journal of men's health RSS feed: Current Issue. Journal of Men's Health is a comprehensive, accessible resource of knowledge directly applicable to the daily care of patients, offering key information and insight about men's health and gender medicine to other healthcare professionals, patient groups and policy makers. Topics covered include the fields of family medicine and primary care, urology and andrology, internal medicine and oncology, pediatric and adolescent health, sexual medicine, aging and geriatric medicine, nutrition and well being, preventive and sports medicine, mental health including psychosomatic and psychosocial medicine, public health, social medicine, gender medicine, and basic science. Peer reviewed research and reviews, best practice guidelines, literature overviews, educational materials including self-test CME, commentaries and debate, industry and product news will be published. Electronic usage: An increasing number of readers access the journal online via ScienceDirect, one of the world's most advanced web delivery systems for scientific, technical and medical information. Average monthly article downloads for this journal: 2,720* * Figure is an average based on full text articles downloaded monthly via ScienceDirect between August 2008 and March 2009 For more information on the journal please contact the Publisher, Chris Hammond or the Editor in Chief, Prof. Meryn . For other journal or Society information please contact the Secretariat, Helga Reiter . For sponsorship and advertising opportunities, please contact Sarah Cahill . For information on publishing supplements to the journal, please contact Magda Scheijgrond . Your comments and feedback are very welcome via jmh http://www.jmhjournal.org/?rss=yesElsevier Inc.en © 2009 Published by Elsevier Inc. All rights reserved. journal of men's health1875-686764December 2009 © 2009 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.jmhjournal.org/article/PIIS187568670900342X/abstract?rss=yesEditorial Board10.1016/S1875-6867(09)00342-Xjournal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9iiiiiihttp://www.jmhjournal.org/article/PIIS1875686709003443/abstract?rss=yesContents10.1016/S1875-6867(09)00344-3journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9277278http://www.jmhjournal.org/article/PIIS1875686709003601/abstract?rss=yes Siegfried MerynGleanings from the WCMH 2009Siegfried Meryn, Ridwan Shabsigh10.1016/j.jomh.2009.10.002journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Editor-in-Chief Editorial279282http://www.jmhjournal.org/article/PIIS1875686709003364/abstract?rss=yesISMH News10.1016/j.jomh.2009.10.001journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9ISMH News and Views283292http://www.jmhjournal.org/article/PIIS1875686709003303/abstract?rss=yesNews from the European Men's Health Forum10.1016/j.jomh.2009.09.030journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9EMHF News293294http://www.jmhjournal.org/article/PIIS1875686709002978/abstract?rss=yesIt is well documented that women are twice as likely to be diagnosed with major depression, yet there are still a significant number of men who suffer from the disorder, and there is evidence that the gap between women and men is narrowing . Although the symptom profile and eventual course of depression may be similar in both men and women, several authors have identified important masculine-specific modes of experiencing and expressing depression . Increasing acceptance of a masculine form of depression has compelled clinicians and researchers to devote greater attention to better understanding the factors that contribute to the illness and how to treat it. This editorial considers the role of loss and grief as contributing factors to depression among men, and the use of group therapy for treating depressed men.Grief and groups: Considerations for the treatment of depressed menJohn S. Ogrodniczuk, John L. Oliffe10.1016/j.jomh.2009.07.005journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Editorial295298http://www.jmhjournal.org/article/PIIS1875686709003339/abstract?rss=yesAbstract: Penile prosthetic surgery represents a valid option in the treatment of different penile diseases. There are several types of prostheses and we have witnessed remarkable developments since their commercialisation in the 1970s. Penile prostheses can be semi-rigid or inflatable. Semi-rigid prostheses can be malleable and mechanical, while inflatable prostheses may have two or three components.A penile prosthesis implant is recognised as a valid approach for treating those cases of erectile dysfunction (ED) where pharmacological agents have not proved useful. This treatment is also indicated in cases of penile fibrosis, priapism, Peyronie's disease and in phalloplasty for sex reassignment or demolition surgery.The implantation of a penile prosthesis is characterised by the relative ease of the surgical technique and by the speed of the procedure. The incision is usually performed at a penoscrotal or infrapubic level for inflatable prostheses, while semi-rigid cylinders are placed through a subcoronal or penoscrotal incision. The procedure is performed by a corporotomy of both sides and the subsequent insertion of the cylinders. The pump is inserted in the scrotum. If the procedure includes the insertion of a three piece prosthesis, then the reservoir is located in the Retzius space and then filled with 65ml or 100ml saline solution depending on its size. At the end of the procedure the surgeon inserts a drain in the scrotum, the wound is closed and the device is tested.The first month following surgery can be characterised by variable pain and oedema with spontaneous resolution in most cases. Several complications may occur including mechanical complications, infections and erosion of the cylinders.Penile prosthesis implants represent a valid and safe therapeutic option for achieving satisfactory sexual intercourse in those patients where other approaches have failed. Recent literature has shown that couples’ satisfaction with the use of a prosthesis can reach 97%.Penile prosthesis implant: when, what and howC. Bettocchi, F. Palumbo, M. Spilotros, G. Lucarelli, V.D. Ricapito, S. Palazzo, M. Battaglia, F.P. Selvaggi, P. Ditonno10.1016/j.jomh.2009.09.033journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Reviews299306http://www.jmhjournal.org/article/PIIS1875686709003352/abstract?rss=yesAbstract: Singapore is now considered to be a developed country. It also has one of the fastest aging populations in the world. Life expectancy at birth in 2007 was 78.2 years for men and 82.9 years for women. The aging population and change in disease patterns with a consequent increase in chronic diseases and disability present a challenge to the health system.The frequently observed disparity between statistics for men's and women's health is also seen in Singapore. Men die younger and suffer more illness. Diseases such as cancer, heart disease, cerebrovascular disease, sexually transmitted diseases and injuries are more commonly seen among men in the country. Mental health issues are also significant, with men having higher suicide rates than women. These conditions result in years of productive life lost. The results of the Singapore National Health Survey 2004 suggest that more men than women have unhealthy lifestyles which predispose them to chronic diseases.Healthcare policy in Singapore emphasizes building a healthy population through preventive healthcare programs and promoting a healthy lifestyle. The Health Promotion Board Singapore is a key driver of health promotion programs in the country. There are over 2000 primary healthcare clinics including 18 government subsidized ones. The uptake of these services and programs depends on men themselves. Traditional models of gender roles could influence the differing attitude of men and women to health with a consequent impact on differing health outcomes between men and women. Facilities providing healthcare and efforts to promote health among men have to consider this.An overview of the status of men's health in SingaporeSeng-Hin Teoh, Seng-Bin Ang, Bryan Y. Tan, Peter H. Lim, Carol Y. Tan10.1016/j.jomh.2009.07.008journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Reviews307316http://www.jmhjournal.org/article/PIIS1875686709003273/abstract?rss=yesAbstract: Background: This study sought to examine the association between the type and intensity of exercise as a lifestyle habit with sex steroid hormones, sexual activities, sleep parameters and aging in men.Methods: Exercise scores, sleep duration and sexual activities were evaluated through a self-administered questionnaire, while testosterone (T), sex hormone binding globulin (SHBG), estradiol (E2) and dehydroepiandrosterone sulfate (DHEAS) levels were measured using established immunoassay methods. Bioavailable T was calculated using Vermeulen's formula.Results: Moderately intense exercise as a lifestyle habit was significantly associated with higher coital frequency, higher sex hormone concentrations, and more men engaging in masturbation, but fewer men having problems falling asleep. While increasing the intensity of exercise did not alter the beneficial effects noted with moderately intense exercise on sex hormones, masturbation and falling asleep, it was significantly associated with decreased coital frequency.Conclusion: This study showed that moderately intense exercise as a lifestyle habit was associated with better sexual function, better ability to fall asleep and higher concentrations of sex hormones. These findings support the importance of promoting a lifestyle habit of exercise to mitigate the increased risks of having sexual and sleep dysfunctions as men age.The association of exercise with sleep, sex steroids, sexual activities and aging in Asian menVictor H.-H. Goh, Terry Y.Y. Tong10.1016/j.jomh.2009.07.007journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Original articles317324http://www.jmhjournal.org/article/PIIS1875686709003261/abstract?rss=yesAbstract: Background: Racial and ethnic minorities have lower cardiovascular disease (CVD) risk factor control and lower awareness of their CVD risk status despite being at higher risk for the disease. We sought to understand the reach and potential impact of delivering a CVD risk reduction program by Community Health Workers (CHW) in 15 Denver, Colorado barbershops.Methods: This mixed-methods study analyzed data from CVD screenings of 1674 barbershop clients and from semi-structured interviews with barbershop owners.Results: In 2 years, two CHWs screened a total of 1674 clients in barbershops for cardiovascular risk, nearly 80% of whom were African American. Screening results indicated that clients visiting barbershops are at risk for CVD and other health conditions. One third of clients had medium or high Framingham risk scores, one-quarter had mildly to severely high blood pressure, 45% had borderline high or high cholesterol, with 75% of clients considered overweight or obese according to BMI. Importantly, 41% of screened clients reported having no prior knowledge of their CVD risk before the screening. Barbershop owners reported many benefits of this screening program on their businesses, clients and personal health.Conclusions: Barbershops represent a promising venue for reaching primarily male, African American populations at risk for cardiovascular disease. © 2009 WPMH gmbH. Published by Elsevier Ireland Ltd.Cutting cardiovascular risk in barbershopsDeborah S. Main, Elizabeth M. Whitley, Pedro Arévalo Rincon, Joe McGloin, Mark A. Hocker, Stanley K. Thomas, Patti Iwasaki10.1016/j.jomh.2009.07.006journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Original articles325330http://www.jmhjournal.org/article/PIIS187568670900298X/abstract?rss=yesAbstract: Background: Research has shown that those men who are dissatisfied with their bodies will mask these concerns in sports practices. Accordingly, men's body dissatisfactions often go unrecognised because the practices drawn upon to conceal them are perceived as customary forms of public masculine behaviour. This paper examines whether a group of British Rugby Union men, aged 18–30 of varied ethnic origin, participating in a 1st XV Team at a British university, experience body anxieties and use rugby and health-related sports acts to overcome and conceal them. It moves away from some of the existing methods used in clinical and sociological research to examine men's body dissatisfactions as it combines collaborative visual research methods with conventional qualitative methods to examine these men's anxieties.Methods: Collaborative photography and in-depth photo-elicitation interviews were conducted with 10 men participating in an elite university Rugby Union team in the United Kingdom.Results: The rugby men expressed varying degrees of body anxiety and used the sport, and health-related practices, to conceal these concerns. Visual research methods combined with conventional qualitative methods made it easier for these men to verbalise their body anxieties in more intimate dimensions of the sport.Conclusions: These findings show that these men experience body anxieties, yet there are limited intimate dimensions for these men to express them in Rugby Union, without ramifications for their masculine identity and sports performance. More research is needed to examine these dimensions as they are significant for understanding rugby men's body anxieties and the impact their relationships with other rugby men have to these concerns. The implications are that visual research methods could be used in clinical research, assessment and treatment interventions, as they might assist in encouraging other sportsmen to express these concerns.“Get up, shut up and stop being a fanny”: Rugby Union men and their suppression of body anxietyNatalie Darko10.1016/j.jomh.2009.09.001journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Original articles331337http://www.jmhjournal.org/article/PIIS1875686709003297/abstract?rss=yesAbstract: Background: Over the years the involvement of the partner in the childbirth process has resulted in an increasing interest in the partner's role. Research into the partner's experiences is still limited. This study aimed to describe the experiences of fathers at the birth of their child from the father's perspective.Method: Sixteen fathers were interviewed about their experiences at the birth of their child between 8 days and 6 weeks after the birth. The interviews were analysed using a phenomenological approach.Results: The findings not only recount that the moment of birth was a life changing and overwhelming moment characterised by feelings of love and belonging, but go further in revealing the birth of a child as a movement from belonging to belonging through a blessed moment of love for a child.Conclusion: What this finding indicates is that the birth of a child is an important experience in the quality of life of men, calling for their participation at the birth of the child and for a strategy of leaving the family alone right after this outstanding life moment of a new birth.From belonging to belonging through a blessed moment of love for a child – the birth of a child from the fathers’ perspectiveKerstin Erlandsson, Helena Lindgren10.1016/j.jomh.2009.09.029journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Original articles338344http://www.jmhjournal.org/article/PIIS1875686709003285/abstract?rss=yesAbstract: Background: Prostate cancer (PCa) patients have elevated anxiety and depression, often showing impairments in decision-making and weakened relationships with their partner and family. Although treatment for these psychological side-effects of PCa is strongly recommended, relatively little is known of the causal processes underlying them. This study compared cancer-based lifestyle changes vs patient behavioural responses to cancer as predictors of anxiety and depression among PCa patients.Methods: PCa patients (381) were surveyed for their responses to standardised anxiety and depression questionnaires, plus a questionnaire designed to assess the kinds of lifestyle changes that had occurred to them and their responses to those changes.Results: Anxiety was most powerfully predicted by PCa-induced lifestyle changes but depression was most powerfully predicted by patient responses to those changes. Negative emotions, plus social withdrawal and worry were the underlying factors contributing most powerfully to combined anxiety–depression scores.Conclusion: PCa patient anxiety and depression may be instigated at different times and by different causal factors. In terms of possible treatment models, both supportive and action-based counselling strategies may be of benefit, but at different stages during the PCa patient's experiences of diagnosis and treatment.Helping prostate cancer patients understand the causes of anxiety and depression: comparing cancer-caused vs patient response eventsChristopher F. Sharpley, Vicki Bitsika, David R.H. Christie10.1016/j.jomh.2009.08.193journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Original articles345353http://www.jmhjournal.org/article/PIIS1875686709003327/abstract?rss=yesAbstract: Being engaged in life is associated with healthy aging. Various indicators of healthy aging, such as greater longevity, lower incidence of cardiovascular disease, higher levels of subjective well-being and/or reduced levels of depression are associated with higher overall activity levels in general, and more specifically with engagement in social and productive activities. Being physically active and/or engaging in regular exercise has also been positively related with indicators of healthy aging. Physical activity and exercise guidelines have been published for older adults, including frail adults over age 70. Older men can be encouraged to engage in exercise in various ways, including being provided with tangible information on available resources by the health care provider. Motivational interviewing, tailored to the provider–patient relationship, can be a useful tool for the provider to encourage the patient to recognize a need or opportunity for change and take steps to a more active and healthy life.Engagement in life activities promotes healthy aging in menMark W. Hoglund, Richard Sadovsky, Justin Classie10.1016/j.jomh.2009.09.032journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Healthy Aging in Men354365http://www.jmhjournal.org/article/PIIS1875686709002966/abstract?rss=yesAbstract: Increasing interest in the early diagnosis of urothelial carcinoma of the bladder (UCB) has led to a better understanding of bladder carcinogenesis and an explosion of new biomarkers for this disease. Current surveillance protocols after initial diagnosis include serial cystoscopy, which is invasive and expensive, and cytology, which has a low sensitivity and suffers from high variability. To date, the US Food and Drug Administration (FDA) has approved six urine-based biomarkers to complement cystoscopy in the monitoring of UCB patients. In addition, various promising tests are under investigation.In this review, we describe the rationale and address the most recent and relevant findings for the FDA-approved biomarkers (bladder tumor antigen (BTA) test, BTA stat, BTA TRAK, ImmunoCyt, NMP22, and UroVysion) and the most promising investigational biomarkers (urinary UCB test, BLCA-1, BLCA-4, hyaluronic acid, hyaluronidase, Lewis X antigen, microsatellite analysis, Quanticyt, soluble Fas, survivin, telomerase, and cytokeratin 20).Most of the comparative studies have shown that noninvasive biomarkers have equal or higher sensitivity for UCB detection than cytology, even in high-grade cancers. None of these tests, however, meets all of the criteria of an ideal tumor biomarker. For the investigational biomarkers, improved standardization and automation are still required, as well as prospective, large-scale assessment in heterogeneous patient populations. Moreover, despite the use of urine biomarkers in a variety of clinical situations, their role is not well defined at this time.Identifying an optimal marker that would replace, delay, or complement cystoscopy and/or cytology in the monitoring of patients with UCB is still ongoing. Urinary biomarkers may eventually be used to screen patients at high-risk, to help diagnose or even predict disease recurrence, and to decrease the need for invasive procedures.Critical review of biomarkers for the early detection and surveillance of bladder cancerDaher C. Chade, Shahrokh F. Shariat, Guilherme Godoy, Siegfried Meryn, Guido Dalbagni10.1016/j.jomh.2009.07.004journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Continuing Medical Education368382http://www.jmhjournal.org/article/PIIS1875686709003340/abstract?rss=yesAbstract: Recent research has addressed ways to identify and treat male patients who perpetrate intimate partner violence (IPV). This phenomenon refers to the person who causes violence or abuse to be inflicted on a victim. A case study will be presented to illustrate a male patient at-risk for IPV perpetration. The goals of this review are to (1) define the prevalence of male patients who perpetrate IPV, (2) describe the pathophysiology and etiologies associated with IPV perpetration, (3) list the methods to diagnose and evaluate male patients who perpetrate IPV, and (4) understand the treatments for IPV perpetration. To meet these objectives, a systematic review of medical and allied health databases was conducted to analyze the case study presented. The prevalence of male primary care and emergency medicine patients who perpetrate IPV is 7–41%. The most widely used measurement tool to detect male IPV perpetration is the Conflict Tactics Scale. Most studies of IPV perpetrators have focused on associations with demographic factors, prior history of violence, mental health diagnoses, and substance use disorders. An 8-question screening tool is available to diagnose IPV perpetration, and at-risk patients should be evaluated for concurrent mental health and substance abuse problems. The most appropriate current treatment for IPV perpetration is referral to a batterer intervention program. An algorithm is presented to address screening, assessment, intervention, and documentation. The review concludes with the case progression and resolution.Academic men's health: Case studies in clinical practice: Intimate partner violence perpetrationVijay Singh10.1016/j.jomh.2009.09.034journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Case Studies383392http://www.jmhjournal.org/article/PIIS1875686709003315/abstract?rss=yesEvents 2009/201010.1016/j.jomh.2009.09.031journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9Updates393395http://www.jmhjournal.org/article/PIIS1875686709003005/abstract?rss=yesThe European Men's Health Forum is launching the first International Policy Review which highlights how differences in health issues affecting men across the world vary and in policy responses by public health authorities. EU policy makers have embedded the mainstreaming of concerns for gender equity in all EU policy areas as a core governance principle but little provision has ever been made to address men's health issues specifically at this level. Growing pressure by national and European NGOs and the favourable attitude of several national governments are prompting the European Commission to order the first ever EU men's health report. Could this huge undertaking signal a change of position among EU executive circles?Men's health a new challenge for EU institutionsE. Savoye10.1016/j.jomh.2009.09.003journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts396396http://www.jmhjournal.org/article/PIIS1875686709003017/abstract?rss=yesTwo sexual medicine services in Sheffield share a common assessment process for men presenting with ED. Data has been collected over a ten year period with the total number of records currently 7,030. The majority of men were seen within a urology based service with around a fifth being assessed in a psychosexual service. Testosterone levels have been recorded in the database for 5,134 (73.03%) of these men – usually when the tests have been performed at the base site. Since 2005, the clinic protocol was modified to ensure that all patients with a first level of 12nmol/l and below have a second measure between 0800 and 1000.Testosterone levels in men with erectile dysfunction (ED) across two different service populations – a review of over 5,000 menK.R. Wylie, D. Davies-South, D. Steward, A.J. Bennett10.1016/j.jomh.2009.09.004journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts396396http://www.jmhjournal.org/article/PIIS1875686709003029/abstract?rss=yesBackground: Hypogonadism (HG) is a clinical disorder consisting of reduced testosterone (T) levels in addition to characteristic signs and symptoms of low T. Current instruments commonly used to assess HG in men lack adequate measurement properties. In this study, we present the quantitative validation of a new self-report instrument to identify male HG.The Hypogonadism Screener: Psychometric Validation in Male Patients and ControlsR.C. Rosen, A.B. Araujo, M.M. Miner, R. Shabsigh, A.D. Seftel, M.K. Connor, E. Gerstenberger10.1016/j.jomh.2009.09.005journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts396396http://www.jmhjournal.org/article/PIIS1875686709003030/abstract?rss=yesHypogonadism and, more specifically, late-onset hypogonadism (LOH) in men is recognized as a growing clinical concern in an increasingly ageing population. With advancing age, men experience a gradual reduction in circulating, biologically available testosterone , approximately 1% per year from as early as age 30 years. As men age, there is a decline in the function of many endocrine systems, with reductions in the secretion rate not only of testosterone, but also of adrenal androgen precursors such as dehydroepiandrosterone (DHEA), thyroid hormones, growth hormone, insulin like growth factor-I, renin, and angiotensin . Male age-related changes in testosterone – which have been described as the “andropause” or “testosterone deficiency” – are gradual and so more insidious compared with the menopause in women . The International Society for the Study of the Aging Male (ISSAM) has issued standards, guidelines, and recommendations for the investigation, treatment, and monitoring of LOH, and provides the following definition of the condition: “A biochemical syndrome associated with advancing age and characterized by a deficiency in serum androgen levels with or without a decreased genomic sensitivity to androgens.” .Epidemiology on HypogonadismC. Bettocchi10.1016/j.jomh.2009.09.006journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts396396http://www.jmhjournal.org/article/PIIS1875686709003042/abstract?rss=yesErectile dysfunction (ED) can occur after any treatment for prostate cancer. After radical prostatectomy (RP), ED may occur in 12-47% of patients depending upon patient age, comorbidities, preoperative ED and surgical technique. Following nerve injury, penile neuropraxia can result in corpus cavernosum smooth muscle dysfunction, fibrosis and an increase in veno-occlusive ED. The use of rehabilitation techniques after RP is widely used to treat this smooth muscle dysfunction, but remain controversial. Rehabilitation techniques include regular PDE 5 inhibitor, VED or vaso-active agent injection use. While regular PDE 5 inhibitor and vaso-active injections have shown promise, VED use is unlikely to increase return of normal function. Regular vacuum erection device (VED) use, however, may preserve post RP penile length. Return of natural erections may take up to 2-3 years with or without rehabilitation.Post Prostatectomy Erectile DysfunctionC.C. Culley10.1016/j.jomh.2009.09.007journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts397397http://www.jmhjournal.org/article/PIIS1875686709003054/abstract?rss=yesWhy is this discussion important? Because a link between testosterone deficiency and cardiovascular risk has been shown by a number of studies. The link begins with the association between low testosterone levels and a number of chronic illnesses. As it happens, a number of these chronic illnesses, especially diabetes, hypertension, hyperlipidemia and obesity have all been implicated with increased cardiac risk and cardiovascular events. The chronic illnesses listed above have been clustered together to form the metabolic syndrome, which has been shown to increase the risk of cardiovascular disease. The metabolic syndrome has also been associated with low testosterone levels in a number of studies, including long-term prospective epidemiological studies. We know that the core of metabolic syndrome is insulin resistance, and this too has been associated with hypogonadism. Even induced hypogonadism in men with recurrent prostate cancer has been associated with insulin resistance, which occurs rather rapidly. Other studies have also shown that after development of hypogonadism, insulin resistance occurs within a short time, excluding the possibility that the association is dependent on increased BMI or increase in fat mass. Conversely, correction of hypogonadism induces a rapid decrease in insulin resistance. Even women who have endothelial dysfunction, as manifested by female sexual dysfunction, have been found to have associated metabolic syndrome.Panel Discussion: Are men more prone to diabetes and metabolic syndrome? The link between testosterone deficiency and metabolic syndrome and insulin resistanceA.T. Guay10.1016/j.jomh.2009.09.008journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts397397http://www.jmhjournal.org/article/PIIS1875686709003066/abstract?rss=yesSeveral publications have shown clear associations between ED and CVD. The challenge has been to establish whether this is merely a matter of shared risk factors with endothelial dysfunction as the common denominator or whether early detection of ED can predict later development of CVD. This is important, as the shared risk factors can be treated effectively improving or even resolving the ED and at the same time reducing the risk of potentially fatal CVD events. This early detection of ED may be a highly cost effective measure as ED can be diagnosed with a simple question during a routine visit without the need for expensive investigations. The triad of ED, metabolic syndrome and hypogonadism are inexorably linked with cardiovascular risk. Early interventions with lifestyle modification or lipid management may also prove cost effective when compared with long term drugs for ED and CVD.ED as a predictor of CVD – The Scientific EvidenceG. Hackett10.1016/j.jomh.2009.09.009journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts397397http://www.jmhjournal.org/article/PIIS1875686709003078/abstract?rss=yesMany explanations have been offered to explain the gender differences in life expectancy seen across all nations and cultures. Current theories include; lifestyle (particularly alcohol), obesity, risky lifestyle, hormones (particularly testosterone and oestrogen) and treatment seeking behaviour. Significantly greater proportions of health budgets are spent on both treatment and prevention of disease in women leading to the criticism that modern health care delivery, particularly in primary care, is too female-orientated.Outcome differences in cardiovascular diseaseG. Hackett10.1016/j.jomh.2009.09.010journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts397397http://www.jmhjournal.org/article/PIIS187568670900308X/abstract?rss=yesIt has been known for several years that low testosterone levels are common in men with type 2 diabetes. It is only recently that testosterone replacement therapy (TRT) is being studied in more detail and considered more widely in this group. The benefits of TRT are not only confined to improvement in the classical symptoms of hypogonadism but also on metabolic and cardiovascular elements. Historically testosterone has been thought without significant clinical evidence to have adverse effects of the cardiovascular system.More than 8 years of experience in treating men with Type 2 Diabetes with TestosteroneT.H. Jones10.1016/j.jomh.2009.09.011journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts398398http://www.jmhjournal.org/article/PIIS1875686709003091/abstract?rss=yesObesity is the well-known cause of cardiovascular complications and high mortality in men. The majority of obese men have hypogonadism. The benefit of testosterone therapy in obesity treatment of hypogonadal men is known but it needs to be confirmed in prospective placebo-controlled studies.Obesity and androgen deficiency in men – MOSCOW STUDYS.Y. Kalinchenko, Y.A. Tishova, G.Z. Mskhalaya, F. Saad10.1016/j.jomh.2009.09.012journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts398398http://www.jmhjournal.org/article/PIIS1875686709003108/abstract?rss=yesThe mental health of males has been relatively seldom the topic of psychiatric research. However, in the past years a number of programs were initiated to uncover the basis why males have higher suicide rates than females. This is insofar interesting since epidemiological data also indicate that females have higher depression rates and depression is the most important factor for suicidal. The concept of male depression has been introduced in the literature over 10 years ago and thereafter followed up in different research protocols. It emerged that high sensation seeking behaviour, aggression, substance abuse, as well as hereditary factors play an important role. However, until now there is no specific therapy for male depression and interestingly most of the clinical studies are conducted in females. The limited data available indicate that females have a better outcome in the pharmacological approaches. Hereditary factors of male mental health do not only play an important role in depression, but also in other specific psychiatric diseases like addiction, schizophrenia as well as anxiety disorders.Male mental health and behavioral factorsS. Kasper10.1016/j.jomh.2009.09.013journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts398398http://www.jmhjournal.org/article/PIIS187568670900311X/abstract?rss=yesMale depression is related to: Cardiovascular risk factorsMale mental health and behavioural factors: Questions and answersS. Kasper10.1016/j.jomh.2009.09.014journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts398398http://www.jmhjournal.org/article/PIIS1875686709003121/abstract?rss=yesMen's health in Australia has attracted a certain amount of interest internationally. This is partly because, after Ireland, Australia will be the first country to endorse a national men's health policy. The author has been one of the architects of this policy, both as a consultant to the Federal Government's Department of Health and Ageing and as one of the Health Minister's appointed Men's Health Ambassadors. The genesis of this policy will be developed in the presentation: the facilitating factors and the inhibiting factors will be highlighted. The tensions are to be found in the status and financial capacity of medical interests as opposed to the advocates of a more holistic social view of men's health and the until recently somewhat negative view of men's health generated by the sociological construct of “masculinity”. The policy attempts to steer a middle path between all of these. Since the same dynamics are global, it is anticipated that the issues will be relevant to an international audience.The Social Determinants of men's health in Australia, with lessons from research into male suicideJ. Macdonald10.1016/j.jomh.2009.09.015journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts399399http://www.jmhjournal.org/article/PIIS1875686709003133/abstract?rss=yesIntroduction: Radical prostatectomy is the gold standard therapy for clinically localised prostate cancer in men with a life expectancy ≥10 years. Erectile dysfunction (ED) and urinary incontinence are both common in men who undergo bilateral nerve-sparing radical prostatectomy (BNSRP) surgery which over time has become the ideal technique replacing, when feasible, the non-nerve sparing procedures.Prevention and management of Post-prostatectomy EDA. Martin Morales10.1016/j.jomh.2009.09.016journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts399399http://www.jmhjournal.org/article/PIIS1875686709003145/abstract?rss=yesThe disparities in men's health must address due to its importance to men individually, their families and the economy at large. Although this may seem obvious, it is often overlooked by the United States media, policy-makers and in many cases, by men themselves. Men, for the most part, do not take proper care of themselves and, in many cases, do not have regular check ups. Men die younger than women and are more likely to die from abuse of alcohol and drugs, obesity, heart disease, cancer and suicide.The Oklaho-MAN: Tackling Oklahoma's State of Men's HealthS.D. Petty10.1016/j.jomh.2009.09.017journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts399399http://www.jmhjournal.org/article/PIIS1875686709003157/abstract?rss=yesHypogonadism is a highly prevalent condition, especially among aging men with such common comorbidities as diabetes II, the metabolic syndrome and other major chronic diseases. Symptomatic hypogonadism has a profound negative impact on quality of life and severe hypogonadism is associated with increased mortality. Testosterone replacement therapy is very efficacious in relieving the symptoms and improving the quality of life. Although testosterone replacement therapy is generally safe, concern is raised about effects on the prostate. This is mainly derived from the well established fact that castration causes regression of metastatic prostate cancer.Hypogonadism, testosterone replacement therapy and prostate health issuesR. Shabsigh10.1016/j.jomh.2009.09.018journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts399399http://www.jmhjournal.org/article/PIIS1875686709003169/abstract?rss=yesBackground: Throughout the world, there is an increased interest in using testosterone for the treatment of late-onset hypogonadism (LOH) or testosterone deficiency syndrome (TDS) in aging men. However, concerns of inducing prostate diseases – both prostate cancer and BPH/LUTS – oftentimes outweigh the benefits of testosterone therapy resulting in a high degree of hesitance whether to treat hypogonadism.Prostate Safety Parameters under Testosterone Therapy – a Review of the Current KnowledgeF. Saad, A. Yassin, A. Haider, A. El-Sakka, R. Shabsigh10.1016/j.jomh.2009.09.019journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts400400http://www.jmhjournal.org/article/PIIS1875686709003170/abstract?rss=yesSymptomatic therapy in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is debatable. Until today a clear strategy is not available. For years, Pollenextrakt has been discussed as symptomatic drug. We would like to present our results concerning Cernilton®, a rye-grass pollen extract versus placebo in men with category IIIa chronic prostatitis/chronic pelvic pain syndrome. We are presenting the data of a multicenter, randomized, prospective, double-blind, and placebo-controlled clinical phase III study. Patients have been randomized to Cernilton® or placebo for 12 weeks. In the subsequent open follow-up period of another 12 weeks all patients received Cernilton®. Patients were evaluated by Meares and Stamey 4-glass test and the NIH-CPSI at baseline and after 12 and 24 weeks. A total of 39 patients (Cernilton® – Cernilton®, n=48; placebo – Cernilton®, n=45) completed the follow-up period up to 24 weeks as the primary efficacy cohort. The pain, quality of life domains and the total NIH-CPSI score improved significantly at week 12 in the Cernilton® group versus placebo and continued to improve at week 24 in both groups. The latter effects were more pronounced in patients with cross-over from placebo to Cernilton® from week 12 on. Urinary symptoms improved moderately, but not significantly in both groups. Leucocytes in the post-massage urine improved significantly in both groups at week 12 and continued to improve at week 24 in both groups with a more pronounced effect in the Cernilton® – Cernilton® group. Adverse events were minor in all patients. Cernilton® compared to placebo significantly improved total symptoms, pain and quality of life and reduced leucocytes in the post-massage urine in patients with CP/CPPS IIIa without severe side-effects up to 24 weeks. Cernilton® can therefore be recommended for patients with CP/CPPS for long term treatment.The role of “Pollenextrakt” for the symptomatic therapy of CP/CPPSW. Weidner10.1016/j.jomh.2009.09.020journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts400400http://www.jmhjournal.org/article/PIIS1875686709003182/abstract?rss=yesBackground: To provide preliminary data from an ongoing study assessing the safety and effectiveness of injectable long-acting testosterone undecanoate (TU) in hypogonadal men in daily clinical practice.IPASS: Data from an Ongoing Study of the Tolerability and Effectiveness of Injectable Testosterone Undecanoate for the Treatment of Male HypogonadismM. Zitzmann, J.U. Hanisch, A. Mattern10.1016/j.jomh.2009.09.021journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts400400http://www.jmhjournal.org/article/PIIS1875686709003194/abstract?rss=yesMen and women have a different hormonal environment during the fetal period, puberty and adult life. The two most striking differences are the relation between estrogenic and androgenic hormones, cyclic variations in hormone levels seen during the fertile period of the female and the predetermined loss of sex hormone production at menopause in females. Endocrine disturbances caused by a variety of diseases and also life style induced perturbances thus need to be addressed differently in men and. After puberty male normally have a strong muscle anabolic drive as function of higher androgen levels than females and androgens can be used for therapy in males to correct loss of anabolic activity. In females androgens are produced in the adrenal and ovaries with approx equal contribution on serum testosterone levels. One peculiar aspect of female testosterone levels is the lack of feed-back control mechanism as testosterone physiologically emanates from “leakage” of testosterone from the ovaries (testosterone is the precursor to estrogen) and from conversion of adrenal androgen precursors. None of these processes are under direct feed-back control. Nevertheless, testosterone seems to play an important role in females, both due to its effect on the central nervous system and its anabolic activity. Increment in testosterone levels, usually associated with some concomitant disease (polycystic ovary syndrome or adrenal over activity) is associated with negative changes in glucose and lipid metabolism. This in contrast to what is seen in males were loss of testosterone is associated with derangement in glucose and lipid metabolism (metabolic syndrome, type 2 diabetes, hyperlipidemia). It is also noted that obesity in females is associated with increased testosterone level while the contrary is seen in men. These observations may seem contradictory and suggest that androgen therapy in women may cause of worsen metabolic disorders while in men such therapy may improve the metabolic state. Thus strategies to ameliorate metabolic pertubances associated with metabolic syndrome in males and females must address endocrine alterations in different ways. As testosterone is an excellent anabolic hormone it can be used in men to improve muscle mass and the ability to perform physical activity while in females this mechanism cannot be utilized. Estrogens in some respect excerpt beneficial effects in postmenopausal women and may facilitate loss of intra abdominal fat (as testosterone does in males), however postmenopausal use of estrogen is pharmacotherapy and not substitution therapy as postmenopausal women have low estrogen levels while healthy normal men maintain to a large extent testosterone production independent of age.Gender related pitfalls and openings in prevention of metabolic syndrome related type 2 diabetesS. Arver10.1016/j.jomh.2009.09.022journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts400400http://www.jmhjournal.org/article/PIIS1875686709003200/abstract?rss=yesThe world's population is ageing fast, and this global trend is not inevitable in Asia. Spending on health is likely to grow even faster as patients get older. In aging countries, the ratio of people of working age to those of retirement age will deteriorate dramatically over the next few decades. In Japan, for instance, which currently has about three workers to every pensioner the number will halve by 2050. And because of a huge increase in the number of over-80s, a lot more money will be needed to provide long-term care for them as they become frailer. This financial situation will force older populations to keep in work places longer than before in order to sustain the health care system. In the society where the longevity is almost ubiquitously achieved, preventive medicine and one that is directed to the improvement of quality of life would be more stressed. Especially, men's health should be emphasized more since a persistent longevity gap has existed between men and women in almost every country.Where is men's health today? The Asian perspectiveS. Horie10.1016/j.jomh.2009.09.023journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts401401http://www.jmhjournal.org/article/PIIS1875686709003212/abstract?rss=yesMen over past decades have shown poorer health outcomes than women across all racial and ethnic groups as well as socioeconomic status. This can be contributed to social and cultural attitudes that have been engrained in American boys and men for decades. Men are taught at an early age to suck it up and that big boys don’t cry.Societal, Cultural, and Social Barriers to Men's Health in the USAS.T. Williams10.1016/j.jomh.2009.09.024journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts401401http://www.jmhjournal.org/article/PIIS1875686709003224/abstract?rss=yesEndothelium plays a vital role in the vasodilation and hemodynamic events involved in erection physiology. Due to its relevant functions, a close link has been established between endothelial integrity and erectile dysfunction (ED). It is currently recognized that ED is the early harbinger of a more generalized vascular systemic disorder, and, therefore, an evaluation of endothelial health in ED patients is warranted. Data on the involvement of several biochemical and cellular endothelial markers on the pathogenesis of ED are continuously expanding. Furthermore, several noninvasive methods for clinical endothelial function assessment have been proposed. Most of them, including flow-mediated dilatation, venous occlusion plethysmography, pulse wave analysis and peripheral arterial tonometry, assess peripheral endothelial function. Other techniques that assess penile endothelial dysfunction, such as penile venous occlusion plethysmography and penile nitric oxide release test, have also been proposed. No ideal technique exists and all have advantages and limitations. Markers of endothelial function may aid early diagnosis of ED and can provide answers on important issues, such as whether endothelial dysfunction is widespread in various vascular beds and if involvement of a specific vascular territory precedes over others. Furthermore, given the complementary and independent prognostic value of various endothelial markers, a “multimarker” approach in men with ED may be an effective strategy to improve prediction of cardiovascular risk beyond the use of traditional risk factors in daily clinical practice. Finally these markers have the potential to assess whether various treatments confer additional benefits by having a favorable effect on endothelial function. Detection of endothelial dysfunction in both the laboratory and clinical settings is a challenging opportunity with diagnostic, prognostic and therapeutic potential.Detecting endothelial dysfunction in ED patients: are there reliable markers?Charalambos Vlachopoulos10.1016/j.jomh.2009.09.025journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts401401http://www.jmhjournal.org/article/PIIS1875686709003236/abstract?rss=yesQuality of life in patients with prostate carcinoma after radical prostatectomy is often deteriorated by the lost of erectile function and incontinence. Several medical and surgical options are available to increase these conditions.Illustrative Cases of ED and incontinenceT. Pottek10.1016/j.jomh.2009.09.026journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts401401http://www.jmhjournal.org/article/PIIS1875686709003248/abstract?rss=yesTraditional approaches have failed to engage men in the healthcare system at rates comparable to women. A Center for Disease Control study of gender and ambulatory care use found that even after excluding pregnancy-related visits, women visited doctors for such reasons as annual examinations and preventive services twice as often as men. Another major U.S. study has shown that one-third of men as opposed to less than one-fifth of women have no regular physician, and that three times as many men as women have not seen a physician in the past year. Only 18% of males state that if they were in pain or sick, they would seek health care promptly. 24% of males stated that even if they were in pain or sick, they would delay seeking help as long as possible, while 17% stated that they would delay going to a doctor for a week or more. Men's inattention to health matters does not reflect a lack of intelligence, but an approach unsuitable for men. Public health screenings that evinced substantial adult male participation engage entire families to bring men in and help them understand health and medication regimens, take time to explain and promote understanding of disease processes and management, treat the male individual as a whole person, “not just a prostate,” use multiple and diverse media formats to advertise the event, use a peer-to-peer approach, and treat seeking healthcare as a group event like going to a sports game. Men appear to participate actively when they have motivated partners who use tactful, non-blaming, encouraging approaches tailored to the man's individual personality. Bringing health screening and treatment to the workplace whenever possible frees men from having to choose between going to work and going to the doctor. Promoting healthcare as a means to maximize performance, achievement and productivity increases its relevance to men. Screening for veteran status must be made routine to identify key health issues related to military service. Health care providers must make special efforts to listen carefully to men given the unique cultural hurdles men must overcome in the act of seeking health care.Can Healthcare Be Made More Effective For Men?J.J.E. Bonhomme10.1016/j.jomh.2009.09.027journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts402402http://www.jmhjournal.org/article/PIIS187568670900325X/abstract?rss=yesMen's health may be considered a vital but often overlooked aspect of family health. The health status of adult males has often been dismissed as irrelevant to the well-being of the family. However, the family is built on highly interactive relationships such that the health challenges facing fathers frequently have widespread and demonstrable negative effects on the health of the family as a whole. Following widowhood or disability of a husband, a family may face the loss of a long term companion and considerable bereavement, as well as a difficult burden of care for the disabled person. Surviving spouses face an increased risk of dying over the course of the next year. In disability, a family is likely to face increased health care expense in the face of diminished earnings. Poverty is strongly associated with widowhood, with children often bearing considerable financial hardship as well. The prevailing catchphrase “maternal and child health” ignores a growing body of evidence that the health of fathers may have considerable bearing on birth defect risks, healthy psychosocial development of children and adolescents, and future propensities towards medical and psychiatric illness in adult offspring. Advanced paternal age has been associated with increased risk of a number of conditions, including nasal aplasia, cleft palate, hydrocephalus, pulmonic stenosis, and schizophrenia. A father's tobacco smoking increases risk of cleft lip, cleft palate, hydrocephalus, and ventricular septal defect, while a father's alcohol increases likelihood of ventricular septal defect. Sexually transmitted infections including HIV, HPV, HSV, and chlamydia may have particularly severe consequences for women and children if not controlled among men. Babies of men exposed to chemicals in the course of their daily work are more likely to be miscarried, stillborn, or to develop cancer later in life. Offspring of Vietnam or Cambodia veterans have significantly increased rates of acute myelogenous leukemia. The crucial role of fathers in the growth and development of socially well adjusted, physically and mentally healthy children must be more widely publicized and recognized, and the more inclusive concept of parental and child health must replace current prevention efforts that focus narrowly on maternal health.A Family Health Question: What About Dad?J.J.E. Bonhomme10.1016/j.jomh.2009.09.028journal of men's health 6, 4 (2009)2009-12-01journal of men's health2009-12-0164S1875-6867(09)X0005-9WCMH Abstracts402402