Monday 18 February 2019

Looking after men’s health

Getting to grips with male health means looking after the whole package, writes brian finnegan, which requires regular check-ups and screening

While men spend an inordinate amount of time thinking with their down-below bits, very few of us ever think about them. Sexual health and sexual fantasies hardly go together in the mind of the average Joe Bloggs, but according to specialist in men's health Dr Shay Keating, guys should be getting to grips with the whole package.

"Men are notoriously bad at going to the doctor," he says. "They might go because of a chest infection, but they rarely get regular health check-ups."

Although it's generally understood that as men get older, they are more prone to health issues, this is not always the case when it comes to our 'nuts and bolts'. For instance, as Dr Keating points out, testicular cancer is most common in men between the ages of 20 and 40. As many people know, cyclist Lance Armstrong suffered from testicular cancer, as did comedian Tom Green.

"Just as we advise women to examine their breasts, we always tell men to examine their testicles, maybe once a month while having a shower. If they ever notice any changes in size, if they're painful or have a hard lump in them, go straight to the doctor and get them checked. Early detection of testicular cancer is important because all you have to do is remove the testicle and you're fine. If it's not detected and nothing is done, then it can become problematic."

Men over 40 should also be getting into the habit of submitting to a prostate examination once a year. In 2003, Robert De Niro admitted that he suffered from prostate cancer and successfully fought off the illness.

The prostate, for those of you who don't know, is located in the anus. "If you put a finger up the back passage, you can actually feel the prostate," Dr Keating says, with the blase air of a man who does this kind of thing as part of his nine-to-five. "A doctor will feel for lumps, inflammation or a change in size," he adds without blinking an eye.

The prospect of a yearly PSA examination, as it is called, might not be appealing, but statistics prove that precaution is wise. The incidence rate for prostate cancer in Ireland is significantly higher than in the EU, according to the National Cancer Registry. Prostate cancer incidence increased in all age groups, but the largest absolute change in case numbers between 1994 and 2009 was in the 55-64 year age group, while the largest relative increase (19pc annually) was in men aged under 55.

"The good news is that prostate cancer is very curable and the outcome is always better if it is caught early," says Dr Keating. "This is why seeing a doctor on a regular basis is so important."

There are even less edifying ailments that doctors see regularly -- such as genital warts. "It's one of the more common STIs. It's very rare that they will cause health problems in men, so usually they are treated for cosmetic reasons. There is a cream you can put on them that will isolate and kill off the virus, but it leads to painful inflammation. Most of my patients prefer me to just cut them off. In the short term it might be sore, but three days later you've healed up."

Thankfully, that's probably as painful as it gets in the treatment of sexually transmitted infections (STIs). For instance, the treatment for chlamydia, which is most common at the moment in men between the ages of 19 to 25, is simply four pills swallowed with a glass of water.

"Women can't detect chlamydia in themselves, but men can," says Dr Keating. "There might be pain when urinating or there's a discharge of a clear greyish colour. For some, it may lead to a chronic enlargement of the prostate."

The other biggie in the STI department is herpes, which comes in two strains, Type 1 and Type 2. "When I was at medical college we were told that Type 1 was above the waist and Type 2 is below the waist, which isn't really true if you are having oral sex," says Dr Keating.

"If it's Type 1, the chances of you getting multiple occurrences is quite low, but if it's Type 2 you can have multiple attacks in a year that can be debilitating.

"The good news is that the longer you have herpes, the frequency and severity of attacks lessens."


Syphilis is largely limited to the gay population. A public health campaign brought numbers down after an outbreak in the early 2000s, but now cases are increasing again. "It's time for gay men to become extra vigilant," says Dr Keating. "Going for regular sexual health check-ups is imperative if you are sexually active."

Last, but not least, on the list,is gonorrhoea. "We will always see gonorrhoea," Dr Keating says. "Over time gonorrhoea can become resistant to the treatment. So it's about changing the medication. In the past 10 years we've had to change the medication five times. If we see someone with gonorrhoea, we have to make sure the antibiotic is the appropriate one."

Taking good care of your sexual health is very important. Taking care of the spread of STIs is equally so. "The first thing we do in sexual health is ask the patient to, if at all possible, identify who might have infected them or who they might have infected," says Dr Keating. "Then we make contact and try to treat them."

Here's hoping Dr Keating won't be on the other end of your phone soon.

Dr Shay Keating is a men's health specialist in Dublin, call 087 234 5551

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