Diabetes in Men & 5 Associated Men’s Health Conditions

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By 2030, the number of Singapore residents above 40 with diabetes is projected to increase by another 200,000 from about 400,000 today. 

The prevalence of diabetes among adults increased from 8.2% in 2004 to 11.3% in 2010. A higher proportion of men were diabetic (12.3%) compared with women (10.4%). We can imagine how the number would have increased even more by today.

For men living with type 2 diabetes, they are also at higher risk for certain conditions as compared to other men. In this article I will share more about unique mens health issues faced by men with type 2 diabetes.

1. Erectile Dysfunction (ED)

According to a study published in Journal of Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, men with diabetes are much more likely to experience Erectile Dysfunction than men who don’t have diabetes. High blood glucose causes damage to small blood vessels and/or  nerves like the ones that supply the penis. Hence poorly controlled diabetes contributes to Erectile Dsyfunction.

Other than sugar control, there are also some diabetic medicines that causes side effects like ED which adds on to the problem.

Other than diabetes, these men are usually also obese and suffering from hypertension, both of which also adds on to the risk for ED.

https://youtu.be/xVUwgNqRKho

2. Urinary Tract Infection: 

Urinary Tract Infection (UTI) is usually caused by bacteria. It can affect any part of the urinary tract. Anywhere including the kidneys, bladder, ureters, urethra, and, in men, the prostate gland. Most of the time the infection is in the bladder. Women are 10 times more likely to get a UTI as compared to men. However men with diabetes are at a higher risk of getting UTIs than men without diabetes.

Why are men with diabetes more prone to UTIs? There are a few possible reasons. One, men with diabetes have poor circulation. This reduces the ability of white blood cells to travel in the body and fight off any kind of infection. Two, high glucose levels can also raise the risk of a UTI. Three, some men with diabetes have poor ability to empty their bladders. What happens is, urine stays in the bladder for too long and this becomes conducive for bacteria to grow.

3. Balanitis

Balanitis is an infection of the skin on the head (glans) of the penis. In uncircumcised men, this area is covered by the foreskin, or prepuce. Balanitis can occur in both circumcised and uncircumcised men, however, uncircumcised men are at higher risk for balanitis and also recurrent infections.  

Any man can develop balanitis, but the condition is most likely to occur in men who have phimosis (tight foreskin) or poor hygiene. Other than this group of men, men with diabetes are also at high risk of balanitis especially if they have poor sugar control. When sugar is poorly controlled, excess sugar may be exreted in the urine. This sugar rich urine when trapped underneath the foreskin, will provide a conducive environment for yeast and bacteria. On top of that, men with poorly controlled diabetes is also unable to fight of infections effectively. Read: What are the Causes of Balanitis

https://youtu.be/1F5iKRxhg8k

4. Posthitis

Posthitis is inflammation of the foreskin It is characterized by swelling or redness of the foreskin. In some cases, it may happen together with tears on the foreskin which may be quite painful. It is usually caused by an infection like fungus or bacteria. In some cases, it might be due to tears in the skin due to abrasion or friction during intercourse. The selling may lead to phimosis and tightness of the foreskin which makes it difficult for the skin to retract. 

Circumcision is usually a definite treatment for men who has recurrent balanitis posthitis or UTI. It is a very effective treatment to reduce the risk of UTIs, balanitis and also there won’t be anymore posthitis when the foreskin is removed.

5. Low Testosterone

 In the past few years, scientists have found some connection between low testosterone and diabetes. One study showed that in 2,100 men over age 45, the odds of having low testosterone were 2.1 times higher in men with diabetes. Low testosterone doesn’t cause diabetes but it might be the other way around. Men with diabetes might develop low testosterone. Read Andropause

A link between diabetes and low testosterone is well established. Men with diabetes are more likely to have low testosterone while men with low testosterone are more likely to develop diabetes as well. Testosterone improves the body’s ability to take up sugae in response to insulin. Men with low testosterone may have insulin resistance. In this condition, their body need to produce more insulin in order to reduce the same amount of sugar in the blood.

Read: Low Testosterne & Low Libido

All in All

So if you happen to be diagnosed with type 2 diabetes, do keep a look out for some of the issues mentioned above. If you happen to have any of the above conditions, do consider health screening as any of the condtions might be an indication of diabetes. Do consult your doctor if you are experiencing any of the above symptoms and conditions.

 
 
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How To Apply Testosterone Gel (Androgel)?

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https://youtu.be/Q-nn9x4RJ5s

What is Testosterone Gel (Androgel)?

This medicine contains testosterone, a male hormone produced naturally in the body. This medicine is used in adult men for testosterone replacement to treat various health problems caused by a lack of testosterone such as male hypogonadism. 

What do you need to know before you use Androgel?

Do not use this medication if:

 If you are allergic to testosterone or any of the ingredients of this medicine (listed in section 6),

– If you are suffering from prostate cancer,

– If you are suffering from breast cancer.

How to apply?

The recommended dose is 5g of gel (i.e.50 mg of testosterone) applied once daily at approximately the same time, preferably in the morning.

The daily dose may be adjusted by your doctor, on an individual patient basis, not exceeding 10 g of gel per day.

The gel must be gently spread onto clean, dry, healthy skin as a thin layer on the shoulders, arms or stomach.

After opening the sachet, the entire contents should be taken out of the sachet and applied immediately onto the skin.

Allow the gel to dry for at least 3-5 minutes before dressing.

Wash your hands with soap and water after applying.

Do not apply to the genital areas (penis and testes) as the high alcohol content may cause local irritation.

Possible transfer of testosterone

During close and relatively long periods of skin contact testosterone may be transferred to another person unless you cover the treated area and could result in the other person showing signs of increased testosterone such as more hair on the face and body and a deepened voice.

It may cause changes in the menstrual cycle of women. Wearing clothes covering the application area or washing the application area before contact protects against such transfer.

The following precautions are recommended:

For the patient:

– wash your hands with soap and water after applying the gel,

– cover the application area with clothing once the gel has dried,

– wash the application area before making close contact with another person.

If you believe testosterone has been transferred to another person (man, woman or child), this person should:

– wash the affected area of skin immediately with soap and water,

– report any signs such as acne or changes in the growth or pattern of hair on your body or face to your doctor. You should preferably wait at least 1 hour before showering or bathing after applying this medicine.

How to store Androgel

This medicinal product does not require any special storage conditions. Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the box.

 
 
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Low Testosterone & Low Libido

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Having low levels of testosterone or Testosterone Deficiency Syndrome is common and can occur in about 1 in every 200 men under the age of 60 and 1 in 10 men over the age of 60. Commonly the symptoms may be subtle and thus can be easily overlooked as “Oh, it’s just part of aging.”

As men age, levels of testosterone drop by about 1-1.5% each year after age of 30 but not all males experience the drop in levels. It is known from studies that the more overweight you are, the faster the decline in the levels of testosterone. In addition, it has been shown in studies that low testosterone levels are associated with cardiovascular risks like coronary arterial disease and metabolic syndrome including type 2 diabetes.

Effects of having low testosterone:

  • Regression of some features of male sexual characteristics
  • Low mood or irritability
  • Poor concentration
  • Low energy, feeling tired
  • Hot flushes and sweats
  • Decreased libido
  • Reduced beard or body hair growth
  • Low semen volume
  • Gynecomastia
  • Reduced muscle strength
  • Fracture (osteoporosis)
  • Erectile dysfunction

It has been shown in some studies that supplementation of testosterone in those with low testosterone levels can increase their libido. 

Causes of low testosterone

Generally the causes of low testosterone can be classified into testicular (Primary) and Hypothalomo-pituitary (Secondary) causes.

Primary

  • Age-Related Testosterone Deficiency
  • Chromosomal: Klinefelter syndrome – Congenital;
  • Undescended testes
  • Surgery: bilateral orchiectomy
  • Trauma
  • Infection: mumps orchitis
  • Radiotherapy/chemotherapy/drugs (spironolactone, ketoconazole)

Secondary

  • Idiopathic hypogonadotropic hypogonadism
  • Pituitary microadenoma (<1 cm) or macroadenoma (>1 cm)
    • Functional or non-functional: in men typically macroprolactinoma
  • Other causes of hypothalamic pituitary damage: surgery, radiotherapy, trauma, infiltrative disease such as haemochromatosis

Treatment options

Lifestyle modifications – diet and exercise

It has been shown in studies that resistance weight training can increase levels of testosterone. Reducing body fat has also been shown to increase levels of testosterone. There are some studies show high-intensity interval training (HIIT) is more effective in reducing body fat than steady-state cardio.

Medications: Testosterone Replacement

There are several formulations available for replacing testosterone. The choice of which formulation to use is largely patient preference.

  1. Slow releasing formulation injections – generally given every 10-12 weeks as an intramuscular injection. Some people prefer that as they only need to get 1 injection once every 3 months or so rather than to take medication daily.
  2. Short acting formulation injections – these injections are given once every 1 to 3 weeks. Most of the time, patients learn to inject themselves.
  3. Gels or capsules – generally capsules are taken twice daily and gels are applied once daily. Gels are preferred by some as it is only used once daily and also in some cases, those who used the injectable form experience swings in their symptoms especially when it approaches the time for the next dose. But as the gel is applied daily, the levels of testosterone remain relatively stable and thus avoid the swing. However, gels may not be suitable for a person with an active lifestyle as the testosterone in the gel may not have enough time to be absorbed before they commence their exercise or when they shower after the exercise.

Next read: 7 TESTOSTERONE BOOSTING FOODS THAT YOU CAN FIND IN THE SUPERMARKET

Watch next: HOW DO YOU INJECT CAVERJECT

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Hipogonadisme – Penyebab, Gejala & Pengobatan

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Apakah semua pria mengalami gejala Hipogonadisme (Andropause atau Menopause Pria) atau apakah beberapa pria bahkan tidak menyadari bahwa mereka sedang mengalaminya? Hipogonadisme pria adalah suatu kondisi di mana tubuh tidak menghasilkan cukup testosteron.

English: What are the Causes, Symptoms & Treatment of Hypogonadism 

Doktor yang boleh berbahasa melayu

Hipogonadisme pria Vs. Andropause (Menopause Pria)

Secara teknis, istilah andropause (Menopause Pria) tidak ada dalam bidang medis. Ini karena tidak seperti penurunan besar kadar estrogen pada wanita yang mengalami menopause, tidak ada penurunan tingkat testosteron pada pria sehingga tidak ada “pause”. Lebih tepatnya, itu harus diistilahkan sebagai defisiensi androgen atau sindrom defisiensi testosteron atau hipogonadisme pria.

Mengapa Testosteron Penting?

Testosteron penting sepanjang kehidupan pria mana pun.
Ini menentukan perkembangan karakteristik seksual pria selama perkembangan janin. Tanpa testosteron pada saat yang tepat dari perkembangan janin, genitalia pria eksternal tidak akan membesar.
Selama masa pubertas, pria perlu mengembangkan karakteristik seksual sekunder seperti rambut wajah, rambut kemaluan, pembesaran penis dan testis hingga ukuran dewasa.
Dalam kasus di mana terdapat infeksi pada testis, atau trauma atau cedera pada testis atau testis yang tidak turun sebelum masa pubertas, maka pria tidak mengembangkan karakteristik seksual sekunder tersebut.
Ia diperlukan untuk produksi sperma oleh testis. Testosteron juga diperlukan untuk menjaga kesehatan tulang secara langsung dan tidak langsung karena beberapa testosteron dikonversi menjadi estrogen yang juga membantu menjaga kesehatan tulang.
Ini juga membantu dalam mempertahankan massa otot yang secara tidak langsung meningkatkan kadar lemak tubuh.
Testosteron juga dapat memengaruhi mood dan dorongan seksual pada pria dan juga dapat memengaruhi ereksi.
Ada juga semakin banyak bukti yang menunjukkan bahwa testosteron adalah faktor yang perlu dipertimbangkan untuk kesehatan jantung. Sejumlah penelitian telah menunjukkan bahwa pria yang memiliki penyakit arteri koroner memiliki kadar testosteron yang lebih rendah.
Tingkat testosteron yang rendah juga dikaitkan dengan peningkatan risiko kanker prostat tingkat tinggi.

Apa Gejala Utama Testosteron Rendah?

Gejala umum dari testosteron rendah adalah:

  1. Tingkat Energi Rendah
  2. Perubahan Suasana Hati atau Iritabilitas
  3. Konsentrasi yang buruk
  4. Mengurangi Kekuatan Otot
  5. Libido rendah
  6. Masalah Ereksi (kesulitan ereksi atau mempertahankan ereksi)

Questionaire tentang Kekurangan Testosteron

Anda juga dapat menggunakan kuesioner di bawah ini sebagai alat untuk menilai kemungkinan kekurangan testosteron

  1. Apakah Anda mengalami penurunan libido (dorongan seksual)?
  2. Apakah Anda kekurangan energi?
  3. Apakah Anda memiliki penurunan kekuatan dan / atau daya tahan?
  4. Apakah Anda kehilangan ketinggian?
  5. Pernahkah Anda memperhatikan ‘kenikmatan hidup’ yang menurun?
  6. Apakah Anda sedih dan / atau pemarah?
  7. Apakah ereksi Anda kurang kuat?
  8. Sudahkah Anda mencatat kemunduran kemampuan bermain olahraga baru-baru ini?
  9. Apakah Anda tertidur setelah makan malam?
  10. Apakah ada penurunan kinerja kerja Anda saat ini?

Jika Anda menjawab ya untuk Pertanyaan 1 atau 7 dan 3 pertanyaan lainnya, maka Anda mungkin ingin menemui dokter Anda untuk mendiskusikan kekurangan testosteron.

Apakah Testosteron Rendah Berbahaya Dengan Cara Apa Pun?

(Haruskah pria khawatir tentang penurunan kadar testosteron?)
Ada semakin banyak bukti yang menunjukkan hubungan antara kadar testosteron rendah dan risiko kardiovaskular dan juga kematian (kematian). Masih perlu dijelaskan lebih lanjut, apakah testosteron rendah menyebabkan peningkatan risiko kardiovaskular / kematian atau sebaliknya.
Seperti disebutkan sebelumnya, ada beberapa penelitian yang menunjukkan bahwa ada risiko kanker prostat tingkat tinggi pada pria dengan kadar testosteron rendah. Selain itu, kadar testosteron yang rendah dikaitkan dengan diabetes, obesitas, dan kadar kolesterol tinggi. Ditemukan rata-rata pria sangat gemuk memiliki kadar testosteron 25% lebih rendah daripada pria tidak gemuk.

Apa Pilihan Perawatan untuk Testosteron Rendah?

Jika testosteron Anda rendah tetapi tanpa gejala, konsensus umum adalah untuk tidak diobati. Namun, ada cara non-farmasi untuk meningkatkan kadar testosteron Anda.

  1. Latihan ketahanan atau Resistance training

Latihan ketahanan – ada sejumlah kajian yang menunjukkan bahwa resistance training  bisa meningkatkan kadar testosteron walaupun hanya sementara.

  1. High intensity Interval Training (HIIT)

Pelatihan Interval Intensitas Tinggi (HIIT) juga dapat meningkatkan kadar testosteron hingga 17% dalam kajian setelah 6 bulan latihan.

  1. Mengurangi Lemak Tubuh

Mengurangi kadar lemak tubuh melalui diet dan olahraga yang tepat dapat meningkatkan kadar testosteron juga.

Tanya Jawab tentang Hipogonadisme:

 

1. Apa Perbedaan Antara Hipogonadisme dan Testosteron Rendah?

Anda dapat memiliki kadar testosteron yang rendah tetapi selagi anda tidak memiliki gejala yang disebabkan oleh testosteron, anda tidak memiliki sindrom kekurangan testosteron atau kekurangan androgen.

 

2. Apakah Hipogonadisme biasa?

Satu dari 10 pria yang lebih tua mungkin memiliki sindrom kekurangan testosteron.

 

3. Bagaimana Hypogonadism Diobati?

Ada berbagai cara untuk menggantikan Testosterone yang tersedia di Singapura.

4. Injeksi testosteron:
Ini adalah pilihan bagi mereka yang tidak ingin minum obat setiap hari. Umumnya, suntikan ini diberikan setiap 8-12 minggu tergantung pada keperluan individu. Ada juga suntikan jangka pendek tetapi orang itu harus  nyaman dengan suntikan diri

5. Kapsul Testosteron:
Ini adalah pilihan bagi mereka yang tidak suka jarum dan lebih suka minum obatnya. Penyerapan tergantung pada diet (lebih baik dengan makanan berlemak tinggi).

6. Gel testosteron:
Cara ini memberikan tingkat penyerapan terbaik dan paling stabil dibandingkan dengan 2 pilihan yang sebelumnya. Ini juga merupakan pilihan termudah bagi kebanyakan orang karena hanya perlu mengoleskan gel pada kulit.
Namun, beberapa orang merasa tidak nyaman untuk menggunakannya karena perlu menunggu gel kering .
Ia juga ada risiko transfer testosteron secara tidak sengaja ke pasangan wanita atau anak-anak jika tersentuh.

Jika anda perlu berbicara dengan dokter mengenai Hipogonadisme (Andropause), silakan kunjungi klinik pria kami.
Atau, anda dapat mengirim email kepada kami hello@dtapclinic.com.sg atau hubungi kami untuk membuat janji. Bicaralah dengan dokter Anda hari ini!

Micropenis – Does Size Really Matter?

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When it comes to penis size, many men always feel that big is better. They sometimes like to compare with other men, or worse with the porn actors they see in videos. When comparing with these actors, most men will definitely feel inadequate. This may lead them to think that there is an unusually small penis. They may think that they have a condition called micropenis.
However, not many realise that there is an actual medical condition where the size of the penis is referred to as a “Micropenis”.
But what causes the condition? how small actually is a Micropenis? And how is it treated?

But how small exactly is a Micropenis?

Micropenis refers to any penis which, when stretched, is below 2.5 standard deviations size for the age of the patient.
In adults, the condition refers to any penis smaller than 7cm ( 2.8 inches ) in length.

What Causes Micropenis?

Micropenis may be caused by

  • Growth hormone deficiency
  • Structural anomaly
  • Testicular disorder
  • Genetic syndrome
  • Abnormal hypothalamic or Pituitary function

What are the Treatments for Micropenis?

1. Hormonal Replacement Therapy

If micropenis is diagnosed as being caused by a testosterone deficiency, testosterone replacement therapy is generally highly effective in treating micropenis.
This hormone treatment usually consists of intramuscular injections.
The main ingredient of these injections is testosterone.
Depending on the results, the treatment may or may not be continued.
In most cases, the treatment induces some penile growth, which in return may stimulate additional penis growth.
Many times, the treatment results in a normal sized penis.
On the other hand, sometimes there is no or very small improvement
In cases when a patient is unresponsive to hormonal therapy for micropenis treatment, surgery remains a last resort treatment for adults.

2. Surgical Treatment

Penile enhancement surgery uses an implant in order to effectively enhance the length and girth of the penis.
You will be referred to a urology surgeon if you require surgical treatment in this case.

Frequently Asked Questions (FAQs) on Micropenis

How do I measure my penis?

The most reliable penis measurement is called the Stretched Penis Length. It measures the penis while it’s flaccid.
Press the ruler tight against the pubic bone at the base of the penis.
Don’t just measure from where the penis separates from the scrotum, or you’ll lose precious centimetres.
Now gently, but very firmly, stretch the penis as far as it will go.
Measure from the pubic bone to the tip of the stretched penis.

Does it mean that there is less chance of getting a child with micropenis?

Although the equipment is smaller, it sexually functions like any other penis.
However, it could be difficult to impregnate a woman since it’s further away from the opening of the womb (cervix). And that makes it harder for the sperm to reach the egg.

My penis length is longer than 7 cm but I want it to be bigger. Is that possible?

Length and girth of a penis are normally fixed at a particular size right after puberty. It doesn’t change in size after the man passes puberty. There are products in the market that promises to enlarge your penis like pumps, oils devices etc.
However, these products are not well studied and clinically proven so you will have to try it at your own risks. If you do want to increase the firmness or have some improvement in your penile girth, you can consider ESWT (Extracorporeal Shockwave Therapy). This therapy is not meant for penile enlargement but it helps to increase blood flow to the penis. Some patients noticed their penis appearing bigger due to increased blood flow and firmer erection.

If you think you have micropenis issues, please visit our DTAP Clinics or you can call us, or email us for an appointment at hello@dtapclinic.com.sg for a proper assessment.

Take Care!

Also, Read:

  1. Things to do to maintain your penis health
  2. Paraphimosis – My Foreskin is Stuck
  3. 10 Ways to Improve Sexual Performance for Men
  4. Weak Erection: Does Size Matters?
  5. An Overview of STD by an STD Doctor
  6. Sexual Health Advice for Travellers 
  7. What you need to Know about Erectile Dysfunction 
  8. What You Need to Know about Premature Ejaculation Treatment
  9. What you need to know about Testosterone Deficiency Syndrome
  10. What is HIV / AIDS Signs and Symptoms