecologist for women. Typical issues of focus include but are not limited to male hypogonadism (also known as low testosterone), enlarged prostate, prostate cancer, and erectile dysfunction,
Erectile Dysfunction
Erectile dysfunction is defined as “the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse” and is estimated to impact more than 20 million American individuals (Maher, Abdulaziz, Ayman, et al). Erectile dysfunction impairs many aspects of the lives of those experiencing it, including sexual performance, personal relationships, and self -esteem. Erectile dysfunction becomes more prevalent with age and is often caused by “organic factors or diseases, such as pelvic vascular disease, diabetes mellitus, neurodegenerative disorders, side effects of medication, pelvic surgery, and trauma” (Padma-Nathan, Hellstrom, Kaiser, et al).
Treatments for ED can include, but are not limited to:
• Lifestyle modifications
• Oral medications
• Injected vasodilator agents
• Vacuum erection devices
(Yafi, Jenkins, Albersen, et al. 2016)
Male Hypogonadism (Low Testosterone)
Male hypogonadism refers to a condition in which an individual does not produce ample testosterone, the male sex hormone. Other names for this condition include Testosterone deficiency syndrome, Testosterone deficiency, Primary hypogonadism, Secondary hypogonadism, Hypergonadotropic hypogonadism, and Hypogonadotropic hypogonadism. Symptoms of this condition can include reduced sex drive, erectile dysfunction, loss of armpit/pubic hair, shrinking testicles, hot flashes, low/zero sperm count, depressed mood, concentration/memory difficulties, increased body fat, enlarged breast tissue, as well as decrease in muscle strength and endurance. Testosterone levels decrease naturally over time for individuals assigned male at birth, but the American Urological Association considers any level under 300 nanograms per deciliter as hypogonadism. After the age of approximately 30, an individual’s testosterone level decreases by 10-15% each decade (Cleveland Clinic, 2019).
Enlarged Prostate (BPH: Benign prostatic hyperplasia)
Approximately 90% of men will experience enlargement of the prostate gland by the age of 85. This condition is progressive and can lead to long-term complications “eg, acute urinary retention [AUR], need for enlarged prostate-related surgery” (Naslund, Miner, 2007). There are various treatment options that are available for this condition, and the most effective choice depends on age, overall health, seriousness of symptoms, and size of prostate. Some treatment options include:
Self Care
For more mild symptoms, taking steps such as avoiding caffeine and alcohol, urinating on a schedule, reducing stress, and exercising regularly can help to minimize symptoms
Medications
Medications such as Alpha-1 blockers, finasteride, dutasteride are used to control symptoms of BPH.
Surgery
When to Visit a Men’s Clinic
Individuals experiencing any of the following symptoms could benefit from seeking treatment at a men’s clinic.
- Low sex drive
- Sparse facial and body hair
- Erectile dysfunction
- Fatigue, poor energy level
- Decrease in muscle mass
- Concentration issues
- Depressed mood
- Low sense of well being
- Low sperm count
- Increase in body fat
What to Expect at your First Visit
1. Questions
During an initial assessment at a men’s clinic, you can expect your provider to ask questions about any current symptoms you are experiencing, past medical
problems, your family history, sexual history, and any current medications.
2. Physical Exam
Your provider will take vitals like blood pressure, heart rate, temperature, and heart rhythms and additionally monitor for visible indicators of disease.
3. Tests and Panels
Before your provider can begin treatment, they will order labs which would likely include checking baseline testosterone levels, estrogen levels, FSH, LH as well as
routine labs including a Comprehensive Metabolic Panel and Complete Blood Count. These lab results will aid your clinician in making treatment decisions.
4. Treatment and Medication Advice
Your provider will work with you to create a collaborative treatment plan where you will be an equal participant in making treatment decisions that are most effective for you.
Cleveland Clinic. (2019, September 4). Cleveland Clinic Survey: Men will do almost anything to avoid going to the doctor. https://newsroom.clevelandclinic.org/2019/09/04/cleveland-clinic-survey-men-will-do-almost-anything-toavoid-going-to-the-doctor
Houma n, J.J, Eleswa ra pu, S.V., Mills, J.N., Current a nd future trends in men’s health clinics . Transl Androl Urol. 2020, March 9.
Key data: Understanding of health and access to services. Men’s Health Forum. (2017, January 5). https://www.menshealthforum.org.uk/key-data-understanding-health-and-access-services#:~:text=%E2%80%8BHealth%20literacy
Maher S Moazin, Abdulaziz Baazeem, Ayman Al-Bakri, et al. Phosphodiesterase type 5 inhibitors as treatment for erectile dysfunction: a webinar-based poll unveiling perceptions of healthcare professionals. (2024) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2023-0155
Naslund. M, Miner. M. A review of the clinical efficacy and safety of 5a -reductase inhibitors for the enlarged prostate. Elsevier. 2007, January.
Padma-Nathan, H, Hellstrom, W, Kaiser, F, et al.,Treatment of Men with Erectile Dysfunction with Transurethral Alprostadil. The New England Journal of Medicine. 1997, January 2.
Weiner, P.R, Sa lib, A. Developing a men’s hea lth program. The Canadian Journal of Urology. 2020
Yafi, F., Jenkins, L., Albersen, M. et al. Erectile dysfunction. Nat Rev Dis Primers 2, 16003 (2016). https://doi.org/10.1038/nrdp.2016.3
