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Men's Sexual Health Needs Often Ignored

Men's Sexual online pharmacy Needs Often Ignored
By Peter Hill | Published 10/2/2007 | Men Health | Unrated

We can't agree on what men's sexual health is. We can't agree who's responsible for it. But just hoping it will happen isn't working, a new report concludes.

The study, "In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men," is the work of the nonprofit Allan Guttmacher Institute. One of the report's authors is David Landry, senior research associate at the institute.

"One of the critical factors is that there is no place for men to go for sexual and reproductive health care," Landry tells WebMD. "Men need to be aware, their partners should be aware, that women don't have to assume responsibility alone."

The problem isn't exactly hidden. In fact, it's often front-page news:

• Record rates of sexually transmitted diseases and HIV
• More teen pregnancies and births in the U.S. than anywhere else in the developed world
• Fathers failing to fulfill their responsibilities as parents
• Continued high divorce rates

What would men's reproductive healthcare look like? Sarah S. Brown, director of the National Campaign to Prevent Teen Pregnancy, says the report paints a vivid picture.
"It looks like good education in schools; it means reimbursement for counseling and care for men as well as for women; it means training for physicians in men's and women's sexual health issues," Brown tells WebMD.

Providing more reproductive health services to men shouldn't mean cuts in services to women, Landry is quick to point out.

"Clearly women do need special clinical and diagnostic services," he says. "But the principle types of services we are talking about for men are awareness raising and counseling. These are services which tend to be the least expensive to provide. By providing for men we are also doing something good for women."

One focus of the report is on men in their teens and early 20s. Some findings:

• One in four teens are sexually experienced by age 15. Nine out of 10 men have had sex by their 20th birthday.

• Poor and minority youths begin sexual activity at a younger age than more affluent or white teens.

• More often than not, a man will use a condom during his first sexual experience. Later, condom use declines.

• Only 7% of births involve teenage men.

• Each year, 13% of all abortions involve teenage men. More than half of teenage pregnancies involving teenage men result in a birth.

• Men in their 20s are involved in half of all U.S. births -- and half of all U.S. abortions.

• Eight out of 10 children fathered by men in their early 20s are born out of wedlock.

The report also considers the needs of older men:

• Half of all men father a child by the age of 30.

• Eight of 10 men in their 40s are married or living with a woman.
• By age 49, the average man has had two children.

• More than one in 10 men in their 30s has a child he does not live with.

• Eight of 10 U.S. adults with AIDS is a man.

• Half of all men who use condoms do so for birth control, not disease prevention.

"The value of this report is that it takes a life span perspective," Brown says. "What I love is that it addresses the whole life span of men."

So what do men need? The report says men have several unmet needs. The first of these is the need for better information. Parents, doctors, teachers, and community leaders must be involved in ensuring access to essential information. This includes education on:
• Basic sexuality and reproductive health

• Genital health

• Healthy relationships. Topics should include when sexual involvement is appropriate; forms of sexual expression; sexual coercion and violence; and the influence of alcohol and drugs on behavior.

• Pregnancy prevention, including abstinence and condom use

• Prevention of sexually transmitted diseases and HIV

• The responsibilities of fatherhood

• How to obtain other services

Men also need to learn specific skills.

These include skills in preventing pregnancy and disease, and fathering skills.
Men often need counseling. This should include:

• Help developing self-esteem and gaining a sense of control over one's life and one's decisions

• Help getting through major life events and decisions

• Mentoring in developing values and motivation

Men need healthcare.

This should include preventive services beginning prior to adolescence and continuing throughout life. Doctors should follow AMA guidelines in obtaining a sexual history and in testing for sexually transmitted diseases.
"What we call for is a communitywide effort," Landry says. "We need to raise awareness to a broader extent."

Advocate..

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 Another guest blogger

When this whole thing started, meaning, form the moment I was told, "You have cancer." (and actually, those weren't the words, they weren't even speaking directly to me. They were telling my mom, and said, "She has cancer." and I just happened to be laying in the hospital bed next to her, drugged up from a 9 hour spinal fusion surgery, and overheard them. Either way, same impact.) and for quite some time after being diagnosed, any kind of cancer campaigning really rubbed me the wrong way. Pink ribbons made me angry. And I'll admit, even now, pink buckets of KFC for cancer just seems inane. Part of that is my opinions about the fast food industry, but something about the way cancer awareness is presented to the public, is a bit euphemistic, to the point of being cutesy.



But I'm experiencing, both with myself and through meeting cancer survivors, that once people reach a certain comfort level in their own situations, that there's almost a natural progression towards advocacy and awareness, and just wanting to help. 

My biggest topic, I want to advocate, and actually bring change to, is early detection. And not just to the public, but to the medical industry, as well. Here's a little background on me: I'm 29 now, I was diagnosed 2 years ago at 27. There is no history of breast cancer on my mother's side, my father's sister died of breast cancer at 50. I was 24 at the time, so breast cancer didn't seem like an immediate concern then, though looking back, I probably already had it. Plus, doctor's tell me that paternal genetics don't really factor in, anyway. Well, ok then.

 

But I wasn't a complete dullard. I had been doing self exams in the shower from the time I was a teenager. My mom had this model her obgyn gave her of this little squishy plastic breast with some, what I can only assume were, marbles embedded in it. It hung in the shower, and I felt it, and felt my own, and aside from it not even feeling like a real breast, I never felt anything even remotely close to this doughy, plasticine-like, marble filled maquette in my own breasts. Granted, I was just a teenager at this point, but I continued self exams throughout my 20's, and was told a variety of different methods for examining, and what to look for. I was told, "Lumpy, like oatmeal, was ok lumpy." Well, what kind of oatmeal are we talking about here?? I like my oatmeal lumpy. I was told not to dig around in the breast, that abnormalities would be felt with a flat hand. I was told pain is an indicator, but that premenstrual pain and firming was totally normal. And I was told that every woman has one breast that's larger than the other.



Here's what I did find: one breast was bigger than the other, and before my periods, it would get firm and painful, and the nipple seemed kind of anchored to the interior of the breast, where the other did not. I told my obgyn, who did an exam, and told me to lay off the caffeine. This was probably 6 months before I was diagnosed with Stage IV breast cancer. At that point my main concern was all the other pain I was having. Back pain, chest pain, trouble breathing. I went to several other specialists to address all these other pains, no one really came up with anything. Muscle spasm, was one guess, pneumonia, was another. One of the specialists even did a breast exam. He told me it was most likely Costochondritis, an infection of the ribcage, and it would go away. The night before I woke up unable to walk, with no feeling in my legs, and went to the hospital to learn I had a broken back caused by the metastasis, I remember standing in front the mirror looking at my body, and wondering why I was in so much pain. My whole chest seemed misshapen, and there were dark veins running in the direction of my left breast. Once I was diagnosed the oncologist even said that my tumor is not easy to locate. It was large, and flat, and just kind of blended in. Looking back, that firmness I felt around my periods was probably the closest I ever was to detecting it before it metastasized. But I did mention that to my doctor's, and was told it was pretty normal, just stop drinking coffee. So I don't know what else I could have done to catch it any earlier.



I recently reconnected with a friend and told her my story. She is 32, and said that she has similar symptoms with her breasts, pain, firmness, size difference, even chest pain. I don't want to make anyone paranoid, or turn them into a hypochondriac, so I just told her to see her doctor. She did... they told her to stop drinking coffee. Hearing those words again, made me shudder. I understand it would be unlikely, for a friend of mine to have the the exact same condition, but because I have it, there's no way I can sit here and say it's not a very REAL possibility. Because it is REAL for me. And the sad truth is that cancer IS almost that common.



So my dilemma is, what do I do with this? How can my story help? Especially since my story consists of me having next to no symptoms until it was already advanced! I don't know how that's supposed to help anyone? But I do feel the first step is putting my story out there, and seeing what comes from that.

 

 I understand the medical industry is not going to start doing mammograms on every 25 year old, with no maternal family history of cancer, who's breasts hurt occasionally. But maybe if people weren't only specifically looking for perfectly round marbles, or extra lumpy oatmeal, or knew that zombie veins on their chest might mean more than just poor circulation, and if doctors exams were a little less generic, and their patients concerns weren't dismissed due to age.... then maybe, someone, anyone, might not find themselves where I am now. And that would be something.

 

About the guest blogger:

Kourtney Logan Lampedecchio was diagnosed with stage IV HER2/neu positive breast cancer at the age of 27. Upon discovery it had already metastasized to her spine, deteriorating the T3, 4, and 5 vertebrae, requiring a spinal fusion surgery. Recently, 12 brain metastasis where discovered, and she just finished a course of radiation to treat those. Through it all, Kourtney continues to pursue her passions of spending time with her horse and dog, friends and family, who are her support system, and without them would be lost. She is also continuing to pursue her professional and academic goals of becoming a scenic designer for theatre, by working freelance in the Sacramento, CA area, and attending graduate school in the fall at UC Davis, where she is also currently undergoing treatment. She is now 29, and lives with her family in Placerville, CA. 

You can check out her blog at http://www.kourtneylogan.blogspot.com/