Mental Health | Movember 2020

Latest statistics show that the number of male suicides in Singapore is double that of women. 

Mental health experts are not surprised by this finding. Men are generally less willing to express their vulnerabilities. They usually feel it’s not manly to be sharing their feelings or problems. 


Suicide prevention service Samaritans of Singapore (SOS) said 239 men committed suicide in 2017, compared with 122 women.

The majority of the men were 60 years old or older.

• Men are often reluctant to openly discuss their health or how they feel about the impact of significant life events;

 • Men are more reluctant to take action when they don’t feel physically or mentally well, and; 

• Men engage in more risky activities that are harmful to their health. 

These behaviours are strongly linked to adherence to some harmful aspects of traditional masculinity. Men often feel pressure to appear strong and stoic, and talking about feeling mentally or physically unwell can be perceived as weakness. By allowing negative and harmful aspects of masculinity to be considered the norm, men feel there’s only one way they can be considered “manly”.

How to prevent it?

Use the ALEC model

Ask

Start by asking how he’s feeling. It’s worth mentioning any changes you’ve picked up on: has he stopped replying to texts? Does he sound different on the phone? Has he gone quiet in the group chat? Use a prompt like,”You haven’t seemed yourself lately – are you feeling OK?”
Trust your instinct. Remember, people often say “I’m fine” when they’re not, so don’t be afraid to ask twice.

You can use something specific you’ve noticed, like, “It’s just that you haven’t been replying to my texts, and that’s not like you.”

Listen

Give him your full attention. Let him know you’re hearing what he’s saying and you’re not judging. You don’t have to diagnose problems or offer solutions, but asking questions lets him know you’re listening. Ask a question like, “That can’t be easy – how long have you felt this way?”

Encourage Action

Help him focus on simple things that might improve how he feels. Is he getting enough sleep? Is he exercising and eating well? Maybe there’s something that’s helped him in the past – it’s worth asking. Suggest that he share how he’s feeling with others he trusts. This will make things easier for both of you. And if he’s felt low for more than two weeks, suggest that he chat to his doctor.

Check In

Follow up your conversation with a phone call or FaceTime. This helps to show that you care; plus, you’ll get a feel for whether he’s feeling any better.

Where to seek help?

Samaritans of Singapore: 1800-221-4444

Singapore Association for Mental Health: 1800-283-7019

Institute of Mental Health’s Mental Health Helpline: 6389-2222

Care Corner Counselling Centre (Mandarin): 1800-353-5800

Shan You Counselling Centre (Mandarin): 6741-0078

Silver Ribbon: 6386-1928

Tinkle Friend: 1800-274-4788


Start a conversation with your friends and loved ones. Create awareness. Encourage those at risk to seek help. Together we can help to reduce deaths among men from the above conditions.

Why Keeping Active and Eating Well Are Not Enough – Maintaining Good Air Quality Is Also Key to A Healthy Lifestyle

Given the events of 2020, you are likely spending more time indoors, specifically in your own home, than ever before. While we often put time and energy into eating well and staying active, there is a hidden health culprit in our now more highly frequented home environments that we rarely consider – the air we breathe.

Keeping ourselves and our families healthy during this pandemic is on everyone’s mind. And while many of us can apply nutrition and movement to our health routine, it’s important to remember that good air quality is just as pivotal to our overall health, especially for those who suffer with allergies or respiratory issues.

Maintaining good air quality might seem simple: have good ventilation, control contaminants, and maintain optimal humidity to reduce allergens like dust mites, fungi and mold. Yet, there are many lesser-known challenges of maintaining optimal air quality throughout our indoor spaces.

Without proper knowledge, ensuring the good quality of the air we breathe in our indoor spaces, like our homes, offices and schools, is easier said than done. There are many factors that can affect the air quality in your home and by extension your health, but the variables that affect indoor air quality can be broken down into three main categories: indoor environmental issues, indoor air contaminants, and insufficient air exchange.


Indoor Environmental Issues

Indoor environmental issues include humidity, which can affect your health in two ways. First, if there is too much moisture in the air (high humidity) and you are asthmatic, you may notice an increase in your asthma attacks. High humidity can also contribute to dust mites and fungi spore growth. On the other end, if there is not enough moisture (low humidity), you and your family may suffer from respiratory tract infections frequently.

Other indoor environmental issues include poor air circulation, meaning there is very little airflow or movement in your house. This might be a problem if you have very few windows in your home or office. You may not be in an area where you can leave your door open to let in the fresh air.

Indoor air quality can also be affected by ventilation system issues, specifically the condition of your HVAC system. The air might be unevenly distributed throughout the system. Another problem might be that the exhaust ventilation is insufficient.

Modern homes are particularly vulnerable to this type of problem.


Indoor Air Contaminants

You may be surprised by the number of air contaminants that can affect our indoor spaces and prevent healthy breathing. These include pollutants from human actions such as smoking tobacco. Construction materials in new homes and remodels are also damaging to air quality from resulting particles including fiberglass, asbestos, formaldehyde and dust.

There are also harmful chemical solvents hidden in everyday items like perfume, glues, disinfectants, cleaning solutions, solvents, pesticides, paints and even our carpets and furniture, where bacteria, fungi and molds can live.


Insufficient Air Exchange

In order to keep the air inside as healthy as possible, you should always have good external ventilation of air frequently. Stagnant air carries a higher concentration of aerial contaminants and allergens.


Maintaining Better Health with Healthy Air Quality

There are many hidden health culprits existing in our modern indoor spaces. Even in our own homes. Unlike other elements of maintaining a healthy lifestyle such as exercising or eating well, keeping our air quality clean is low-maintenance and a low-time investment with a simple piece of technology: an air purifier.

While there are several reasons why you should consider an air purifier for your health, we have listed our top five reasons:

1. Keep allergies at bay

Allergy sufferers know how absolutely debilitating an allergy attack can be. Sometimes the symptoms can be quite overwhelming which include sneezing, a runny nose, coughing, post-nasal drip, nasal congestion, itchy nose and eyes.

Regardless of your allergies, an air purifier will help ensure your indoor air quality is at a healthy level, helping you to control and improve symptoms. Air purifiers are also quite adept at filtering out the harmful allergens and are recommended for allergy sufferers, as they provide added protection against severe attacks.

2. Managing pets impact on allergies

Pets are well-known causes of many allergies. An air purifier allows you to have pets even if you have allergies, as it helps to remove pet dander (dead cells from hair and skin) in the environment that may worsen allergic symptoms.

3. Improving respiratory problems

If you or a loved one suffers from asthma or any condition that might be worsened by allergies, an air purifier is an excellent idea. Sometimes attacks are unpredictable so keeping your air clean and healthy with an air purifier helps minimize attacks and makes breathing easier.

4. Improving air quality in a new home

If you have just moved into a new home, it is a good idea to buy an air purifier. It may help to remove harmful irritants like paint fumes leaving the air healthy to breathe.

5. Lessening the impact of tobacco smoke at home

If a loved one is a smoker and you have allergies or breathing issues, it can be tough. However, an air purifier can contribute to cleaner air.

I certainly want you and your loved ones healthy on the other side of this pandemic.

Prostate Cancer | Movember 2020

Movember is a month to create awareness for Men’s health. 

Why do we need to create this awareness? 

There are an increasing number of men suffering from specific conditions unique to men like prostate cancer, testicular cancer and also mental illness. On top of them there are more men dying from these conditions. 

In this article, we will touch on prostate cancer.

Prostate cancer

Prostate cancer is the 3rd most common cancer diagnosed in males in Singapore and accounts for 12% of all male cancers diagnosed from 2008 to 2018. According to the Singapore Cancer Registry report from 2015, the incidence has been increasing from 9.7 per 100,000 previously to 28.5 per 100,000 in 2008-2012.

Males in Singapore have a higher rate of prostate cancer than their counterparts in Asia, for example, China, Japan and India. Locally, Malay and Indian men appear to have a lower risk of prostate cancer as compared to Chinese men at about 15.9-17.9 per 100,000 as compared to 25.6 per 100,000.


What is Prostate Cancer?

Prostate cancer is cancer that occurs in the prostate.

The prostate is a walnut shaped gland located just below the bladder surrounding the urethra. The prostate’s function is to produce seminal fluid. This fluid is necessary to nourish and transport sperm that is produced in the testes.


Who is at risk?

Prostate cancer can affect any man. However some are at higher risk than others.

These include:

  • Men above 50. The risk of prostate cancer increases with age especially after the age of 50. More than 80% are diagnosed in people 65 years and older.
  • Family history of prostate cancer. 20% of prostate cancers occur in men who had a history of prostate cancers in their family. This type of prostate cancer is due to inherited genes and shared environmental or lifestyle factors. Having a brother or father with prostate cancer increases your risk 2 to 3 times. Having a sister or mother with breast or ovarian cancer also increases your risk.
  • Ethnicity – Men of African ancestry are at higher risk of prostate cancer compared to men of other races. 
  • Obesity – Men with BMI higher than 27.5 are at a higher risk for many different types of cancers including prostate cancer. Lack of physical activity and poor eating habits are also contributing factors.

Prostate Cancer Screening

  • Prostate Specific Antigen (PSA): This is a blood test that looks out for a protein released by the prostate. This level is usually elevated in benign prostate enlargement, prostate cancer or prostate inflammation.
  • Digital rectal examination: This is a medical examination performed by the doctor. The doctor will place his finger gently in the back passage (rectum) to feel the texture and size of the prostate. In prostate cancer it may be enlarged or have abnormal nodules.
  • Family history: The doctor will ask for any history of prostate, ovarian or breast cancer in the family.
  • Prostate Biopsy: An ultrasound guided biopsy is performed to determine the presence of cancer. This is usually performed if any of the previous screenings mentioned above is suspicious for prostate cancer.

Prostate Cancer Screening Singapore


How do we prevent it?

Fruit and vegetables: Consuming a wide variety of fruits and vegetables has moderately good evidence to reduce prostate cancer risk. Garlic and spring onions has been shown to boost immune system and reduce prostate cancer risk

Lycopene, green tea, soy products and pomegranate: Some limited evidence has shown that the above foods may reduce prostate cancer risk. You can obtain lycopene in cooked or processed tomatoes, watermelon and guavas.

Maintain a healthy weight: Obesity is a known risk factor for prostate cancer. Obese men are at higher risk for developing aggressive forms of prostate cancer.

Stay active: Higher physical activity shows a small to moderate protective effect against developing prostate cancer especially advanced  cancer. Exercise helps to boost our antioxidant defense and fight cancer causing changes in the body.

Reduce fat intake: A higher fat intake has been associated with a higher risk of prostate cancer and its progression. By reducing your fat intake from animal and dairy sources, it can improve cardiovascular health and reduce risk of prostate cancer.

Quit Smoking: Smoking has a significant impact on occurrence of prostate cancer that can lead to death. Smokers were 20% more likely to develop prostate cancer compared to non smokers. By not starting or quitting smoking, it reduces your risk of getting advanced prostate cancer.

With the above information, I hope it can help you make the right decision in prevention and screening for prostate cancer. Do consult your doctor if you would like to screen for prostate cancer or if you have any urinary symptoms.

Other articles on prostate health: Prostatitis, Enlarged Prostate What You Need To Know, Prostate Cancer Screening & What you need to know about prostate massage.

7 Common Causes For Painful Ejaculation

Should pain come right after delightful joy with your partner? No! There is no such thing as extreme joy culminating in sharp pain. If it happens to you, my friend, you need to get some advice.

Painful ejaculation is the most simple term to describe it. There are many other terms in the dictionary like dysejaculation, odynorgasmia, post orgasmic pain, dysorgasmia or orgasmalgia, etc etc but really there is no other simpler term to describe it but painful ejaculation.

To be honest it is quite a common but poorly understood phenomenon associated with sexual dysfunction. 

It actually happens in  1–10% in the general population depending where you live and it actually increases to 30–75% among men who suffer from chronic prostatitis or chronic pelvic pain syndrome.

The severity of painful ejaculations may vary from a minor discomfort to excruciating pain (Really it may occur anywhere including penis, scrotum and perineal/perianal region, you get the idea…) The pain typically starts immediately before or during ejaculation and commonly lasts between 2 to 24 hours. It can be so painful that you can get turned off and your partner dissatisfied and concerned at same time.

So why do we have this happening?


7 simple reasons why

1. Infections, infections, sexually transmitted infections.

 One other thing that all men share besides our obvious anatomy, is our prostate.

The prostate is like the major town where our semen has to flow through and contributes to the flow. Imagine if there is congestion at the town caused by inflammation and foreign bacteria attacking. The very thought itself is painful. Chlamydia is often one STD/STI that results in prostatitis.

2. Stones

Nope, not the rolling stones but the ones that get stuck in the seminal vesicles which are like the canals of Venice but in our town of prostate.

3. Nerve causes

Sexual neurasthenia, wow big word here but it just means sensitive nerves firing off ad nauseam till they are painful and tired out.

4. Drugs

Essentially there is a small risk with all antidepressants: tricyclic antidepressants (TCAs, e.g. clomipramine, imipramine, desipramine, protriptyline, amoxapine), the selective serotonin reuptake inhibitors (SSRIs, e.g. fluoxetine), venlafaxine and the MAOIs

5. Prostate issues

Yes, the prostate itself can have issues with its own inhabitant cells with inflammation of prostate , prostate cancer, benign prostatic hyperplasia .

6. Post operation

Any prostate surgery , pelvic radiation and hernia repair amongst others.

7. Psychiatric

Sometimes it has nothing to do with the town but the overall governance of the town.

Psychological issues may also be the cause of painful ejaculations, especially if the patient does not experience this problem during masturbation.

Idiopathic – sometimes things just happen.


What can doctors do for us? Rigorous medical and sexual history! This along with chronological order of events is very important to finding out why. The type and location of the pain matters too. It is just not enough to tell the doc pain pain.

He/she will then do a focused physical examination that may disclose scars from previous surgeries or radiotherapy in the groin area whereas skin lumps and penile discharge may be suggestive of sexually transmitted diseases. Palpation of a swollen and painful prostate during digital rectal examination is a diagnostic finding for acute prostatitis whereas a nodule can be felt in the presence of a prostate cancer. 

Similarly, a urine test may confirm the location of urinary infection and confirm the diagnosis of prostatitis. And blood tests for prostate specific antigen levels may also suggest prostate issues if raised.

Abdominal CT scans are rarely required. MRI studies may be helpful when investigating the cause of pudendal neuropathy. However, no obvious aetiology is found in a significant number of patients with the complaint of painful ejaculations, despite extensive investigation. Which lies in our Idiopathic category above.

Treatment of painful ejaculation must be tailored according to the underlying cause, if detected. 

Remember friends, painful ejaculation should never ever be taken for the peak of joyous fun with your partner. Stay safe!

Next read: Delayed Ejaculation | Premature Ejaculation

Mycoplasma Hominis

What is Mycoplasma hominis?

Mycoplasma hominis is a tiny bacterium which can be transmitted through sexual contact. It is a member of the Mycoplasma spp. family which also include Mycoplasma genitalium


How is Mycoplasma hominis transmitted?

Mycoplasma hominis is most commonly transmitted through sexual contact – genital-to-genital intercourse as well as oral-genital intercourse. It can also be transmitted from mother to neonate during vaginal delivery.

Most infections are acquired in sexually active adults and colonization, which is when one carries the bacterium but has no symptoms, can occur. 


What are the symptoms of Mycoplasma hominis?

Many individuals with Mycoplasma hominis may be asymptomatic, i.e. they have no symptoms whatsoever. 

In men who do experience symptoms, they may notice possible symptoms of urethritis (inflammation of the urine tube) – pain or discomfort in the urine tract/when passing urine or penile discharge. 

Women with Mycoplasma hominis infrequently have symptoms. However, Mycoplasma hominis can be associated with bacterial vaginosis, a vaginal infection with overgrowth of bacteria that are not normally part of the normal vaginal flora. 

Also read: Common Medical Conditions That Are Asymptomatic


What are possible complications of Mycoplasma hominis?

While there is some research that suggests Mycoplasma hominis infection may be possibly associated with complications in pregnancy and that it may have a correlation with developing pelvic inflammation and infertility, there is currently no consensus or conclusive data about this. 


How is Mycoplasma hominis diagnosed and treated?

Mycoplasma hominis can be diagnosed through a culture test, where the bacterium is grown from either a urine sample (if from a male) or a swab sample (if from a female), or a PCR test, which looks for the presence of the bacterial DNA in the aforementioned samples. 

Various types of antibiotic treatment can be used to clear a Mycoplasma hominis infection. However, the choice of antibiotics will depend on whether the specific strain of Mycoplasma hominis isolated has any antibiotic resistance or not. 


How can I prevent or avoid Mycoplasma hominis? 

As with all STDs, safe and responsible sexual practices are crucial in prevention of Mycoplasma hominis infection. These include using barrier protection if possible e.g. condoms, doing regular sexual health screening and also ensuring that you know your sexual partner’s infection status. 

Next read: 10 things you didn’t know about this STD: Mycoplasma Genitalium

Epididymitis

The epididymis is a ductal system behind the testis and serves as a conduit for sperm produced in the testicle to be transported into the Vas Derferens to eventually reach the urethra. Epididymitis is a condition where the epididymis becomes inflamed usually from an infection, though trauma and autoimmune disease is a possible cause.


Signs & Symptoms

Symptoms of epididymitis include localised testicular pain and swelling of the posterior aspect of the testicle. The area can sometimes be warm to touch with redness of the scrotal skin. The area will be  painful when being examined with relief of the pain achieved when the area is elevated. 

Severity and etiology of epididymitis varies with the age of the patient. For young children presenting with testicular pain, a diagnosis of Testicular Torsion needs to be considered first, after which a mumps infection affecting the testicle needs to be ruled out. For sexually active men under 35 years of age, Gonorrhea and Chlamydia are the 2 most common organisms responsible for epididymitis. In older patients, epididymitis can occur concurrently with prostatitis especially if there is an underlying prostatic obstruction such as Benign Prostatic Hyperplasia (BPH) or recent catheterization.

Rapid STD Test for Chlamydia and Gonorrhoea


Most cases of epididymitis can be treated outpatient with oral non-steroidal antiinflamatory drugs (NSAIDS), local application of ice and oral antibiotics. A urine test is sometimes done to determine the organism causing the infection. Patients with epididymitis generally improve within 48 – 72 hours. If the symptoms do not abate within that period, an alternative diagnosis needs to be considered and further imaging such as a scrotal ultrasound performed.

The Signs & Symptoms Of Chlamydia In Women & Men


Today we are going to talk about the signs and symptoms of Chlamydia in Men and Women.

Chlamydia is one of the most common bacterial Sexually Transmitted Infections (STIs) worldwide. It is caused by a bacterium called Chlamydia trachomatis. According to the United States Centers for Diseases Control and Prevention, Chlamydia is the most frequently reported bacterial STI in the US, with approximately 2.86 million infections reported every year.

The reason why Chlamydia is so common is because most individuals with Chlamydia do not have any symptoms. In fact, less than 50% of both men and women with Chlamydia develop symptoms. Asymptomatic individuals may be unaware that they are infected and continue to spread it to their sexual partners.

If symptoms do develop, they may occur anytime from days to weeks after the initial infection.


Symptoms of Chlamydia in men

  • Dysuria, or painful urination
  • Urinary frequency and urgency
  • Discomfort along the urethra, or urinary tract
  • Penile discharge 
  • Pain or swelling of the testicles due to a less common but serious infection known as epididymo-orchitis
  • Pain or discomfort in the pelvis due to prostatitis, which is inflammation of the prostate gland

Symptoms of Chlamydia in women

  • Abnormal vaginal discharge which may be different in colour, odour, quantity and consistency
  • Bleeding after sexual intercouse 
  • Abnormal spotting or bleeding in between menstrual periods
  • Painful sexual intercourse
  • Chronic pelvic or abdominal pain and/or fever due to a complication known as Pelvic Inflammatory Disease, whereby the infection spreads upwards to affect the uterus and fallopian tubes.

There are other complications of Chlamydia that can affect both men and women.

Firstly, conjunctivitis, which is an infection of the eye lining, can occur after contact with infected fluids. Symptoms include eye discharge, irritation, redness and lid swelling.

Next, proctitis, which is inflammation of the rectum due to anal sex, usually does not cause symptoms. If symptoms do occur, individuals may experience rectal discomfort, discharge or pain

Lastly, oral chlamydia, which results from providing oral sex, again usually does not cause symptoms. If symptoms do occur, individuals may experience sore throat, painless sores in the mouth, tonsillar swelling and painful swallowing.

Chlamydia can be tested using urine or swabs from the throat, rectum, cervix and urethra. Rapid testing is available at our clinics. Treatment involves a course of oral antibiotics to eliminate the bacteria.

Next read: Common STD Incubation Periods


If you would like to find out more about Chlamydia Testing and Treatment, come down to any of our clinics for a consultation.
Rapid Chlamydia & Gonorrhoea PCR Screening (Next Day Results) is available in all our clinics in Singapore.

Candidiasis in Men


Candida or yeast infection can affect men too. This may lead to a condition known as balanitis — inflammation of the head of the penis.

Yeast infections in men are common because the fungus that causes yeast infections (candida) is normally present on skin, especially moist skin. 

Balanitis is more common in uncircumcised men.


Signs and symptoms of Balanitis

  • Moist skin on the penis, possibly with areas of a thick, white substance collecting in skin folds
  • Areas of shiny, white skin on the penis
  • Redness, itching or a burning sensation on the penis

You may be more likely to develop balanitis from a yeast infection if you:

  • Aren’t circumcised
  • Use antibiotics for prolonged periods
  • Have diabetes
  • Have an impaired immune system, such as with HIV
  • Are overweight
  • Practice poor hygiene

If you and your partner both have symptoms of a yeast infection, it’s important that you both be treated to avoid reinfecting each other.


Treatment options

Treatment includes topical creams or oral medication. Usually this treatment works well in clearing the infection.

However, in some men, this infection may be recurrent and occurs several times a year. This happens more often among men with diabetes as they are at higher risk of infection. In cases of recurrent balanitis, circumcision would be the best solution to prevent recurrent balanitis.

Do see a doctor if you are experiencing any of these symptoms.

Just got diagnosed with HIV? What is next?

You have just been recently diagnosed with HIV. You’re likely experiencing a rollercoaster of emotions and have lots of questions which are understandable. As you go through these feelings, whether of anger, fear, sadness or guilt, it is important to first take a deep breath and begin the process of finding a health care provider and as much as possible, look for any form of support available. 


Finding Support

1. Friends & Family

As you are coming to grips with the new diagnosis, you may face difficulty as to what the next step will be. You may want to talk about it with a trusted friend or family member. Although you may feel uncomfortable with breaking the news, you may realize that shouldering the burden alone actually makes it more difficult to process the news and that telling someone you trust may be a positive experience as it can help you get the much-needed support and it may actually strengthen relationships. It is important to be informed of the condition yourself – it may be best to obtain information about HIV before telling others about the new diagnosis. There are many myths that surround HIV which contribute to the stigma attached to it but by knowing more about living with HIV can reassure your loved ones that with effective medications available, you can live a long and healthy life.


2. Telling your partner

It is important to let your current or former partners know that they may have been exposed. They then should be tested for HIV. It is encouraging to know that many people living with HIV continue to have relationships and can have children who don’t have HIV. The term ‘undetectable = untransmittable’ (shortened to U=U) was coined and is used as a campaign to prevent sexual transmission of HIV without the use of condoms based on numerous studies that demonstrated this. This is achievable by taking treatment daily and having undetectable viral load levels for at least 6 months. However, until U=U is achieved, the proper use of condoms must be done to prevent transmission. In addition, your partner may also want to consider PrEP, in addition, to use of condom before you achieve undetectable viral loads for at least 6 months.


3. Clinics & Support Groups

As HIV is a chronic medical condition that requires lifelong follow-up and treatment, it is essential to establish a relationship with an HIV health care provider that is as honest and open as possible. You may either be managed at the clinic where the HIV diagnosis was made or referred to an HIV specialist and their team for HIV management. 

Among other tests, the key ones that will be done at the first clinic visit as well as during subsequent visits are HIV viral load as well as CD4 counts. The HIV viral load is a measure of the amount of virus detectable in the blood and the CD4 count is the amount of CD4 cells, which are white blood cells that play an important role in the immune system. The goal for everyone living with HIV is to reach an undetectable HIV viral load as quickly as possible.

Many guidelines recommend that HIV treatment be started immediately after the diagnosis is made. This is because studies have shown that immediate treatment can lower the risk of long term effects on the immune system and reduce the risk of HIV transmission.  

There are many support groups available where you can be a part of, to obtain further information from or would simply like to reach out for a listening ear as you may not be ready to tell your friends or family about the new diagnosis.

Here is a list of support groups available in Singapore & Malaysia:

Action for AIDS (AFA) (Singapore)

Oogachaga (Singapore)

GayHealth.sg (Singapore)

PT Foundation (Malaysia)

This article is written by Dr. Ezlyn Izharuddin. Dr Ezlyn has experience in HIV Treatment and Management, as well as other Infectious Diseases management.


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Lelaki Dan Diabetes

Menjelang tahun 2030, jumlah penduduk Singapura yang berumur di atas 40 tahun dengan diabetes diramalkan  meningkat sebanyak 200,000 lagi dari sekitar 400,000 orang sekarang.

Penyebaran diabetes di kalangan orang dewasa meningkat dari 8.2% pada tahun 2004 kepada 11.3% pada tahun 2010. Sebilangan besar lelaki adalah diabetes (12.3%) berbanding dengan wanita (10.4%). Kita dapat membayangkan bagaimana jumlahnya akan bertambah lebih banyak pada hari ini.

Bagi lelaki yang hidup dengan diabetes jenis 2, mereka juga berisiko lebih tinggi untuk penyakit  tertentu berbanding lelaki lain. Dalam artikel ini saya akan berkongsi lebih banyak mengenai masalah kesihatan lelaki yang dihadapi oleh lelaki dengan diabetes jenis 2.

1) Disfungsi ereksi (ED)

Menurut kajian yang diterbitkan dalam Journal of Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, lelaki yang menghidap diabetes lebih cenderung mengalami ED berbanding lelaki yang tidak menghidap diabetes. Glukosa darah tinggi menyebabkan kerosakan pada saluran darah kecil dan / atau saraf seperti yang membekalkan zakar. Oleh itu diabetes yang kurang terkawal menyumbang kepada ED.

Selain kawalan gula, terdapat juga beberapa ubat diabetes yang menyebabkan kesan sampingan seperti ED.

Selain diabetes, lelaki ini biasanya juga gemuk dan menderita hipertensi, yang mana kedua-duanya juga menambah risiko ED.

2) Jangkitan saluran kencing: Jangkitan saluran kencing (UTI) biasanya disebabkan oleh bakteria.

Ia boleh menjejaskan bahagian saluran kencing. Di mana sahaja termasuk buah pinggang, pundi kencing, ureter, uretra, dan, pada lelaki, kelenjar prostat. Selalunya jangkitan berlaku di pundi kencing. Wanita 10 kali lebih mungkin mendapat UTI berbanding lelaki. Namun lelaki yang menghidap diabetes berisiko lebih tinggi mendapat UTI daripada lelaki tanpa diabetes. Mengapa lelaki yang menghidap diabetes lebih cenderung kepada UTI? Terdapat beberapa kemungkinan sebab. Satu, lelaki yang menghidap diabetes mempunyai peredaran yang lemah. Ini mengurangkan keupayaan sel darah putih untuk bergerak di dalam badan dan melawan segala jenis jangkitan. Dua, tahap glukosa yang tinggi juga dapat meningkatkan risiko UTI. Tiga, beberapa lelaki yang menghidap diabetes mempunyai kemampuan yang lemah untuk mengosongkan pundi kencing mereka. Apa yang berlaku adalah, air kencing berada di dalam pundi kencing terlalu lama dan ini menjadi kondusif untuk pertumbuhan bakteria.

3) Balanitis: Balanitis adalah jangkitan pada kulit pada kepala (glans) zakar.

Pada lelaki yang tidak disunat, kawasan ini dilindungi oleh kulup, atau kulit. Balanitis boleh berlaku pada lelaki yang disunat dan tidak disunat, namun, lelaki yang tidak disunat berisiko lebih tinggi untuk balanitis dan juga jangkitan berulang.

Mana-mana lelaki boleh mengalami balanitis, tetapi keadaannya kemungkinan besar terjadi pada lelaki yang mengalami phimosis (kulup ketat) atau kebersihan yang buruk. Selain kumpulan lelaki ini, lelaki yang menghidap diabetes juga berisiko tinggi mengalami balanitis terutamanya jika mereka mempunyai kawalan gula yang buruk. Apabila gula kurang terkawal, gula berlebihan dapat dikeluarkan dalam air kencing. Air kencing kaya gula ini apabila terperangkap di bawah kulup, akan memberikan persekitaran yang kondusif untuk ragi dan bakteria. Selain itu, lelaki dengan diabetes yang tidak terkawal juga tidak dapat melawan jangkitan dengan berkesan.

4) Posthitis: Posthitis adalah radang kulup.

Ia dicirikan oleh bengkak atau kemerahan kulup. Dalam beberapa kes, ia mungkin berlaku bersama dengan air mata di kulup yang mungkin agak menyakitkan. Biasanya disebabkan oleh jangkitan seperti jamur atau bakteria. Dalam beberapa kes, ini mungkin disebabkan oleh air mata di kulit akibat lelasan atau geseran semasa persetubuhan. Penjualannya boleh menyebabkan phimosis dan keketatan pada kulup yang menyukarkan kulit untuk menarik kembali.

Sunat biasanya merupakan rawatan yang pasti bagi lelaki yang mengalami balanitis posthitis berulang atau UTI. Merupakan rawatan yang sangat berkesan untuk mengurangkan risiko UTI, balanitis dan juga tidak akan ada lagi penyakit posthitis ketika kulup dikeluarkan.

5) Testosteron Rendah: Dalam beberapa tahun kebelakangan ini, saintis menemui beberapa kaitan antara testosteron rendah dan diabetes.

Satu kajian menunjukkan bahawa pada 2.100 lelaki berusia lebih dari 45 tahun, kemungkinan mempunyai testosteron rendah adalah 2.1 kali lebih tinggi pada lelaki dengan diabetes. Testosteron rendah tidak menyebabkan diabetes tetapi mungkin sebaliknya. Lelaki yang menghidap diabetes mungkin mengalami testosteron rendah. Hubungan antara diabetes dan testosteron rendah sudah terjalin. Lelaki dengan diabetes lebih cenderung mempunyai testosteron rendah sementara lelaki dengan testosteron rendah juga cenderung menghidap diabetes. Testosteron meningkatkan keupayaan tubuh untuk mengambil gula sebagai tindak balas terhadap insulin. Lelaki dengan testosteron rendah mungkin mempunyai ketahanan terhadap insulin. Dalam keadaan ini, tubuh mereka perlu menghasilkan lebih banyak insulin untuk mengurangkan jumlah gula yang sama dalam darah.

Oleh itu, sekiranya anda didiagnosis menghidap diabetes jenis 2, perhatikan beberapa perkara yang dinyatakan di atas. Sekiranya anda mengalami salah satu daripada syarat di atas, pertimbangkan untuk menjalani pemeriksaan kesihatan. Rujuk doktor anda sekiranya anda mengalami gejala dan keadaan di atas