1. Gender and its Impact on Men’s Health 2nd Year Sex, Gender and Medicine Seminar Rob McLachlan Deputy Director of Endocrinology Monash Medical Centre Australia

2. Since mid-1980s, gender-based inequalities in health of women have been acknowledged by policy makers and health service planners Only in recent years that inequalities in health outcomes for men have received attention Gender differences in health

3. Gender Health perspective – where are the men? l Andrology = the study of health matters that relate to being male – u Reproductive u Non-reproductive F CVS disease F lifestyle/behaviours

4. Limited prevalence men’s reproductive health data available (AIHW report: Reproductive Health Indicators in Australia, 2002) Men’s health policy at State level is variable Government policy

5. Consequences l Limited community awareness l Limited GP access - availability of ‘Well Men’s’ approach cw women l Doctors are male- healthy or otherwise l Patients are male – single or partnered l Vulnerable to exploitative commercial ‘Men’s Health’ clinics

6. What is the formal status of andrology at the governmental, or educational level? l Andrology Australia – funded by Communicable Disease and Health Protection Branch of Dept Health (in the HIV/Hepatitis section). What the……?? l World Health Organization – Gender = women l Only one Prof. of Andrology in Australia l No specific Australia curricula in andrology - teaching fragmented between urology, internal medicine endocrinology and O&G

7. Men use health services at a lower rate Men experience higher rates of CVS and cancer Men die 5 years earlier than women Men experience higher rates of accidents and injuries, including suicide Gender differences in health* A variety of risk behaviours contribute to poorer health status

8. Reproductive disorders are common  prevalence with  age Significantly effect quality of life Does Society educate and ‘allow’ boys and men to seek help? Are medical staff ready to listen? Do doctors feel comfortable with issues? Male health issues

9. Approx. 50% of Australian men may experience some type of prostate problem at some stage of their life Prostate diseases: -Benign enlargement -Prostatitis (inflammation of the prostate) -Cancer (10,055 new cases and 2,644 deaths recorded, AIHW 1997) Compare community-medical recognition with that of female breast disease Prostate disease

10. One in 200 men under 60 years Klinefelter’s syndrome 1:650 males – 75% escape diagnosis lifelong – diagnosis 10 seconds - effects of this neglect ?Education of boys/men ?Education and willingness of doctors to assess Androgen Deficiency

11. The inability to achieve and/or maintain an erection that allows sexual intercourse. About 30% of men over age 50 have erectile dysfunction (impotence) Marker of underlying heart disease and diabetes Effects quality of life and relationships Why is ED hilarious - ? fear ?embarrassment Erectile Dysfunction

12. In Australia 550 new cases annually Peak ages of 18 and 39 years, it is the second most common cancer in Australia Why do some men present late with obvious mass? Testicular Cancer

13. Affects about one man in 20 40% of infertile couples using IVF Infertility major stress Fertility = virility Anger- guilt – relationships - coping Male Infertility

14. Andrology Australia (Australian Centre of Excellence in Male Reproductive Health) aims to enhance the reproductive health of males by programs focusing on community and professional education and research For more information visit www.andrologyaustralia.org