Men’s Health

by Paul Spencer, B.Pharm

Remember, remember the fifth of November! Whilst traditionally linked with the gunpowder plot, November has over recent years become the month when the usually smooth shaven male throws their razor blades to the wind in support of Movember. The Movember Foundation is a not for profit, charitable organisation that creates awareness around men’s health issues such as prostate cancer & testicular cancer. (click here for more information about Movember).

As a community pharmacist it has been evident over the years that men have a tendency to ignore health issues, preferring to ‘soldier on’ rather than asking for advice. In many cases those ‘niggling’ health issues are easily treated with a range of over the counter medicines.

Bad breath

Bad breath or halitosis can be caused by a number of things, most commonly the bacteria that build up on the teeth and gums as a result of food particles trapped between the teeth. These bacteria break down the food particles and as they do so they release sulphur gases which give rise to the typical unpleasant smell of bad breath. Plaque and gum disease are also responsible.

Strong foods such as garlic, onions and spicy foods can add to the problem as strong smelling substances released when these foods are digested are removed from the body in the breath. 
A dry mouth can also cause the breath to smell. Saliva washes away food particles, and if the flow of saliva slows down, for example during the night, food particles remain in the mouth where they are broken down by bacteria. This is why bad breath is common in the mornings. Smoking, drinking lots of alcohol, coffee or tea also cause bad breath as these dry up the flow of saliva too.

Correct brushing with a fluoride toothpaste is the best way of preventing bad breath and keeping teeth and gums healthy. Using dental floss or interdental brushes last thing at night helps clean between the teeth and remove any food particles that cause bad breath.

Mouthwashes such as Corsodyl (chlorhexidine) and Oraldene (hexetidine) contain antibacterial ingredients that attack and help to kill the bacteria causing bad breath. Mouthwashes can help freshen the mouth and will mask bad breath, but they are only temporary measures. Good brushing and flossing is far more effective.

CB12 is a new, unique, long-lasting mouth rinse proven to prevent and neutralise bad breath. CB12 neutralises the substances and processes that cause bad breath by combating the sulphur gases that cause bad breath instead of simply masking the smell for a short period of time. CB12 also contains fluoride to help prevent tooth decay.

Body Odour

There are 3-4 million sweat glands on the body, but sweat itself does not smell. The unpleasant odour is produced by bacteria on the skin that break down the sweat into acids. Anyone who has reached puberty can produce body odour, but as men tend to sweat more than women, they are more likely to have body odour.

The best way to avoid getting body odour is to keep areas of your body prone to sweating clean and free of bacteria. Using soap to wash every day, paying particular attention to areas that sweat most such as armpits, genital area and feet, will help to remove sweat and reduce the number of bacteria on your skin. Using an antiperspirant or deodorant daily will also help prevent body odour. Antiperspirants reduce the amount of sweat your body produces, whereas deodorants use perfume to mask the smell of sweat. Regularly shaving your armpits can also help reduce body odour because the hair in your armpits traps sweat and odour and provides ideal conditions for bacteria to multiply.

Driclor contains aluminium chloride hexahydrate and is a clinically proven antiperspirant for the treatment of excessive perspiration. It’s a clear, colourless solution which is used for the treatment of excessive perspiration of the underarms, the hands and the feet. It works by blocking the sweat glands. This causes the pressure of fluid within the sweat glands to rise to the point where they temporarily stop sweat production. The product is applied before going to bed at night in order to block the sweat glands while they are least active. It should then be washed off in the morning. The sweat glands will then remain blocked and so will not produce sweat during the day. (The sweat glands unblock as the dead cells on the surface of the skin are naturally shed.)

Baldness/Hairloss

Alopecia is the medical term that describes a loss of hair and sometimes baldness. Hair loss can be a side effect of chemotherapy, and in these cases, hair loss is usually temporary. However, any type of hair loss can reduce confidence and self-esteem. Male-pattern baldness is the most common type of hair loss and can affect both men and women (female-pattern baldness). In either case it can be difficult to cope with. Both types follow a pattern of a receding hairline, followed by thinning of the hair on the crown and temples. Male-pattern baldness is more common than female-pattern baldness and around half of all men will be affected at some point.

Male pattern baldness can be treated with finasteride which is only available on prescription and minoxidil (Regaine) which can be bought over the counter in pharmacies. There is evidence to suggest that minoxidil can cause hair regrowth in some men and needs to be used for at least four months before any effect is seen. The balding process will usually resume if treatment with minoxidil is stopped. Any new hair that regrows will fall out two months after treatment is stopped. Side effects are uncommon.

Minoxidil can also be used to treat female pattern baldness and may help hair to grow in around 1 in 4 women. Again, minoxidil should be used for at least four months before any effect is seen.

If you have inherited the genes responsible for male- or female-pattern baldness, there is not much that you can do to prevent it. Treatments may slow down your hair loss, but they are not an actual cure. Many people lose their hair as they get older, and there is no need to be embarrassed or depressed about it. If hair loss is making you worried or unhappy, you can talk to your GP or ask them to refer you to a dermatologist (a specialist in skin conditions).

Weight Loss

The most widely used method to assess a persons weight is the body mass index (BMI). The body mass index (BMI) is your weight in kilograms divided by your height in metres squared. You can use the NHS Choices’ BMI healthy weight calculator to work out your own BMI.

if your BMI is between 25 and 29, you would be considered overweight
if your BMI is between 30 and 40, you would be considered obese
if your BMI is over 40, you would be considered very obese (known as ‘morbidly obese’)

Another useful method is to measure around your waist. People with larger waists (94cm or more in men and 80cm or more in women) are more likely to develop obesity-related health problems.
The risks of obesity

Being obese increases your risk of developing a number of serious and potentially life-threatening diseases such as:

type 2 diabetes 
heart disease 
some types of cancer, such as breast cancer and colon cancer stroke

In addition, obesity can damage your quality of life and can often trigger depression.

There are four main goals in the treatment of obesity:

to prevent further weight gain
to gradually lose weight through a combination of a calorie-controlled diet and regular exercise
to avoid regaining any lost weight
to improve your general state of health and reduce your risk of obesity-related complications

A medication called orlistat (Alli) can aid weight loss, and can boost your weight loss by up to 50%, in conjunction with a reduced calorie, lower-fat diet, providing you follow the Alli weight loss program and are willing to lose weight gradually in conjunction with a healthy lifestyle. Alli weight loss pills work by stopping some of the fat you eat from being absorbed. For example, for every 2 lb (1 kg) you lose from eating healthily, adding Alli can help you lose 1 lb (1/2 kg) more. Your pharmacist can advise you whether Alli is suitable for you.

Premature Ejaculation

Premature ejaculation is the most common ejaculation problem and is where the male ejaculates too quickly during sexual intercourse. Many men are unsure about how long ‘normal’ sex should last before ejaculation. A study1 looking at 500 couples from five different countries found the average time between penetration and ejaculation was around five-and-a-half minutes. However, it is up to the individual and his partner to decide whether or not they are happy with the time it takes for him to ejaculate. Regularly ejaculating before or within one minute of penetration would usually be regarded as a medical problem that requires treatment. Premature ejaculation can occur at any age but it is more common in younger men. It is estimated that about 40% of men experience premature ejaculation.

The most common causes of premature ejaculation are psychological. Disease or physical conditions affecting the penis are very rarely the cause. Anxiety, stress, guilt and worries about being a good lover can all lead to premature ejaculation.

STUD 100 spray contains the anaesthetic lidocaine and is sprayed on the head and shaft of the penis, normally between 5 and 15 minutes before intercourse. It delays ejaculation by reducing the sensitivity of the penis. Some antidepressant drugs can also be used but these are only available on prescription from your GP. These approaches help many men, but some will need further specialist help by a referral to a sex therapist.

References:

NHS Direct Wales – Erectile Problems (accessed 6/7/2013)1