Being mindful of Men's health

CHENNAI: From physical illnesses like cardiovascular problems, sexual health, and hypertension to a host of mental health issues, there are many illnesses and health conditions that are more common in men compared to women. However, a large number of these are often ignored or at least not given enough attention, only to be found when it is too late to do anything about them.

Cardiovascular diseases are one of them. Men are at a greater risk of developing cardiovascular diseases, such as heart attacks and coronary artery disease, compared to women. This is partly attributed to hormonal differences and lifestyle factors. Often times, the signals of cardiovascular diseases, including heart attacks and cardiac arrest, go unrecognised in men.

Symptoms such as chest pain, shortness of breath, fatigue, or high blood pressure are ignored or attributed to other factors, leading to a delay in seeking medical care. “Men have a higher risk of cardiac issues because of hormonal differences. Estrogen and progesterone play a protective role in the case of women until menopause.

The higher amount of belly fat in men is another cause, and the hip to waist ratio is also not considered while looking at fitness,” says Dr Suresh Rao, senior cardiologist at MGM Healthcare. In a large study to understand weight, shape and mortality risk in older persons involving nearly 15,000 people aged 75 or above, the researchers at the University of Alabama at Birmingham found that men should have a waist to hip ratio slightly under 1.0 - .99, while it should ideally be 1.0 to .90 or lower.

According to Dr Rao, while stress is common in both men and women, men tend to externalise during such times in the form of anger or other ways to cope with it. Also, more men smoke or consume liquor, which is yet another reason why they are at a higher risk of cardiac problems. Men also face a slightly higher risk of developing hypertension or high blood pressure compared to women. This difference in risk tends to become more apparent after the age of 45. Several factors contribute to this increased risk such as hormonal differences, lifestyle factors, central obesity and others.

Hormonal variations, including differences in levels of sex hormones such as estrogen and testosterone, may also play a role. Estrogen is believed to have a protective effect on blood vessels, while testosterone may contribute to higher blood pressure levels. “Prevalence of hypertension among men with diabetes is higher in the younger age groups and up to 40 years of age.

After this age, the incidence drops. The prevalence of hypertension is about 35 per cent in men, and we have witnessed a significant overlap between people with diabetes and hypertension. Women aged below 40 have less prevalence but it rises post menopause and at a higher age. The same goes for heart diseases. But with diabetes, women face equal risk of heart diseases, irrespective of the age,” says leading diabetologist Dr V Mohan. Also, he adds, abdominal obesity is a major concern in men and obesity is another factor associated with higher risk of hypertension. “Men tend to have a higher prevalence of abdominal obesity, which is strongly linked to hypertension and diabetes.

Obesity is a major risk factor for both high blood sugar and high blood pressure both,” he says. The various coping mechanisms that men adopt to deal with stress, like higher smoking, alcohol, and unhealthy dietary habits, only make matters worse by increasing the risk of diabetes, hypertension and cardiac problems. Dr Mohan says it is crucial to raise awareness about these men’s health issues and encourage open discussions, regular health check-ups, and timely medical intervention to address these concerns effectively.

Sexual health

Men’s sexual health concerns, such as erectile dysfunction (ED) low libido, and others are frequently overlooked or considered taboo topics. Lack of awareness, cultural factors, and embarrassment may prevent men from seeking medical advice or treatment. Dr Sanjay Prakash J, Consultant Microsurgical Andrologist and Male Sexual Health & Urologist at AINU Hospital, says that globally the estimated prevalence of male sexual dysfunction ranges between 10 per cent and 48 per cent and is expected to cross 320 million by 2025.

In India, the estimated prevalence is around 22 per cent. “There has been a paradigm shift in the trend, with younger males being diagnosed with sexual disorders. It has been reported that 1 in 10 men has some form of sexual dysfunction, and 25 in 100 men with ED are below 35 years. In a single-centre survey conducted on 400 men with any form of sexual disorder, 100 were in their 20s.

This is attributed to the increased incidence of hypertension, obesity, metabolic syndrome, increased alcohol, smoking, drug culture among the young, work-related stress, performance anxiety, excess porn, and inappropriate sexual habits,” says Dr Sanjay. He adds that the sexual health is equally important as mental and physical health, but is often ignored due to the stigma attached or the male chauvinistic attitude, which even stops them from seeking timely treatment. This not only affects the quality of sex life but also leads to decreased work productivity, psychosocial problems such as anxiety, depression, anger, frustration, poor self-esteem, guilt, lack of confidence, and relationship difficulties.

It thus is prudent to shed the perceived shame and seek medical help. There are many advanced treatments available with significant success rates, which can be customised according to a person’s need. Timely intervention will help improve their productivity and overall quality of life.

Mental health

Mental health problems such as depression, anxiety, and stress are often overlooked or even stigmatised in our society, as men are always told to “man up”.

As a result, they are less likely to seek help or talk about their emotional well-being, leading to undiagnosed and untreated mental health issues. As many men are breadwinners of the family, work-related stress is very common in men. “Most men who struggle with mental health issues are found to have career-related problems such as work stress, retaining a job for a long time and unemployment. Their work also gets impacted due to the pre-existing mental health issues such as anxiety or depression.

This causes a lot of stress for them, as people who visit Institute of Mental Health are usually people who need to work to support their family. There is also the stigma about mental health issues and they are misunderstood because of their mental health condition. Each disorder is very different in a man and their signs present differently,” says a therapist at the Institute of Mental Health.

Anxiety and depressive disorders are traditionally thought to be more prevalent in women. But the figures may be misleading because of barriers to help-seeking in men, gender stereotyping being one of them. Dr Bindu Menon, Professor and Head, Department of Psychiatry at Amrita Hospital, says having anxiety or depression is perceived as weakness, which makes many men to prefer suffering silently instead of being labelled as ‘wimps’ or weaklings. “The other reason is that men deal with distress in different ways than women.

They tend to bottle up their feelings and do not like to talk about them, the way women do. They tend to use dysfunctional coping behaviours more often – indulging in high risk behaviours, aggressive outbursts, including self-aggression or suicide, and substance use. In contrast, women tend to reach out more for help and actively seek social support. All these put men at high risk for mental health issues,” says Dr Bindu.

Common mental health issues and risk factors in men include developmental disorders like autism spectrum disorders and specific learning disorders, and attention deficit hyperactivity disorder. These put the individual at risk for co-morbid psychiatric disorders like substance use disorders, completed suicide and psychotic disorders. Mental health problems in men may not present in a typical manner,” adds Dr Bindu