Why are psychosocial issues important?Living with a reproductive health problem can often affect men psychologically as well as physically. Relationships can suffer, quality of life can be reduced and aspects of the social side of life can be affected.
How to cope with the distress that is felt and learning to utilise the social support that is available is important when dealing with sexual and reproductive health problems. In some instances, treatment and recovery may be delayed by failing to deal with the psychological side, making the understanding of psychosocial issues an important part of treating male sexual and reproductive health problems.  Back to top
How much is known about psychosocial issues?Currently, there is little information available on the psychosocial aspects of male reproductive health problems, although some information is available about the life-threatening reproductive disease prostate cancer. Back to top
Do male reproductive health problems affect relationships?Male sexual and reproductive health problems can have a significant impact on relationships, particularly those with partners. Many men do not feel comfortable speaking to others, even their partner, about personal matters such as their sexual or reproductive health. Partners are often the first to identify that a problem may exist, but many men are reluctant to then speak to a health professional, thinking that the problem may go away or, in some cases, that it is an inevitable part of ageing. Partners may feel anxious and upset if they feel that professional help is needed but not being sought and they may also be worried about the man’s long-term health.
From the male’s perspective, it is common for men with infertility to be concerned about the medical impact on their partner if seeking infertility treatment. This is because it is the women who must then undergo the often-invasive treatment to achieve a family even though the infertility is not female-based. Some men will even suggest that their marriages end so their partners can find another partner who is fertile.
Some sexual and reproductive health problems also have an impact on social networks and relationships. For example, prostate enlargement (BPH) may limit a man’s social life by the need to have easy access to toilets. In cases of infertility, some women try to “protect” their partners by telling others that it is they who have the infertility problem. They are often concerned people might judge their male partners to be less than fully masculine. Back to top
Do male reproductive health problems affect masculinity?Masculinity refers to the socially constructed ideas about qualities and characteristics that are appropriate for men. It can relate to physical characteristics (for example, muscle development, facial and body hair) and to behavioural or emotional characteristics (for example, dominance, aggression).
Being told that there is a reproductive health problem can strike at the core of man’s feelings of being a male. For example, most infertile men at some time struggle with the idea that they are not able to do what other men can. This often leads men to confuse their infertility with their sense of masculinity, sexuality, virility and potency. Similarly, losing a testis as a result of testicular cancer treatment can sometimes lead to stress in regard to a change in body image and feelings of being less sexually attractive.
Concerns about future fertility are also common. It is not unusual for men to experience episodes of erection difficulties while they try to come to terms with a diagnosis of infertility or outcomes from testicular cancer treatment.
In contrast, androgen deficiency does have a direct effect on being male as the body is not producing enough testosterone for all parts of the body to function normally. Back to top
Is quality of life affected by sexual and reproductive health problems?Excluding prostate and testicular cancer, male sexual and reproductive health problems are generally not considered life-threatening. Although there has been little research on the association between quality of life and male reproductive health, it is generally acknowledged that these problems can adversely affect a man’s mental and physical health and therefore their quality of life and sense of well-being.
Men with erectile dysfunction and low sexual desire are reported to experience reduced quality of life. Sex is a normal part of life and an important part of many relationships, and difficulty getting and keeping an erection can have serious physical and psychological consequences. Seeking help to keep an active sex life is important, regardless of age or whether or not the man is involved in an ongoing relationship. Erectile dysfunction is often an early warning sign for life-threatening health issues such as diabetes or heart disease and these illnesses can also severely affect quality of life. Men suffering from androgen deficiency can often experience a lack of motivation or low self-confidence which can lead to a reduced ability to endure workrelated pressure or perform at work.
Studies have shown that men with significant lower urinary tract symptoms (LUTS) have lower quality of life scores. Pain, sleep deprivation due to repeated visits to the toilet during the night, and an ongoing need to pass urine are just a few of the consequences of this disease which can have a negative impact on quality of life. Treatments for prostate disease can sometimes also affect quality of life due to a subsequent inability to get an erection or development of incontinence. Quality of life issues are often taken into account in the decision-making process when considering the most appropriate treatment. Awareness of what to expect after treatment can prepare men to manage possible erection or toileting problems. Back to top
What role do partners play in the treatment of sexual and reproductive health problems?Male sexual and reproductive health problems and their treatment can affect partners, families and lifestyle. Understanding the problem and how the treatment works will enable couples to work together and gain a positive result from treatment.
Partners can provide valuable support throughout the treatment process and can play many roles in helping men cope. Many men rely heavily on their partners to talk through their concerns and uncertainties. Including partners in the decisionmaking process and discussion of treatment can also be helpful for both members of the couple, especially in coping with any possible side-effects following treatment. Back to top
How can extended family and friends help?There is a tendency for men not to discuss health problems, particularly issues relating to sexual performance, with extended family and friends because of embarrassment. They may also find it difficult to deal with the stress associated with a recent diagnosis, particularly if they do not feel comfortable speaking to others about their emotions. However, for many men, families and friends are the most known and trusted people, and people who can be relied upon to respond in helpful ways. Speaking about sexual and reproductive health concerns with a trusted friend can lead to support and greater understanding of a problem. In some instances, men are relieved to find that other friends may also have similar conditions. Back to top
Does knowledge and understanding help emotionally?Many men are not interested in health issues or accessing information until their health has been affected. In many instances, men are shocked and often unprepared when they find out they have a problem. A range of emotions can be experienced when men are diagnosed with a reproductive health problem.
Delaying a visit to the doctor can often create more anxiety or fear as men try to deny the existence of a problem. Seeking early medical help to understand the problem and why it may have happened can help men deal with this. Knowledge can calm anxieties and prepare men for objective decisionmaking. Diagnosis of a condition is usually a prime motivator for men to seek further information.
There are many sources of useful information but these have to be used carefully. The Internet is one good source, and actively seeking medical information to improve their knowledge can help men emotionally. Back to top
Where can men find support?The psychological impact of male reproductive health disorders can have negative outcomes for men and their partners. An emotional response to an initial diagnosis or uncertainty about treatments is normal, and expert assistance to work through these feelings is recommended. Talking to a doctor or skilled counsellor about the emotional impact or relationship issues is an important part of treatment. Some men also seek peer support groups as they often find it helpful to talk with others experiencing similar problems.
 Download: Psychosocial Issues fact sheet PDF (77kb)
Author: Professor Rob McLachlan (MMBS FRACP PhD), Prince Henry’s Institute of Medical Research
Date: June 2005 Back to top
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