tag:theconversation.com,2011:/au/topics/mens-health-33389/articlesMen's health – The Conversation2023-11-21T23:30:20Ztag:theconversation.com,2011:article/2116752023-11-21T23:30:20Z2023-11-21T23:30:20ZHere’s what happens to your penis as you age<figure><img src="https://images.theconversation.com/files/558209/original/file-20231108-29-2x75fz.jpg?ixlib=rb-1.1.0&rect=0%2C1%2C1000%2C664&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-stethoscope-yellow-banana-on-blue-1070813387">Shutterstock</a></span></figcaption></figure><p>All parts of your body age and the penis is no exception. </p>
<p>Changes to how your penis looks or works can be signs of underlying health issues and can affect your quality of life. So understanding which changes are normal and when to seek help is important.</p>
<p>Here’s what you can expect to happen to your penis as you age, and when to be concerned.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-do-i-clean-my-penis-125135">'How do I clean my penis?'</a>
</strong>
</em>
</p>
<hr>
<h2>Will my penis shrink?</h2>
<p>There is no definitive evidence your <a href="https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/bju.13010">penis length and girth</a> will naturally change as you age, despite what you may <a href="https://www.healthline.com/health/mens-health/penis-shrinkage">read</a>.</p>
<p>This is because there is no study that follows the same adults and their penis measurements over decades; existing studies only compare penis size between different adults of different ages. </p>
<p>There are also many different ways to <a href="https://www.nature.com/articles/s41443-019-0157-4">measure</a> penis size – including stretched, flaccid (floppy) and erect. This makes it difficult to compare studies.</p>
<p>However, for some people, conditions associated with ageing can appear to decrease penis length. These include:</p>
<ul>
<li><p>obesity (which hides the base of the penis)</p></li>
<li><p>the effects of <a href="https://www.auajournals.org/doi/10.1016/j.juro.2007.03.119">prostate surgery</a> (temporarily)</p></li>
<li><p><a href="https://www.healthymale.org.au/mens-health/peyronies-disease">Peyronie’s disease</a> (where scarring in the fibrous layer of the penis causes it to bend abnormally).</p></li>
</ul>
<p>Erect penis length may also decrease with age due to:</p>
<ul>
<li><p>erectile dysfunction (the inability to achieve erections sufficient for sexual activity)</p></li>
<li><p>less <a href="https://pubmed.ncbi.nlm.nih.gov/1459150/">penile elasticity</a>, which reduces how much the penis expands.</p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/are-chemicals-shrinking-your-penis-and-depleting-your-sperm-heres-what-the-evidence-really-says-160007">Are chemicals shrinking your penis and depleting your sperm? Here's what the evidence really says</a>
</strong>
</em>
</p>
<hr>
<h2>Will I still have erections?</h2>
<p>Erectile dysfunction affects 15% of men in their 50s to almost 90% of men over 80, according to an <a href="https://link.springer.com/article/10.1007/s10508-014-0465-1">English study</a> of more than 6,000 people. Existing health conditions increased the risk significantly, and the risk was more than doubled in those who rated their health as fair to poor.</p>
<p><a href="https://www.healthymale.org.au/mens-health/erectile-dysfunction">Medications</a> such as sildenafil (Viagra) and tadalafil (Cialis) can help. But they do not reverse the underlying blood vessel and nerve damage that cause erectile dysfunction. Eventually other treatments – such as injections or <a href="https://www.healthymale.org.au/news/what-are-penis-pumps-and-how-do-they-work">penile pumps</a> – may be options.</p>
<p>Other changes that occur with age include <a href="https://pubmed.ncbi.nlm.nih.gov/9836563/">decreased penis sensitivity</a>, which might reduce arousal. Ejaculation is <a href="https://pubmed.ncbi.nlm.nih.gov/8254833/">delayed</a> and happens <a href="https://linkinghub.elsevier.com/retrieve/pii/S0302283816003778">less often</a>.</p>
<p>Semen volume and the force of ejaculation <a href="https://pubmed.ncbi.nlm.nih.gov/27652226/">decrease</a> with age. The time taken to “recover” from ejaculating and become sexually responsive again (known as the <a href="https://pubmed.ncbi.nlm.nih.gov/31405769/">post-ejaculatory refractory time</a>) also increases with age. </p>
<p>Reaching orgasm is “impossible” or “moderately difficult” for <a href="https://pubmed.ncbi.nlm.nih.gov/25624001/">33% of men</a> in their 70s.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/weekly-dose-the-hard-facts-on-viagra-58289">Weekly dose: the hard facts on Viagra</a>
</strong>
</em>
</p>
<hr>
<h2>Will the shape of my penis change?</h2>
<p>The shape of your penis is not usually expected to change with age. However, Peyronie’s disease (an abnormally bent or curved penis) becomes <a href="https://www.healthymale.org.au/mens-health/peyronies-disease">more common</a> with age. This may be because of accumulation of damage from minor injuries over time.</p>
<p>This condition affects <a href="https://pubmed.ncbi.nlm.nih.gov/11890244/">6.5% of men</a> over 70 and can cause short-term pain and long-term erectile dysfunction.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/558561/original/file-20231109-15-6so9wq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Older smiling man holding banana in each hand, one large, one small" src="https://images.theconversation.com/files/558561/original/file-20231109-15-6so9wq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/558561/original/file-20231109-15-6so9wq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/558561/original/file-20231109-15-6so9wq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/558561/original/file-20231109-15-6so9wq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/558561/original/file-20231109-15-6so9wq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/558561/original/file-20231109-15-6so9wq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/558561/original/file-20231109-15-6so9wq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">No, your penis doesn’t automatically change shape as you age. But you might notice other changes.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/old-country-doctor-smiling-while-comparing-758197381">Shutterstock</a></span>
</figcaption>
</figure>
<h2>Will I pee more?</h2>
<p><a href="https://www.healthymale.org.au/mens-health/urinary-problems-luts">Lower urinary tract symptoms</a> such as incontinence, a weak urine stream, problems with starting and stopping peeing, and nocturia (frequent night time urination) increase as we get older. </p>
<p>These symptoms are moderate to severe in <a href="https://pubmed.ncbi.nlm.nih.gov/17070357/">almost 50% of men</a> over 65, and in <a href="https://pubmed.ncbi.nlm.nih.gov/18554695/">70% of men</a> over 80. This is likely due to <a href="https://pubmed.ncbi.nlm.nih.gov/6206240/">higher rates</a> of benign prostatic hyperplasia (enlarged prostate) as men age, which has various effects, including on urine flow.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-can-your-doctor-tell-from-your-urine-74990">Health Check: what can your doctor tell from your urine?</a>
</strong>
</em>
</p>
<hr>
<h2>Changes can take their toll …</h2>
<p>Physical and functional changes in the penis can affect a man’s <a href="https://pubmed.ncbi.nlm.nih.gov/25624001/">health and wellbeing</a>. </p>
<p>Problems with erections or ejaculating can reduce someone’s <a href="https://pubmed.ncbi.nlm.nih.gov/30554952/">quality of life</a> if they still want to have sex. So <a href="https://www.healthymale.org.au/partners-guide">open discussion</a> with a partner, seeking support and professional advice can help.</p>
<p>Lower urinary tract symptoms can also <a href="https://pubmed.ncbi.nlm.nih.gov/15814179/">affect</a> a man’s mental health and personal relationships. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/558565/original/file-20231109-25-sl40tf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Older gay couple sitting on sofa, one with hand on shoulder, looking at open laptop" src="https://images.theconversation.com/files/558565/original/file-20231109-25-sl40tf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/558565/original/file-20231109-25-sl40tf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/558565/original/file-20231109-25-sl40tf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/558565/original/file-20231109-25-sl40tf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/558565/original/file-20231109-25-sl40tf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/558565/original/file-20231109-25-sl40tf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/558565/original/file-20231109-25-sl40tf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Be open with your partner about any concerns.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/older-same-sex-male-couple-browsing-2356931529">Shutterstock</a></span>
</figcaption>
</figure>
<h2>… but can be sign of disease</h2>
<p>Erectile dysfunction can also hint at serious health problems <a href="https://www.healthymale.org.au/mens-health/erectile-dysfunction">such as</a> heart disease, high blood pressure, diabetes and disorders of the nervous system.</p>
<p>In this way, the penis reflects vascular health in the rest of the body. So having erectile dysfunction can <a href="https://pubmed.ncbi.nlm.nih.gov/30665816/">predict</a> your risk of a future heart attack or stroke.</p>
<p>Lower urinary tract symptoms are also often associated with sexual dysfunction, and can <a href="https://www.healthymale.org.au/mens-health/urinary-problems-luts">increase the risk</a> of urinary tract infections and chronic kidney disease.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/does-it-matter-if-you-sit-or-stand-to-pee-and-what-about-peeing-in-the-shower-206869">Does it matter if you sit or stand to pee? And what about peeing in the shower?</a>
</strong>
</em>
</p>
<hr>
<h2>What’s normal and when should I see my GP?</h2>
<p>Normal ageing includes changes to the penis’ blood vessels, nerves, and associated organs, such as the prostate. So, as you age, it is normal to have:</p>
<ul>
<li><p>minor changes in the size and shape of the penis</p></li>
<li><p>a gradual decrease in erectile function and sensitivity</p></li>
<li><p>mild urinary symptoms that don’t bother you.</p></li>
</ul>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/28217447/">Staying healthy</a>
and regularly seeing your GP to <a href="https://www.healthdirect.gov.au/essential-screening-tests-for-men">check for</a> common conditions (such as high blood pressure) should slow down these age-related changes. Other health conditions (such as diabetes) accelerate these changes.</p>
<p>However, it is important to seek medical attention if:</p>
<ul>
<li><p>there is a significant change in size or shape of the penis, or if you develop unusual lumps</p></li>
<li><p>there is pain or discomfort in or around your penis</p></li>
<li><p>erectile dysfunction becomes persistent or bothers you</p></li>
<li><p>urinary symptoms occur suddenly or bother you.</p></li>
</ul>
<hr>
<p><em>For more information about men’s health, including resources for partners, see the <a href="https://www.healthymale.org.au">Healthy Male website</a>.</em></p><img src="https://counter.theconversation.com/content/211675/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tim Moss works for Healthy Male, a website to promote men's health.</span></em></p><p class="fine-print"><em><span>Jinghang Luo and Rob McLachlan do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Understanding which changes are normal and when to seek help is important. Here’s what you need to know.Rob McLachlan, Professor and clinician in fertility medicine, Hudson InstituteJinghang Luo, Andrology Fellow, Hudson InstituteTim Moss, Adjunct Associate Professor, Department of Obstetrics and Gynaecology, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2068692023-06-16T03:37:43Z2023-06-16T03:37:43ZDoes it matter if you sit or stand to pee? And what about peeing in the shower?<figure><img src="https://images.theconversation.com/files/532080/original/file-20230614-29-n8jj3y.jpg?ixlib=rb-1.1.0&rect=0%2C2%2C1000%2C663&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/closeup-young-caucasian-man-using-his-656574232">Shutterstock</a></span></figcaption></figure><p>Do you sit or stand? That is the question about <a href="https://docs.cdn.yougov.com/0l6u6ha4yz/YouGov%20-%20Sit%20down%20urination%20men%20international.pdf">7,000 men</a> around the world <a href="https://today.yougov.com/topics/society/articles-reports/2023/05/16/where-world-are-men-most-likely-sit-down-wee">have been asked</a> about how they pee.</p>
<p>We’ll get to their answers soon. But the <a href="https://www.news.com.au/lifestyle/health/health-problems/urologist-reveals-men-are-emptying-their-bladders-wrong/news-story/b3a86aeab9cc97825554dfef5b28a7f0">media interest</a> that followed prompted one urologist <a href="https://www.telegraph.co.uk/health-fitness/body/the-health-benefits-of-sitting-down-to-pee/">to recommend</a> some men sit to urinate, especially as they age.</p>
<p>What is the best way to urinate? Does that apply to women? We research the <a href="https://www.tandfonline.com/doi/abs/10.1080/21688370.2022.2099214?journalCode=ktib20">bladder</a> and <a href="https://journals.physiology.org/doi/full/10.1152/ajpcell.00441.2022">lower urinary tract</a>. Here’s what the evidence says.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-can-your-doctor-tell-from-your-urine-74990">Health Check: what can your doctor tell from your urine?</a>
</strong>
</em>
</p>
<hr>
<h2>Do most men stand to pee?</h2>
<p>The survey found men in different countries differ in how they pee. </p>
<p>In Germany, 40% of men report sitting while they pee every time, as do 25% of Australians. In the United States, it’s just 10%. </p>
<p>Some people even view <a href="https://www.bmj.com/content/1/1174/1281.1">standing to pee</a> as “superior” and sitting inferior. In German, the word <a href="https://www.urbandictionary.com/define.php?term=Sitzpinkler">Sitzpinkler</a> means
someone who sits to pee; it can also be used as an insult.</p>
<p>But habits may be changing. In Australia, for instance, the survey found younger men are more likely to sit down than older men. Some 36% of younger men sit down most or every time, while only 20% of men aged 55 and older report doing so.</p>
<h2>So should men stand or sit?</h2>
<p><strong>When it doesn’t matter</strong></p>
<p>In general, the literature suggests it <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0101320">doesn’t matter</a> if a healthy man stands or sits when he pees.</p>
<p>Regardless of the position, there seems to be no difference in the time taken to pee, the flow rate, and how completely the bladder is emptied.</p>
<p>So long as there are no urinary concerns, men are free to choose their preferred position. If you chose to stand, just be sure to aim well.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-urine-sterile-do-urine-therapies-work-experts-debunk-common-pee-myths-191862">Is urine sterile? Do urine 'therapies' work? Experts debunk common pee myths</a>
</strong>
</em>
</p>
<hr>
<p><strong>When it can</strong></p>
<p>Recommendations for sitting or standing become less clear for men with <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/nau.24839">lower urinary tract symptoms</a>. These include issues such as having poor stream (for example, a dribble rather than a steady flow of urine), straining while urinating or feeling the bladder has not <a href="https://www.ics.org/committees/standardisation/terminologydiscussions/feelingofincompletebladderemptying">completely emptied</a> after finishing.</p>
<p>For some of these men <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0101320">sitting</a> is preferred to help increase the flow and empty the bladder. Others find the same relief comes from standing.</p>
<p>For men with <a href="https://www.continence.org.au/news/novembers-all-about-mens-health-so-whats-bph-anyway">benign prostatic hyperplasia</a>, otherwise known as an enlarged prostate, there is evidence <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361486/">standing</a> may help fully empty the bladder. But this advice may not work for all. That’s because how much the prostate has become enlarged, and the impact this has on urinary flow, can be different between people.</p>
<p>As standing or sitting <em>can</em> matter, for some men, it’s worth having a chat with your doctor about what’s best for you.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-men-really-take-longer-to-poo-152233">Do men really take longer to poo?</a>
</strong>
</em>
</p>
<hr>
<h2>How about women?</h2>
<p>The structure of the female pelvic area is quite different to males, as it accommodates the vagina, uterus and reproductive structures. And the female anatomy is just not designed to pee standing up. So, making a habit of, say, peeing in the shower, is not advised.</p>
<p>Females do not have a prostate, which helps supports the male bladder while standing. This lack of support can place extra strain on the bladder region when not sitting down, making it harder for the bladder to fully empty.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of female pelvic floor muscles and urinary tract" src="https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=480&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=480&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=480&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=603&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=603&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=603&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When standing, women’s pelvic floor muscles don’t relax properly, so their bladder may not fully empty.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/female-pelvic-floor-labeled-157672304">Alila Medical Media/Shutterstock</a></span>
</figcaption>
</figure>
<p>The structure of the <a href="https://www.continence.org.au/about-continence/continence-health/pelvic-floor">pelvic floor</a> muscles are also different in females. For females, it is particularly important to allow these muscles to fully relax to allow the urine to flow freely.</p>
<p>If the bladder doesn’t <a href="https://www.continence.org.au/types-incontinence/urinary-incontinence/chronic-urinary-retention">empty fully</a>, it can lead to increased infections, bladder stones, and even impact kidney health in the long term.</p>
<p>Even with one leg up, the pelvic floor does not rest properly, so the bladder may not be able to fully empty. As such, sitting down is usually the best position to let these muscles relax.</p>
<p>Standing and “hovering” over the loo may keep these muscles slightly constricted, making it hard to fully empty the bladder. A contracted pelvic floor can also cause the urine to spray more than usual, which is why you might often find drops of urine on a toilet seat after someone before you has tried to hover over it.</p>
<h2>How about peeing in the shower?</h2>
<p>Peeing in the shower not only makes it harder for your muscles to relax, it can be unhygienic. It might also cause an association between water and urination, leading to issues where hearing water might make you need to rush to the bathroom.</p>
<p>So, for both males and females, peeing in the shower is a clear no-no.</p>
<hr>
<p><em>If you or someone you know has bladder or bowel issues, the Continence Foundation of Australia has <a href="https://www.continence.org.au">online resources</a> and a <a href="https://www.continence.org.au/get-support/who-can-help/national-continence-helpline">helpline</a> (1800 33 00 66).</em></p><img src="https://counter.theconversation.com/content/206869/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The recent survey confirmed what many people think – men prefer to stand when peeing. But is that the best way?Christian Moro, Associate Professor of Science & Medicine, Bond UniversityCharlotte Phelps, PhD Candidate, Health Science and Medicine, Bond UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1982752023-06-02T14:45:22Z2023-06-02T14:45:22ZPostnatal depression: what new fathers need to know – and how to ask for help<figure><img src="https://images.theconversation.com/files/529771/original/file-20230602-15-weta8e.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4157%2C2763&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Postnatal depression symptoms are quite similar to depression symptoms.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/tired-unhappy-father-holding-his-baby-1432243013">christinarosepix/ Shutterstock</a></span></figcaption></figure><p>Many people think of postnatal depression as a condition that only affects women. But in reality, postnatal depression affects <a href="https://www.nhs.uk/mental-health/conditions/post-natal-depression/overview/">almost as many men as women</a> – with some research estimating it occurs in up to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659987/">10% of fathers</a>.</p>
<p>Yet despite how common postnatal depression may be in men, there still isn’t very much information out there about it. This can make it hard to know if you may have postnatal depression – and how to get help if you do.</p>
<p>Here’s what you need to know.</p>
<hr>
<figure class="align-right ">
<img alt="Quarter life, a series by The Conversation" src="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><strong><a href="https://theconversation.com/uk/topics/quarter-life-117947?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">This article is part of Quarter Life</a></strong>, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/he-is-always-there-to-listen-friendships-between-young-men-are-more-than-just-beers-and-banter-200301?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">‘He is always there to listen’: friendships between young men are more than just beers and banter</a></em></p>
<p><em><a href="https://theconversation.com/body-image-issues-affect-close-to-40-of-men-but-many-dont-get-the-support-they-need-179046?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Body image issues affect close to 40% of men – but many don’t get the support they need</a></em></p>
<p><em><a href="https://theconversation.com/anxiety-can-lead-to-erection-problems-in-young-men-but-reaching-for-viagra-isnt-always-the-solution-191980?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Anxiety can lead to erection problems in young men – but reaching for Viagra isn’t always the solution</a></em></p>
<hr>
<h2>Why it happens</h2>
<p>There are many reasons why postnatal depression happens. And, contrary to popular belief, it isn’t just due to hormones. Even in women, hormones only <a href="https://www.nature.com/articles/nrdp201822">play a small role</a> in postnatal depression.</p>
<p>Instead, postnatal depression is typically due to a <a href="https://pubmed.ncbi.nlm.nih.gov/29096280/">combination of risk factors</a> – such as a previous history of depression, sleep problems after the baby is born, lack of social support or financial challenges. Postnatal depression can also <a href="https://pubmed.ncbi.nlm.nih.gov/30818245/">happen at any age</a>.</p>
<p>The symptoms of postnatal depression are quite similar to symptoms of depression. As such, <a href="https://bestpractice.bmj.com/topics/en-gb/512">symptoms of postnatal depression</a> may include low mood, lack of motivation, poor sleep, feeling guilty or worthless, poor concentration, changes in appetite or weight, fatigue and thoughts of death or suicide. </p>
<p>The main difference between depression and postnatal depression is that these feelings tend to happen in the postnatal period (typically the first year or so after the baby is born).</p>
<p>It can be normal to struggle with your mental health somewhat after your baby is born. After all, it can be an overwhelming and emotional time, with nearly every aspect of your life changing – from your daily routine, your relationship with your partner, to the amount of sleep you get every night. </p>
<figure class="align-center ">
<img alt="Female doctor speaks with male patient." src="https://images.theconversation.com/files/529772/original/file-20230602-29-y77d67.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529772/original/file-20230602-29-y77d67.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529772/original/file-20230602-29-y77d67.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529772/original/file-20230602-29-y77d67.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529772/original/file-20230602-29-y77d67.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529772/original/file-20230602-29-y77d67.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529772/original/file-20230602-29-y77d67.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Consider speaking with your GP if symptoms have lasted more than a few weeks.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/smiling-indian-woman-doctor-talking-consulting-2078659627">fizkes/ Shutterstock</a></span>
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</figure>
<p>But if you’ve been experiencing low mood and lack of motivation for more than a few weeks, and are finding these feelings are making it difficult to engage with your infant, you may want to consider speaking with your GP or a mental health professional. It’s also worth noting that postnatal depression can happen at any time in the first year or two after the baby is born – not just in the early months.</p>
<h2>Getting help</h2>
<p>Postnatal depression is not likely to go away on its own. If you suspect you may be struggling with postnatal depression, it’s important to seek support – not only for your wellbeing, but because postnatal depression can also affect your bond <a href="https://acamh.onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.2008.02000.x">with your baby</a>.</p>
<p>First of all, there’s <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2020.599039/full">nothing wrong with needing help</a>, and seeking support – either from loved ones, friends or a doctor – is nothing to be <a href="https://www.magonlinelibrary.com/doi/full/10.12968/bjmh.2018.7.3.130">embarrassed by</a>.It does not <a href="https://www.magonlinelibrary.com/doi/full/10.12968/bjmh.2018.7.3.130">make you weak</a>, nor does experiencing postnatal depression make you a “<a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03947-7">failure</a>”. </p>
<p>While it can be difficult to know how to take the first step in getting support, a good starting point is simply acknowledging that this is a difficult thing to talk about. As simple as this sounds, it may just help you feel less awkward about sharing your experiences when you do speak to someone. It’s also worth remembering that when you do speak to someone, it’s important to say how you really feel – not what you feel you should say. </p>
<p>It’s also <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03947-7">normal if you feel angry</a> about feeling the way you do. Many young men who struggle with their mental health feel angry that they feel this way, or worry that they’ve let their loved ones down or that the system will not listen to them. To deal with that anger, be patient. Try to let the anger go – it may help you feel more at ease opening up about your other emotions.</p>
<p>You may also find it easier to talk about your experiences in certain settings. For example, while some people may find it easier to speak with their GP or in online chat groups, you may find it more comfortable to speak up in a less formal setting – such as while watching sports with friends. You can begin this conversation with something as simple as asking how others are doing, before sharing your own feelings and experiences. Or, if your friends are also parents themselves, you might ask if any of them experienced similar feelings during the postnatal period.</p>
<p>If you’re finding it hard to speak to loved ones, you could also consider using a mental health app. Some people find it easier to use an app to ask questions, find solutions and discuss how they’re feeling. Apps such as <a href="https://thedadpad.co.uk/ask-dadpad/mental-health-new-dads/">DadPad</a> have a number of resources that can help you navigate fatherhood. </p>
<p>Postnatal depression in fathers is real and it does matter. Fortunately, compared to just a few years ago, there’s more awareness and help available than ever before.</p><img src="https://counter.theconversation.com/content/198275/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrew Mayers does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Postnatal depression is thought to affect up to 10% of fathers.Andrew Mayers, Principal Academic in Psychology, Bournemouth UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2038342023-04-20T20:02:00Z2023-04-20T20:02:00ZLike father, like son: new research shows how young men ‘copy’ their fathers’ masculinity<figure><img src="https://images.theconversation.com/files/521992/original/file-20230420-3111-6zjdof.jpg?ixlib=rb-1.1.0&rect=10%2C0%2C6699%2C4476&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Today’s men express their maleness in different ways. Some adhere to more traditional models of masculinity, characterised by beliefs in male superiority and endorsement of risky or violent behaviours. Others embrace more progressive stances.</p>
<p>But how do men develop their ideas, beliefs and behaviours in relation to masculinity?</p>
<p>Our <a href="https://link.springer.com/article/10.1007/s11199-023-01364-y">new study</a> addresses this question by focusing on one important factor influencing how young men express their masculinity – their fathers.</p>
<p>Our research set out to ask: do young men “copy” their fathers’ masculinity?</p>
<p>We found that young men whose fathers support more traditional forms of masculinity are more likely to do so themselves.</p>
<p>This highlights the critical role fathers play in steering boys towards healthier ideas about masculinity.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/who-is-a-real-man-most-australians-believe-outdated-ideals-of-masculinity-are-holding-men-back-147847">Who is a real man? Most Australians believe outdated ideals of masculinity are holding men back</a>
</strong>
</em>
</p>
<hr>
<h2>Measuring masculinity</h2>
<p>We analysed data from 839 pairs of 15-to-20-year-old men and their fathers. These data were taken from a large, Australian <a href="https://tentomen.org.au/">national survey</a> on men’s health. </p>
<p>The survey asked men a set of 22 <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Ft27381-000">scientifically validated questions</a> about how they felt and behaved in relation to many issues around masculinity. For example, they were asked about:</p>
<ul>
<li><p>the significance of work and social status for their sense of identity</p></li>
<li><p>their take on showing emotions and being self-reliant</p></li>
<li><p>their endorsement of risk-taking and violent behaviours</p></li>
<li><p>the importance they assigned to appearing heterosexual and having multiple sex partners</p></li>
<li><p>and their beliefs about winning, dominance over others and men’s power over women.</p></li>
</ul>
<p>Taken together, the answers to these questions offered us a window into whether the men participating in the survey adopted more of a traditional or progressive type of masculinity. They also enabled us to compare fathers’ and sons’ expressions of masculinity.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1611118336385110017"}"></div></p>
<h2>What we found</h2>
<p>We found that, on average, young men are slightly more traditional in how they express their masculinity than their fathers.</p>
<p>On a scale from 0 to 100, with 100 indicating high conformity to traditional masculinity and 0 indicating low conformity, the average masculinity score for young men was 44.1, and for their fathers, it was 41.</p>
<p>Using statistical models, we then examined whether there was an association between how traditional a father’s masculinity is and how traditional their son’s masculinity is. To make sure we isolated the effect of fathers’ masculinity, the models took into account other factors that may also shape young men’s expressions of masculinity. These included their age, education, sexual orientation, religion, household income and place of residence, among others.</p>
<p>The results were clear. Young men who scored highly on the traditional masculinity measures tended to have fathers who also scored highly.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/521414/original/file-20230417-14-rydizx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/521414/original/file-20230417-14-rydizx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/521414/original/file-20230417-14-rydizx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/521414/original/file-20230417-14-rydizx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/521414/original/file-20230417-14-rydizx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/521414/original/file-20230417-14-rydizx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/521414/original/file-20230417-14-rydizx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The red dots denote the size of the association between the fathers’ and sons’ scores. The further away from zero, the stronger the association.</span>
<span class="attribution"><a class="source" href="https://link.springer.com/article/10.1007/s11199-023-01364-y#citeas">Francisco Perales et al, Sex Roles, Springer Nature</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>We identified similar results for 20 of the 22 individual masculinity questions. The strongest father-son associations emerged for questions about the endorsement of violence, importance of appearing heterosexual, and desirability of having multiple sexual partners.</p>
<p>This indicates these aspects of masculinity are comparatively more likely to be “passed on” from fathers to sons.</p>
<h2>What our findings mean</h2>
<p>As is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0049089X21000740?via%3Dihub">well-established</a>, social learning is important in shaping young people’s attitudes and behaviours. While fathers aren’t the only influence, <a href="https://link.springer.com/article/10.1007/s11199-023-01364-y">our study</a> suggests young men learn a lot about how to be a man from their dads. This is an intuitive finding, but we had little empirical evidence of it until now.</p>
<p>Confirming that dads “pass on” their masculinity beliefs to their sons has far-reaching implications. For example, it goes a long way in explaining why traditional models of masculinity remain entrenched in today’s society. Our study indicates that breaking this cycle requires bringing fathers into the mix.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-draw-of-the-manosphere-understanding-andrew-tates-appeal-to-lost-men-199179">The draw of the 'manosphere': understanding Andrew Tate's appeal to lost men</a>
</strong>
</em>
</p>
<hr>
<p>Policies, interventions and programs aimed at promoting <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216955">healthy masculinity</a> among young people are more likely to work if they also target their dads. This proposition is consistent with a growing body of programs focused on <a href="https://pubmed.ncbi.nlm.nih.gov/31495253/">engaging fathers</a> in positive parenting.</p>
<p>What’s more, our findings underscore the potential long-term effects of successful intervention. If a program manages to help young people develop <a href="https://www.unfpa.org/sites/default/files/pub-pdf/Adolescent-Boys-and-Young-Men-final-web_0.pdf">positive masculinity</a>, it’s likely that — as they themselves become fathers — their own children’s masculinity is also positively affected.</p><img src="https://counter.theconversation.com/content/203834/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ella Kuskoff receives funding from the Australian Research Council's Centre of Excellence for Children and Families over the Life Course (Project ID CE200100025). </span></em></p><p class="fine-print"><em><span>Michael Flood has received funding from the AFL, Australia Institute, Australian Research Council, Australian Primary Health Care Research Institute Foundation, BHP, Department of Defence, Diversity Council of Australia, Human Rights Commission, Jesuit Social Services, NAPCAN, NRL, Our Watch, PwC, UNWomen, Victorian Government, Victorian Health Promotion Foundation, White Ribbon Australia, and World Health Organization.</span></em></p><p class="fine-print"><em><span>Tania King receives funding from the Australian Research Council (DE200100607 & LP180100035)</span></em></p><p class="fine-print"><em><span>Francisco Perales does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>This is an intuitive finding, but we had little empirical evidence of it until now. It highlights the critical role fathers play in steering boys towards healthier expressions of masculinity.Francisco Perales, Adjunct Associate Professor, School of Social Science, The University of QueenslandElla Kuskoff, Research Fellow, ARC Centre of Excellence for Children and Families over the Life Course, The University of QueenslandMichael Flood, Professor of Sociology, Queensland University of TechnologyTania King, Associate professor, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1879252022-08-23T20:04:31Z2022-08-23T20:04:31ZSuicide rates reveal the silent suffering of Australia’s ageing men<figure><img src="https://images.theconversation.com/files/477292/original/file-20220803-14-yx5kuh.jpg?ixlib=rb-1.1.0&rect=15%2C7%2C5188%2C3456&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://images.unsplash.com/photo-1595843471708-94f8f23d5be6?ixlib=rb-1.2.1&ixid=MnwxMjA3fDB8MHxwaG90by1wYWdlfHx8fGVufDB8fHx8&auto=format&fit=crop&w=3270&q=80">Unsplash/Mark Timberlake</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Men aged 85 and older have the highest suicide rates in Australia, but the tragedy has gone relatively unnoticed. This group is growing older, feeling alone and flying under the radar.</p>
<p>The tragedy of suicide is recognised as a major public health issue. Yet what may come as a surprise to many is data <a href="https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/latest-release#intentional-self-harm-deaths-suicide-in-australia">published</a> by the Australian Bureau of Statistics showing men over 85 have suicide rates more than three times the average rate.</p>
<p>Public perception is that men – in particular, young men – have the highest suicide risk. While this is true for the net number of suicides, if we don’t consider age-standardised rates (which account for differences in age distribution across the population) we miss a crucial finding.</p>
<h2>Adjusting for age</h2>
<p>Men aged over 85 accounted for a relatively small proportion of all male suicides (3.1%) in 2020 (the latest data available). But the age-specific suicide rate was 36.2 deaths per 100,000 (up from 32.3 per 100,000 in 2019). For women aged over 85, this rate was much lower (6.2 per 100,000). The next highest rate was for men in both the 40-44 and 50-54 age bands (27.1 per 100,000).</p>
<p>In 2020, the overall suicide rate was 12.1 per 100,000 people.</p>
<p>But this issue is rarely addressed in public discourse or policy directives. The <a href="https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/2020-21#psychological-distress">National Study of Mental Health and Wellbeing</a> released last month did not include data on people older than 85.</p>
<p>This risk is <a href="https://theconversation.com/elderly-men-have-the-highest-suicide-rate-and-ageism-stops-us-from-doing-something-about-it-46923">not new</a>, but little has changed to address it over the past decade. In light of COVID and what it has <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2021.679711/full">revealed about ageism</a> and the value of older people in our society, it is crucial to explore these issues again. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/477294/original/file-20220803-1926-uuu06d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="older man with head in hands" src="https://images.theconversation.com/files/477294/original/file-20220803-1926-uuu06d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/477294/original/file-20220803-1926-uuu06d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/477294/original/file-20220803-1926-uuu06d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/477294/original/file-20220803-1926-uuu06d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/477294/original/file-20220803-1926-uuu06d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/477294/original/file-20220803-1926-uuu06d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/477294/original/file-20220803-1926-uuu06d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">All the key risk factors for suicide have become even more relevant due to COVID.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/senior-man-covering-his-face-hands-701935606">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/drought-increases-rural-suicide-and-climate-change-will-make-drought-worse-185392">Drought increases rural suicide, and climate change will make drought worse</a>
</strong>
</em>
</p>
<hr>
<h2>Preventable deaths</h2>
<p>It is startling that men who have shown resilience to survive to late life are at such risk of preventable death. Many factors contribute, including physical and material circumstances like <a href="https://pubmed.ncbi.nlm.nih.gov/28511737/">frailty, chronic pain, bereavement</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/23209090/">financial troubles</a>. However, we cannot assume only external issues cause distress and lead to suicide.</p>
<p>In fact, for older people, successful ageing is rarely defined purely by physical circumstances. Ageing well often implies flourishing despite hardship.</p>
<p>The silent challenge among men aged over 85 who take their own lives is psychological and existential distress, which can <a href="https://pubmed.ncbi.nlm.nih.gov/20438238/">reinforce feelings of loneliness and worthlessness</a>. Older men at risk of suicide may feel they are “no longer needed” or perceive themselves as “burdensome” to family and community.</p>
<p>These beliefs can overlap with major life transitions, such as retirement, <a href="https://pubmed.ncbi.nlm.nih.gov/31431103/">stopping driving</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/21500012/">moving to residential care, where they are a minority</a>. Such stressful events can increase feelings of marginalisation, loss of independence and worthlessness, and also lead to social isolation.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-challenging-masculine-stereotypes-is-good-for-men-114300">How challenging masculine stereotypes is good for men</a>
</strong>
</em>
</p>
<hr>
<h2>Talking about it</h2>
<p>A reluctance to express their feelings or be vulnerable has long been discussed as an important factor for men’s wellbeing, especially when they’re feeling low. </p>
<p>Research suggests gender stereotypes and social norms linked to masculinity <a href="https://pubmed.ncbi.nlm.nih.gov/27664823/">reduce help-seeking behaviours</a> and <a href="https://journals.sagepub.com/doi/abs/10.1177/2156869317725890">can increase suicide risk</a>. Many ageing men hold restrictive and stoic beliefs about what it means to be a man. This may make them <a href="https://pubmed.ncbi.nlm.nih.gov/29019282/">less inclined to share</a> when they aren’t coping. </p>
<p>Yet emerging research <a href="https://pubmed.ncbi.nlm.nih.gov/27473200/">challenges the assumption</a> men don’t talk because they can’t. One reason men are not talking about their mental health struggles is because there’s <a href="https://opus.lib.uts.edu.au/handle/10453/153516">nowhere for them</a> to open up in a way they see as culturally and socially acceptable.</p>
<p>Instead, older men are speaking through their actions.</p>
<p>Suicide prevention and early intervention responses that are not tailored to the needs of older men are unlikely to be effective. We need to meet men where they are and listen to their quiet and absent voices by designing programs in partnership with them.</p>
<p>This means better understanding men’s <a href="https://pubmed.ncbi.nlm.nih.gov/28871841/">barriers</a> to suicide interventions. These include a lack of trust in traditional services and an aversion to “formal” supports that frame emotional distress and suicidal behaviours as mental illness. </p>
<p>It also means exploring, developing and funding new options that are acceptable, relevant and accessible, such as gendered support, peer-led programs, community-based informal support and programs combining exercise with mental health promotion. </p>
<p>The objective is not only to develop more suitable suicide prevention for this specific group, but also to examine broader interactions between ageing, isolation and loneliness; <a href="https://www.cambridge.org/core/journals/international-psychogeriatrics/article/covid19-the-implications-for-suicide-in-older-adults/9890D02E0DA3021FCFE66B9A29F2684E">all key risk factors</a> for suicide that have become even more relevant due to COVID.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1549314424833466368"}"></div></p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/friday-essay-grey-haired-and-radiant-reimagining-ageing-for-women-182336">Friday essay: grey-haired and radiant – reimagining ageing for women</a>
</strong>
</em>
</p>
<hr>
<h2>More calls for help</h2>
<p>Increased feelings of distress and loneliness produced by the pandemic can be measured by <a href="https://www.abc.net.au/news/2021-08-04/lifeline-records-highest-daily-calls-on-record/100350522">increased calls to services such as Lifeline</a>. And more persistent mental health problems are likely to present more slowly, <a href="https://psycnet.apa.org/fulltext/2020-41461-001.html">over longer horizons</a>, and peak after the most acute phases of the pandemic.</p>
<p>Older people have handled much of the burden of COVID, including unprecedented <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295320/">restrictions and ageist sentiments</a>. We must recognise these factors – growing old, being alone and feeling unheard - underpin increasing distress felt by men aged over 85, not only during the pandemic, but more generally.</p>
<p>This group must be seen as a priority population for suicide prevention. We must start listening and work together to find solutions so older men can access the help they need in a way that suits them.</p>
<hr>
<p><em>UNSW Ageing Futures Institute would like to acknowledge the research contribution of <a href="https://www.lifeline.org.au/about/our-research/">Lifeline Research Foundation</a>’s Dr Anna Brooks (National Manager) and Dr Tara Hunt (Research and Engagement Manager).</em></p>
<hr>
<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, you can call these support services, 24 hours, 7 days:</em></p>
<ul>
<li><p><em>Lifeline: 13 11 14</em></p></li>
<li><p><em>Suicide Call Back Service: 1300 659 467</em> </p></li>
<li><p><em>Kids Helpline: 1800 551 800 (for people aged 5 to 25)</em></p></li>
<li><p><em>MensLine Australia: 1300 789 978</em></p></li>
<li><p><em>StandBy - Support After Suicide: 1300 727 24</em></p></li>
</ul><img src="https://counter.theconversation.com/content/187925/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rhys Mantell receives PhD scholarship funding from The National Health and Medical Research Council’s (NHMRC).</span></em></p><p class="fine-print"><em><span>Adrienne Withall receives funding from the NHMRC and MRFF. She is affiliated with the Ageing Futures Institute and the Australian Human Rights Institute. </span></em></p>If we consider suicide rates within age groups, men over 85 are at three times the average risk. We should make sure older men have ways to express when they’re not coping and seek help.Rhys Mantell, PhD Candidate, School of Population Health, UNSW SydneyAdrienne Withall, Senior Research Fellow, School of Population Health, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1874982022-08-10T15:33:02Z2022-08-10T15:33:02ZMen’s fertility also declines with age — here’s what to know if you’re planning to wait to have kids<figure><img src="https://images.theconversation.com/files/477665/original/file-20220804-25-yu6m7w.jpg?ixlib=rb-1.1.0&rect=0%2C14%2C4992%2C3974&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fertility tends to decline from 40 onwards.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/sperm-spermatozoa-magnifying-glass-analysis-spermogram-2157696345">Home creator/ Shutterstock</a></span></figcaption></figure><p>While women are often reminded about their “biological clock,” many guys just <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.13116">don’t feel the same pressures</a> when it comes to settling down and starting a family. In fact, a lot of men in their 20s – especially cisgender, heterosexual men – don’t think a great deal about <a href="https://dash.harvard.edu/handle/1/40046518">having children</a> or when they <a href="https://dora.dmu.ac.uk/handle/2086/22039">might want to have children</a>.</p>
<p>This might be because many people think men have all the time in the world when it comes to having children. Exceptional examples such as Mick Jagger – who had a child when he was 73 years old – are often cited to reinforce this argument. But in reality, there are many things men need to bear in mind when it comes to their fertility and starting a family. </p>
<p>In recent decades we have seen a gradual shift towards more people becoming parents later in life. In England and Wales, both men and women are having children later than <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthcharacteristicsinenglandandwales/2020">ever before in recorded history</a>. Men alone now have children on average aged <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthcharacteristicsinenglandandwales/2020">nearly 34-years-old</a>, compared to around <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthcharacteristicsinenglandandwales/2017">29-years-old in the mid-70s</a>. </p>
<hr>
<figure class="align-right ">
<img alt="Quarter life, a series by The Conversation" src="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption"></span>
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<p><em><strong><a href="https://theconversation.com/uk/topics/quarter-life-117947?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">This article is part of Quarter Life</a></strong>, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/online-dating-fatigue-why-some-people-are-turning-to-face-to-face-apps-first-184910?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Online dating fatigue – why some people are turning to face-to-face apps first</a></em></p>
<p><em><a href="https://theconversation.com/baby-names-why-we-all-choose-the-same-ones-185546?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Baby names: why we all choose the same ones</a></em></p>
<p><em><a href="https://theconversation.com/body-image-issues-affect-close-to-40-of-men-but-many-dont-get-the-support-they-need-179046?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Body image issues affect close to 40% of men – but many don’t get the support they need</a></em></p>
<hr>
<p>There are <a href="https://pubmed.ncbi.nlm.nih.gov/21652599/">multiple, complex reasons</a> for this – including young people facing more difficulties buying houses and living in an uncertain economic climate, alongside changes in the way people date and form relationships. Another factor is that both women and men are <a href="https://www.rbmojournal.com/article/S1472-6483(13)00501-4/fulltext">staying in education longer</a>, and taking longer to establish careers. Alongside this, people appear to feel more pressure to have children at a time when they can <a href="https://link.springer.com/chapter/10.1007/978-90-481-8969-4_11">give them the “best start” in life</a>.</p>
<p>While some people can have children in their 30s, 40s and beyond with ease, others may struggle. There are often misconceptions that only women face fertility difficulties the older they get but growing evidence suggests that age also affects a man’s fertility, too – <a href="https://www.drfertility.co.uk/pages/does-age-affect-male-fertility">from around about 40 onwards</a>. In fact, age has been shown to <a href="https://link.springer.com/article/10.1186/s12958-015-0028-x">negatively affect sperm quality</a>, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0378512219301343">reduce fertility</a>, and carry a greater likelihood of both <a href="https://link.springer.com/article/10.1186/s12958-015-0028-x">miscarriage</a> and <a href="https://link.springer.com/article/10.1007/s11934-018-0802-3">health conditions</a> in children – particularly <a href="https://link.springer.com/article/10.1186/s12958-015-0028-x">autism, schizophrenia, bipolar disorder and childhood leukaemia</a>. </p>
<p>But this evidence is rarely talked about – and men <a href="https://www.sciencedirect.com/science/article/abs/pii/S001502821202345X">often aren’t aware</a> their fertility can decline as they get older. While this is not a reason to panic – arguably the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854095/">risks still remain low</a> – it is something to be aware of if you are planning to wait to have kids.</p>
<h2>Improving your odds</h2>
<p>So what can you do then to make sure you have the best chance possible when you do want to have children? There are a couple of factors to take into account.</p>
<p>The first is your lifestyle. Research shows that many different lifestyle factors can affect a man’s fertility. In particular, research suggests avoiding <a href="https://www.tandfonline.com/doi/full/10.1080/14647273.2017.1382733">smoking</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/29713532/">excess alcohol intake</a>, as well as having a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848840/">healthy diet and BMI</a>, are important for healthy sperm and for fertility. Men (and women) <a href="https://www.youtube.com/watch?v=ETwDCKBaYd4">are encouraged to think about these things</a> – and others such as <a href="https://academic.oup.com/humrep/article/33/9/1749/5066758?login=true">avoiding tight underwear</a>, <a href="https://www.nice.org.uk/guidance/cg156/evidence/full-guideline-pdf-188539453">drugs and steroids</a> – in their teens and 20s.</p>
<figure class="align-center ">
<img alt="A group of young men drink beers in a pub." src="https://images.theconversation.com/files/477666/original/file-20220804-1334-shfeux.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/477666/original/file-20220804-1334-shfeux.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/477666/original/file-20220804-1334-shfeux.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/477666/original/file-20220804-1334-shfeux.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/477666/original/file-20220804-1334-shfeux.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/477666/original/file-20220804-1334-shfeux.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/477666/original/file-20220804-1334-shfeux.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lifestyle factors such as excess drinking can affect fertility.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/people-leisure-friendship-bachelor-party-concept-389227426">Ground Picture/ Shutterstock</a></span>
</figcaption>
</figure>
<p>But having a healthy lifestyle is only one part of the equation. Another key part is age. Ideally, you want to try to have children before “fertility ageing” becomes a problem – that is, before age may affect your chance of conceiving or the wellbeing of your children. Although many people believe that men can continue having children well into old age, the evidence shows us that this may not necessarily be true – and may also come with risks. This is why it may be important for more young men to start thinking about whether, when and under what circumstances they may want children, and build these ideas into <a href="https://theconversation.com/forget-freezing-sperm-its-time-for-men-to-take-responsibility-for-the-foreplay-of-fatherhood-43753">how they plan and live their life</a>.</p>
<p>Being single is a <a href="https://pubmed.ncbi.nlm.nih.gov/32802369/">key reason</a> why both men and women aren’t able to have children at their ideal time – and why some <a href="https://www.emerald.com/insight/content/doi/10.1108/WWOP-09-2017-0025/full/html">remain childless</a> even if they wanted children. So it’s important to keep fatherhood in mind when navigating dating and relationships. Both <a href="https://journals.sagepub.com/doi/abs/10.1111/j.1467-954X.2010.01924.x">avoiding “settling down”</a> or staying with the wrong person for too long can affect your (and your partner’s) chances of finding the right person to have children with in the future. </p>
<p>Fertility isn’t just down to one person. If you do have a partner, it may be important to consider both of your ages and fertility when considering having kids. A woman’s fertility <a href="https://www.britishfertilitysociety.org.uk/fei/at-what-age-does-fertility-begin-to-decrease/">decreases faster</a> than a man’s does, so having frank and honest conversations about if and when you’d both like to become parents may help you avoid future arguments and disappointments. </p>
<p>New technologies continue to be developed which may help people increase their odds of becoming parents in the middle and older age. In particular, <a href="https://www.emerald.com/insight/publication/doi/10.1108/9781787564831">egg freezing is a growing phenomenon</a> and some suggest <a href="https://jme.bmj.com/content/41/9/775.short?g=w_jme_ahead_tab">sperm freezing in younger adulthood</a> can help men have children later in life but using the best quality sperm. But just because these technologies may make it possible, doesn’t mean you shouldn’t still think about whether and when you want to have children as you begin to plan your adult life.</p>
<p><iframe src="https://action.bridged.media/?id=62ebc4f42e78b514b03ec1f9&embed=true" width="100%" height="400px" style="border:none; overflow: hidden;"></p></iframe></p><img src="https://counter.theconversation.com/content/187498/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Caroline Law does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Despite what many men believe, they might not have all the time in the world when it comes to having children.Caroline Law, Senior Research Fellow, De Montfort UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1844512022-06-28T02:00:42Z2022-06-28T02:00:42ZMen have pelvic floors too – and can benefit when they exercise them regularly<figure><img src="https://images.theconversation.com/files/469907/original/file-20220621-22-zu5l9t.jpg?ixlib=rb-1.1.0&rect=13%2C41%2C4580%2C3021&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://image.shutterstock.com/image-photo/sick-man-prostate-cancer-premature-600w-791204665.jpg">Shutterstock</a></span></figcaption></figure><p>“Kegels” and pelvic floor exercises are usually associated with “women’s business” – think pregnancy, childbirth, and menopause. But men have pelvic floors too. </p>
<p>Just like women, at various times in their lives men can benefit from training their pelvic floors to address a variety of health concerns. About 30% of men visiting the doctor have <a href="https://www.continence.org.au/incontinence/who-it-affects/men">urinary incontinence</a>, or bladder leakage, but a large majority don’t bring it up. Around 15% of men also experience faecal incontinence, or bowel leakage, and take longer to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069320/">seek help</a> for it compared to women. </p>
<p>The pelvic floor muscles are also involved in sexual function. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324914/">Erectile dysfunction</a> affects around 10% of healthy men, and up to almost 40% of men with chronic health conditions, and can be associated with pelvic floor issues.</p>
<p>People sometimes assume these problems are just a normal part of ageing; but common doesn’t mean inevitable. There is often much improvement to be had with some simple strategies – including pelvic floor rehabilitation. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1536587745195343872"}"></div></p>
<h2>Pelvic floor dysfunction in men is really common</h2>
<p>Though pelvic floor problems are <a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2000.tb11669.x">more common in women</a>, one in eight men <a href="https://choose.physio/your-lifestage/adults/mens-health">have issues</a> with their pelvic floor, bladder or bowel. </p>
<p>The pelvic floor is a group of muscles lining the base of the pelvis. For men, this <a href="https://www.continence.org.au/who-it-affects/men/male-pelvic-floor-muscles">supports</a> the bladder, prostate gland and bowel. It is essential in maintaining core stability, bladder and bowel control, and for erectile function and sexual satisfaction. </p>
<p>Most men have little reason to think about their pelvic floor for the majority of their lives, until something goes wrong medically (in comparison to women, who tend to be introduced to pelvic floor exercises much younger, often in the context of pregnancy and childbirth). </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/469908/original/file-20220621-25-eny4r6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="couple look affectionate in bed" src="https://images.theconversation.com/files/469908/original/file-20220621-25-eny4r6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/469908/original/file-20220621-25-eny4r6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/469908/original/file-20220621-25-eny4r6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/469908/original/file-20220621-25-eny4r6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/469908/original/file-20220621-25-eny4r6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/469908/original/file-20220621-25-eny4r6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/469908/original/file-20220621-25-eny4r6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Working on your pelvic floor strength might even improve your sex life.</span>
<span class="attribution"><a class="source" href="https://image.shutterstock.com/image-photo/happy-asian-senior-couple-having-600w-1684173169.jpg">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/playing-games-with-your-pelvic-floor-could-be-a-useful-exercise-for-urinary-incontinence-182431">Playing games with your pelvic floor could be a useful exercise for urinary incontinence</a>
</strong>
</em>
</p>
<hr>
<h2>Why it happens</h2>
<p><a href="https://www.continence.org.au/who-it-affects/men/male-pelvic-floor-muscles">Risk factors</a> for incontinence and pelvic floor problems in men include ageing, prostate issues, pelvic surgery, bowel issues including constipation, chronic coughing, frequent heavy lifting, and being overweight. </p>
<p>Prostate cancer affects up to 15% of men and is the <a href="https://www.wcrf.org/cancer-trends/worldwide-cancer-data/">second most common cancer</a> in men (and fourth most common cancer overall). </p>
<p>The largest source of pelvic floor physiotherapy referrals for men tends to be in the context of prostate surgery. This is because surgery on the prostate gland (which sits very close to the base of the bladder) causes trauma to the nearby structures and nerves that maintain bladder control and erectile function. </p>
<p>However, we know that training the pelvic floor early (starting pre-operatively) means post-operative side effects like incontinence <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7471070/">resolve more quickly</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/prostate-cancer-linked-to-bacteria-raising-hope-of-new-test-and-treatment-181542">Prostate cancer linked to bacteria, raising hope of new test and treatment</a>
</strong>
</em>
</p>
<hr>
<h2>How can men exercise their pelvic floors?</h2>
<p>To engage the pelvic floor, the sensation should feel like a squeeze, lift and relax of the muscles running between the pubic bone, tailbone, and sit bones. Some popular cues include visualising: </p>
<ul>
<li> stopping urine mid-flow (but <a href="https://www.wellandgood.com/im-a-pelvic-floor-therapist-and-this-is-why-you-shouldnt-stop-your-flow-mid-pee/">not actually doing this</a>)</li>
<li> holding in wind</li>
<li> retracting the penis/testicles</li>
<li> pulling the perineum (skin between the genitals and back passage) away from your underwear.</li>
</ul>
<p>It is important to ensure that the abdominal, gluteal (buttock) and thigh muscles stay relaxed, with breathing maintained throughout. </p>
<p>Exercises can be performed in any position, and if done right, should be able to be done inconspicuously (even when there are other people around!). But it’s quite common to find the exercises difficult to do without some coaching. </p>
<p>Working with a health professional such as a <a href="https://choose.physio/find-a-physio">pelvic floor physiotherapist</a> may be beneficial. Physiotherapists trained in men’s health and pelvic floor conditions will teach clients how to perform exercises correctly. Often they do this with biofeedback devices such as real-time ultrasound imaging that can help identify the right muscles to use and refine technique. </p>
<p>Not all pelvic floor problems require more strengthening. Optimal muscle function requires good strength, but also correct timing, co-ordination and relaxation. </p>
<p>A pelvic floor that is too tight can be problematic, for both men and women, and can contribute to symptoms of pelvic or genital pain, sexual dysfunction, urinary issues including overactive bladder, and bowel problems. </p>
<p>Your specific concerns will inform the way in which your physio might prescribe exercises, but good targets to aim for are to be able to: </p>
<ol>
<li>turn the pelvic floor on and off 10 times in 10 seconds</li>
<li>strongly hold 10 seconds, repeated 10 times</li>
<li>maintain an easy hold for 1 minute.</li>
</ol>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1537925051722309637"}"></div></p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/technology-for-incontinence-hasnt-developed-that-much-since-ancient-egyptian-times-98349">Technology for incontinence hasn't developed that much since ancient Egyptian times</a>
</strong>
</em>
</p>
<hr>
<h2>If I don’t have pelvic floor problems, do I need to do exercises?</h2>
<p>Like a good gym program keeps you in optimal physical health and helps stave off injuries, it stands to reason that a regular pelvic floor training routine might serve to combat the likelihood of bladder, bowel and erectile dysfunction. However, the literature is scarce for preventative use in asymptomatic men.</p>
<p>Knowing where your pelvic floor is and how to exercise it properly can never be a bad thing – and training might even have some happy side effects, like <a href="https://link.springer.com/article/10.1007/s11934-013-0358-1">reduced waking in the night</a> with the need to urinate, reduced dribbling post-urination, better bowel emptying, and improved sexual satisfaction. </p>
<p>If you are unsure whether pelvic floor exercises are suitable for you or if you’re doing them properly, check in with a trusted health professional.</p><img src="https://counter.theconversation.com/content/184451/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mischa Bongers is the Founder and Principal Physiotherapist at Pelvic Fix Physiotherapy. She is affiliated with CQUniversity as a Sessional Lecturer, Curtin University as a Physiotherapy Clinical Supervisor, and Queensland Health as a Senior Women's Health Physiotherapist. </span></em></p>Knowing where your pelvic floor is and how to exercise it properly can help male incontinence – and might even have some happy side effects.Mischa Bongers, Sessional Lecturer, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1842372022-06-14T19:05:03Z2022-06-14T19:05:03ZNZ men get sick or injured more and die sooner than women – a targeted health policy is long overdue<figure><img src="https://images.theconversation.com/files/468603/original/file-20220613-17-p7egai.jpg?ixlib=rb-1.1.0&rect=29%2C7%2C4880%2C3680&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Getty Images</span></span></figcaption></figure><p>Successive New Zealand governments have failed to develop a policy or strategy focused on men’s health, falling behind countries like Mongolia, Australia, Ireland, Iran, Malaysia, South Africa, Brazil and the state of Quebec.</p>
<p>The consequences of this failure for New Zealand men are dire, with research showing men falling behind women in terms of access to health care, diagnoses and overall life expectancy. </p>
<p>The picture is even more bleak for Māori and Pacific men.</p>
<p>This week is <a href="https://www.menshealthweek.co.nz/">Men’s Health Week</a> – a good time to consider how New Zealand men might be better served by a targeted health policy and how this might benefit the country as a whole. </p>
<h2>Male inequalities in health</h2>
<p>In New Zealand there are significant differences in poor health and life expectancy between men and women, between men of different ethnicities and those who are gender diverse. </p>
<p>Women outlive men by four years, and for men aged between <a href="https://journal.nzma.org.nz/journal-articles/seven-things-you-need-to-know-about-mens-health">50 and 75 years</a> the death rate is 30% higher than for women. The life expectancy for Māori and Pacific men is between seven and five years less than other men. </p>
<p>Additionally, men are more likely to live with an illness or injury and, as a result, <a href="https://journal.nzma.org.nz/journal-articles/targets-and-actions-for-non-communicable-disease-prevention-and-control-in-new-zealand">die prematurely</a>. </p>
<figure class="align-center ">
<img alt="Doctor checks pulse of man in hospital bed." src="https://images.theconversation.com/files/468623/original/file-20220613-13-o9ow2q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/468623/original/file-20220613-13-o9ow2q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/468623/original/file-20220613-13-o9ow2q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/468623/original/file-20220613-13-o9ow2q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/468623/original/file-20220613-13-o9ow2q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/468623/original/file-20220613-13-o9ow2q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/468623/original/file-20220613-13-o9ow2q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Men’s life expectancy in New Zealand is significantly lower than women’s.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com.au/detail/photo/man-in-hospital-bed-having-pulse-taken-royalty-free-image/104117253?adppopup=true">David Sacks/Getty Images</a></span>
</figcaption>
</figure>
<p>These health inequalities were highlighted during the <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2020.1823760">COVID-19 pandemic</a>, with men contracting COVID at higher rates, experiencing more severe symptoms and being more likely to die. </p>
<p>In New Zealand, there is also a <a href="https://www.health.govt.nz/publication/suicide-web-tool#key.">stark disparity</a> between male and female deaths by suicide. In 2018, 446 men died by suicide, compared to 177 women. </p>
<p>For men, this grim statistic is not just youth related – older men are also at <a href="https://www.nzdoctor.co.nz/article/undoctored/high-rates-suicide-continue-among-older-nz-men-otago-research-reveals">high risk</a>. And men with disabilities report <a href="https://academic.oup.com/jpubhealth/article/41/4/707/5160101">higher rates</a> of suicidal ideation than non-disabled men.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/sometimes-its-hard-to-be-a-man-43264">Sometimes it's hard to be a man</a>
</strong>
</em>
</p>
<hr>
<p>Gender diverse research is in its infancy, but recent research shows trans men are more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216046/">report psychological distress</a> than trans women. </p>
<p>Biological sex differences alone, however, can’t explain men’s higher risk of premature death and poorer overall health status. These outcomes are irrefutably linked to cultural and socioeconomic factors.</p>
<h2>What stops men going to the doctor?</h2>
<p>Many men are reluctant to seek care and support from the health system, arguably because it is not structured around their needs. </p>
<p>Primary care services are generally only open at times men are at work, and the feminine atmosphere of <a href="https://www.researchgate.net/publication/349255723_Men's_Health_Promotion_in_Waiting_Rooms_An_Observational_Study">many waiting areas</a> reinforces the perspective that health is women’s work.</p>
<p>Generally, men only think about their health if an issue prevents them from undertaking an important practical aspect of their lives – be that sport, playing with their children or doing their job. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/building-healthy-relationship-skills-supports-mens-mental-health-177243">Building healthy relationship skills supports men's mental health</a>
</strong>
</em>
</p>
<hr>
<p>Consequently, they are unlikely to seek help unless their functional ability is affected. </p>
<p>Ultimately, this means men are <a href="https://www.tandfonline.com/doi/full/10.1080/10833196.2018.1452562">seeking help</a> for health problems much later, resulting in higher levels of potentially preventable health issues, reduced treatment options and greater use of more expensive hospital services.</p>
<p>Sadly, men are also at higher risk of being fatally injured through their occupation. Between 2005-2014, 955 workers were fatally injured, of which <a href="https://injuryprevention.bmj.com/content/27/2/124">89% were men</a>.</p>
<p>Unfortunately, the lifestyle choices of men, including smoking, poor diet, unsafe alcohol consumption and the abuse of other substances, frequently have negative consequences on their health and well-being. While these lifestyle behaviours can be linked to perceptions of what it means to be a man, these choices are by and large modifiable. </p>
<p>An effective men’s health policy would explicitly recognise that health promotion programmes need to be designed specifically for men.</p>
<figure class="align-center ">
<img alt="Injured worker in high visible vest." src="https://images.theconversation.com/files/468629/original/file-20220613-21-ddvdqb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/468629/original/file-20220613-21-ddvdqb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/468629/original/file-20220613-21-ddvdqb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/468629/original/file-20220613-21-ddvdqb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/468629/original/file-20220613-21-ddvdqb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/468629/original/file-20220613-21-ddvdqb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/468629/original/file-20220613-21-ddvdqb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In New Zealand, almost 90% of work injuries happen to men.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com.au/detail/photo/man-wearing-high-visibility-jacket-with-bandaged-royalty-free-image/159615155?adppopup=true">Monty Rakusen/Getty Images</a></span>
</figcaption>
</figure>
<h2>Where policy can help</h2>
<p>Globally, there are a number of gender-specific health promoting programmes that have proved their usefulness in relation to men’s health. </p>
<p>The <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6472-3">Rugby Fans in Training</a> healthy lifestyle programme, resulted in changes to men’s physical activity levels and diet, leading to weight loss. </p>
<p>The male-focused <a href="https://www.teagasc.ie/publications/2022/farmers-have-hearts-cardiovascular-health-programme.php">Farmers Have Hearts</a> cardiovascular health programme in Ireland resulted in improved outcomes for farmers, with over 80% successfully making some form of lifestyle behaviour change. </p>
<p>Research on the <a href="https://menssheds.ie/the-mens-shed-movement-highlighting-the-importance-of-community-and-friendship-for-wellbeing/">“Men’s Shed”</a> movement has shown its ability to foster a sense of community, nurture a sense of belonging and reduce the negative health impacts of loneliness. </p>
<p>While some successful initiatives and programmes that target men are currently established in New Zealand, a cohesive approach is lacking despite mounting national and international evidence that gender specific initiatives are effective.</p>
<p>Focusing on men’s health doesn’t have to come at the cost of women’s health initiatives and it is commendable the government has committed to a women’s health strategy as part of the Pae Ora (Health Futures) Bill.</p>
<p>However, men’s health musn’t be forgotten. </p>
<p>The government also needs to implement a men’s health policy that facilitates a cohesive, equitable approach, enabling men to enhance their lives, not only for their benefit but also the benefit of their families, communities and for society as a whole.</p><img src="https://counter.theconversation.com/content/184237/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Elaine Hargreaves has received funding from the Health Research Council of New Zealand. </span></em></p><p class="fine-print"><em><span>Ally Calder, Fiona Doolan-Noble, and Hui Xiao do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>When it comes to men’s health strategies, New Zealand has fallen behind countries like Mongolia, Iran and Malaysia. In Men’s Health Week it’s time to ask: what is the plan to save men’s lives?Fiona Doolan-Noble, Co-Director Centre for Men's Health and Senior Research Fellow, Rural Health, University of OtagoAlly Calder, Lecturer, University of OtagoElaine Hargreaves, Associate Professor of Exercise Psychology, University of OtagoHui Xiao, University of OtagoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1821412022-05-25T01:01:42Z2022-05-25T01:01:42ZSurprise! How men react when becoming a dad isn’t part of the plan<figure><img src="https://images.theconversation.com/files/460488/original/file-20220429-13-qbw5dq.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C663&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-woman-hands-hiding-pregnancy-test-1195326700">Shutterstock</a></span></figcaption></figure><p>For many dads, having a child is unplanned. What happens next can vary. One man said:</p>
<blockquote>
<p>We broke up and she called me soon after to tell me she was pregnant […] she just asked me if I wanted to be in our baby’s life and I accepted without thinking twice.</p>
</blockquote>
<p>Another said:</p>
<blockquote>
<p>I wanted to have an abortion, since we weren’t ready, but it wasn’t my choice, it was hers […] but the resentment was there for a long time.</p>
</blockquote>
<p>These two comments came from tens of thousands of posts on the social media site Reddit we analysed as part of <a href="https://www.sciencedirect.com/science/article/pii/S2667321522000476?via%3Dihub">our research</a> into men’s experiences of unplanned pregnancy.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-studied-100-years-of-australian-fatherhood-heres-how-todays-dads-differ-from-their-grandfathers-166348">We studied 100 years of Australian fatherhood. Here's how today's dads differ from their grandfathers</a>
</strong>
</em>
</p>
<hr>
<h2>Unplanned pregnancies are common</h2>
<p>Having an unplanned child is more common than you might think. In Australia <a href="https://pubmed.ncbi.nlm.nih.gov/26456762/">40% of pregnancies</a> are mis-timed, unexpected or unwanted. That’s an estimate comparable with rates <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30029-9/fulltext">worldwide</a>.</p>
<p>Most research on the impact of unplanned pregnancies focuses on mothers. We wanted to know about the experiences of dads. So we turned to two forums specifically for <a href="https://www.reddit.com/r/daddit/">new</a> and <a href="https://www.reddit.com/r/predaddit/">expecting dads</a> on Reddit.</p>
<p>We “scraped” tens of thousands of posts, spanning a year, then applied an innovative <a href="https://pubmed.ncbi.nlm.nih.gov/30744717/">machine learning</a> technique to group the data into meaningful topics. This allowed us to identify themes in the men’s online discussions.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/machine-learning-is-changing-our-culture-try-this-text-altering-tool-to-see-how-159430">Machine learning is changing our culture. Try this text-altering tool to see how</a>
</strong>
</em>
</p>
<hr>
<h2>Here’s what we found</h2>
<p><a href="https://www.sciencedirect.com/science/article/pii/S2667321522000476?via%3Dihub">Our research showed</a> men who reluctantly or unexpectedly became fathers experienced a complex range of emotions and reactions. Many needed support. </p>
<p>The dads in our study posted to Reddit using pseudonyms. So they were free to be honest and raw as they shared their emotions on a topic many consider taboo.</p>
<p>Some were “filled with regret”, “sadness”, “guilt” and hopelessness of a “never-ending, soul-crushing grind”. Some lacked bonds with their infants, one feeling “like the tin man without a heart”.</p>
<p>One man said:</p>
<blockquote>
<p>I keep on having really bad breakdown episodes. There are days when I just sit and cry thinking how miserable my life has become.</p>
</blockquote>
<h2>Unplanned fatherhood and postnatal depression</h2>
<p>Earlier research shows it’s common for dads to have <a href="https://www.sciencedirect.com/science/article/pii/S026661381930213X?casa_token=aFeik2hGNskAAAAA:jD_01eW0wFce3gXn9cpmIQV5prFnISfFZRQ_n6W41w19po1iP5evTq6rbR_h9xIDvbvu7FBL94A">short periods of negative thoughts</a> after their baby is born. Feelings of loss about their previous life are common.</p>
<p>However, persistent negative and intense emotions may indicate depression and anxiety at this time.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Baby in cot with father in background clutching cushion, holding head" src="https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Unplanned fatherhood increases a man’s risk of postnatal depression.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cute-baby-bed-young-father-suffering-1656784711">Shutterstock</a></span>
</figcaption>
</figure>
<p>In fact, unintended fatherhood is linked to an <a href="https://psycnet.apa.org/record/2012-26354-019">increased</a> <a href="https://www.sciencedirect.com/science/article/pii/S0277953608005789?casa_token=cUY_BmkyG1AAAAAA:jnaSyT80P963Q7q9-IZXrzO2Djb2tLCuMptqhwKUFUkmzuS1qeAY3yzpiK6n6fyuGlvmRLW2X6U">risk</a> of a man having postnatal depression.</p>
<p>Paternal depression is, in turn, linked to a higher risk of depression <a href="https://pubmed.ncbi.nlm.nih.gov/20483973/">in their partners</a> and more behavioural problems <a href="https://www.mja.com.au/system/files/issues/195_11_121211/fle10192_fm.pdf">in their children</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/dads-get-postnatal-depression-too-55829">Dads get postnatal depression too</a>
</strong>
</em>
</p>
<hr>
<h2>Let’s debunk some myths</h2>
<p>Like earlier research, ours debunks the myth that <a href="https://psycnet.apa.org/record/2020-29612-001">men do not seek help</a> when in need. Men sought and received advice and support from other dads about everything from night feeds and nappies to reassurance that what they were feeling was normal.</p>
<p>Studies show <a href="https://pubmed.ncbi.nlm.nih.gov/21464468/">peer support</a>, often online, can be a foot-in-the-door for men who feel uncomfortable disclosing vulnerability. This is particularly important for a taboo subject such as unwanted parenthood. </p>
<p>In our study, not all men were distressed. Some reported feeling happy “but freaking out” and simultaneously “scared, hopeful, excited, terrified”.</p>
<p>Sharing experiences allowed these fathers to validate and normalise the full spectrum of their emotions and sometimes re-frame a sense of hopelessness. </p>
<p>Men told each other “you are not alone”, “I felt the same”, “it does get better” and “it’s not as bad as people say”.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/childrens-well-being-goes-hand-in-hand-with-their-dads-mental-health-102347">Children’s well-being goes hand in hand with their dads’ mental health</a>
</strong>
</em>
</p>
<hr>
<h2>How to reduce the stigma</h2>
<p>In this study and <a href="https://journals.sagepub.com/doi/full/10.1177/0265407519864444">our earlier research</a> men said they were concerned that not wanting children would be seen as abnormal.</p>
<p>We hope our work raises awareness that desire for children is not universal. We can do more to normalise and destigmatise varied narratives that represent how people feel about parenthood. </p>
<p>When it comes to family planning, a first step is to include men in discussions about reproductive health before they become fathers and are expecting a child. </p>
<p><a href="https://static1.squarespace.com/static/56e1ed8d3c44d863de3040ee/t/6271c31d5e3a870ef25d1df1/1651622690479/MT2021-09-071-MACDONALD.pdf">Pre-conception planning</a> with health professionals involves becoming physically and psychologically ready for parenthood and is important for mothers, fathers and, ultimately, their offspring. </p>
<p>Once the baby is born, it is important dads have access to support. Family and health-care systems are mainly focused on mothers and infants, and could be better <a href="https://www.healthymale.org.au/resources-tools/current-research-projects-studies/plus-paternal/case-for-change">equipped, resourced and trained</a> to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165032720330111">detect fathers at risk of mental health problems</a>. <a href="https://coastfraseridpscd.ca/wp-content/uploads/2015/07/Zero-to-3-May-2015-Issue.pdf#page=62">Father-inclusive practice</a> is beneficial to fathers, mothers and children.</p>
<h2>When things go right</h2>
<p>When fathers have access to the right help at the right time, it can make all the difference. One man said:</p>
<blockquote>
<p>I ended up going to a psychiatrist after a suicide attempt. It did some good, it faced me with my own immaturity. May I suggest trying it? Everybody is different, but it seriously helped in my case.</p>
</blockquote>
<hr>
<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em></p><img src="https://counter.theconversation.com/content/182141/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqui Macdonald is convener of the Australian Fatherhood Research Consortium.</span></em></p><p class="fine-print"><em><span>Imogene Smith does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Most research on the impact of unplanned pregnancies focuses on mothers. So we turned to Reddit to find out what dads really thought.Imogene Smith, Casual academic, provisional psychologist and Doctor of Psychology (Clinical) candidate, Deakin UniversityJacqui Macdonald, Senior lecturer and research fellow in psychology, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1772432022-04-24T14:02:52Z2022-04-24T14:02:52ZBuilding healthy relationship skills supports men’s mental health<figure><img src="https://images.theconversation.com/files/458918/original/file-20220420-17-6shyho.jpg?ixlib=rb-1.1.0&rect=278%2C24%2C4734%2C3612&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There are few courses or programs that teach men relationship skills from the perspective of healthy masculinity.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Healthy relationships positively influence men’s well-being. <a href="https://doi.org/10.1016/j.jad.2017.06.007">Men who are partnered or married live longer lives than single men,</a> and they have better mental health than women and unpartnered men. Marriage appears to offer a protective influence on men’s health, reducing loneliness, depression and suicidality, and is associated with <a href="https://doi.org/10.1017/S0033291719002964">less substance and alcohol use</a>. </p>
<p>Despite these benefits, male suicide continues to be a global crisis. As men’s health researchers, our focus has been on men’s suicidality. Much of this work is motivated by the fact that <a href="https://www150.statcan.gc.ca/n1/pub/82-624-x/2012001/article/desc/11696-04-desc-eng.htm">men complete suicide at three to four times the rate of women,</a> and are known to use more lethal methods (guns, asphyxiation) to end their life. </p>
<p>While major depression is a contributing factor to suicidality, <a href="https://doi.org/10.1016/j.socscimed.2021.113831">a recent review</a> concluded that being unmarried, single, divorced or widowed are also strong predictors of suicidality among men.</p>
<p>Men who adhere to traditional aspects of masculinity — emotional stoicism, needing to be in control, fear of being seen as weak for seeking help — are <a href="https://doi.org/10.1177%2F1049732317718148">more likely to self-isolate, resort to anger or aggression, or self-harm when they experience distress</a>. The links between men’s mental illness, suicidality and intimate relationships are particularly concerning when considering the high rates of divorce and separation in countries including <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220309/dq220309a-eng.htm">Canada</a>, <a href="https://www.abs.gov.au/statistics/people/people-and-communities/marriages-and-divorces-australia/latest-release">Australia</a> and <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/divorce">Britain</a>.</p>
<p>To investigate the intersection of men’s health and intimate relationships, we conducted in-depth, <a href="https://doi.org/10.1177%2F16094069211053522">semi-structured interviews over Zoom</a> with 49 men and 30 service providers who work with male clients. We collected men’s first-person experiences of an intimate partner break-up, as well as providers’ perspectives of relationship challenges and how masculinity influences men’s coping in strained relationships. </p>
<h2>The impact of relationship loss</h2>
<p>Interestingly, men enjoyed interviewing from home in familiar surroundings and openly shared detailed stories about their relationship break-ups. They also reported anxiety, depression and suicidality in the aftermath of a relationship ending. We found that <a href="https://doi.org/10.1016/j.ssmqr.2022.100039">relationship loss exacerbated pre-existing mental health issues for some men, and for others, it catalyzed the onset of mental health challenges</a>. </p>
<figure class="align-center ">
<img alt="A man with a beard sitting alone looking away from the camera toward a window" src="https://images.theconversation.com/files/458923/original/file-20220420-24727-etvhry.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/458923/original/file-20220420-24727-etvhry.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/458923/original/file-20220420-24727-etvhry.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/458923/original/file-20220420-24727-etvhry.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/458923/original/file-20220420-24727-etvhry.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/458923/original/file-20220420-24727-etvhry.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/458923/original/file-20220420-24727-etvhry.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Men described their distressed states, fragile mental health and potential for breaking down in the wake of breaking up.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Men in long- and short-term partnerships talked about the challenges they faced during the course of their relationships: domestic conflict, parenting stressors, infidelity, illness or job loss. The also discussed how these issues made it difficult for them to effectively negotiate with a partner to maintain and grow their relationship, or amicably separate. </p>
<p>Gendered aspects of traditional masculinity, such as autonomous problem solving, maintaining control over life events and being seen as a confident family man, were tested and undone by distressed relationships.</p>
<p>The men described their distressed states, fragile mental health and potential for breaking down in the wake of breaking up. Many participants commented on how they struggled with the emotional work involved in sustaining a long-term relationship. </p>
<p>Intense emotions, including sadness, anger, guilt and regret, were triggered by the loss of partners, and manifested in varying degrees of anxiety, depression, and for some men, suicidality. Several men detailed the experience of panic attacks that lead to hospitalization in the wake of a break-up. </p>
<p>To cope with emotional distress, many men relied on alcohol, “Herculean” amounts of cannabis, excessive exercising, frenzied dating, marathon gaming and other emotion-blunting strategies. However, we also learned that with time, most men sought out friends and family for support and searched for books, podcasts and online resources to alleviate distress and better understand relationship dynamics. </p>
<p>Some men reached out beyond their own networks and joined parenting or divorce groups, and found activities with male peers helped improve their mental health. Many attended professional therapy to address longstanding mental health issues or experience the benefits of professional therapeutic rapport for the first time.</p>
<h2>Relationship skills</h2>
<figure class="align-center ">
<img alt="A man and a woman relaxing on a sofa talking" src="https://images.theconversation.com/files/458927/original/file-20220420-23-238lzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/458927/original/file-20220420-23-238lzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/458927/original/file-20220420-23-238lzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/458927/original/file-20220420-23-238lzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/458927/original/file-20220420-23-238lzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/458927/original/file-20220420-23-238lzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/458927/original/file-20220420-23-238lzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Healthy relationships positively influence men’s well-being.</span>
<span class="attribution"><span class="source">(Pexels/Ekaterina Bolovtsova)</span></span>
</figcaption>
</figure>
<p>Because the influence of intimate partner relationships on men’s health — and on others in their life — is so pivotal, the question of relationship skills arises. We performed a <a href="http://doi.org/10.1002/hpja.463">scoping review</a> — an assessment of the scope of available research — of relationship skills training for men. It concluded that existing programs tend to be corrective in nature, designed to change men’s behaviour in the context of family or intimate partner violence. </p>
<p>There are few settings, courses or programs upstream of domestic violence that teach men relationship skills from the perspective of healthy masculinity. It may be timely to develop relationship skills training and interventions to support men in coping with the stressors inherent in intimate relationships to benefit their health, and those around them.</p>
<p>Given the positive influence of healthy relationships on men’s mental health, making strength-based relationship skills resources a priority, beyond programs that address abuse, could have clear benefits for men’s well-being.</p><img src="https://counter.theconversation.com/content/177243/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>John L. Oliffe receives funding from Movember and is supported by a Tier 1 Canada Research Chair in Men’s Health Promotion.</span></em></p><p class="fine-print"><em><span>Gabriela Gonzalez Montaner and Mary Theresa Kelly do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Healthy relationships have a positive influence on men’s health and mental health. Prioritizing relationship skills for men is one way to approach the global crisis in male suicide.John L. Oliffe, Professor and Canada Research Chair in Men's Health Promotion, University of British ColumbiaGabriela Gonzalez Montaner, Project Coordinator, Men's Health Research Program, University of British ColumbiaMary Theresa Kelly, Research Contractor, Men's Health Research, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1660332021-09-08T20:12:17Z2021-09-08T20:12:17Z20 years on, 9/11 responders are still sick and dying<figure><img src="https://images.theconversation.com/files/419188/original/file-20210903-23797-akqghk.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2396%2C1595&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://photos.aap.com.au/search/world%20trade%20center%20attack">Shawn Baldwin/AP/AAP Image</a></span></figcaption></figure><p>Emergency workers and clean-up crew are among 9/11 responders still suffering significant health issues 20 years after the <a href="https://www.history.com/topics/21st-century/9-11-attacks">terrorist attacks</a>.</p>
<p>More than <a href="https://pubmed.ncbi.nlm.nih.gov/18500709/">91,000 workers and volunteers</a> <a href="https://www1.nyc.gov/site/911health/enrollees/rescue-recovery-workers.page">were exposed</a> to a range of hazards during the rescue, recovery and clean-up operations.</p>
<p>By March 2021, some 80,785 of these responders had enrolled in the <a href="https://www.cdc.gov/wtc/">World Trade Center Health Program</a>, which was set up after the attacks to monitor their health and treat them.</p>
<p>Now our <a href="https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/article/abs/health-trends-among-911-responders-from-20112021-a-review-of-world-trade-center-health-program-statistics/09B87521287B943402782DAADB47E0B9">published research</a>, which is based on examining these health records, shows the range of physical and mental health issues responders still face.</p>
<h2>Breathing problems, cancer, mental illness</h2>
<p>We found 45% of responders in the health program have aerodigestive illness (conditions that affect the airways and upper digestive tract). A total of 16% have cancer and another 16% have mental health illness. Just under 40% of responders with health issues are aged 45-64; 83% are male.</p>
<p>Our analysis shows 3,439 of responders in the health program are now dead — far more than the <a href="https://parade.com/1248604/jessicasager/9-11-facts/">412 first responders who died on the day</a> of the attacks.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1304362152757727238"}"></div></p>
<p>Respiratory and upper digestive tract disorders are the number one cause of death (34%), ahead of cancer (30%) and mental health issues (15%). </p>
<p>Deaths attributed to these three factors, as well as musculoskeletal and acute traumatic injuries, have increased six-fold since the start of 2016. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-the-pain-of-9-11-still-stays-with-a-generation-64725">How the pain of 9/11 still stays with a generation</a>
</strong>
</em>
</p>
<hr>
<h2>An ongoing battle</h2>
<p>The number of responders enrolling in the health program with emerging health issues rises each year. More than 16,000 responders have enrolled in the past five years. </p>
<p>Cancer is up 185% over the past five years, with leukaemia emerging as particularly common, overtaking colon and bladder cancer in the rankings.</p>
<p>This equates to an increase of 175% in leukaemia cases over a five-year period, which is not surprising. There is a <a href="https://pubmed.ncbi.nlm.nih.gov/32771228/">proven link</a> between benzene exposure and acute myeloid leukaemia. Benzene is found in jet fuel, one of the toxic exposures at the World Trade Center. And acute myeloid leukaemia is one of the main types of leukaemia reported not only by responders, but by <a href="https://www.wtc-illness.com/cancers/leukemia-blood-cancer">residents of lower Manhattan</a>, who also have higher-than-normal rates. </p>
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<p>Prostate cancer is also common, increasing 181% since 2016. Although this fits with the age profile of many of the health program’s participants, some responders are developing an <a href="https://pubmed.ncbi.nlm.nih.gov/31221798/">aggressive, fast-growing form</a> of prostate cancer. </p>
<p>Inhaling the toxic dust at the World Trade Center site may trigger a cascading series of cellular events, increasing the number of inflammatory T-cells (a type of immune cell) in some of the responders. This increased inflammation <a href="https://pubmed.ncbi.nlm.nih.gov/26816843/">may eventually lead to prostate cancer</a>.</p>
<p>There may also be a <a href="https://pubmed.ncbi.nlm.nih.gov/31490535/">significant link between</a> greater exposure at the World Trade Center and a higher risk of long-term cardiovascular disease (disease affecting the heart and blood vessels). Firefighters who responded to the World Trade Center on the morning of the attacks were 44% more likely to develop cardiovascular disease than those who arrived the next day.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/air-pollution-causes-cancer-so-lets-do-something-about-it-19380">Air pollution causes cancer, so let's do something about it </a>
</strong>
</em>
</p>
<hr>
<h2>The mental health effects</h2>
<p>About <a href="https://pubmed.ncbi.nlm.nih.gov/31625489/">15-20%</a> of responders are estimated to be living with <a href="https://www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/ptsd">post-traumatic stress disorder</a> (PTSD) symptoms — roughly <a href="https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd">four times</a> the rate of the general population. </p>
<p>Despite 20 years having passed, PTSD <a href="https://pubmed.ncbi.nlm.nih.gov/28805168/">is a growing problem</a> for responders. Almost half of all responders <a href="https://pubmed.ncbi.nlm.nih.gov/31776767/">report</a> they need ongoing mental health care for a range of mental health issues including PTSD, anxiety, depression and <a href="https://www.medicalnewstoday.com/articles/325578">survivor guilt</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/9-11-anniversary-a-watershed-for-psychological-response-to-disasters-2975">9/11 anniversary: a watershed for psychological response to disasters</a>
</strong>
</em>
</p>
<hr>
<p>Researchers <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364857/">have also found</a> brain scans of some responders indicate the onset of early-stage dementia. This is consistent with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364857/">previous work</a> noting cognitive impairment among responders occurs at about twice the rate of people 10-20 years older.</p>
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<h2>COVID-19 and other emerging threats</h2>
<p>Responders’ underlying health conditions, such as cancer and respiratory ailments, have also left them <a href="https://www.usatoday.com/in-depth/news/nation/2021/05/05/covid-risk-911-september-2001-ground-zero-responders-causes-concern/4961779001/">vulnerable to COVID-19</a>. By the end of August 2020, <a href="https://www.newsweek.com/how-many-people-died-911-thousands-perishing-september-11-related-illnesses-1531058">some 1,172 responders</a> had confirmed COVID-19.</p>
<p>Even among responders who have not been infected, the pandemic <a href="https://www.thecity.nyc/2020/9/10/21431746/how-many-9-11-survivors-have-died-of-covid-19">has exacerbated</a> one of the key conditions caused by search and rescue, and recovery after terrorist attacks — PTSD.</p>
<p><a href="https://www.nbcnews.com/news/us-news/covid-19-has-killed-dozens-9-11-first-responders-n1239885">More than 100 responders have died</a> due to complications from the virus, which has also exacerbated other responders’ PTSD symptoms.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1304566412325814274"}"></div></p>
<p>The number of responders with cancers associated with asbestos exposure at the World Trade Center is expected to rise in coming years. This is because mesothelioma (a type of cancer caused by asbestos) usually takes <a href="https://www.canceraustralia.gov.au/cancer-types/mesothelioma-cancer/awareness#:%7E:text=It%20usually%20takes%20a%20very,and%20roofing%2C%20and%20in%20insulation.">20-50 years to develop</a>. </p>
<p>As of 2016, at least 352 responders had been diagnosed with the lung condition <a href="https://www.mayoclinic.org/diseases-conditions/asbestosis/symptoms-causes/syc-20354637">asbestosis</a>, and at least 444 had been diagnosed with another lung condition, <a href="https://www.mayoclinic.org/diseases-conditions/pulmonary-fibrosis/symptoms-causes/syc-20353690">pulmonary fibrosis</a>. Exposure to asbestos and other fibres in the toxic dust <a href="https://www.asbestos.com/world-trade-center/">may have contributed</a>.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-harms-of-asbestos-wont-be-known-for-decades-14845">Health harms of asbestos won't be known for decades </a>
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</em>
</p>
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<h2>Lessons learned</h2>
<p>Our research involved analysing data from existing databases. So we cannot make direct links between exposure at the World Trade Center site, length of time there, and the risk of illness. </p>
<p>Differences in age, sex, ethnicity, smoking status and other factors between responders and non-responders should also be considered. </p>
<p>Increased rates of some cancers in some responders may also be associated with <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2764101">heightened surveillance</a> rather than an increase in disease.</p>
<p>Nevertheless, we are now beginning to understand the long-term effects of responding to the 9/11 terrorist attacks. Exposure is still having both a physical and mental health impact and it’s likely responders are still developing illnesses related to their exposures.</p>
<p>Ongoing monitoring of responders’ health remains a priority, especially considering the looming threat of new asbestos-related cancers.</p><img src="https://counter.theconversation.com/content/166033/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>More 9/11 responders died from physical and mental health issues after the terrorist attacks than on the day itself. And survivors are still suffering 20 years later.Erin Smith, Associate Professor in Disaster and Emergency Response, School of Medical and Health Sciences, Edith Cowan UniversityBrigid Larkin, PhD candidate, Edith Cowan UniversityLisa Holmes, Lecturer, Paramedical Science, School of Medical and Health Sciences, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1651312021-07-28T18:12:19Z2021-07-28T18:12:19ZDoes testosterone drive success in men? Not much, our research suggests<figure><img src="https://images.theconversation.com/files/413158/original/file-20210726-23-252qvb.jpg?ixlib=rb-1.1.0&rect=1%2C5%2C997%2C480&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Not quite what the science says. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/playful-caucasian-business-people-work-place-1620124252">UfaBizPhoto/Shutterstock</a></span></figcaption></figure><p>There’s a widespread belief that your testosterone can affect where you end up in life. At least for men, there is some evidence for this claim: several studies have linked higher testosterone to socioeconomic success. But a link is different to a cause and using DNA, our new <a href="https://advances.sciencemag.org/lookup/doi/10.1126/sciadv.abf8257">research</a> suggests it may be much less important for life chances than previously claimed.</p>
<p>In previous studies, male <a href="https://pubmed.ncbi.nlm.nih.gov/26302434">executives</a> with higher testosterone have been found to have more subordinates, and financial traders with higher testosterone found to generate greater daily <a href="https://www.pnas.org/content/105/16/6167">profits</a>. Testosterone has been found to be higher among more highly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686046">educated</a> men, and among <a href="https://pubsonline.informs.org/doi/abs/10.1287/mnsc.2016.2664">self-employed</a> men, suggesting a link with entrepreneurship. Much less is known about these relationships in women, but one study suggested that for women, disadvantaged socioeconomic position in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686046">childhood</a> was linked to higher testosterone later in life.</p>
<p>The beneficial influence of testosterone is thought to work by affecting behaviour: experiments suggest that testosterone can make a person more <a href="https://www.pnas.org/content/113/41/11633">aggressive</a> and more <a href="https://www.nature.com/articles/srep11206">risk tolerant</a>, and these traits can be rewarded in the labour market, for instance in wage negotiations. But none of these studies show definitively that testosterone influences these outcomes because there are other plausible explanations. </p>
<p>Rather than testosterone influencing a person’s socioeconomic position, it could be that having a more advantaged socioeconomic position raises your testosterone. In both cases, we would see a link between testosterone and social factors such as income, education and social class. </p>
<p>There are plausible mechanisms for this too. First, we know that socioeconomic disadvantage is stressful, and chronic stress can <a href="https://www.sciencedirect.com/science/article/pii/S0031938408000954?via%3Dihub">lower testosterone</a>. Second, how a person perceives their status relative to others in society might influence their testosterone: studies of sports matches, usually between men, have often found that testosterone <a href="https://pubmed.ncbi.nlm.nih.gov/27720891/">rises in the winner</a> compared to the loser.</p>
<figure class="align-center ">
<img alt="Older man holds head in front of a computer." src="https://images.theconversation.com/files/413159/original/file-20210726-21-197i1au.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/413159/original/file-20210726-21-197i1au.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/413159/original/file-20210726-21-197i1au.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/413159/original/file-20210726-21-197i1au.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/413159/original/file-20210726-21-197i1au.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/413159/original/file-20210726-21-197i1au.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/413159/original/file-20210726-21-197i1au.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Chronic stress can lower your testosterone.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/stressed-man-working-desk-busy-creative-130607537">Shutterstock</a></span>
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<p>It’s also possible that some third factor is responsible for the associations seen in previous studies. For instance, higher testosterone in men is linked to good <a href="https://pubmed.ncbi.nlm.nih.gov/26846952/">health</a> – and good health may also help people succeed in their careers. A link in men between testosterone and socioeconomic position could therefore simply reflect an impact of health on both. (For women, higher testosterone is linked to <a href="https://pubmed.ncbi.nlm.nih.gov/20090761/">worse</a> health, so we would expect an association of higher testosterone and lower socioeconomic position.)</p>
<h2>Look at it this way</h2>
<p>It is very difficult to pick apart these processes and study just the effects of testosterone on other things. With this goal in mind, we applied a causal inference approach called “Mendelian randomisation”. This uses genetic information relevant to a single factor (here, testosterone) to isolate just the effect of that factor on one or more outcomes of interest (here, socioeconomic outcomes such as income and educational qualifications).</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/413160/original/file-20210726-22-8vvsyh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="DNA visualisation with coloured bars" src="https://images.theconversation.com/files/413160/original/file-20210726-22-8vvsyh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/413160/original/file-20210726-22-8vvsyh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=368&fit=crop&dpr=1 600w, https://images.theconversation.com/files/413160/original/file-20210726-22-8vvsyh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=368&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/413160/original/file-20210726-22-8vvsyh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=368&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/413160/original/file-20210726-22-8vvsyh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=462&fit=crop&dpr=1 754w, https://images.theconversation.com/files/413160/original/file-20210726-22-8vvsyh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=462&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/413160/original/file-20210726-22-8vvsyh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=462&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">DNA can tell us a lot about our relationship with testosterone.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/big-genomic-data-visualization-dna-test-1102537814">Zita/Shutterstock</a></span>
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<p>A person’s circulating testosterone can be affected by environmental factors. Some, like the time of day, are straightforward to correct for. Others, like somebody’s health, are not. Crucially, socioeconomic circumstances could influence circulating testosterone. For this reason, even if we see an association between circulating testosterone and socioeconomic position, we cannot determine what is causing what. </p>
<p>This is why genetic information is powerful: your DNA is determined before birth and generally does not change during your lifetime (there are rare exceptions, such as changes which occur with cancer). Therefore, if we observe an association of socioeconomic position with genetic variants linked to testosterone, it strongly suggests that testosterone is causing the differences in socioeconomic outcomes. This is because influence on the variants of other factors is much less likely.</p>
<p>In more than 300,000 adult participants of the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, we identified genetic variants linked to higher testosterone levels, separately for men and women. We then explored how these variants were related to socioeconomic outcomes, including income, educational qualifications, employment status, and area-level deprivation, as well as self-reported risk-taking and overall health.</p>
<p>Similar to previous studies, we found that men with higher testosterone had higher household income, lived in less deprived areas, and were more likely to have a university degree and a skilled job. In women, higher testosterone was linked to lower socioeconomic position, including lower household income, living in a more deprived area, and lower chance of having a university degree. Consistent with previous evidence, higher testosterone was associated with better health for men and poorer health for women, and more risk-taking for men.</p>
<p>However, there was little evidence that genetic variation related to testosterone affected socioeconomic position at all. In both men and women we detected no effects of genetic variants related to testosterone on any aspect of socioeconomic position, or health, or risk-taking. </p>
<p>Because we identified fewer testosterone-linked genetic variants in women, our estimates for women were less precise than for men. Consequently, we could not rule out relatively small effects of testosterone on socioeconomic position for women. Future studies could examine associations in women using larger, female-specific samples.</p>
<p>But for men, our genetic results clearly suggest that previous studies may have been biased by the influence of additional factors, potentially including the impact of socioeconomic position on testosterone. And our results indicate that – despite the social mythology surrounding testosterone – it may be much less important for success and life chances than earlier studies have suggested.</p><img src="https://counter.theconversation.com/content/165131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amanda Hughes receives funding from the Health Foundation and the Medical Research Council.</span></em></p><p class="fine-print"><em><span>Neil Davies works in a unit that receives support from the University of Bristol and the UK Medical Research Council, and NMD is also supported by a Norwegian Research Council Grant number and the Health Foundation. </span></em></p><p class="fine-print"><em><span>Sean Harrison does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>New research suggests that despite the social mythology that surrounds testosterone in men, it may be much less important for life chances than previously thought.Amanda Hughes, Senior Research Associate in Epidemiology, University of BristolNeil Davies, Senior Research Fellow, University of BristolSean Harrison, Systematic Reviewer, University of BristolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1600072021-05-03T20:08:22Z2021-05-03T20:08:22ZAre chemicals shrinking your penis and depleting your sperm? Here’s what the evidence really says<figure><img src="https://images.theconversation.com/files/398259/original/file-20210503-13-ocd03y.jpg?ixlib=rb-1.1.0&rect=14%2C0%2C4977%2C3323&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>A doomsday scenario of an end to human sperm production has been <a href="https://www.theguardian.com/commentisfree/2021/mar/18/toxic-chemicals-health-humanity-erin-brokovich">back in the news recently</a>, now with the added threat of shrinking penises.</p>
<p>Professor Shanna Swan, a US epidemiologist who studies environmental influences on human development, recently published a <a href="https://www.shannaswan.com/countdown">new book</a> called Countdown.</p>
<p>In it, she suggests sperm counts <a href="https://www.theguardian.com/society/2021/mar/28/shanna-swan-fertility-reproduction-count-down">could reach zero by 2045</a>, largely owing to the impact of a range of environmental pollutants used in manufacturing everyday products: phthalates and bisphosphenol A (BPA) from plastics, and per- and poly-fluoroalkyl substances (PFAS) used, for example, in waterproofing. Under this scenario, she says, most couples wanting to conceive would need to rely on assisted reproductive technologies.</p>
<p>She has also warned these chemicals are shrinking penis size.</p>
<p>Such extraordinary claims require extraordinary evidence. I would argue the evidence is not strong enough.</p>
<h2>Correlation doesn’t equal causation</h2>
<p>Epidemiologists find associations between disease and potential contributing factors, like lung cancer and smoking. But their work can’t identify the causes of disease — just because two things are associated doesn’t mean one is causing, or caused by, the other.</p>
<p>An article written by environmental activist Erin Brockovich in <a href="https://www.theguardian.com/commentisfree/2021/mar/18/toxic-chemicals-health-humanity-erin-brokovich">The Guardian</a> in March leads by referring to “hormone-disrupting chemicals that are decimating fertility”. But causation is <a href="https://pubmed.ncbi.nlm.nih.gov/33385395/">far from established</a>. </p>
<p>It’s reasonable to expect chemicals that <a href="https://pubmed.ncbi.nlm.nih.gov/33385395/">affect hormone function</a> in our bodies, like BPA and PFAS, could affect reproduction in males and females, given available evidence. But we don’t have irrefutable proof.</p>
<figure class="align-center ">
<img alt="A man and a pregnant woman outside with their dog." src="https://images.theconversation.com/files/398265/original/file-20210503-17-fzbt4d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/398265/original/file-20210503-17-fzbt4d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/398265/original/file-20210503-17-fzbt4d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/398265/original/file-20210503-17-fzbt4d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/398265/original/file-20210503-17-fzbt4d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/398265/original/file-20210503-17-fzbt4d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/398265/original/file-20210503-17-fzbt4d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Could environmental pollutants be leading to infertility? Establishing cause and effect isn’t clear-cut.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Selective reporting</h2>
<p>In 2017, Swan and several colleagues published <a href="https://pubmed.ncbi.nlm.nih.gov/28981654/">an exhaustive review study</a> showing an apparent drop in men’s sperm counts of 59.3% between 1973 and 2011. This research informs the arguments Swan makes in Countdown and those we’ve seen in the media.</p>
<p>What’s not often mentioned is the fact the researchers only observed a decline in sperm count in groups of men from North America, Europe, Australia, and New Zealand, but not in groups of men from South America, Asia or Africa.</p>
<p>When Swan and her colleagues combined the data from all countries, they saw a decline because the studies of “Western” men outweigh those of men elsewhere (in the number of studies and participants).</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/huge-drop-in-mens-sperm-levels-confirmed-by-new-study-here-are-the-facts-81582">Huge drop in men's sperm levels confirmed by new study – here are the facts</a>
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<p>Swan and her colleagues worked hard to avoid bias when conducting their study. But <a href="https://pubmed.ncbi.nlm.nih.gov/9455838/">selection bias</a> (related to how study participants are chosen), <a href="https://pubmed.ncbi.nlm.nih.gov/2406472/">publication bias</a> (resulting from researchers’ tendency to report only observations they think will be of interest) and other limitations of the original work used as the basis for their investigation could be influencing the results of the larger study.</p>
<p>Many studies from different parts of the world show declining sperm counts, which is concerning, but we don’t fully understand the <a href="https://pubmed.ncbi.nlm.nih.gov/32168194/">reasons for the apparent decline</a>. Blaming chemicals in the environment overlooks <a href="https://pubmed.ncbi.nlm.nih.gov/29774489/">other important factors</a> such as chronic disease, diet, and obesity, which people can act on to improve their fertility.</p>
<h2>The problem with extrapolation</h2>
<p>Swan’s 2017 study boils down to a straight descending line drawn between sperm counts of groups of men studied at different times between 1973 and 2011.</p>
<p>Just because a straight line can be drawn through the data, this doesn’t justify extrapolation of that line beyond its earliest and latest data points. It’s unscientific to assume trends in data exist outside the range of observations.</p>
<p>We know sperm counts of men in the early 1940s were around <a href="https://pubmed.ncbi.nlm.nih.gov/1393072/">113 million sperm per ml of semen</a>, not the roughly 140 million/ml you get from extrapolating backwards from Swan’s research. Concluding sperm counts will reach zero in 2045, based on extrapolating forward from the available data, is just as likely to be incorrect. </p>
<p>When Swan told <a href="https://www.axios.com/newsletters/axios-future-e58ada65-1a84-4550-afd8-79d698bb7d38.html?stream=future&utm_campaign=newsletter_axiosfutureofwork&utm_medium=email&utm_source=newsletter">news website Axios</a> “If you look at the curve on sperm count and project it forward” she was encouraging unjustifiable and unscientific interpretation of her data — even though she acknowledged it was “risky” to extrapolate in this way. Unfortunately this caution is too often unmentioned.</p>
<p>For example, <a href="https://www.theguardian.com/commentisfree/2021/mar/18/toxic-chemicals-health-humanity-erin-brokovich">Brockovich writes</a>: “That would mean no babies. No reproduction. No more humans.” That’s hyperbole. It’s just not science.</p>
<figure class="align-center ">
<img alt="An illustration of sperm." src="https://images.theconversation.com/files/398266/original/file-20210503-23-8j0tma.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/398266/original/file-20210503-23-8j0tma.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/398266/original/file-20210503-23-8j0tma.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/398266/original/file-20210503-23-8j0tma.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/398266/original/file-20210503-23-8j0tma.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/398266/original/file-20210503-23-8j0tma.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/398266/original/file-20210503-23-8j0tma.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Swan has extrapolated from recent data to predict sperm counts could reach zero by 2045. But this isn’t necessarily accurate.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Relax, your penis isn’t shrinking</h2>
<p>Claims of shrinking penises are obvious clickbait. But only <a href="https://pubmed.ncbi.nlm.nih.gov/30403786/">a single study</a>, of 383 young men from the Veneto region in northeastern Italy, links men’s penis size to the types of chemicals Swan attributes to declining sperm counts.</p>
<p>Within Veneto there are <a href="https://figshare.com/articles/figure/Supplemental_Figure_1/7016234">geographic zones</a> with varied levels of PFAS contamination. A group of 212 men who live in areas with high or intermediate PFAS exposure and have high levels of these chemicals in their bodies, had an average penis length of 8.6cm, about 10% lower than the average of a group of 171 men from an area without exposure (9.7cm).</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/science-or-snake-oil-do-men-need-sperm-health-supplements-84379">Science or Snake Oil: do men need sperm health supplements?</a>
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<p>But a few features of this study affect the reliability of the observations and whether we can generalise them to other populations.</p>
<ol>
<li><p>men were grouped according to where they lived, not where they were born. Since genital size is <a href="https://pubmed.ncbi.nlm.nih.gov/30403786/">determined before birth</a>, the environment during their mothers’ pregnancies is more relevant to penis size than where the men lived at the time of the study. Some men will likely have relocated from their place of birth but how many, and where they may have moved to and from, we don’t know</p></li>
<li><p>the levels of PFAS exposure for men living in the contaminated regions of Veneto are extreme, because of <a href="https://pubmed.ncbi.nlm.nih.gov/29108835/">decades of industrial pollution</a>. How the potential effect of such large exposures relates to smaller and more common exposures to pollutants, like from plastic food wrap, we don’t know</p></li>
<li><p>the study is missing details about its subjects and the conditions under which measurements were made. It’s <a href="https://pubmed.ncbi.nlm.nih.gov/33748967/">usual</a> to exclude people with conditions that might affect study outcomes, such as congenital abnormalities, but it’s not clear whether this happened in the study. Variables that <a href="https://pubmed.ncbi.nlm.nih.gov/31171853/">influence penile measurements</a> (such as room temperature, posture, and whether the penis is held straight or hanging) are not mentioned.</p></li>
</ol>
<p>And from a semantic perspective, for penises to be “shrinking” they must be getting shorter over time, on either an individual or population basis. I cannot find any reports of men’s penises shortening as a consequence of environmental pollution. <a href="https://pubmed.ncbi.nlm.nih.gov/31171853/">Available data</a> <a href="https://pubmed.ncbi.nlm.nih.gov/25487360/">don’t suggest</a> a decline in penis size over the past few decades.</p>
<p>While environmental pollution is a pressing concern, the evidence suggests the catastrophic collapse of human reproduction and accompanying penis shrinkage is thankfully a pretty unlikely prospect.</p>
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<p>
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Read more:
<a href="https://theconversation.com/considering-using-ivf-to-have-a-baby-heres-what-you-need-to-know-108910">Considering using IVF to have a baby? Here's what you need to know</a>
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<img src="https://counter.theconversation.com/content/160007/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tim Moss is Health Content Manager at Healthy Male (formerly Andrology Australia). He is the current President of The Perinatal Society of Australia and New Zealand. </span></em></p>Warnings of an end to human sperm production have been making headlines recently, now with the added threat of shrinking penises. Is this science or sensationalism?Tim Moss, Adjunct Associate Professor, Department of Obstetrics and Gynaecology, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1522332021-01-27T01:10:59Z2021-01-27T01:10:59ZDo men really take longer to poo?<figure><img src="https://images.theconversation.com/files/377953/original/file-20210111-15-ruzndd.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-man-toilet-using-phone-619346291">from www.shutterstock.com</a></span></figcaption></figure><p>There’s a common assumption men take longer than women to poo. People say so on <a href="https://twitter.com/trenduso/status/1100968885203931136">Twitter</a>, in <a href="https://www.sammichespsychmeds.com/men-bathroom-memes/">memes</a>, and <a href="https://www.youtube.com/watch?v=nLcEU6ahlOI">elsewhere</a> <a href="https://www.livescience.com/why-men-take-longer-to-poop.html">online</a>. But is that right? What could explain it? And if some people are really taking longer, is that a problem?</p>
<p>As we sift through the evidence, it’s important to remember pooing may involve time spent sitting on the toilet and the defaecation process itself.</p>
<p>And there may be differences between men and women in these separate aspects of going to the toilet. But the evidence for these differences isn’t always as strong as we’d like.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-we-have-to-poo-every-day-we-asked-five-experts-98701">Do we have to poo every day? We asked five experts</a>
</strong>
</em>
</p>
<hr>
<h2>Men may spend longer sitting on the toilet</h2>
<p>Men do appear to spend more time sitting on the toilet. An <a href="https://www.dailymail.co.uk/femail/article-2641550/Britons-favourite-loo-terature-revealed-Sports-biographies-erotic-magazines-bathroom-reading-material-poll.html">online survey</a> by a bathroom retailer suggested men spend up to 14 minutes a day compared with women, who spend almost eight minutes a day. But this survey doesn’t have the rigour of a well-designed scientific study.</p>
<p>Would there be any physiological reason to explain why men spend longer on the toilet? Well, the evidence actually suggests the opposite.</p>
<p>We know it <a href="https://www.tandfonline.com/doi/abs/10.1080/00365520310000410">takes longer</a> for food to travel through the intestines in women than in men. Women are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175559/">more likely to suffer</a> from constipation related to irritable bowel syndrome than men. So, you’d expect women to take longer to defaecate, from the start of the bowel motion to expulsion.</p>
<p>But this is <a href="https://pubmed.ncbi.nlm.nih.gov/12870773/">not the case</a> even if you take into account differences in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986479/">fibre intake</a> between men and women.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-and-what-can-i-do-about-it-102579">Explainer: what is irritable bowel syndrome and what can I do about it?</a>
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<p>Instead, how long it takes someone to poo (the defaecation time) is <a href="https://pubmed.ncbi.nlm.nih.gov/28470247/">heavily influenced</a> by the mucus lining the large bowel. This mucus makes the bowel slippery and easier for the stools to be expelled. But there’s no evidence this mucus lining is different in men and women. </p>
<p>One thing we do know, however, is mammals from elephants to mice have a similar defaecation time, <a href="https://pubs.rsc.org/en/content/articlelanding/2017/sm/c6sm02795d#!divAbstract">around 12 seconds</a>. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1100968885203931136"}"></div></p>
<p>For humans, it’s slightly longer, but still quick. In <a href="https://pubmed.ncbi.nlm.nih.gov/12870773/">one study</a> it took healthy adults an average two minutes when sitting, but only 51 seconds when squatting. Again, there were no differences in defaecation time between men and women, whether sitting or squatting. </p>
<p>If there’s no strong evidence one way or the other to explain any gender differences in how long it takes to poo, what’s going on? For that, we need to look at the total time spent on the toilet.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-the-best-way-to-go-to-the-toilet-squatting-or-sitting-63991">What's the best way to go to the toilet – squatting or sitting?</a>
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<hr>
<h2>Why do people spend so long on the toilet?</h2>
<p>What I call the “toilet sitting time” is the time of defaecation itself and the time allocated to other activities sitting on the toilet. For most people, the time spent just sitting, aside from defaecating, accounts for most of their time there.</p>
<p>So what are people doing? Mainly reading. And it seems men are <a href="http://news.bbc.co.uk/2/hi/health/1230115.stm">more likely</a> to read on the toilet than women.</p>
<p>For instance, a <a href="https://pubmed.ncbi.nlm.nih.gov/19019015/">study</a> of almost 500 adults in Israel found almost two-thirds (64%) of men regularly read on the toilet compared with 41% of women. The longer people spent on the toilet, the more likely they were to be reading. However, in the decade or more since this study was conducted, you’d expect adults would be more likely to be reading or playing games on their mobile phones rather than reading paper books.</p>
<p>People might also be sitting longer on the toilet for some temporary relief from the stresses of life.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Meme about men avoiding parenting responsibilities by sitting on the toilet for longer" src="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=417&fit=crop&dpr=1 600w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=417&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=417&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=524&fit=crop&dpr=1 754w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=524&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=524&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sometimes, people just need time to themselves.</span>
<span class="attribution"><a class="source" href="https://www.sammichespsychmeds.com/men-bathroom-memes/">Ramblin Mama</a></span>
</figcaption>
</figure>
<p>One <a href="https://www.dailymail.co.uk/femail/article-2641550/Britons-favourite-loo-terature-revealed-Sports-biographies-erotic-magazines-bathroom-reading-material-poll.html">poll</a> found 56% of people find sitting on the toilet relaxing, and 39% a good opportunity to have “some time alone”. Another <a href="https://www.independent.co.uk/life-style/bathrooms-shower-washing-habits-poll-a8988626.html">online survey</a> revealed one in six people reported going to the toilet for “peace and quiet”. Although these are not scientific studies, they offer useful insights into a social phenomenon.</p>
<p>Then there can be medical reasons for a prolonged defaecation time, and consequently a lengthier time sitting on the toilet. </p>
<p>An anal fissure (a tear or crack in the lining of the anus) can make defaecation a painful and lengthy process. These fissures are <a href="http://eknygos.lsmuni.lt/springer/526/178-191.pdf">just as common</a> in men as in women. </p>
<p>And <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306148/">obstructive defaecation</a>, where people cannot empty the rectum properly, is a common cause of chronic constipation. This is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3030249/">more common</a> in middle-aged women. </p>
<h2>Are there any harms from spending too long on the loo?</h2>
<p>In a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236649/">Turkish study</a>, spending more than five minutes on the toilet was associated with haemorrhoids and anal fissures. Another study from <a href="https://pubmed.ncbi.nlm.nih.gov/31996480/">Italy</a> noted the longer the time people spent on the toilet, the more severe their haemorrhoids.</p>
<p><a href="http://www.annalsgastro.gr/files/journals/1/earlyview/2019/ev-01-2019-19-AG4360-0355.pdf">One theory</a> behind this is prolonged sitting increases pressure inside the abdomen. This leads to less blood flow into the veins of the rectum when passing a bowel motion, and ultimately to blood pooling in the vascular cushions of the anus. This makes haemorrhoids more likely to develop. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-why-do-people-get-haemorrhoids-and-how-do-you-get-rid-of-them-94820">Explainer: why do people get haemorrhoids and how do you get rid of them?</a>
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</em>
</p>
<hr>
<h2>What can we do about this?</h2>
<p>In addition to the usual advice about increasing the amount of fibre in your diet and ensuring you drink enough water, it would be sensible to limit the amount of time spent on the toilet.</p>
<p>Different researchers recommend a <a href="https://pubmed.ncbi.nlm.nih.gov/28150480/">different</a> <a href="https://pubmed.ncbi.nlm.nih.gov/27723447/">upper limit</a>. But I <a href="https://pubmed.ncbi.nlm.nih.gov/30346317/">and others</a> recommend the SEN approach:</p>
<ul>
<li><p><strong>S</strong>ix minute toilet sitting time maximum</p></li>
<li><p><strong>E</strong>nough fibre (eating more fruit and vegetables, and eating wholegrains)</p></li>
<li><p><strong>N</strong>o straining during defaecation. </p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-causes-constipation-114290">Health Check: what causes constipation?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/152233/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Vincent Ho does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>If you believe the memes, men spend ages in the toilet. But they’re not always pooing. Here’s what they’re really doing.Vincent Ho, Senior Lecturer and clinical academic gastroenterologist, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1495972020-11-12T18:58:05Z2020-11-12T18:58:05ZDUDES Club and Movember: Indigenous men taking ownership of their health<figure><img src="https://images.theconversation.com/files/368478/original/file-20201110-14-lpjns.jpg?ixlib=rb-1.1.0&rect=77%2C176%2C1874%2C1278&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">DUDES Club members and research team at a retreat in northern British Columbia.</span> <span class="attribution"><span class="source">(Jeff Topham)</span>, <span class="license">Author provided</span></span></figcaption></figure><p>Why do so many men grow moustaches every November? It started in Australia in 2003 <a href="https://ca.movember.com/about/history">when a small group of men grew moustaches</a> to support men’s health and prostate cancer. From humble beginnings, the Movember movement has focused important international attention on issues like men’s mental health and suicide prevention, as well as prostate and testicular cancer. </p>
<p>But can a moustache save a life? According to DUDES Club members, it can.</p>
<p><a href="http://dudesclub.ca/">DUDES Club</a> is an innovative, community-driven men’s health program incorporating Indigenous approaches to healing and wellness. With help from Movember, <a href="https://ca.movember.com/story/view/id/11267/the-dudes-club-a-brotherhood-for-men-s-health">a three-year research project with the DUDES Club</a> demonstrated how a grassroots initiative could be mobilized to work by, for and with Indigenous men. </p>
<h2>Indigenous men’s health</h2>
<p>Research shows that men in general are <a href="https://doi.org/10.5489/cuaj.2308">less likely to seek medical attention than women</a> in addition to being <a href="https://www150.statcan.gc.ca/t1/tbl1/en/cv.action?pid=1310039201#timeframe">three times more likely than women to die by suicide</a>. Indigenous men’s health is further impacted by a lack of research on health services directed <a href="https://doi.org/10.1080/13691058.2020.1722856">specifically at Indigenous men</a>. In addition to the <a href="https://doi.org/10.1016/j.cpr.2016.09.002">impacts of harmful masculine norms</a> such as being “strong and silent,” independent and emotionless, <a href="https://www.cbc.ca/radio/unreserved/indigenous-masculinity-and-the-lasting-impacts-of-colonization-1.5109762/for-indigenous-men-masculinity-can-be-a-glass-ceiling-of-sorts-professor-says-1.5109769">Indigenous men endure the impacts of historical injustices</a> through ongoing <a href="https://www.wellesleyinstitute.com/wp-content/uploads/2015/02/Full-Report-FPSCT-Updated.pdf">experiences of racism, violence and social exclusion</a>.</p>
<p>As an Indigenous health researcher, I am interested in community health and well-being, particularly in urban areas. I study gendered experiences of colonization and their impacts on Indigenous peoples and communities. Through my research with DUDES Club, I worked with community partners, elders, health-care practitioners and DUDES Club members to better understand Indigenous men’s health and extend the model throughout British Columbia. </p>
<p>DUDES Club started in <a href="https://www.youtube.com/watch?v=KVfmAHxrCiU&feature=youtu.be">Vancouver Native Health Society in 2010</a>. It has since grown into a national model for men’s health and well-being with 40 sites throughout B.C. and two nationally.</p>
<p>During weekly “think tanks” at the Vancouver club, members choose topics for bi-weekly sessions. This gives members a sense of ownership over the process and empowers them to take control of their own health. The presence of a health professional at most sites makes health information accessible for men who don’t usually seek out such information. </p>
<h2>Safety, trust and connection</h2>
<p>A survey of 150 men at the Vancouver DUDES Club demonstrated that most came from a context of disenfranchisement, such as <a href="https://www.cfp.ca/content/62/6/e311">unstable housing, unemployment and poverty</a>. In addition, many of the men live with complex histories of trauma, mental health and/or substance use issues. In the face of structural and systemic barriers, the research showed how important community connection and belonging are to mental, physical and emotional health.</p>
<figure class="align-center ">
<img alt="On a white table, four black leather vests bearing the DUDES Club insignia and different locations in B.C." src="https://images.theconversation.com/files/368888/original/file-20201111-23-z5u8g5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/368888/original/file-20201111-23-z5u8g5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/368888/original/file-20201111-23-z5u8g5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/368888/original/file-20201111-23-z5u8g5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/368888/original/file-20201111-23-z5u8g5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/368888/original/file-20201111-23-z5u8g5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/368888/original/file-20201111-23-z5u8g5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">DUDES Club has grown into a national model for men’s health and well-being with 40 sites throughout B.C. and two nationally.</span>
<span class="attribution"><span class="source">(Jeff Topham)</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Fourteen focus groups were conducted with men in Vancouver, Prince George and Smithers, B.C. In these groups, men described DUDES Club as a place where they can feel purpose and belonging, where they can work together to build peer support networks and engage in community advocacy. The research demonstrated that safety and trust are crucial for men taking ownership over their health. DUDES Club builds safety and trust because it is confidential, includes health professionals who understand member’s reality, and encourages strong peer relationships where respectful listening is the norm. </p>
<p>For men who attend often, the DUDES Club makes them feel more connected to others and improves their quality of life, meaning <a href="https://www.cfp.ca/content/62/6/e311">those who attend more often benefit more from the program</a>. One elder described DUDES Club as a “safe haven.” Its informal motto — “leave your armour at the door” — demonstrates that DUDES Club is a safe space in which to challenge ideas of masculinity that say men have to be the “tough guy.” These ideas have prevented men from seeking health information and created disparities that have persisted for generations.</p>
<h2>The value of grassroots organizing</h2>
<p>While DUDES Club is available to all men, many Indigenous men (63 per cent in the Vancouver DUDES Club) access the program through a <a href="https://www.fnha.ca/wellness/sharing-our-stories/warriors-meet-again">partnership with the First Nations Health Authority</a>. The presence of elders at DUDES Clubs is important, not only for the cultural knowledge they share, but for the humour and love they bring to the gatherings. </p>
<p>Ultimately, the DUDES Club is not just about men’s health and well-being. It is about the health of communities, women, youth, children and elders. DUDES Club reminds men that they are part of a community that values them even as mainstream social supports and health services <a href="https://www.nationalnewswatch.com/2020/11/07/health-experts-urge-ottawa-to-amend-canada-health-act-to-include-anti-racism-pillar/#.X6nlzmhKhEZ">fail them and their communities over and over again</a>.</p>
<p>DUDES Club holds great value as a grassroots health promotion and community wellness model for all people who identify as male. It is a simple yet powerful example of grassroots community organizing that is helping us better understand how intersecting factors (including gender, culture and experiences of colonization) can impact people differently. </p>
<p>So, yes: Moustaches can save lives.</p><img src="https://counter.theconversation.com/content/149597/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lyana Patrick received funding from Movember Canada as part of the research team evaluating the DUDES Club between 2013-2016. She is currently a board member with the DUDES Club Society. </span></em></p>DUDES Club, with a little help from Movember, has shown how a grassroots health and mental health initiative could be mobilized to work by, for and with Indigenous men.Lyana Patrick, Assistant Professor of Indigenous Health, Simon Fraser UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1477062020-10-09T13:34:02Z2020-10-09T13:34:02ZMuscle dysmorphia: why are so many young men suffering this serious mental health condition?<figure><img src="https://images.theconversation.com/files/362640/original/file-20201009-19-172af9o.jpg?ixlib=rb-1.1.0&rect=7%2C7%2C4985%2C3315&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Muscle dysmorphia can lead to other mental health conditions, such as anxiety or depression.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/attractive-muscular-man-admiring-his-muscles-689811460">F8 studio</a></span></figcaption></figure><p><a href="https://www.mentalhealth.org.uk/news/millions-men-uk-affected-body-image-issues-mental-health-foundation-survey">Body image concerns</a> among men are increasingly common and can have a serious impact on mental health. And for an estimated <a href="http://www.bbc.co.uk/newsbeat/article/34307044/muscle-dysmorphia-one-in-10-men-in-gyms-believed-to-have-bigorexia">one in ten young men</a> who go the gym in the UK, these body image concerns can result in a mental health condition known as muscle dysmorphia.</p>
<p>Though researchers are only just beginning to understand the complexities of the condition, it appears young men are currently being affected by it at a higher rate compared to other populations. It’s believed there are many reasons driving this, but researchers have found that media and social media pressure, alongside changing ideas of masculinity may both be major causes.</p>
<p>Sometimes referred to as “<a href="https://www.sciencedirect.com/science/article/abs/pii/S1740144505000744">bigorexia</a>” or “reverse anorexia”, people with muscle dysmorphia believe their body is too small, skinny, or insufficiently muscular – even though the opposite may be true. This distorted view causes a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0033318297714002?via%3Dihub">preoccupation</a> with becoming <a href="https://www.sciencedirect.com/science/article/abs/pii/S1740144512000125">overly muscular and lean</a>, often leading to the development of dangerous habits, such as excessive weight training, restrictive dieting and the use of substances such as anabolic steroids. It can also lead to anxiety, depression and may affect their daily life.</p>
<p>But currently diagnosing muscle dysmorphia is still difficult. Though several <a href="https://www.sciencedirect.com/science/article/abs/pii/S1740144504000269">self-report surveys</a> exist to help physicians diagnose patients, these surveys only <a href="https://www.dovepress.com/muscle-dysmorphia-current-insights-peer-reviewed-article-PRBM">assess related symptoms</a> (such as a desire for bigger muscle, or body image issues) rather than offering a robust diagnosis. </p>
<p>Diagnosis also relies on patients meeting a specific <a href="https://www.sciencedirect.com/science/article/abs/pii/S0033318297714002?via%3Dihub">set of criteria</a>, such as having a preoccupation with being lean and muscular, weight lifting excessively and dieting. But since so many different methods are used to diagnose muscle dysmorphia, this can make fully understanding the condition difficult. </p>
<p>However, in general, most experts agree people with muscle dysmorphia tend to engage in <a href="https://www.tandfonline.com/doi/full/10.1080/10640260902848477?needAccess=true">steroid use</a>, have <a href="https://www.sciencedirect.com/science/article/pii/S1740144517300529">symptoms of eating disorders</a> (such as compulsive exercise and eating habits) and higher body dissatisfaction, usually with their <a href="https://www.tandfonline.com/doi/pdf/10.1080/23311908.2016.1243194">general appearance, weight and muscularity</a>.</p>
<p>People with muscle dysmorphia also tend to have lower self-esteem, higher anxiety levels when their physique is exposed, <a href="https://www.cogentoa.com/article/10.1080/23311908.2016.1243194">higher rates of depression</a>, and obsessive compulsive behaviours towards <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/erv.1088">exercise and diet</a>. For example, people may prioritise training over <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/erv.1016">work or social activities</a> or <a href="https://www.sciencedirect.com/science/article/abs/pii/S1740144512000125">strictly eat every three hours</a> to ensure muscle gain. And if these behaviours are disrupted, it causes anxiety and emotional disturbance.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/exercise-addiction-is-a-real-mental-health-condition-yet-still-poorly-understood-133577">Exercise addiction is a real mental health condition, yet still poorly understood</a>
</strong>
</em>
</p>
<hr>
<p>Muscle dysmorphia tends to affect men in their <a href="https://connect.springerpub.com/content/sgrjcp/31/4/255">mid-20s to mid-30s</a>, though average age of onset is <a href="https://www.tandfonline.com/doi/abs/10.1080/hrp.9.5.254.259">19 years old</a>. Research suggests it’s most common in <a href="https://journals.sagepub.com/doi/10.1177/0004867415614106">weightlifting</a> and <a href="https://www.karger.com/Article/Abstract/12362">bodybuilding</a> communities. </p>
<p>However, research also shows <a href="https://link.springer.com/article/10.1186/s12967-014-0221-2">almost 6% of US students</a> have it. Another study found 4.2% of women and 12.7% of men in the US military <a href="https://academic.oup.com/milmed/article/181/5/494/4158268">have muscle dysmorphia</a>. So while it appears to predominantly affect young men, there’s limited research on its prevalence in other populations.</p>
<h2>The ‘ideal’ body</h2>
<p>There are many reasons a person may develop muscle dysmorphia, and it’s unique to each person. However, research suggests that the media (and social media), as well as pressure from family and friends, are likely causes.</p>
<p>For example, media portrayals of men over time have become more muscular. Specifically, over several decades <a href="https://onlinelibrary.wiley.com/doi/10.1002/1098-108X(200101)29:1%3C90::AID-EAT15%3E3.0.CO;2-F">male models in magazines</a> have become significantly larger and leaner. Even <a href="https://onlinelibrary.wiley.com/doi/10.1002/%28SICI%291098-108X%28199907%2926%3A1%3C65%3A%3AAID-EAT8%3E3.0.CO%3B2-D">male action figures</a> have changed over time, becoming unrealistically muscular.</p>
<figure class="align-center ">
<img alt="Superhero action figures, including Captain America." src="https://images.theconversation.com/files/362642/original/file-20201009-19-1sr4k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/362642/original/file-20201009-19-1sr4k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/362642/original/file-20201009-19-1sr4k9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/362642/original/file-20201009-19-1sr4k9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/362642/original/file-20201009-19-1sr4k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/362642/original/file-20201009-19-1sr4k9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/362642/original/file-20201009-19-1sr4k9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Portrayals of unrealistic male physiques are everywhere.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/kuala-lumpur-malaysia-october-6-2018-1197291274">Aisyaqilumaranas/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Muscle dysmorphia is linked to the belief that a <a href="https://www.tandfonline.com/doi/full/10.1080/23311908.2016.1243194">muscular physique is ideal</a>. So being exposed to these images and ideals in the media may cause concern and a distorted view of one’s body. Studies also show <a href="https://link.springer.com/article/10.1007/s10964-019-01190-0">social media use</a> is directly linked to the idolisation of muscularity in young boys. Viewing images of <a href="https://psycnet.apa.org/buy/2020-23347-001">fit people on social media</a> also predicts a fixation with becoming more muscular.</p>
<p>The view that <a href="https://www.sciencedirect.com/science/article/abs/pii/S2211266920300207">being muscular is valuable</a> is typically learned from friends and family, and pressure to be muscular may come in the form of <a href="https://www.tandfonline.com/doi/full/10.1080/23311908.2016.1243194">comparisons or comments</a> about appearance from loved ones. Research shows some men even seek a muscular physique to cope with bullying and emasculation from <a href="https://www.semanticscholar.org/paper/The-Muscled-Self-and-Its-Aftermath%3A-A-Life-History-Sparkes-Batey/009cb96b6a5be6fed9b0d99d8c0576198d9fe697">family members</a> and <a href="https://psycnet.apa.org/doiLanding?doi=10.1037/men0000072">romantic partners</a>.</p>
<p>Some researchers also believe believe a so-called “<a href="https://journals.sagepub.com/doi/10.1177/000276486029005004">masculine crisis</a>” may be contributing to increased cases of muscle dysmorphia. This reflects the perceived belief there are less opportunities for men to <a href="https://www.semanticscholar.org/paper/The-Fitness-Revolution.-Historical-Transformations-Andreasson-Johansson/b67cca687f646e256b97d97ac6383d21f032d7dc">assert their masculinity</a> through manual and industrial labour. This may leave some men feeling threatened and emasculated. </p>
<p>As a result, men have learned to use a muscular physique to <a href="https://books.google.co.uk/books/about/Little_Big_Men.html?id=z-ax2426Kw0C&redir_esc=y">visually show their masculinity</a>. Increasingly, masculinity in modern culture represents not what you do, but <a href="https://journals.sagepub.com/doi/abs/10.1177/1469540519846196?journalCode=joca">how you look</a>. So, the value that society has placed on being muscular may explain why muscle dysmorphia is more common in men.</p>
<p>Given muscle dysmorphia is potentially under-reported, we cannot accurately know how common it is. Instead, we can only speculate based on the limited evidence we have. The uncertainty is partly because of inconsistent diagnostic tools, and the notion it’s <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0025923">taboo</a> for men to be concerned with appearance or sharing their feelings.</p>
<p>Little research has explored the treatment options for muscle dysmorphia, but <a href="https://connect.springerpub.com/content/sgrjcp/31/4/255">one review</a> suggests that cognitive behavioural therapy, thought restructuring (a technique that helps people understand and challenge their thoughts, feelings, and beliefs), and family therapy could all be beneficial. </p>
<p>Given that internal experiences are hard to change, people suffer with the condition long-term. But seeing as the condition is similar to <a href="https://www.nhs.uk/conditions/body-dysmorphia/">body dysmorphic disorder</a>, which causes people to obsess over perceived flaws in their appearance more generally, researchers may already have promising potential solutions to help manage emotions and symptoms associated with muscle dysmorphia.</p><img src="https://counter.theconversation.com/content/147706/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ieuan Cranswick does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Social media and changing ideas about masculinity are making more and more young men believe their body is too small, skinny or insufficiently muscular.Ieuan Cranswick, Senior Lecturer in Sport and Exercise Therapy, Leeds Beckett UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1442492020-09-02T13:51:10Z2020-09-02T13:51:10ZMen are buying potentially risky steroid substitutes online to get the ‘ideal body’<figure><img src="https://images.theconversation.com/files/354966/original/file-20200826-7087-dhrj2z.jpg?ixlib=rb-1.1.0&rect=22%2C0%2C6809%2C4891&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Selective androgen receptor modulators (SARMs) may be perceived as a safer muscle-building alternative to steroids.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Unapproved muscle-building drugs are being <a href="https://doi.org/10.1210/jc.2018-01706">sold over the internet</a>. These chemicals, called SARMS or selective androgen receptor modulators, are popular in part due to their <a href="https://www.uspharmacist.com/article/recreational-use-of-selective-androgen-receptor-modulators">perceived safety compared to anabolic steroids</a>, but the health risks of these drugs are still widely unknown and potentially serious.</p>
<h2>Images in society influence our body image</h2>
<p>Images of bodies surround us in our daily life, in advertising, media, the Twitterverse and dating apps, informing <a href="http://hdl.handle.net/10523/7863">the way we feel and think about our bodies</a>. We come to understand ourselves through the images circulating in our culture and society that define what it means to belong to a particular gender. </p>
<p>For many men, social images create an understanding of what their bodies should look like to be <a href="https://doi.org/10.1177/1557988316669042">considered masculine</a>. Often the dominant ideal, both celebrated and desired, is fat-free, with bulging muscles and well-defined pecs: a celebration of <a href="https://doi.org/10.1080/14680777.2017.1367701">strength and power</a>.</p>
<figure class="align-center ">
<img alt="A young man in a hoodie looks pensive with his arms folded across his chest. Behind him, on a blackboard, a drawing of caricatured muscular arms lines up with his shoulders." src="https://images.theconversation.com/files/354704/original/file-20200825-15-5cxmst.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/354704/original/file-20200825-15-5cxmst.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/354704/original/file-20200825-15-5cxmst.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/354704/original/file-20200825-15-5cxmst.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/354704/original/file-20200825-15-5cxmst.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=478&fit=crop&dpr=1 754w, https://images.theconversation.com/files/354704/original/file-20200825-15-5cxmst.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=478&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/354704/original/file-20200825-15-5cxmst.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=478&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">For many men, social images create an understanding of what their bodies should look like to be considered masculine.</span>
<span class="attribution"><span class="source">(Pixabay)</span></span>
</figcaption>
</figure>
<p>Many men strive to embody this idealized image of masculinity, but it’s not one everyone can achieve. The difference between men’s actual bodies and the cultural ideas about masculinity that may <a href="https://doi.org/10.1176/appi.ajp.157.8.1297">explain the rise of muscle dysmorphia and anabolic steroid abuse</a>. </p>
<p>We suggest that more discussion is needed surrounding both masculine body image ideals and the potential dangers of SARMs in our society.</p>
<h2>Body image standards affect men differently</h2>
<p>For many <a href="https://www.apa.org/pi/lgbt/programs/safe-supportive/lgbt/key-terms.pdf">sexually diverse men</a> (gay, bi, pansexual, queer, men who have sex with men, etc.), the consequences of not living up to idealized standards for masculine bodies <a href="https://doi.org/10.1176/appi.ajp.157.8.1297">can be toxic</a>, including negative body image and <a href="https://doi.org/10.1016/j.bodyim.2019.08.007">body dissatisfaction</a>. </p>
<p>This can influence the way people live, such as eating and exercising. For example, one study noted a small association with social media use and <a href="https://doi.org/10.1089/cyber.2017.0375">body dissatisfaction, eating disorder symptoms and thoughts about using anabolic steroids</a>. Sexually diverse men have also reported engaging in <a href="https://doi.org/10.1136/bmjopen-2014-005205">intensive anaerobic training, the use of protein powders and the use of anabolic steroids</a> to achieve their desire to become muscular. </p>
<p>Ethnicity can also intersect with body image for sexually diverse men. <a href="https://doi.org/10.1016/j.bodyim.2013.03.006">In one study</a>, Black, East/Southeast Asian, South Asian, Latino/Brazilian gay and bisexual men report skipping meals, vomiting and taking steroids to achieve bodies that cultural messages and images define as the most masculine. </p>
<h2>Potential danger</h2>
<p>Anabolic steroids can be viewed by men with body dissatisfaction as <a href="https://doi.org/10.1001/jama.2016.17441">a way to achieve this idolized masculine body</a>. Now SARMs, which are not steroids per se but <a href="https://www.uspharmacist.com/article/recreational-use-of-selective-androgen-receptor-modulators#:%7E:text=Discovered%20in%20the%20late%201990s,and%20facilitate%20recovery%20from%20exercise.&text=SARMs%20are%20not%20anabolic%20steroids,to%20androgen%20receptors%20">act in a similar way</a> by increasing muscle mass and strength, are perceived as a safer alternative to steroids and are easily purchased online: A potential danger for those desperate to achieve these hyper-muscular bodies.</p>
<figure class="align-right ">
<img alt="A black dumbbell with drug capsules in the foreground" src="https://images.theconversation.com/files/354706/original/file-20200825-18-1edejsp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/354706/original/file-20200825-18-1edejsp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=406&fit=crop&dpr=1 600w, https://images.theconversation.com/files/354706/original/file-20200825-18-1edejsp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=406&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/354706/original/file-20200825-18-1edejsp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=406&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/354706/original/file-20200825-18-1edejsp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=510&fit=crop&dpr=1 754w, https://images.theconversation.com/files/354706/original/file-20200825-18-1edejsp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=510&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/354706/original/file-20200825-18-1edejsp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=510&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Anabolic steroids can be viewed by men with body dissatisfaction as a way to achieve the idolized masculine body. Now SARMS may be viewed as an alternative to steroids.</span>
<span class="attribution"><span class="source">(Pexels)</span></span>
</figcaption>
</figure>
<p>SARMS have been researched for more than 20 years as treatments for medical conditions including cancer, osteoporosis, Alzheimer’s disease and muscle-wasting, but no SARMs are approved by the FDA for any medical condition yet and they are not authorized for use in Canada. In fact, Health Canada released a <a href="https://www.healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2020/72293a-eng.php">public health advisory</a> in March 2020 advocating against the use of SARMs, and reported a seizure of various SARMs from stores in Alberta.</p>
<p>We know little about the safety and toxicity of these drugs, which is what makes them risky. A 32-year old male recently suffered <a href="https://doi.org/10.14309/crj.0000000000000370">severe liver injury</a> after taking a SARM for two weeks, suggesting there are indeed health risks.</p>
<p>A factor that may have contributed to this case is that recreational steroid users often take <a href="https://doi.org/10.1210/jc.2018-01706">much higher doses than what is prescribed for medical patients</a>. SARMs, like other drugs, can have <a href="https://doi.org/10.1111/bcp.13316">dose-dependent effects</a>. If men are taking high doses to achieve the dominant image of a masculine body, it is likely that their health risks are higher as well. </p>
<p>Although SARMs may end up being safe drugs when properly used for medical conditions, there are still major <a href="https://doi.org/10.1080/13543784.2020.1777275">health concerns</a> involved with taking SARMs currently, including liver damage, cardiovascular issues and testosterone suppression. Furthermore, the purity of SARMs bought online is currently <a href="https://doi.org/10.1002/dta.2908">highly questionable</a>.</p>
<h2>What can we do?</h2>
<p>In light of these safety concerns, the <a href="https://www.congress.gov/bill/116th-congress/senate-bill/2895/text">SARMs Control Act of 2019</a> was introduced to the United States Congress, which seeks to tighten regulatory control over these drugs. This act effectively equates SARMs with anabolic steroids on a regulatory level. This type of regulation is necessary to help contain a drug with health risks and potential for abuse.</p>
<p>Thus, we have a storm brewing. On one hand we have unrealistic masculine body image standards for gay men, which promote and even demand the use of anabolic drugs to reach that goal. On the other hand, SARMs promise the idolized body and are easily available over the internet.</p>
<p>We need to honestly discuss the dangers of promoting unattainable masculine body image standards for men of all sexual orientations and warn about easily accessible SARMs that may not be safe to use and almost certainly not safe to abuse.</p><img src="https://counter.theconversation.com/content/144249/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Idealized standards for muscular, fat-free male bodies may be fuelling the use of SARMs, or selective androgen receptor modulators, unapproved muscle-building drugs that are easily available online.Stefan Heinze, Graduate student in Pharmacology, Dalhousie UniversityPhillip Joy, Assistant Professor, Mount Saint Vincent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1251352019-12-09T01:11:07Z2019-12-09T01:11:07Z‘How do I clean my penis?’<figure><img src="https://images.theconversation.com/files/305101/original/file-20191204-70167-1dlj45h.png?ixlib=rb-1.1.0&rect=538%2C0%2C2958%2C2000&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Wes Mountain/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><blockquote>
<p>Growing up, no one ever gave me the rundown on how or what I should do to keep my penis clean […] I’ve never read any reliable answer beyond washing it with water. Do I use soap? Any soap? How normal is smegma? If my penis gets itchy from smegma should I go see a doctor? If so, my GP or a urologist? — Anonymous</p>
</blockquote>
<h2>Key points</h2>
<ul>
<li>clean under the foreskin, using soap, but not too much</li>
<li>smegma is normal</li>
<li>if you have any concerns, see your GP.</li>
</ul>
<p><a href="https://theconversation.com/au/topics/i-need-to-know-66587"><img src="https://images.theconversation.com/files/290837/original/file-20190904-175686-polw3q.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=90&fit=crop&dpr=2" width="100%"></a></p>
<p>It’s a shame some people think talking about cleaning and caring for our genitals is embarrassing or taboo. We probably know more about hair care than penis care.</p>
<p>The penis is simply another part of our anatomy, so cleaning should be relatively straight forward.</p>
<p>If you’ve been circumcised, where your foreskin was removed soon after birth, your penis will look something like the one in the diagram (below, right), with the head (or glans) always exposed.</p>
<p>But if you have a foreskin (below left and centre), there are some extra things to think about when washing, which we’ll get to soon.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/305077/original/file-20191204-70116-1vv28db.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/305077/original/file-20191204-70116-1vv28db.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=390&fit=crop&dpr=1 600w, https://images.theconversation.com/files/305077/original/file-20191204-70116-1vv28db.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=390&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/305077/original/file-20191204-70116-1vv28db.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=390&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/305077/original/file-20191204-70116-1vv28db.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=490&fit=crop&dpr=1 754w, https://images.theconversation.com/files/305077/original/file-20191204-70116-1vv28db.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=490&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/305077/original/file-20191204-70116-1vv28db.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=490&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>Foreskin facts</h2>
<p>But first, some foreskin facts. From around the time you turn five, your foreskin <a href="http://www.cirp.org/library/hygiene/camille1/">separates</a> from the head of your penis, bit by bit. This allows you to pull back your foreskin (retract it). In some boys, the foreskin can stay partially stuck to the head of the penis until puberty.</p>
<p>You should <a href="https://www.berghahnjournals.com/view/journals/boyhood-studies/1/2/bhs010206.xml">never forcibly pull back</a> your foreskin. That’ll be painful, you could bleed, you could scar, or have other complications.</p>
<h2>OK, now for the washing part</h2>
<p><a href="http://www.cirp.org/library/hygiene/camille1/">Once your foreskin separates easily from the glans</a>, gently retract and clean underneath the foreskin with each bath or shower. Then, after washing, pull the foreskin forward to its normal position.</p>
<p>When it’s time to dry off, retract the foreskin again so you can dry the head of the penis with a towel. Then, you guessed it, pull the foreskin forward to its normal position.</p>
<p>It’s OK to clean with soap whether you have a foreskin or not. But generally, too much soap is worse than none at all. Excessive cleaning removes essential body oils that would normally keep our skin moist and reduce friction. If you have sensitive skin, you can use a soap-free wash from the chemist.</p>
<h2>What about smegma?</h2>
<p><a href="https://www.healthline.com/health/smegma">Smegma</a> is a thick, whitish discharge consisting of a build-up of dead skin cells, oil and other fluids under the foreskin. And it’s very useful. It protects and lubricates the penis. </p>
<p>Some people have oilier skin than others and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1464-410x.1999.0830s1034.x">tend to have more smegma</a>.
So some smegma is normal, but if you have too much or it becomes smelly, you may need to clean more.</p>
<h2>Things to watch out for (and when to see your GP)</h2>
<p>If the head of your penis becomes painful, red, itchy and has a discharge, you may have a treatable condition called <a href="https://www.mshc.org.au/SexualHealthInformation/SexualHealthFactSheets/BALANITIS/tabid/134/Default.aspx#.XcJiPfZuKUk">balanitis</a>.</p>
<p>It’s more common if you have a foreskin. And the bacteria and fungus that cause it like the warm and moist conditions under there.</p>
<p>Skin disorders, infection, poor hygiene, friction from sexual activity, and using too much soap all <a href="https://www.dermnetnz.org/topics/balanitis/">cause the condition</a>.</p>
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Read more:
<a href="https://theconversation.com/how-to-make-your-next-sexual-health-check-less-erm-awkward-72498">How to make your next sexual health check less, erm ... awkward</a>
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<p>You can clear a mild case with good hygiene and simple treatments, such as an antiseptic or antifungal cream. You can buy these from any pharmacy. In addition to the medication, the cream itself helps protect and moisturise the inflammed skin. </p>
<p>If you have balanitis you may need to be more careful than usual to avoid urine irritating your inflamed skin. Retract your foreskin when you urinate. Dry the head of the penis gently after you finish.</p>
<p>If your penis is still inflamed after a week of these simple measures it’s <a href="https://www.aafp.org/afp/2018/0115/p102.html">best to see your GP</a>. They can then investigate other causes, such as <a href="https://www.ncbi.nlm.nih.gov/books/NBK537143/">psoriasis or an allergy</a>.</p><img src="https://counter.theconversation.com/content/125135/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David King does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It’s a surprisingly common question. Here’s what you need to know.David King, Senior Lecturer in General Practice, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1258182019-10-29T05:10:27Z2019-10-29T05:10:27ZDoes eating dairy foods increase your risk of prostate cancer?<figure><img src="https://images.theconversation.com/files/298863/original/file-20191028-113987-1aoxwt0.jpg?ixlib=rb-1.1.0&rect=16%2C25%2C5590%2C3707&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">If you're a male who enjoys dairy, there's no reason to stop having it.</span> <span class="attribution"><span class="source">From shutterstock.com</span></span></figcaption></figure><p><em><a href="https://theconversation.com/au/topics/research-check-25155">Research Checks</a> interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.</em></p>
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<p>Recent headlines <a href="https://thenewdaily.com.au/life/wellbeing/2019/10/22/dairy-prostate-cancer-risk/">have warned</a> a diet high in dairy foods may increase men’s risk of prostate cancer. </p>
<p>The news is based on a <a href="https://jaoa.org/article.aspx?articleid=2753613">recent review</a> published in the Journal of the American Osteopathic Association which claimed to find eating high quantities of plant-based foods may be associated with a decreased risk of prostate cancer, while eating high quantities of dairy products may be associated with an increased risk.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1186913900970856448"}"></div></p>
<p>But if you’re a man, before you forego the enjoyment and known nutritional benefits of milk, cheese and yoghurt, let’s take a closer look at the findings.</p>
<h2>What the study did</h2>
<p>This study was a review, which means the researchers collated the findings of a number of existing studies to reach their conclusions.</p>
<p>They looked at 47 studies which they claim constitute a comprehensive review of all available data from 2006-2017. These studies examined prostate cancer risk and its association with a wide variety of foods including vegetables, fruits, legumes, grains, meat (red, white and processed), milk, cheese, butter, yoghurt, total diary, calcium (in foods and supplements), eggs, fish and fats.</p>
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Read more:
<a href="https://theconversation.com/six-foods-that-increase-or-decrease-your-risk-of-cancer-28270">Six foods that increase or decrease your risk of cancer</a>
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<p>Some studies followed groups of men initially free of prostate cancer over time to see if they developed the disease (these are called cohort studies). Others compared health habits of men with and without prostate cancer (called case-control studies). Some studies recorded the incidence of prostate cancer in the group while others concentrated on the progression of the cancer.</p>
<p>For every potential risk factor, the reviewers marked studies as showing no effect, or an increased or decreased risk of prostate cancer. The results varied significantly for all the foods examined.</p>
<p>For cohort studies (considered more reliable than case-control studies), three studies for vegan diets and one for legumes recorded decreased risk of prostate cancer. For vegetarian diets and vegetables, some reported decreased risk and some recorded no effect. Fruits, grains, white meat and fish appeared to have no effect either way.</p>
<p>An increased risk was reported for eggs and processed meats (one study each), red meat (one out of six studies), fats (two out of five), total dairy (seven out of 14), milk (six out of 15), cheese (one out of six), butter (one out of three), calcium (three out of four from diet and two out of three from supplements) and fats (two out of five).</p>
<p>Notably, some very large cohort studies included in the review showed no association for milk or other dairy products. And most case-control studies, though admittedly less reliable, showed no association.</p>
<p>The authors also omitted other studies published within the review period which showed <a href="https://www.ncbi.nlm.nih.gov/pubmed/18584476">no significant association</a> between dairy and prostate cancer.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/298879/original/file-20191028-113972-11es3ym.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/298879/original/file-20191028-113972-11es3ym.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/298879/original/file-20191028-113972-11es3ym.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/298879/original/file-20191028-113972-11es3ym.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/298879/original/file-20191028-113972-11es3ym.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/298879/original/file-20191028-113972-11es3ym.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/298879/original/file-20191028-113972-11es3ym.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A person’s weight likely has more influence on their risk of developing prostate cancer than whether or not they eat dairy.</span>
<span class="attribution"><span class="source">From shutterstock.com</span></span>
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</figure>
<p>So the inconsistency in results across the studies reviewed – including large cohort studies – amount to very limited evidence dairy products are linked to prostate cancer.</p>
<h2>Could it be vitamin D?</h2>
<p>In earlier research, a link between milk and prostate cancer has been attributed to a high calcium intake, possibly changing the production of a particular form of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858034/">vitamin D</a> within the body. </p>
<p>Vitamin D is an important regulator of cell growth and proliferation, so scientists believed it may lead to prostate cancer cells growing unchecked. But the evidence on this is limited, and the review adds little to this hypothesis. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/psa-testing-for-prostate-cancer-is-only-worth-it-for-some-93284">PSA testing for prostate cancer is only worth it for some</a>
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<p>Perhaps the review’s most surprising omission is mention of the <a href="https://www.wcrf.org/dietandcancer/prostate-cancer">World Cancer Research Fund (WCRF) Continuous Update Project report on prostate cancer</a>. This rigorous global analysis of the scientific literature identified much stronger risk factors that should be considered as possible confounding factors.</p>
<p>For example, the evidence is rated as “strong” that being overweight or obese, and being tall (separate to weight), are associated with increased risk of prostate cancer. The exact reasons for this are not fully understood but could be especially significant in Australia where <a href="https://www.aihw.gov.au/reports/overweight-obesity/overweight-and-obesity-an-interactive-insight/contents/what-is-overweight-and-obesity">74% of men are overweight or obese</a>.</p>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/31552571">new Australian study</a> found a higher body mass index was a risk factor for aggressive prostate cancer.</p>
<p>For dairy products and diets high in calcium, according to the WCRF, the evidence remains “limited”.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/why-full-fat-milk-is-now-ok-if-youre-healthy-but-reduced-fat-dairy-is-still-best-if-youre-not-122184">Why full-fat milk is now OK if you're healthy, but reduced-fat dairy is still best if you're not</a>
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<h2>It’s about the whole diet</h2>
<p>It’s not wise to judge any diet by a single food group or nutrient. A healthy diet overall should be the goal.</p>
<p>That being said, milk, cheese and yoghurt are included in <a href="https://www.eatforhealth.gov.au/guidelines">Australia’s Dietary Guidelines</a> because of evidence linking them with a lower risk of heart disease, type 2 diabetes, bowel cancer and excess weight. These dairy products are also sources of protein, calcium, iodine, several of the B complex vitamins, and zinc.</p>
<p>Evidence about dairy products and prostate cancer remains uncertain. So before fussing about whether to skip milk, cheese and yoghurt, men who wish to reduce their risk of prostate cancer would be better advised to lose any excess weight. <strong>– Rosemary Stanton</strong></p>
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<h2>Blind peer review</h2>
<p>I agree with the author of this Research Check who highlights there is a high degree of variability in the results of the studies examined in this review. </p>
<p>While the authors searched three journal databases, most comprehensive reviews search up to eight databases. Further, the authors did not undertake any assessment of the methodological quality of the studies they looked at. So the results should be interpreted with caution. </p>
<p>Although the authors concluded higher amounts of plant foods may be protective against prostate cancer, the figure presented within the paper indicates more studies reported no effect compared to a decreased risk, so how they came to that conclusion in unclear. For total dairy they present a figure showing there were as many studies suggesting no effect or lower risk as there were showing higher risk. </p>
<p>Importantly, they did not conduct any meta-analyses, where data are mathematically pooled to generate and overall effect across all studies.</p>
<p>As the reviewer points out, many other important sources of high quality data have not been included and there are a number of recent higher quality systematic reviews that could be consulted on this topic. <strong>- Clare Collins</strong></p><img src="https://counter.theconversation.com/content/125818/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute and the ABC. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and the Heart Foundation evidence reviews on meat and dietary patterns.</span></em></p><p class="fine-print"><em><span>Rosemary Stanton does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A recent study reported a high consumption of dairy products was associated with an increased risk of prostate cancer. But breaking down the results shows there’s no reason for men to give up dairy.Rosemary Stanton, Visiting Fellow, School of Medical Sciences, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1228672019-10-23T19:06:03Z2019-10-23T19:06:03ZRisky business: how our ‘macho’ construction culture is killing tradies<figure><img src="https://images.theconversation.com/files/298217/original/file-20191022-55712-5vl4l9.jpg?ixlib=rb-1.1.0&rect=0%2C33%2C7360%2C4869&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The rates of suicide among males working in the construction industry are almost double the rates seen overall among Australian men.</span> <span class="attribution"><span class="source">From shutterstock.com</span></span></figcaption></figure><p>The construction and building industries can be dangerous places to work. These jobs not only pose risks to a person’s physical health, but can threaten their mental health, too.</p>
<p>In Australia, “tradies” make up less than one-third of all people in employment, but represent <a href="https://www.safeworkaustralia.gov.au/media-centre/media-release/tradie-health-focus-august">58% of serious claims for workers’ compensation</a>. Construction ranks in the top three for industries with the <a href="https://www.abs.gov.au/ausstats/abs@.nsf/0/7EBF2FCCABAB02C3CA256AE2007DBCEF?Opendocument">highest work-related injury or illness</a> and <a href="https://www.safeworkaustralia.gov.au/doc/work-related-traumatic-injury-fatalities-australia-2017">deaths related to traumatic injury</a>.</p>
<p>While accidents and disease can be put down to the occupational risk of working on construction sites, the disproportionate <a href="http://mengage.org.au/suicide/mates-in-construction-suicide-in-the-construction-industry">rates of mental illness seen in this industry</a> cannot. Construction workers are <a href="https://au.news.yahoo.com/powerful-message-behind-colour-construction-workers-hats-104822117.html">overrepresented</a> in suicide rates in Australia, and this urgently needs to be addressed.</p>
<p>The physically demanding work tradespeople do has long been associated with male toughness and “macho” workplace cultures. But it’s this toxic mentality that’s largely responsible for tradies’ poor mental health. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/like-a-cancer-of-the-workplace-bullying-is-a-symptom-of-dysfunction-43831">Like a 'cancer' of the workplace, bullying is a symptom of dysfunction</a>
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<h2>The stats on tradies’ mental health and suicide</h2>
<p>Research shows workers in construction are at <a href="https://www.blackdoginstitute.org.au/news/news-detail/2018/08/30/new-partnership-set-to-support-good-mental-health-on-construction-sites">a higher risk of experiencing mental health problems</a> than workers in other professions.</p>
<p>In 2012 in Australia, <a href="http://matesinconstruction.org.au/wp-content/uploads/2016/03/Cost-of-suicide-in-construction-industry-final-report.pdf">a total of 169 men</a> working in the construction industry committed suicide.</p>
<p>A <a href="http://micaus.bpndw46jvgfycmdxu.maxcdn-edge.com/wp-content/uploads/2015/11/17584-mic-qld-Deakin-report-volume-2-297x210mm-v10.pdf">2017 report</a> indicated the suicide rate is 24.2 per 100,000 male construction workers compared to 13.9 per 100,000 males in all other occupations – almost double.</p>
<h2>Why do we have this problem?</h2>
<p>Research into <a href="http://www.arcom.ac.uk/-docs/proceedings/fd40ad046dd020e737446df16e609a9c.pdf">Australia’s construction industry</a> indicates workers can be on site for up to double their contracted work time. So long hours, resulting in fatigue and poor work-life balance, are likely affecting tradies’ mental well-being. </p>
<p>Importantly, this research points to <a href="http://www.arcom.ac.uk/-docs/proceedings/fd40ad046dd020e737446df16e609a9c.pdf">strong links</a> between masculine workplace norms and the increased likelihood of mental health issues.</p>
<p>A “macho” work culture emphasises self-reliance; there’s an expectation tradespeople can withstand <a href="http://www.austmine.com.au/Events/category/articles-editorials/why-do-male-construction-workers-have-such-a-high-suicide-rate">insecure and transient</a> work arrangements. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-ask-someone-youre-worried-about-if-theyre-thinking-of-suicide-100237">How to ask someone you're worried about if they're thinking of suicide</a>
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<p>There’s also stigma associated with men <a href="https://www.sbs.com.au/topics/life/culture/article/2019/09/24/truth-about-masculinity-why-dont-you-just-man">talking to others about psychological distress</a>. For this reason, many ignore stress-related mental health problems like panic attacks, anxiety, insomnia and depression, risking the worsening of symptoms. Competition at work may also lead to a breakdown of trust, a lack of collegiality, and conflict.</p>
<p>“Macho” workplaces <a href="https://www.sciencedirect.com/science/article/abs/pii/S0191308510000079">decrease the likelihood men will look after themselves</a> by consulting health-care professionals, talking to a supervisor about reducing hours or asking for time off. </p>
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<img alt="" src="https://images.theconversation.com/files/298230/original/file-20191023-149560-d6qkge.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/298230/original/file-20191023-149560-d6qkge.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/298230/original/file-20191023-149560-d6qkge.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/298230/original/file-20191023-149560-d6qkge.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/298230/original/file-20191023-149560-d6qkge.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/298230/original/file-20191023-149560-d6qkge.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/298230/original/file-20191023-149560-d6qkge.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">There are programs in Australia which aim to foster better mental health among construction workers.</span>
<span class="attribution"><span class="source">From shutterstock.com</span></span>
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</figure>
<p>Further, a culture where workers are expected to be tough and self-reliant is exacerbated by <a href="https://www.abc.net.au/news/2019-03-03/stories-of-hazing-rituals-for-apprentices-revealed/10821874">the problem of bullying and hazing</a> on work sites. Victims can be left feeling isolated, increasing their risk of burnout, depression and suicidal thoughts. </p>
<p>High profile cases such as the <a href="https://www.smh.com.au/national/nsw/alec-meikle-killed-himself-after-relentless-bullying-inquest-hears-20131202-2ylea.html">suicide of apprentice Alec Meikle in Bathurst</a> after he was relentlessly bullied have brought this problem to public attention.</p>
<h2>What about women?</h2>
<p>The construction industry is highly segregated in terms of gender, with women making up only <a href="https://www.women.nsw.gov.au/__data/assets/pdf_file/0017/268010/3000_WNSW-OccasionalPaper_document_ART.pdf">1-3% of tradies in Australia</a> and other Western countries. </p>
<p><a href="https://www.csu.edu.au/research/ilws/publications/technical-reports/A_trade_of_ones_own_Regional_NSW_stakeholder_findings_2019.pdf">Our research</a> and <a href="https://sydney.edu.au/content/dam/corporate/documents/business-school/research/women-work-leadership/One-of-the-Boys-report.pdf">other work in the field</a> has looked at the barriers women face to equity and inclusion in the construction and building industries. We’ve identified the “macho” culture as being harmful to women as well as men.</p>
<p>Based on our interviews with tradeswomen and industry stakeholders in New South Wales, it’s clear bullying and harassment are very real issues for both genders. </p>
<p>Some women have been subject to dangerous pranks and left alone on heavy lifting and other jobs that require more than one person. These sorts of risky practices are linked to injury and psychological distress for women as well as men. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/the-female-tradie-shortage-why-real-change-requires-a-major-cultural-shift-97091">The female tradie shortage: why real change requires a major cultural shift</a>
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<h2>What’s being done?</h2>
<p>The tightening of regulations, and particularly <a href="https://www.safeworkaustralia.gov.au/resources-publications/reports">Safe Work Australia’s</a> continued focus on high risk industries, has meant tradies are physically safer on work sites today than they were a decade ago. On site fatalities in Australia declined by <a href="https://www.safeworkaustralia.gov.au/system/files/documents/1812/work-related-traumatic-injury-fatalities-report-2017.pdf">48% between 2007 and 2017</a>. </p>
<p>But much less is known about the extent of deaths from diseases contracted at work. Estimates suggest as many as <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Education_and_Employment/IndustrialdeathsinAus/Report">2,000 Australians are dying per year</a> as a result of chemicals they were exposed to during their working lives. So this must be an area of focus moving forward.</p>
<p>On the mental health front, alongside <a href="https://www.blackdoginstitute.org.au/news/news-detail/2018/08/30/new-partnership-set-to-support-good-mental-health-on-construction-sites">awareness campaigns</a>, several groups now exist to provide counselling and facilitate peer support networks within the industry. </p>
<p><a href="http://matesinconstruction.org.au/wp-content/uploads/2016/03/Cost-of-suicide-in-construction-industry-final-report.pdf">Mates in Construction</a> conduct various programs to tackle psychological distress on work sites, and are actively involved in <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-019-2142-3">suicide prevention measures</a>. </p>
<p>A program called “<a href="https://www.incolink.org.au/wellbeing-support-services/bluehats-suicide-prevention/">Bluehats</a>” in Victoria aims to challenge the stereotype tough men don’t have emotional or mental health problems. It offers tradies the option to undertake training to become a “bluehat volunteer”, which enables them to provide support to workmates on site. The trained volunteers can be identified by their blue hats.</p>
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Read more:
<a href="https://theconversation.com/how-challenging-masculine-stereotypes-is-good-for-men-114300">How challenging masculine stereotypes is good for men</a>
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<p>Entrenched cultures can be hard to shift. There may be resistance to changes, be it procedures to ensure safer work practices, or new coworkers (women or men) who don’t conform to the “macho” stereotype. </p>
<p>But this change is imperative. Maintaining physically and psychologically dangerous behaviours is killing tradespeople at work. As we continue to enact regulations to protect tradies’ physical health, cultural change is essential for the improvement of their mental health, too.</p><img src="https://counter.theconversation.com/content/122867/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Research shows construction workers are at higher risk of mental illness and suicide than people in other jobs. Addressing this must start with dismantling the ‘macho’ culture on work sites.Donna Bridges, Lecture of sociology, Charles Sturt UniversityBranka Krivokapic-Skoko, Economist and Economic Sociologist, Charles Sturt UniversityElizabeth Wulff, Research Officer, Faculty of Arts & Education, Charles Sturt UniversityLarissa Bamberry, Senior Lecturer, School of Management and Marketing, Charles Sturt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1208932019-09-19T20:54:00Z2019-09-19T20:54:00ZWhy do men have nipples?<figure><img src="https://images.theconversation.com/files/288881/original/file-20190821-170941-jihsap.jpg?ixlib=rb-1.1.0&rect=0%2C14%2C3333%2C3313&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Men have nipples because of a quirk in how embryos develop. But that's only part of the story of this seemingly redundant body part.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/nipple-323037320?src=Ztai78yG_qxfTkWQusy-Hg-1-12">from www.shutterstock.com</a></span></figcaption></figure><p>Women’s nipples have long been a source of fascination and controversy, from celebrity gossip stories of wardrobe malfunctions and “<a href="https://www.cosmopolitan.com/entertainment/celebs/news/g4657/celebrity-nip-slips/">nip slips</a>” to feminist movements for <a href="https://www.telegraph.co.uk/women/womens-life/10880647/Topless-women-campaign-to-Free-The-Nipple-why-on-earth-do-women-want-to-walk-around-topless-in-public.html">gender equality</a>. Nipples even became a <a href="https://www.thesun.co.uk/living/3341970/more-and-more-women-are-wearing-fake-nipples-and-they-come-in-sizes-ranging-from-cold-to-freezing/">fashion accessory</a>. </p>
<p>Men’s nipples are a different story. While they don’t tend to attract the same type of controversy, people have <a href="https://www.google.com/search?client=firefox-b-d&q=why+do+men+have+nipples%3F">long been fascinated</a> about why men have them. The question even made it into a popular science <a href="https://www.penguinrandomhouse.com/books/101277/why-do-men-have-nipples-by-mark-leyner-and-billy-goldberg-md/9781400082315/">book</a>.</p>
<p>So, if (most) men don’t breastfeed, why do men have nipples? The answer lies partly in how we develop in the womb. We’ll get to male breast milk later.</p>
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Read more:
<a href="https://theconversation.com/no-youre-not-hardwired-to-stare-at-womens-breasts-53449">No, you’re not 'hardwired' to stare at women’s breasts</a>
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<h2>A long time ago, when you were an embryo …</h2>
<p>Very early in development, embryos of both sexes have primitive structures that can develop into <a href="https://www.nature.com/scitable/topicpage/genetic-mechanisms-of-sex-determination-314/">either male or female reproductive organs</a> (or rarely into a bit of both).</p>
<p>Several genes determine whether the baby ends up with either male or female reproductive organs. A gene called <a href="https://ghr.nlm.nih.gov/gene/SRY">SRY</a> (sex-determining region Y) on the short arm of the Y chromosome is considered the master gene.</p>
<p>This is activated when the embryo is around seven weeks old. When activated, it eventually leads to the development of male reproductive organs and the disappearance of the primitive female reproductive duct. </p>
<p>As females don’t have a Y chromosome, the primitive female reproductive duct continues to develop into female reproductive organs while the primitive <a href="https://www.nature.com/scitable/topicpage/genetic-mechanisms-of-sex-determination-314/">male reproductive duct disappears</a>.</p>
<p>But breasts and nipples start to form <em>before</em> the SRY gene has been activated, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706056/">between weeks four and six</a>. This is when two ridges called mammary crests or milk lines extend between the primitive armpit and the groin. </p>
<p>So, later in male development, even as most of the mammary crest disappears, the cells around the chest that form primitive nipples and areola smooth muscle remain. These remaining cells go on to form the final breasts and nipples.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/289768/original/file-20190828-184217-ln6st6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/289768/original/file-20190828-184217-ln6st6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/289768/original/file-20190828-184217-ln6st6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/289768/original/file-20190828-184217-ln6st6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/289768/original/file-20190828-184217-ln6st6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/289768/original/file-20190828-184217-ln6st6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/289768/original/file-20190828-184217-ln6st6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/289768/original/file-20190828-184217-ln6st6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">At around seven weeks, a critical gene is activated that puts embryos on the path to being male or female. But by then, critical cells that go on to become breasts and nipples have already developed.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1110267386?src=-1-1&size=medium_jpg">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Once you’re born</h2>
<p>At birth, boys’ and girls’ nipples and breasts look alike. It’s only at puberty, under the influence of hormones, when they begin to change. The nipples of both enlarge but female nipples enlarge more. At the same time, the ducts of the male breasts shrink while female breasts enlarge and remodel. By adulthood, male <a href="https://link.springer.com/article/10.1007/s40750-018-0096-1">nipples are smaller and less variable</a> than female ones.</p>
<p>From an evolutionary standpoint, <a href="https://www.tandfonline.com/doi/abs/10.1080/14681990600674674?scroll=top&needAccess=true&journalCode=csmt20">some argue</a> male nipples remain, not because they present any advantages for a male, but because they do no harm. There is no benefit in eliminating them.</p>
<h2>When development goes wrong</h2>
<p>Sometimes, as with any other body structures, development can go wrong. <a href="https://www.ncbi.nlm.nih.gov/pubmed/9809822">Around one in 20</a> people have supernumerary (or extra) nipples. This occurs when parts of the mammary crest remain. Often these nipples are purely cosmetic and resemble nothing more than a small pigmented mole. Only rarely are they fully functional. The highest number of nipples ever recorded on a human male is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656534/">seven</a>.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/an-extra-organ-or-body-part-is-more-common-than-you-think-76523">An extra organ or body part is more common than you think</a>
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<hr>
<h2>Some men can produce milk</h2>
<p>Intriguingly, sometimes males <a href="https://www.scientificamerican.com/article/strange-but-true-males-can-lactate/">can produce milk</a>. In many cases, this may be caused by recovery from <a href="https://www.ncbi.nlm.nih.gov/pubmed/19100649">starvation</a>, medical conditions that cause <a href="http://www.cmaj.ca/content/182/6/591">hormonal imbalances</a>, or <a href="https://www.aafp.org/afp/2004/0801/p543.html">medications</a>. The milk men produce in these circumstances is <a href="https://www.ncbi.nlm.nih.gov/pubmed/7462406">very similar</a> to that of lactating mothers. </p>
<h2>How do men benefit from having nipples?</h2>
<p>Unless you’re one of the rare men who can use their nipples to breastfeed, men benefit from this seemingly redundant body part for a much more common reason.</p>
<p>Nipples <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Reports+of+intimate+touch%3A+Erogenous+zones+and+somatosensory+cortical+orga-nization">respond to sexual stimulation</a> in both sexes. One study found <a href="https://www.ncbi.nlm.nih.gov/pubmed/16681470">over half the male participants</a> reported feeling enhanced sexual arousal in response to nipple stimulation. There is even <a href="https://www.ncbi.nlm.nih.gov/pubmed/2337382">one report</a> describing a heterosexual man who requested breast enlargement to increase sexual function of his nipples. </p>
<h2>How about ‘man boobs’?</h2>
<p>But for some men, breast enlargement can be the unexpected consequence of being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758064/">overweight or obese</a>. And as we are seeing more obesity in western populations, we’re seeing a rise in “man breasts” or “man boobs”, which are mostly being made up of fat deposits. </p>
<p>Breast enlargement in men, or <a href="https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793">gynaecomastia</a>, can also be caused by a hormone imbalance with a relative excess of oestrogens (female hormones) compared to androgens (male hormones). This mostly affects adolescent boys and usually resolves on its own, although it can persist in as many as <a href="https://www.ncbi.nlm.nih.gov/pubmed/26408934">one in 10 men</a>. In these cases, it can be associated with <a href="https://www.ncbi.nlm.nih.gov/pubmed/26408934">depression, anxiety, disordered eating, body image problems and reduced self-esteem</a>.</p>
<h2>Men get breast cancer too</h2>
<p>Unusually, men can develop <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1610-0387.2011.07720.x">breast cancer</a> and it can have serious consequences.</p>
<p>Only <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351429/">0.5-1%</a> of all breast cancers are diagnosed in men. However, lower awareness of the disease in men means it is more likely to be at an advanced stage when diagnosed. That’s why lumps and changes in men’s nipples (for example, nipple discharge or skin ulcerations such as cracks in the skin), should be checked by a doctor to rule out cancers.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/breast-cancer-campaigns-might-be-pink-but-men-get-it-too-56663">Breast cancer campaigns might be pink, but men get it too</a>
</strong>
</em>
</p>
<hr>
<p>As we’ve seen, men’s nipples deserve as much attention as women’s nipples. Although, this is unlikely to distract the celebrity gossip columnists from their selective obsession with this part of the female anatomy.</p><img src="https://counter.theconversation.com/content/120893/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Moscova does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>How embryos develop, evolution and sexual pleasure all help explain why men have nipples. But ‘man boobs’ are a different story.Michelle Moscova, Senior Lecturer in Anatomy, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1184982019-06-14T17:55:10Z2019-06-14T17:55:10ZFathers need to care for themselves as well as their kids – but often don’t<figure><img src="https://images.theconversation.com/files/279425/original/file-20190613-32347-1qtsgxj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fathers often place more emphasis on their role as head of household than their health.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/father-his-son-playing-inside-their-133093346?src=Caber2Kned2D1HlGBeSkEg-1-12&studio=1">Marmion/Shutterstock.com</a></span></figcaption></figure><p>If you had to choose, which would you rather have: a healthy father or a good father? </p>
<p>Studies suggest men often choose being a good father <a href="https://journals.sagepub.com/doi/full/10.1177/1557988313480227">over being healthy</a>.</p>
<p>Becoming a father is a major milestone in the life of a man, often shifting the way he thinks from being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302395/">“me focused” to “we focused.”</a> But fatherhood can also shift how men perceive their health. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547385/">Our research</a> has found that fathers can view health not in terms of going to the doctor or eating vegetables but <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569257/">how they hold a job</a>, provide for their family, protect and teach their children, and belong to a community or social network.</p>
<p>As founder and director of the <a href="https://www.vanderbilt.edu/crmh/">Center for Research on Men’s Health at Vanderbilt University</a> and as a postdoctoral fellow from Meharry Medical College, we study why men live shorter lives than women, male attitudes about fatherhood, how to help men engage in healthier behavior – as well as what can be done to reduce men’s risk of Type 2 diabetes and heart disease.</p>
<h2>Work, sex and health</h2>
<p><a href="https://journals.sagepub.com/doi/full/10.1177/1524839915614800">Working with men</a> to try to get them to be more physically active, eat healthier and maintain a healthy weight, we found that for many, their own physical and mental health is not high on their list of priorities. Men, we found, treat their bodies as tools to do a job. Health is not always important or something they pay much attention to <a href="https://journals.sagepub.com/doi/pdf/10.1177/1363459306061787">until poor health gets in the way</a> of their ability to go to work, have sex or do <a href="https://journals.sagepub.com/doi/abs/10.1177/1363459306061787">something else</a> important to them. These roles and responsibilities are often the ways they define themselves as men and how others in their lives define their worth.</p>
<p>While many aspects of gender roles have changed, we have found that many men still recognize they are often <a href="https://psycnet.apa.org/record/2005-03190-004">defined as good</a> or successful if they have paid employment that is enough to <a href="https://jamanetwork.com/journals/jama/article-abstract/204078">take care</a> of their children and other responsibilities. Fathers generally aspire to be able to look after their children, spouse, partner or other loved ones. That may mean <a href="https://www.sciencedirect.com/science/article/pii/S0277953615300149">less sleep, longer hours</a> at work and less free time for hobbies and exercise. </p>
<p>Wanting to be a great dad can motivate men to push themselves to work longer and harder than they may have thought possible, but these <a href="https://link.springer.com/chapter/10.1007/978-3-319-43847-4_13">choices can come at a cost</a>, particularly if they also are not making time to take care of themselves.</p>
<p>We have seen <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2019.305002">evidence of despair</a>, such as depressive symptoms, having thoughts of suicide, heavy drinking and marijuana use, among adults in their 20s and 30s. These behaviors tend to be <a href="https://www.routledge.com/Mens-Health-Equity-A-Handbook-1st-Edition/Griffith-Bruce-Thorpe-Jr/p/book/9781138052970">higher in men</a> during the time when they tend to become <a href="https://www.bgsu.edu/content/dam/BGSU/college-of-arts-and-sciences/NCFMR/documents/FP/FP-11-04.pdf">fathers for the first time</a>. Consistent with this pattern, <a href="https://www.cdc.gov/minorityhealth/lcod/men/2018/all-races-origins/index.htm#age-group">unintentional injuries and suicide</a> are leading causes of death for men across racial and ethnic groups in their 20s and 30s. This is not the case for women. </p>
<p>By age 45, <a href="https://www.cdc.gov/minorityhealth/lcod/men/2018/all-races-origins/index.htm#age-group">heart disease and cancer</a> are the leading causes of death for all groups of men. These chronic diseases can be prevented, to some degree, by not smoking, <a href="https://www.cancer.org/healthy/eat-healthy-get-active/acs-guidelines-nutrition-physical-activity-cancer-prevention.html">eating healthier foods and drinking less alcohol</a>. Also, improving sleep, sitting less and moving more are important behaviors for good health. </p>
<p>Rather than trying to restart these behaviors after taking a break from them for a number of years, <a href="https://www.liebertpub.com/doi/pdf/10.1089/obe.2009.0507?casa_token=TBCRrHGlFuUAAAAA%3AMZZB_6knyTpgfuXwoMpl7L9oqbbYL0j76NXNv--bZ5NNay7Ijbdsu_PxJJ7HpD6CaZv3tUBys99f8B7T&">studies have found</a> that it is important to help men keep healthy behaviors a part of their lives as they age. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/279427/original/file-20190613-32366-1s1a696.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/279427/original/file-20190613-32366-1s1a696.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/279427/original/file-20190613-32366-1s1a696.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/279427/original/file-20190613-32366-1s1a696.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/279427/original/file-20190613-32366-1s1a696.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/279427/original/file-20190613-32366-1s1a696.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/279427/original/file-20190613-32366-1s1a696.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Men’s health needs and the relationship with their children change as they age.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/father-children-enjoying-camping-holiday-countryside-181239371?src=VtEE0P298PSHJO-k4FtyIQ-1-13&studio=1">Monkey Business Images/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>As men age, they may not make <a href="https://www.sciencedirect.com/science/article/pii/S0277953615300149">deliberate choices</a> to engage in less healthy behavior, but they may just do so because their lives and environments make unhealthy choices easier than healthy ones. Policymakers have to think about how to make it easier to make healthy choices in men’s daily lives and to incorporate health into the time fathers spend with children and family or at work. Men don’t have <a href="https://www.researchgate.net/profile/Eva_Roos/publication/6620399_Multiple_socio-economic_circumstances_and_healthy_food_habits/links/0deec531ee0fd2725a000000/Multiple-socio-economic-circumstances-and-healthy-food-habits.pdf">equal access</a> to healthy foods or the same opportunities to go to the doctor, be physically active or earn a living wage, and yet, if asked, <a href="https://www.sciencedirect.com/science/article/pii/S0277953606004217">they all want</a> to be healthy and have a positive influence on their children and families. </p>
<p>Where does making time for their own mental and physical health fit into dads’ busy, stressful lives? We have found that it will be different for every father, but loved ones have to help them find a way. Based on our research, we believe that families, particularly women in men’s lives, can play an important role in encouraging fathers to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374446/">eat healthier</a> and take <a href="https://psycnet.apa.org/record/2012-12108-001">better care</a> of their health. </p>
<p>Wives in particular often provide emotional support, offer advice, facilitate men going to the doctor and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/pon.4572">promote healthy behavior</a>. Wives, daughters and other women in fathers’ lives are <a href="https://journals.sagepub.com/doi/full/10.1177/1557988313480227">important sources</a> of information about men’s health, and they often play a key role in helping fathers and other men better understand and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4519397/">cope with stress</a>.</p>
<p>As we celebrate fathers, it is important to recognize that fathers, generally speaking, may not place health at the top of their priorities. Many fathers gladly sacrifice to see their children happy, safe and successful. The problem is that if fathers think only about these goals, their own health can often suffer.</p>
<p>[ <em><a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=thanksforreading">Thanks for reading! We can send you The Conversation’s stories every day in an informative email. Sign up today.</a></em> ]</p><img src="https://counter.theconversation.com/content/118498/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Derek M. Griffith receives funding from the American Cancer Society and the National Institutes of Health. Dr. Griffith also is a volunteer for the American Cancer Society. </span></em></p><p class="fine-print"><em><span>Elizabeth C. Stewart's postdoctoral research fellowship is funded by National Institute of Minority Health and Health Disparities. </span></em></p>Two experts ask whether dads are making their health a priority. Evidence suggests not. Pressures to provide income often hold fathers back.Derek M. Griffith, Professor of Health Systems Administration and Founder and Co-Director of the Racial Justice Institute, Georgetown UniversityElizabeth C. Stewart, Postdoctoral Fellow, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1187052019-06-12T12:06:27Z2019-06-12T12:06:27ZMale victims of domestic abuse face barriers to accessing support services – new study<figure><img src="https://images.theconversation.com/files/279133/original/file-20190612-32366-1n0y61s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Men fear they will be accused of being the perpetrators.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1006008367?src=hjEt4_1TRVVtWP8FpIbl6w-1-23&size=medium_jpg">Mivolchan19/Shutterstock</a></span></figcaption></figure><p>Men who experience domestic violence and abuse face significant barriers to getting help and access to specialist support services, our <a href="https://bmjopen.bmj.com/content/9/6/e021960">latest study</a> shows.</p>
<p>Although the amount, severity and impact of domestic violence and abuse experienced by women is much higher than that experienced by men, men can also suffer significantly as a result of abuse from a partner, ex-partner or an adult family member. </p>
<p>An <a href="https://bmjopen.bmj.com/content/5/5/e007141">earlier study</a> of 1,368 male patients in GP clinic waiting rooms in the UK found that more than one in four had experienced abusive behaviour from a partner or ex-partner. They were also between two and three times more likely to have symptoms of depression and anxiety.</p>
<p>The experiences of many men who are survivors of domestic violence and abuse are similar to those of women. Like female survivors, they find it hard to identify coercion and control as abuse, and to disclose to healthcare professionals that the person who is supposed to love and protect them is harming them. Although they want the abuse to stop and to protect their children from the impact of abuse, they might not necessarily want to end the relationship. </p>
<p>Despite these similarities, the needs of male survivors have been comparatively neglected. Although men also need specialist support, they often face scepticism from healthcare professionals when they disclose this information. </p>
<p>We undertook a review of qualitative studies exploring the barriers to seeking help and the experiences of male victims of domestic violence and abuse in accessing services. Our paper, published in <a href="https://bmjopen.bmj.com/content/9/6/e021960">BMJ Open</a>, not only brings together findings not previously reviewed and synthesised, but also provides evidence for developing services to support men who have suffered domestic violence and abuse. </p>
<p>Our findings confirm what has been found in previous studies about barriers men face in seeking help. It has also given us new insights into what hinders and helps professionals and services to provide effective support.</p>
<p><audio preload="metadata" controls="controls" data-duration="108" data-image="" data-title="‘Steven’s’ story." data-size="1732023" data-source="" data-source-url="" data-license="" data-license-url="">
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‘Steven’s’ story.
</div></p>
<p><em>Steven’s story (not his real name) illustrates how difficult it can be for men to seek help and the challenges for health professionals to respond effectively.</em></p>
<h2>Reasons for not seeking help</h2>
<p>The main reason men don’t seek help is a fear of not being believed, embarrassment at talking about the abuse, and the feeling of being “less of a man”. Men also worried about the welfare of their partner, damaging their relationship or losing contact with their children if they opened up to someone outside their personal network of family and friends. Others lacked the confidence to seek help as a result of the abuse. </p>
<p>The study also found that men were often not aware of specialist support services or felt they were not appropriate for male survivors of abuse. When men did seek help, they did so usually when their situation had reached a crisis point. While both men and women are reluctant to seek professional help for their abuse, there is an added barrier for men: many fear being falsely accused of being the perpetrator. </p>
<p>Confidentiality was very important to those seeking help from services, as were trust and a non-judgemental attitude. Male survivors raised the importance of the continuity and quality of relationships with professionals to whom they disclose the details. Even if they did not report abuse at the time of a crisis, a positive interaction with a professional influenced their decision to disclose the violence and abuse they experienced at a later date. </p>
<p>There were mixed views about how easy it was to open up to doctors and many men said they preferred to get help from a female professional. </p>
<p>We recommend that services should be more inclusive and tailored more effectively to address the needs of diverse male survivor groups, including those in same-sex relationships. Services should offer ongoing support and be widely advertised. Images and wording of publicity materials for services should represent different types of masculinity and sexuality. Also, health professionals need specialised training to address the specific needs of men and to foster greater levels of trust.</p><img src="https://counter.theconversation.com/content/118705/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Eszter Szilassy receives funding from the National Institute for Health Research.
This is independent research funded by the National Institute for Health Research (Programme Grants for Applied Research, REPROVIDE (Reaching Everyone Programme of Research On Violence in diverse Domestic Environments, RP-PG-0614-20012). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care.</span></em></p>Many men who experience domestic abuse or violence are too embarrassed to seek help.Eszter Szilassy, Research Fellow at the Centre for Academic Primary Care, University of BristolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1143002019-03-27T18:42:06Z2019-03-27T18:42:06ZHow challenging masculine stereotypes is good for men<figure><img src="https://images.theconversation.com/files/266034/original/file-20190327-139377-jgy2oa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Men are much less likely than women to seek help for depression and anxiety, and a host of physical conditions.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/DsAjH9B24G8">Karl Fredrickson</a></span></figcaption></figure><p>A man sits in a doctor’s office after months of his wife’s increasingly desperate pleas for him to seek professional help for his constant coughing. In the end, she was the one who booked his appointment and even drove him there.</p>
<p>Another man is meeting with his manager, anticipating derision and mockery when he mentions he needs to reduce his workload to accommodate the birth of his first child.</p>
<p>A third man has a violent encounter outside a pub, fuelled by binge drinking and machismo. He cops a blow to the head and crumples, hitting his head against the pavement.</p>
<p>These aren’t just stereotypes of men. They are the types of experiences and outcomes that reliably differ between men and women. <a href="https://bmjopen.bmj.com/content/3/8/e003320.short">Men are 32% less likely</a> to visit a health professional than women. Men are also <a href="https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-016-0440-0">less likely</a> to seek therapy for psychological complaints, such as feeling down or anxious.</p>
<p>Men also experience higher rates of <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4125.0%7ESep%202018%7EMain%20Features%7EHealth%7E6">suicide</a> and <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4125.0%7ESep%202018%7EMain%20Features%7EHealth%7E6">motor accidents</a>, are more likely to <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4125.0%7ESep%202018%7EMain%20Features%7EHealth%7E6">drink excessively</a> and smoke, and are more prone to serious health conditions such as <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4125.0%7ESep%202018%7EMain%20Features%7EHealth%7E6">heart attacks, strokes, and vascular disease</a>.</p>
<p>Similarly, men are more likely to both <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4906.0%7E2016%7EMain%20Features%7EExperience%20of%20Violence%7E4">perpetrate and experience</a> violence, and to adopt beliefs and behaviours that increase the risk of violence.</p>
<hr>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/how-can-we-make-families-safer-get-men-to-change-their-violent-behaviour-113451">How can we make families safer? Get men to change their violent behaviour</a>
</strong>
</em>
</p>
<hr>
<p>It is no surprise that men die <a href="https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/life-expectancy">four years earlier</a>, on average, than women. A woman can expect to live to just over 84, while a man can expect to live to just over 80.</p>
<p>In a bid to improve men’s health and well-being, the American Psychological Association (APA) recently released <a href="https://www.apa.org/about/policy/boys-men-practice-guidelines.pdf">guidelines for psychologists when working with boys and men</a>. </p>
<p>These guidelines complement the APA’s 2007 guidelines for working <a href="https://www.apa.org/practice/guidelines/girls-and-women">with girls and women</a>. Both guidelines share commonalities, such as focusing on gender-appropriate therapeutic practices and education. </p>
<p>The APA is acknowledging that gender issues are relevant to everyone, not just women, and that the experiences of men may differ to those of women. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/266051/original/file-20190327-139345-v1pc41.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/266051/original/file-20190327-139345-v1pc41.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=577&fit=crop&dpr=1 600w, https://images.theconversation.com/files/266051/original/file-20190327-139345-v1pc41.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=577&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/266051/original/file-20190327-139345-v1pc41.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=577&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/266051/original/file-20190327-139345-v1pc41.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=725&fit=crop&dpr=1 754w, https://images.theconversation.com/files/266051/original/file-20190327-139345-v1pc41.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=725&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/266051/original/file-20190327-139345-v1pc41.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=725&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The guidelines aim to dismantle the ideas that make it difficult for boys and men to express emotions and seek help.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/U2uMgZAZAnw">Annie Spratt</a></span>
</figcaption>
</figure>
<p>But despite the positive intentions of the guidelines, their release was met by backlash and unfounded criticisms in some parts of the media.</p>
<h2>What do the guidelines actually say?</h2>
<p>The guidelines aim to challenge some aspects of traditional masculinity that might cause problems in men’s lives. </p>
<p>Traditional masculinity encompasses a set of norms, ideas and beliefs about what it means to be a man. Such beliefs include identifying men as self-reliant, emotionally reticent, focused on work over family, and oversexed.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/more-than-half-of-aussie-men-report-experiencing-sexual-difficulties-113848">More than half of Aussie men report experiencing sexual difficulties</a>
</strong>
</em>
</p>
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<p>When these beliefs are taken to an extreme level, they can result in poor outcomes for men, such as being dissatisfied in <a href="https://psycnet.apa.org/record/2005-13712-003">romantic relationships</a>, having <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fcou0000176">mental health</a> problems, <a href="https://jss.org.au/what-we-do/the-mens-project/the-man-box/">and engaging in more risky behaviours</a>.</p>
<p>To illustrate the impact of these traditional ideas of masculinity on men’s health and well-being, let’s look at three of the ten APA recommendations in detail.</p>
<p>First, the guidelines urge psychologists to address the high rates of problems like violence, substance abuse, and suicide, which are more commonly experienced by men. </p>
<p>The guidelines highlight the link between beliefs about traditional forms of masculinity and the encouragement of aggressive behaviour in boys by family, peers and the media. As a result, men are more likely to display <a href="https://www.bjs.gov/content/pub/pdf/htus8008.pdf">violent behaviours</a> and to <a href="https://ucr.fbi.gov/crime-in-the-u.s/2013/crime-in-the-u.s.-2013/offenses-known-to-law-enforcement/expanded-offense/">be victims of violence</a>.</p>
<p>The guidelines also highlight the negative links between male childhood abuse and victimisation, and later aggressive behaviour, suicidal thoughts, and substance abuse. </p>
<p>Recognising these patterns offers an opportunity for therapists to engage in gender-appropriate conversations and tailor behavioural change to the problems that plague men.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/clementine-ford-reveals-the-fragility-behind-toxic-masculinity-in-boys-will-be-boys-103760">Clementine Ford reveals the fragility behind 'toxic masculinity' in Boys Will Be Boys</a>
</strong>
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<p>Second, the guidelines highlight the importance of encouraging men’s positive involvement in families. </p>
<p>Despite increasing numbers of dual-income households, there is still strong social pressure for men to be the providers and breadwinners rather than taking on nurturing and caring roles. This expectation can come at the expense of men’s relationships with their partners, children and extended family.</p>
<p>Encouraging men’s positive involvement with their families has been shown to improve health and well-being outcomes for <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1741-3737.2010.00702.x">men</a>, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1651-2227.2007.00572.x">their children</a> and their <a href="https://journals.sagepub.com/doi/abs/10.1177/0192513X13479948">partners</a>. </p>
<p>It may have spillover benefits in making work practices more progressive, with better balance between paid work and time spent with loved ones.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/266045/original/file-20190327-139364-16r36di.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/266045/original/file-20190327-139364-16r36di.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/266045/original/file-20190327-139364-16r36di.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/266045/original/file-20190327-139364-16r36di.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/266045/original/file-20190327-139364-16r36di.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/266045/original/file-20190327-139364-16r36di.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/266045/original/file-20190327-139364-16r36di.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Everyone benefits when men take on more nurturing roles.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/TMpQ5R9mbOc">Caroline Hernandez</a></span>
</figcaption>
</figure>
<p>Third, the guidelines highlight the need for boys and men to more willingly seek help and health care. </p>
<p>Men are more likely than women to die from diseases such as <a href="https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2014-2016.pdf">colorectal cancer</a>, which can be prevented with the right health care. </p>
<p>In terms of mental health, men’s <a href="https://promundoglobal.org/resources/man-box-study-young-man-us-uk-mexico/">reluctance to express emotions</a> and seek help through therapy may underlie the high rates of self-harm and suicide.</p>
<p>Traditional masculinity also encourages risky and competitive actions in men, resulting in <a href="https://www.cdc.gov/healthequity/lcod/men/2015/all-males/index.htm">unintentional injuries being the leading cause of death</a> in men under 45.</p>
<p>According to the guidelines, we need to shift beliefs around self-reliance so men feel more comfortable looking after themselves and seeking professional help and services when needed.</p>
<p>Taken together, the APA guidelines have the potential to improve the lives of men. The guidelines squarely focus on the disparities in outcomes between men and women, and provide clear suggestions on improving men’s well-being through strategies like strengthening family engagement and changing attitudes towards embracing healthy behaviours.</p>
<p>Many non-profit organisations and advocacy groups are already taking on this challenge to encourage healthy masculinity among boys and men. <a href="https://www.ourwatch.org.au/">Our Watch</a>, Australia’s national foundation to prevent violence against women and their children, for instance, provides resources and articles for young people on masculinity and what it means to be a man through their campaign, <a href="https://www.theline.org.au/">The Line</a>.</p>
<p>By recognising that gender also affects men, we can move towards improving the way that clinicians, practitioners and society support boys and men.</p>
<hr>
<p><em>This article is a co-publication with <a href="https://pursuit.unimelb.edu.au/">Pursuit</a>.</em></p><img src="https://counter.theconversation.com/content/114300/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Stratemeyer works for The University of Melbourne. </span></em></p><p class="fine-print"><em><span>Adriana Vargas Saenz works for The University of Melbourne.</span></em></p><p class="fine-print"><em><span>Elise Holland works for Our Watch.</span></em></p>Traditional notions of masculinity affect the health and well-being of men and those around them. Here’s how we can challenge these stereotypes.Michelle Stratemeyer, Associate Lecturer, School of Psychological Sciences, The University of MelbourneAdriana Vargas Saenz, PhD Candidate, School of Psychological Sciences, The University of MelbourneElise Holland, Honorary Research Fellow, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1138482019-03-21T18:56:22Z2019-03-21T18:56:22ZMore than half of Aussie men report experiencing sexual difficulties<figure><img src="https://images.theconversation.com/files/265050/original/file-20190321-93039-8qm4sk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many men were concerned about climaxing too quickly or lacking interest in sex.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/RnR12I78SFo">Krista Mangulsone</a></span></figcaption></figure><p>One in two Australian men aged 18 to 55 have experienced sexual difficulty in the past 12 months, according to <a href="https://www.aihw.gov.au/reports/men-women/male-health/contents/how-healthy">data</a> released this week. </p>
<p>The findings are drawn from the <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3705-6">Australian Longitudinal Study on Male Health</a>, which included more than 12,000 men. Overall, 54% of sexually active men reported having at least one specific sexual problem lasting three months or more. </p>
<p>The men reported a range of difficulties:</p>
<ul>
<li>37% said they reached climax too quickly</li>
<li>15% could not climax or took too long to climax</li>
<li>17% lacked interest in sex</li>
<li>11% felt anxious during sex.<br></li>
</ul>
<p>Erectile dysfunction – defined as trouble getting or keeping an erection – tends to be the focus of media and public discussion about male sexual “problems”. But in this study, only 20% of men aged between 45 to 55 reported erectile dysfunction, and only 14% across all age groups. </p>
<h2>Why do so many men report sexual difficulties?</h2>
<p>Male sexual difficulties are associated with a range of <a href="https://www.nhs.uk/live-well/sexual-health/male-sexual-problems/">physical, psychological or social factors</a> including anxiety, stress and relationship difficulties. </p>
<p>In the <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3705-6">Australian Longitudinal Study on Male Health</a>, men who rated their overall health to be poor were more likely to report one or more sexual difficulties. Disability, mental health diagnoses, obesity, drug and alcohol use, and daily use of pain medication were all associated with an increased likelihood of some form of sexual difficulty. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/erectile-dysfunction-may-be-more-than-just-a-problem-in-bed-21528">Erectile dysfunction may be more than just a problem in bed</a>
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<p>The inability to have a satisfying sexual life can negatively impact <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075511/">quality of life</a>. Discussing concerns about men’s sexual lives should form part of general clinical care, particularly for men with other <a href="https://www.mja.com.au/journal/2003/179/5/chronic-illness-and-sexuality">health conditions</a> that may cause sexual difficulties. </p>
<h2>Performance or pleasure?</h2>
<p>The <a href="https://andrologyaustralia.org/sexual-difficulties/">medical diagnosis</a> of male sexual difficulties or problems tends to be based on performance (erectile function and ability to climax) rather than pleasure or intimacy. </p>
<p>This rests on assumptions that the primary, if not only, source of sexual pleasure for men comes from the performance of sexual penetration – which requires an erection and orgasm. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/265065/original/file-20190321-93051-a2va1a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/265065/original/file-20190321-93051-a2va1a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/265065/original/file-20190321-93051-a2va1a.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/265065/original/file-20190321-93051-a2va1a.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/265065/original/file-20190321-93051-a2va1a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/265065/original/file-20190321-93051-a2va1a.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/265065/original/file-20190321-93051-a2va1a.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many concerns about sexual function relate to performance rather than pleasure.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/633418673?size=huge_jpg">Fergus Coyle/Shutterstock</a></span>
</figcaption>
</figure>
<p>However, <a href="https://www.psychologytoday.com/us/blog/sex-life-the-american-male/201501/what-exactly-is-sexual-satisfaction-1">studies</a> show <a href="https://link.springer.com/article/10.1007/s10508-016-0918-9">many men define sexual pleasure</a> and sexual satisfaction in other terms. This includes the experience of desire, disinhibition, peace and happiness, as well as by giving pleasure and feeling bonded with another person. </p>
<p>While achieving orgasms is part of this, it’s not necessarily the primary goal. </p>
<h2>Masculinity and male sexuality</h2>
<p>The dominant cultural image of masculine sexuality is one of omnipresent sexual desire. <a href="https://journals.sagepub.com/doi/abs/10.1177/1097184X00003001004">Male vitality and virility</a> are associated with a high sex drive. And it’s often assumed men will initiate and lead sexual encounters with women. </p>
<p>Sexual intercourse (penetrative sex with a penis and vagina) is positioned as the <a href="https://www.psychologytoday.com/us/blog/the-big-questions/201709/what-counts-sex">most desired and important sexual act</a> for heterosexual couples. </p>
<p>These images are created and reinforced through media messages – advertising, film and television – as well as through <a href="https://www.tandfonline.com/doi/pdf/10.1300/J015v24n01_20?needAccess=true">marketing of medical “solutions”</a> to male sexual problems. These increasingly come in the form of drugs such as Viagra that promote a sustained erection as the ultimate goal for male sexual satisfaction.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/weekly-dose-the-hard-facts-on-viagra-58289">Weekly dose: the hard facts on Viagra</a>
</strong>
</em>
</p>
<hr>
<p>Even if a man’s personal experience of sexual pleasure and desire is more nuanced or passive, cultural images of sexuality set normative standards for the ways people make sense of their own bodies, sexual desires and sexual experiences.</p>
<p>So it makes sense that men might feel anxious about their sexual performance and be concerned about a lack of sexual desire, not climaxing at the right pace (or at all), or not being able to sustain an erection. </p>
<p>This doesn’t mean these issues aren’t genuine challenges or problems for these men. Rather, it points to cultural pressure on men to enact a particular type of sexuality. </p>
<p>A <a href="https://www.tandfonline.com/doi/abs/10.1080/00224499.2013.860072">2014 Australian study</a> investigated the effects of these pressures on the sexual function of 140 male participants. The researchers found men who were exposed to cultural images of traditional masculinity had significantly higher levels of sexual beliefs that increase vulnerability to sexual dysfunction than those who weren’t. </p>
<h2>Challenging gendered sexual stereotypes</h2>
<p>Expectations of masculinity shape the way men understand sexuality and their bodies in the same way feminine stereotypes affect women’s experiences of sex, sexuality and their bodies.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/265067/original/file-20190321-93032-wh25v5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/265067/original/file-20190321-93032-wh25v5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/265067/original/file-20190321-93032-wh25v5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/265067/original/file-20190321-93032-wh25v5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/265067/original/file-20190321-93032-wh25v5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/265067/original/file-20190321-93032-wh25v5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/265067/original/file-20190321-93032-wh25v5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">It’s time to rethink our cultural concepts of male sexuality.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/K2u71wv2eI4">Tim Marshall</a></span>
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<p>Expectations of masculinity also obscure the sexuality and experiences of people whose gender or sexual identity <a href="https://journals.sagepub.com/doi/full/10.1177/1363460712459158">doesn’t fit the traditional male/female gender binary</a>. </p>
<p>Feminist thinking and activism has exposed the <a href="https://journals.sagepub.com/doi/abs/10.1177/01461672992511012">emotional and social impact of unrealistic feminine sexual stereotypes</a>. It also provides a platform for questioning the impact of male sexual stereotypes. </p>
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Read more:
<a href="https://theconversation.com/clementine-ford-reveals-the-fragility-behind-toxic-masculinity-in-boys-will-be-boys-103760">Clementine Ford reveals the fragility behind 'toxic masculinity' in Boys Will Be Boys</a>
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<p>If more than half of Australian men are concerned about some aspect of their sex lives, we need to closely examine the cultural and political context of male sexuality. Medical or psychological definitions of male sexual difficulties only tell part of the story.</p><img src="https://counter.theconversation.com/content/113848/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Power receives research funding from the Australian Department of Health, the Victorian Department of Health and Human Services, the Australian Research Council and ViiV Healthcare. </span></em></p>Research suggests that men who are exposed to cultural images of traditional masculinity have a greater vulnerability to sexual dysfunction than those who aren’t.Jennifer Power, Senior Research Fellow at the Australian Research Centre in Sex, Health and Society, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.