Sexual health over 60: Do you talk to your doctor? Does your doctor talk to you?

Discussion of sexual health with a GP is seen as routine for younger adults, but this is not the case for older people.

However, research has found that many older adults would value the opportunity to discuss sexual health with their doctor.

Older peopleA new research study (the SHAPE project) being conducted by researchers from the University of Melbourne is exploring the challenges in having conversations about sexual health for both doctors and patients, and ways to overcome these challenges.

The researchers are calling for men and women aged 60 years or over to participate in a short interview on the phone or face-to-face. For more information please see the Project Flyer or contact Dr Sue Malta on 03 9035 7737 or susan.malta@unimelb.edu.au.

Posted in Middle-aged and older males, Research and Evaluation, Sexual health |

Use of MRI in prostate cancer diagnosis

The evidence for the use of MRI in the diagnosis and treatment of prostate cancer has been building.

However, more studies are needed to assess the accuracy of including MRI in the diagnostic process as compared to current diagnostic practices.

Prostate cancer scanA study published in The Lancet Online assessed the accuracy of multi-parametric MRI amongst men with elevated PSA levels who have not had a previous biopsy. The results suggest that up to 27% of these men could avoid biopsies and the associated side-effects if mp-MRI was included in the diagnostic pathway. Importantly, a substantially higher proportion of clinically significant cancers can be detected with the use of MRI-guided biopsy.

Read more in our journal article reviews.

Posted in Men's health, Prostate cancer, Prostate cancer screening, Research and Evaluation |

What do men know about their fertility?

Male infertility is associated with impaired quality of life and poorer health status.

However, few studies have focused on men’s knowledge of their own fertility. Studies of both men and women have found that men are comparatively less knowledgeable about issues of fertility and reproductive health.

baby-539970_484x252A recent Canadian study of men’s knowledge of their own fertility and awareness of factors associated with male infertility has been published in Human Reproduction. Half of the men surveyed had poor knowledge of factors that may affect their fertility. And, more than half expressed a desire for more information about fertility.

The results suggest broad public education for men about fertility is warranted.

Read more in our journal article reviews.

Posted in Andrology Australia, Fertility, Health promotion, Knowledge exchange, Uncategorized |

The Healthy Male Summer edition available now!

The Healthy Male, Summer issue


Issue 61 of The Healthy Male newsletter is out now. Read about our year in review plus a host of other features in the Summer edition.

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Posted in Andrology Australia, Newsletter |

What causes male infertility?

In about half of infertile couples the problem lies either solely with the male or in both the male and female partners.

However, the cause of infertility in the male partner is often difficult to determine and many men are diagnosed with ‘idiopathic male infertility’.

Walk or cycle instead of using the carA recent study published in Human Reproduction, reported that only 40% of men with severe male infertility could be assigned a definite cause and these were mostly for the most severe cases. Although varicocele and leukocytpspermia were more common amongst infertile men than fertile control men, these conditions were not deemed to be the primary causes of infertility in these men.

The authors concluded that there is a need for more research to understand the causes and mechanisms of the less severe cases of male infertility.

Read more in our journal article reviews.

Posted in Fertility, Men's health, Research and Evaluation |

Male birth control injections prevent pregnancy

A new study co-authored by Director of Andrology Australia, Professor Rob McLachlan, takes us one step closer to male hormonal contraception.

Professor Rob McLachlan

Professor Rob McLachlan

Men have been limited in the role they can play in birth control due to the lack of effective options. Research on a male hormonal contraceptive has been ongoing for several years resulting in this trial designed to assess safety and efficacy. This multi-centre study has shown that a male hormonal contraceptive substantially reduces the chance of unplanned pregnancy. Injections of a long-acting progestogen combined with a long-acting androgen were shown to suppress sperm counts to less than 1,000 sperm/mL, a level considered to be “infertile”. The contraceptive was effective in around 95% of men who continued with the injections, a rate comparable to female hormonal contraception. Unfortunately the trial was stopped due to side effects that were deemed to be “risks” by the WHO.

The male contraceptive could potentially provide another birth control option to couples; however there are many hurdles to overcome before it could be taken to the market as Rob explained to the ABC JJJ Hack site.

Read the article online in the Journal of Clinical Endocrinology and Metabolism.

Posted in Knowledge exchange, Men's health, Research and Evaluation |

Finasteride and the risk of sexual dysfunction: results from a large UK patient database

A possible side effect of 5-α reductase inhibitors is sexual dysfunction and some men, particularly those being treated for alopecia, report that sexual dysfunction continues after the withdrawal of treatment.

However, there is little robust evidence to quantify the risk of sexual dysfunction associated with finasteride use for alopecia or the underlying pathophysiology of such an effect.

testosterone prescription on the riseA recent study assessing the risk of erectile dysfunction and non-erectile dysfunction sexual dysfunction in men who used 5-α reductase inhibitors to treat benign prostatic hyperplasia or alopecia has been published in the British Medical Journal. The results suggest that 5-α reductase inhibitors do not significantly increase the risk of incident erectile dysfunction, regardless of indication for use, in men free of sexual dysfunction and major risk factors at baseline.

Read more in our journal article reviews.

Posted in Erectile dysfunction, Men's health, Prostate disease, Research and Evaluation, Sexual health |

The Healthy Male Spring edition available now!

The Healthy Male, Spring issue


Issue 60 of The Healthy Male newsletter is out now. Read about how we celebrated Men’s Health Week in June this year plus a host of other features in the Spring edition.

Thanks to all our supporters who responded to the call in the Winter edition and have collected signatures for our campaign to save Andrology Australia. The petition is now closed but see our campaign page to find out about other ways you can help.

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Posted in Andrology Australia, Newsletter |

What is the best treatment option for men with localised prostate cancer?

The management of clinically localised prostate cancer diagnosed after a PSA test remains controversial.

Active surveillance is an option that can help ameliorate the negative effects of over-treatment of PSA-detected prostate cancer. The longer term outcomes of this approach compared to active treatment after diagnosis (surgery and/or radiotherapy) are still uncertain, with concerns about worse outcomes for men undergoing active surveillance.

man-consults-doctor-200x100A recent study reporting 10-year survival outcomes of men in the ProtecT trial, published in the New England Journal of Medicine, showed a very low prostate-cancer-specific mortality at 10 years (1%) irrespective of whether the man was assigned to active surveillance, surgery or radiotherapy.

Given the relatively small number of deaths, longer term data are needed to fully assess the relative merits of each treatment option, along with data on side-effects of treatments and the impacts of treatment on quality of life.

Read more in our journal article reviews.

Posted in Clinical management, Men's health, Prostate cancer, Prostate cancer screening, Research and Evaluation |

Endocrine Society of Australia Position Statement on Testosterone (Part 2)

The final section of the Endocrine Society of Australia (ESA) Position Statement on Male Hypogonadism (Part 2: treatment and therapeutic considerations) was published in the September issue of the Medical Journal of Australia, complementing Part 1: assessment and indications for testosterone therapy.

testosterone-vial-343x480Developed by leading Australian endocrinologists, including Andrology Australia Director Professor Rob McLachlan, the position statement supports the use of testosterone replacement therapy in men of any age with confirmed androgen deficiency.

Part 2 of the statement highlights that the evidence regarding testosterone treatment and cardiovascular outcomes is weak and inconclusive. Until better evidence is available the statement advises caution with using testosterone in older men with cardiovascular disease, especially those without a confirmed androgen deficiency diagnosis. Further research is needed to see if testosterone therapy in these cases is safe and effective.

Men should speak to their treating doctor before making any decisions about treatment with testosterone. The ESA statement will help doctors in identifying, diagnosing and treating patients with androgen deficiency.

To help guide medical professionals, Andrology Australia, in cooperation with the ESA developed an advisory note outlining the Pharmaceutical Benefits Schedule (PBS) criteria for prescribing testosterone (for medical professionals).

Posted in Clinical management, Men's health, Primary health care, Testosterone |