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Should all patients be asked about their sexual orientation?

Should all patients be asked about their sexual orientation?


In late 2017, NHS England released guidelines recommending that health professionals ask all patients about their sexual orientation in order to improve services for non-heterosexual patients, but should they? Experts debate the issue in The BMJtoday.

After decades of campaigning from lesbian, gay, bisexual and trans (LGBT) charities, sexual orientation is now a protected characteristic that is written into the Equality Act 2010. General practitioner and research fellow Richard Ma, from Imperial College London says all patients should be asked about their sexual orientation.

Ma comments that it would seem like a welcome step for NHS England to include sexual orientation monitoring in  and social care systems.

“Some doctors and patients have expressed concerns about this policy, citing reasons such as intrusion or invasion of privacy, fear of causing offence, doubts about relevance, data security” he says. “Whilst I understand these concerns, they result in inertia; and failure to act undermines hard fought rights of LGBT patients to better healthcare.”

Ma states there are flaws in recognising LGBT health needs. A survey of nearly 7000 gay and bisexual men, commissioned by LGBT charity, Stonewall, shows that smoking, alcohol, and drug use were more prevalent in this group compared to men in general.

“Sexual orientation monitoring is necessary to make the health service for LGBT patients fairer. If we don’t count our LGBT patients, they don’t count.” Ma concludes.

But Michael Dixon, a , says that it should be up to the individual judgement of GPs as to when it’s appropriate or useful to ask such questions about patient sexual .

He says that whilst there are health benefits from knowing a patient’s sexuality, the approach of asking ‘all’ patients is wrong.

“Apparently this is all to stop discrimination under the Equality Act, but surely the best way to avoid discrimination is by not knowing people’s sexuality in the first place” he says.

“In good medical practice, the patient’s own needs, wishes, choices, beliefs, culture, and perspective should come first – not the rules or diktats of any higher body” he concludes.

In a linked patient commentary, Tamás Bereczky, from the European AIDS Treatment Group, says whilst discussing  between doctors and  can be embarrassing, healthcare professionals should be able to talk about all sensitive topics.

“Visibility and honest discussion can also eventually reduce stigma” he concludes.

Provided by: British Medical Journal

Lesbian sexual health neglected by healthcare and education, researchers find

Lesbian sexual health neglected by healthcare and education, researchers find

Due to the AIDS crisis and the HIV epidemic, sexual-health initiatives within LGBT communities have historically been heavily geared toward addressing men who have sex with men (MSM). Meanwhile, sex education in schools has used opposite-sex partners as its primary focus.

Unfortunately, research is revealing that several groups have been neglected in the process.

A new study led by researchers from the University of British Columbia reveals that although lesbian and female-bisexual teens face a higher risk of sexually transmitted infections (STIs) than their heterosexual counterparts, raising awareness of safe sex between women has been overlooked.

In the study, published in the Journal of Adolescent Health on December 28, 160 U.S. girls aged 14 to 18 participated in online focus groups based on whether or not they were sexually experienced.

What the researchers discovered was related to the exclusion of LGBT issues from mainstream sexual-health programs and preconceived ideas about gender.

The researchers identified four main themes as to why participants did not use latex barriers during sex.

A recurring theme was a concern about sexual pleasure or mood being reduced by awkwardness or discomfort. The study’s authors pointed out that sexual-health-promotion interventions have faced challenges in raising awareness of how pleasure can be increased by some STI–prevention methods, such as female condoms that stimulate the clitoris or lubrication on the underside of a dental dam.

Despite these issues, participants did express a willingness to use barriers in the future. Nonetheless, many participants preferred to use STI testing as a safe-sex strategy to determine whether or not they needed to use barriers. For instance, if both partners tested “clean” or “STD-free”, participants didn’t feel they needed to use barriers.

Another reason for avoiding barriers was the idea that sex with another female is low-risk due to the impossibility of impregnation. Several participants also stated that they trusted their female partners more than male partners regarding STIs.

However, the researchers pointed out that the exchange of vaginal fluid by mouth, fingers, or sex toys can transmit STIs; the human papilloma virus (HPV) can be spread by skin-to-skin contact; and genital HPV has been found on fingers, sterilized forceps, and surgical gloves (making transmission via sex toys possible).

The researchers also found that the participants often lacked awareness of safe-sex practices for sexual activity between women and lacked knowledge of the risks involved.

One 18-year-old participant said that when she started having sex, she couldn’t find any online information about safe sex for lesbians. A 15-year-old girl pointed out she had never been taught about STI transfer between female partners. Meanwhile, others were unaware of dental dams (for use during oral sex) or where to obtain them, and still others mentioned that LGBT sex was excluded from heterosexual-based sex education at school.

The researchers noted that the bias toward focusing on men as transmitters of STIs was prevalent within health-care systems, as female-to-female transmission of STIs was only considered once male-to-female transmission was ruled out.

The findings of this study recalls themes of a 2016 UBC–led research paper about transgender youth and sexual activity that pointed out similar gaps due to preconceived notions about which sexual issues are relevant to LGBT people. That study revealed—contrary to assumptions that pregnancy concerns were not relevant to transgender youth—that trans teens and their cisgender counterparts were equally at risk of being involved with pregnancy.

Consequently, such analyses highlight the need to rectify these areas of omission and oversight in both health care and education in order to achieve equality in treatment within health-care systems.

Cycling Won’t Sabotage a Man’s Sex Life: Study

Cycling Won’t Sabotage a Man’s Sex Life: Study

Men who are avid cyclists needn’t worry that hours spent on the bike will translate into problems in the bedroom or bathroom, new research claims.

Reportedly the largest study of its kind involving bikers, swimmers and runners, the findings buck prior reports that cycling could harm sexual or urinary function due to prolonged pressure on the buttocks and the perineum (the area between the scrotum and the anus).

The results provide some reassurance that cycling doesn’t harm the perineum any more than swimming and jogging do, said study author Dr. Benjamin Breyer, a urologic surgeon at the University of California, San Francisco.

“Those athletes [swimmers and runners] also have erectile dysfunction,” he explained. “The truth of the matter is, many men develop erectile dysfunction, but I think if you ride safely the health benefits of cycling are tremendous. The benefits to overall health far outweigh other concerns.”

Cycling, whether done for leisure or transportation, has become increasingly popular, Breyer said. But the activity has received much attention for its potential effects on sexual and urinary health.

“I think a lot of effort goes into cycling from some men to protect their perineum by wearing padded shorts and using different seat types,” he said.

The new research on men surveyed 2,774 cyclists, 539 swimmers and 789 runners. All completed several research-validated questionnaires about sexual health, prostate symptoms, urinary tract infections, genital numbness and saddle sores, among other factors.

Cyclists were also asked about their bike type, saddle (seat) type and angle, frequency of wearing padded shorts, percentage of time spent standing out of the saddle, handlebar type and type of surface on which they usually ride. The cyclists were split into a high-intensity group (cycling more than two years more than three times weekly and averaging more than 25 miles per day) and a low-intensity group.

Notably, high-intensity cyclists logged better erectile function scores than low-intensity cyclists.

Also notably, cyclists did experience more than twice the incidence of scarring or narrowing in the urethra — a condition known as urethral strictures — compared to swimmers or runners. The condition can affect the flow of urine from the body. But cyclists’ sexual and urinary health was comparable overall to the other athletes.

Among cyclists, those standing more than 20 percent of the time while cycling significantly cut their odds of experiencing any genital numbness. Additionally, having handlebar height lower than seat height increased the odds of genital numbness and saddle sores.

Urethral strictures “are such an uncommon event that I wouldn’t keep people from riding,” Breyer said. “I would try to avoid riding habits that result in really significant numbness in the perineum for really long periods.” Instead, he suggested men adopt more of these practices: getting out of the saddle, wearing protective shorts, using a seat that has a cutout, and getting an appropriate bike fitting.

Other urologists praised the study design, saying the comparison between cyclists and other athletes added strength to the findings.

“In my experience with bicyclists, this really reflects what I see,” said Dr. Brian Miles, a urologist at Houston Methodist Hospital in Texas. “Erectile dysfunction, of course, happens to men as they age for various reasons, but with cyclists, their rate seems to be no different in my experience.”

Dr. Aaron Katz is chairman of urology at NYU Winthrop Hospital in Mineola, N.Y. He said the findings were a little surprising, “because as a urologist who’s been in the field for many years, we’ve had this notion that prolonged cycling can have an effect on sexual function.

“But those studies were older and didn’t use a [similar] cross-sectional analysis,” Katz added. “I was really happy to see this study. I think it will allow men who are cycling to continue and not be so worried about it.”

The study is published in the March issue of The Journal of Urology.

More information

The American Sexual Health Association offers more on men’s sexual health.

6 Things That Can Cause Penis Allergies After Sex

6 Things That Can Cause Penis Allergies After Sex


Pains on the surface of the penis, redness or itchiness are some common symptoms of a penis allergy and it can have a huge impact on a couple’s sex life.

All couples seek a healthy relationship with a satisfying sexual life. But no matter how sexually compatible they are, there are always chances that allergies or side-effects of the products used while sex, come in the way of happy couple who are having great sex. One such condition is men having penis allergies immediately after having intercourse. Pains on the surface of the penis, redness or itchiness are some common symptoms of a penis allergy and it can have a huge impact on a couple’s sex life.

While an expert medical attention is required to treat the condition, there are some steps that men can take in order to prevent having such allergies.

Here are some common triggers of penis allergies:

1. Diabetes

Rashes and red spots can develop on the skin because of high blood sugar level. An unusual sign of diabetes, this causes burning sensation and redness on the skin. Antibiotics or anti-allergens too seem to show no results. It is a clear symptom of balanitis and patient must get their blood sugar levels checked if this happens.

2. Latex condoms

Many men are allergic to condoms and may develop itchiness or redness on being exposed to condoms. People who work in the healthcare industry are most prone to such allergies as they wear latex gloves all day long. The spermicides that are present on the lining of the condoms and the dyes that are used to colour these products can cause allergic reactions in some men. There are latex-free condoms available in the market, which are slightly more expensive. But these are an effective rash-free solution.

3. Allergies

In some rare cases, some allergic reactions cause burning sensations, pain and itchiness on the penis. These allergies can be aggravated by pubic hair, female secretions or pubic lice.

4. Infections

Sexually transmitted diseases (STDs) are another possible reason for penis allergies after sexual intercourse. These include trichomonalis vaginalis (red spots on the penis), syphilis (boils on the penis after a few days of sexual intercourse with a person suffering from syphilis) and herpes (red spots on the genital area).

5. Products used by women

Many men are under the misconception that vaginal secretions are to be blamed for their penis allergies. But it is actually some of the products that women use which may be triggering these allergies. These products include creams, lotions, lubricants, perfumes, powders and soaps to name a few.

During sexual intercourse, the delicate skin of the penis might come in contact with these irritants, thus leading to rash or redness of the skin. To get the condition properly treated, medical attention is required. But if an emergency situation rises in the odd hours of the night, you can opt for hypoallergenic products or products which mention they are free of allergens and perfumes.

6. Lack of Lubrication

When couples indulge in sex in a hurry, it often leads to lack of lubrication in women. This causes red spots and abrasion of the skin on penis. However, this kind of sexual intercourse is more painful for women than men.

Ways to deal with penis allergies

Wearing breathable fabrics can go a long way in terms of preventing penis allergies. Also, prevent using lotions or creams as they can cause an adverse allergic reaction. You can penis health creams that are available in the market.

However, we do suggest taking medical assistance for treating penis allergies as a long-term method to prevent them.

Indian start-up ‘Buttalks’ is helping men buy better underwear

Indian start-up ‘Buttalks’ is helping men buy better underwear


At a time when internet-based companies are changing the way Indians pay bills, buy groceries, and commute, three Chennai-based entrepreneurs (Brijesh Devareddy, Surej Salim, and Manish Kishore) are using an e-commerce platform to help Indian men buy better underwear.

The start-up, called Buttalks, went live in August 2017, and already boasts of 1,400 customers, of whom 30% are annual subscribers.

What are their unique offerings?

India has had other innerwear start-ups like Zivame and Pretty Secrets, both of which preceded Buttalks. However, Buttalks is the first subscription-based, personalized innerwear start-up focusing solely on men’s innerwear.

Habits of Indian men with regard to underwear shopping

Despite the proliferation of e-commerce platforms, underwear shopping habits of Indian men remain backward, for the most part.

Buttalks’s initial research found that most men buy underwear in a somewhat mechanical manner without paying attention to what they exactly require.

Indian men also often do not know when it’s time to replace their underwear.

The size of the Indian innerwear market

The Indian innerwear market is expected to reach a valuation of Rs. 68,270 crore by 2024. According to consultancy firm Technopak, the men’s innerwear segment is currently worth Rs. 7,450 crore.

Health implicationsHealth implications of underwear habits

Apart from causing discomfort, ill-fitting and old, worn-out underwear has several health implications for men, implications which are often ignored and played down in Indian society.

According to Rajan Bhonsle, a professor and consultant in sexual medicine, wearing right-sized underwear has direct benefits for a man’s sexual health, while a proper fit helps reduce issues related to infertility.

Men’s health issues need to be highlighted too

“I see that there is so much ignorance about something as basic as this [choosing the right underwear]. This is something that’s never spoken about…women’s health issues have their space, but men’s issues lag behind. All these have to be highlighted,” added Bhonsle.

PackagesThe packages offered by Buttalks

Buttalks works through a subscription model wherein subscribers get periodic doorstep deliveries of underwear from the start-up.

The start-up offers three differently priced sampler or annual subscription plans starting at Rs. 999, the prices of which differ based on the brands that are included in a package.

Customers using the annual plan get three pairs of briefs four times a year.

What about Buttalks’s funding?

However, owing to the as yet unsuccessful subscription model, Buttalks faces many challenges in terms of funding. Although the start-up is set to close its first funding round soon, it remains boot-strapped so far. The co-founders also declined to share details of investors and revenues.

PersonalizationHow Buttalks personalizes underwear for a user

Regardless of one’s subscription plan, the briefs which go into boxes are personalized as per a user’s preferences.

Users have to fill out an exhaustive questionnaire while signing up so that Buttalks knows every customer’s preferences.

The questions range from a user’s preferred choice of fabric, colors, styles, and brands, to even users’ lifestyles.

Sexual partners shun CPR: Fewer than one in five men survive sex heart-attacks sex because their partners are reluctant to give the life-saving technique

Sexual partners shun CPR: Fewer than one in five men survive sex heart-attacks sex because their partners are reluctant to give the life-saving technique


  • Only a third of cases that occurred during intercourse received ‘bystander CPR’
  • This accounted for 20% of patients who survived to hospital discharge
  • Statistics come from 13-year study of 4,500 sudden cardiac arrests in Oregon
  • The technique has been found to double the chance of survival
  • Findings highlight importance of educating public on CPR method
  • Read on for a step-by-step guide to carrying it out by British Heart Foundation


Fewer than one in five men who suffer a cardiac arrest during sex survive, according to new research.

This is because their partner does not know how to perform a simple, life saving technique, say scientists.

It underlines the importance of teaching CPR (cardiopulmonary resuscitation) to the general population, they warned.

Sex is known to trigger a sudden cardiac arrest and this causes the heart to suddenly stop beating. It usually occurs without warning.

The 13-year study of more than 4,500 sudden cardiac arrests (SCAs) in Portland, Oregon, found only a third of cases that occurred during intercourse received ‘bystander CPR’.

It was determined this accounted for the less than 20 per cent of patients who survived to hospital discharge.

Experts say giving CPR can double the chances of survival of a cardiac arrest (stock image)

Experts say giving CPR can double the chances of survival of a cardiac arrest (stock image)

Doubles chance of survival

The British Heart Foundation says about 10,000 people die in the UK each year because bystanders do not know how to do CPR if they see someone having a cardiac arrest.

CPR involves giving regular chest compressions to make the heart pump blood around the body. It has been found to double the chance of survival.

Dr Chugh and colleagues showed although the overall risk of having a cardiac arrest during sex is low, death rates are high.

Only a small percentage of cases are related to sexual activity, but survival remains low.

The study published in the Journal of the American College of Cardiology said this was despite a partner being present.

Sex triggers heart attacks 

It results in around 350,000 deaths annually in the US, and about 100,000 in the UK. It is known sex may trigger cardiac arrests.

So the researchers looked at the community-based Oregon Sudden Unexpected Death Study (Oregon SUDS) database from 2002 to 2015 to discover their frequency during or within an hour after sex among over 18s.

All reported cases were based on emergency medical service reports containing detailed information regarding their cause.

In total, the researchers identified 4,557 during the study period, of which 34 (0.7%) were linked to sexual activity.

On average these patients were more likely to be male, middle aged, African-American and have a history of cardiovascular disease, with a majority taking medication for it.

Overall, the researchers said they found a relatively low burden of cardiac arrest in relation to sex.

Most cases were men with a previous history of cardiovascular disease. The researchers also noted some cases after sex may also involve medications, stimulants and alcohol use.

The latest study is the largest of its kind.

Earlier this year a much smaller French survey of just under 250 men found they were four times more likely to die when having a cardiac arrest during sex.

Just one in eight survived, compared to 50 percent for those who fell victim when doing other physical activities, such as sport or exercise.

That team suspected the reason was men are far less likely to call for help when they are naked.

Less than half of them were given CPR, compared to 80 percent of other cardiac arrest victims. They also had longer delays in getting treatment.

Scientists say the key to surviving is calling the emergency services immediately and starting treatment.

For every minute that the heart attacks passes untreated the chances of survival reduce by ten per cent. 

Source: British Heart Foundation 

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Samantha Jones would be so proud of the progress women’s sexual and reproductive health has made in recent years: Non-toxic tampons have gone mainstream, sex toys are getting a fem-positive makeover, and women aren’t just talking about their orgasms, they’re figuring out how to biohack them. But there’s one goodie drawer item that’s still kept pretty hush-hush: lube.

According to Aimee Eyvazzadeh, MD, a board-certified OB-GYN and reproductive endocrinologist, it’s time to pay more attention to the ingredients in your lube, which can impact your endocrine system, your fertility, and even your susceptibility to STDs. Don’t recall learning that in sex ed? Yeah, same.

Packaging matters more than you might think

You may already know to look for BPA-free water bottles and food containers, but have you ever considered how plastic packaging can affect your lube? “When it comes to plastics, there is so much data out there about BPA and those types of toxins, so you should absolutely care about the plastic containers that water- or silicone-based lubes are sitting in,” says Dr. Eyvazzadeh.

The first reason for concern: BPA is one of many potential hormone-disrupting chemicals that can migrate from packaging into the product it carries. And “the vagina is like a sponge,” says Dr. Eyvazzadeh. “Whatever you put in, it can get absorbed.” So do the math: If it’s in the packaging, it’s likely also in the product—and yes, it’s likely in your body, too.

Considering that the way BPA accumulates in the body can impact your reproductive health and your fertility, maybe save toxic plastics for your next screening of Mean Girls—and definitely leave them off your bedside table. Instead, look for products that come in BPA-free plastic (like those by Good Clean Love, which uses plastic made from recycled sugar cane), or opt for lubricants you find in your pantry (more on that later).

Dr. Eyvazzadeh points to parabens and pthalates as preservatives to avoid when scanning your lube’s ingredients label. “They’re cheap and effective preservatives and allow for a longer product shelf life,” she says. “But with paraben exposure, the issue is that these ingredients are hormone disruptors and can mimic natural estrogen, which could potentially promote cancer, and phthalates are similar to parabens in their effects.”

That being said, preservatives are necessary in products like lube because they inhibit the growth of bacteria and fungi. Luckily, better-for-you options do exist! Potassium sorbate and sodium benzoate are two non-sensitizing preservatives that have been deemed food-grade by the FDA and they make the cut on Whole Foods’ strict quality standards. Wendy Strgar, the founder and CEO of non-toxic lubricant company Good Clean Love, relies on both to keep her products, you know, clean.

Certain chemicals can make sex less safe

Two things that Strgar doesn’t allow into her products: fillers like glycols and petrochemicals like petrolatum. In developing her water-based lubes, Strgar discovered that petrochemicals and glycols strip the vagina of good bacteria it needs to fight off infections.

“When you use a lube that combines those ingredients, it’s likely it will slough off the protective top layer of cells in the vaginal cavity because it’s basically drowning the lactobacilli, which is there to defend against bad bacteria,” says Strgar. “What happens next is your vagina’s pH goes up, creating an ideal situation for bad bacteria to grow.”

Bacterial vaginosis is a common condition resulting from an upset in the balance of good and bad bacteria down there. According to Strgar, when your bacterial balance is out of whack, you’re 60 percent more susceptible to STDs because your immune system may already be strained by fighting off BV. (And be aware that oil-based lubricants can degrade condoms.)

Head to your kitchen for DIY alternatives

Raiding the kitchen isn’t just reserved for your post-romp munchies. According to Dr. Eyvazzadeh, you probably have a full stock of the best natural lubes right in your cabinets.

“Natural products really are the best,” she says. “For my fertility patients, I recommend using either egg whites, olive oil, or coconut oil,” she says. “You likely have many of these at home and know they’re not toxic.” And if your cupboards are bare? Opt for your—or your partner’s—saliva, she adds.


Uganda promoting vasectomies in bid to tackle poverty

Uganda promoting vasectomies in bid to tackle poverty

The Ugandan government has started recruiting “champion men” to promote vasectomies as a method of family planning as high fertility rates continue to plague the African nation.

“Many people think that when a man goes for a vasectomy he is not going to continue being a normal man,” said Martin Owor, a father of six. “But there is no problem. My wife is very happy.”

Owor said his wife initially objected to him having the procedure, but after a long conversation, he decided to go ahead, hoping it will help his children avoid living in poverty.

“My father had 12 children, so we never had a chance of having a quality education,” he said. “I needed a number that I would try to manage.”

The so-called “champion men” speak out publicly as the government tries to increase men’s participation in family planning to decrease birth rates.

“We can’t coerce them, because family planning is voluntary and is supposed to be based on human rights, and we want to keep on engaging them,” said Placid Mihayo, an assistant government commissioner in charge of sexual and reproductive health.

Uganda has long tried to tackle its booming population, with development experts suggesting the high fertility rate is an obstacle in combating poverty.

The population reportedly skyrocketed from 17 million in 1990 to more than 41 million in 2016. The United Nations figures put Uganda as the world’s top 10 fastest-growing population. The country remains one of the poorest in the world, with only $615 per capita income per year, with even lower incomes recorded in rural areas.

“If you produce 100 children and create only two jobs in that period, so where are the other 98 going to get jobs?” said Sam Mwandara, project coordinator for Reproductive Health Uganda, a U.N.-associated group. “The population is expanding so fast in relation to land, jobs, education and health. So it’s alarming.”

The increasing demographics are facilitated by the fact that only 35 percent of married women use modern methods of contraception. Abortion remains illegal in Uganda, with the only exception being to save the woman’s life.

The Associated Press contributed to this report.

10 Questions Men Should Definitely Ask Their Doctors About Testosterone

10 Questions Men Should Definitely Ask Their Doctors About Testosterone


Before you buy into the myth that “real men” have high testosterone levels, make sure you know the facts. 

Perhaps you’ve tried natural ways to boost your libido and they haven’t worked. Or maybe you’re concerned about aging and are tempted by the “miracle cure” testosterone booster that will keep you young forever (we’ve all seen the ads). But it’s important to look beyond clever marketing campaigns if you’re considering testosterone medication. Before you self-diagnose with low testosterone, here are the questions you need to ask yourself.

What is testosterone?

Derived from cholesterol, testosterone is a steroid hormone, called an androgen, mainly secreted by the testicles in men but also (in much smaller amounts) by the adrenal cortex and ovaries in women. A male fetus begins to produce testosterone as early as seven weeks after conception. Testosterone levels rise during puberty, peak during the late teens to early 20s, and then level off. After age 30 or so, it’s normal for a man’s testosterone levels to decline slowly, but steadily, each year. According to the National Institutes of Health (NIH), testosterone is an important male hormone, regulating sexual development, muscle mass, and red blood cell production. Synthetic testosterone was first used as a clinical drug as early as 1937, and is now widely prescribed to men whose bodies naturally produce low levels.

The levels at which testosterone deficiency becomes medically relevant still aren’t well understood, according to the NIH, though it’s not just an issue for older men: Testosterone is one of the eight sexual health conditions millennial men need to be talking about. Normal testosterone production varies widely in men, and levels of the hormone fluctuate throughout the day—they’re usually highest in the morning. Although there is no standard definition of “low” testosterone—commonly referred to as “low-T”—the Mayo Clinic says a healthy range for an average adult male (30-plus) is between 270 and 1,070 nanograms per deciliter of blood. Possible symptoms of low-T, according to the NIH, include reduced sex drive, erectile dysfunction or impotence, increased breast size, lowered sperm count, hot flashes, depression, irritability and inability to concentrate, shrunken and softened testes, loss of muscle mass or hair, and bones becoming prone to fracture.

How is low-T diagnosed?

Most men have more than enough testosterone, but in some men, the body doesn’t produce enough of the hormone, which leads to a condition called hypogonadism. A blood test can tell your doctor how much free testosterone is circulating in your blood, and also show the total amount of the hormone in your body. However, according to the Endocrine Society in clinical practice guidelines published in The Journal of Clinical Endocrinology & Metabolism, low-T should be diagnosed “only in men with consistent symptoms and signs and unequivocally low serum testosterone levels.” The guidelines advise against screening men in the general population to avoid labeling—and medicating—otherwise healthy men “for whom testing, treatment, and monitoring would represent a burden with unclear benefit.”

Is low-T an inevitable part of aging?

When women go through menopause their estrogen levels plummet and stop almost completely. However, the decline in testosterone levels in men works differently. Typically, levels fall by only 1 to 2 percent per year after the age of 40, and low-T is certainly not inevitable. According to the June 2010 issue of the British Medical Journal’s Drug and Therapeutics Bulletin, about 80 percent of 60-year-old men, and half of those in their 80s, have testosterone levels within the normal range for younger men.

How do you treat low-T?

There are real health risks for men with low-T. The condition can be treated with testosterone replacement therapy (TRT), which requires a doctor’s prescription and careful monitoring. Medications come in the form of gels, topical solutions, transdermal patches placed on the skin, buccal patches applied to the upper gums, injections, and pellets implanted under the skin. The products are available under numerous brand names, including Androderm (marketed by Actavis Pharma), Androgel (AbbVie Inc.), Axiron (Eli Lilly USA), Fortesta (Endo Pharmaceuticals), Striant (Actient Pharmaceuticals), Testim (Auxilium Pharmaceuticals), and Testopel (Auxilium). If you’re thinking of taking testosterone to improve strength, atheltic performance, or physical appearance, or to prevent aging, note that the Food and Drug Administration (FDA) has not approved the drug’s use on those grounds. A 2004 report from the Institute of Medicine, Testosterone and Aging: Clinical Research Directions, called TRT for age-related testosterone decline a “scientifically unproven method.”

What are the side effects of taking testosterone?

There are some scary ones, including an increased risk of heart disease. (Here are signs you might be headed for a heart attack.) If you’re considering TRT, make sure you understand all the possible risks. According to the Mayo Clinic, these include the development of acne or oily skin, fluid retention, possibility of increased urinary symptoms (e.g., urinary urgency or frequency), aggressiveness and mood swings, worsening of sleep apnea, reduction in testicular size, breast enlargement, and increased risk of blood clots. In 2014, the FDA revised testosterone product labels to warn about a possible increased risk of heart attacks and strokes in patients. The FDA recommends that patients using testosterone should seek medical attention right away if they experience chest pain, shortness of breath or trouble breathing, weakness in one part or on one side of the body, or slurred speech.

Can I boost testosterone naturally?

Obese men have lower testosterone, as do men who smoke, are physically inactive, or consume more than 28 drinks per week. So losing weight, being more active and drinking less booze may boost your levels without prescription meds. (Here are 17 simple tips to cut back on alcohol.) According to findings presented at the annual meeting of the Endocrine Society in 2012, obese men who lost an average of 17 pounds saw their testosterone levels increase by 15 percent. A 2014 study published in the International Journal of Sports Medicine found that high intensity interval training (HIIT) can boost testosterone levels.

Are there bad candidates for testosterone?

Men with normal testosterone levels should not consider testosterone therapy, and no one—men or women—should use any testosterone product if they have breast cancer. The belief that testosterone may increase the risk of prostate cancer or worsen the symptoms of enlarged prostate has been debated in the medical community for many years. A 2016 study by NYU Langone Medical Center and New York University School of Medicine, reported on ScienceDaily, found that testosterone therapy does not raise risk of aggressive prostate cancer, however it is advisable to tell your doctor if you have a history of prostate cancer before starting therapy.

Are there dangers to taking testosterone?

There’s a black-box warning on testosterone medication packages for a reason. Children who are accidentally exposed to the hormone are at risk of penis or clitoris enlargement, pubic hair growth, increased erections and libido, aggression, and aging bones, warns the FDA. So it’s really important not to apply the product to areas of the body that may come in contact with kids or pregnant women. Once the product is applied, the area should be covered with clothing, and hands should be washed with soap and water. (Check out the five ways you’re washing your hands wrong.) The area should be washed before any skin-to-skin contact with another person. Your bed sheets, pillows, and clothing may have testosterone on them, so warn anyone who comes into contact with them of the risk of exposure.

New UNFPA Study Outlines Inequalities In Sexual Health & Reproductive Rights Globally

New UNFPA Study Outlines Inequalities In Sexual Health & Reproductive Rights Globally


When it comes to reproductive and sexual health policies and access, it’s easy to focus just on what is happening within our own communities and even countries. Here in the US, the past few months have seen some horrendous and frankly deeply disturbing rollbacks of basic access to important healthcare resources such as teen pregnancy prevention programs and mandated birth control coverage through the Affordable Care Act. Those are just the latest in a string of policies coming from the Trump administration’s Health & Human Services department which is now headed up by anti-choice fanatics who care more about religious and moral imposition than data-driven policies that are proven to be effective.

Looking further afield, the situation is even worse in a number of areas, especially in the developing world. Similar to the way reproductive healthcare advocates are bring the conversation around economic stability to the abortion conversation here in the United States, the UNFPA has just released a new study outlining how a woman’s ability to access crucial sexual and reproductive healthcare is directly tied to the potential to escape poverty.

Titled ‘Worlds Apart: Reproductive Health and Rights in an age of Inequality’, the study underscores how the problem is cyclical and compounded right from early on in a girl’s life. If she is not able to get an education and have basic healthcare needs met, she is more likely to marry earlier, have children early, experience health problems, and not be financially independent or stable due to lack of qualifications. If a woman lives in poverty without the opportunity to escape through job skills, education and healthcare access, her children are also more likely to experience the same outcomes.

The study points out that economic disparity is an umbrella issue, as many other social, racial, political and institutional dimensions feed on each other, giving these disparities a ripple effect throughout families and communities.

“Two critical dimensions are gender inequality, and inequalities in realizing sexual and reproductive health and rights; the latter, in particular, still receives inadequate attention. Neither explains the totality of inequality in the world today, but both are essential pieces that demand much more action. Without such action, many women and girls will remain caught in a vicious cycle of poverty, diminished capabilities, unfulfilled human rights and unrealized potential—especially in developing countries, where gaps are widest,” says the intro to the study.

The ability to access the full range of sexual and reproductive healthcare, as well as determine when and how to have a family, is considered a universal human right. That is what 179 governments agreed at the International Conference on Population and Development in 1994. Yet within most developing countries, women in the poorest 20 per cent of the population have, for example, the least access to sexual and reproductive health services, including contraception, while women at the top of the wealth scale generally have access to a fuller range of high-quality services.

When women are disadvantaged from an early stage in life, it means they are less likely to enter the workforce, and less likely to be represented by policymakers. Education is key, as the study shows that for every additional year of school, not to mention higher education such as vocational college or university, means a girl is more likely to earn a better salary, and decrease her risk of maternal healthcare problems.

“This has long-term implications for labor-force participation and lifetime earnings. Equal access to quality education not only addresses absolute deprivation by providing individuals with a pathway out of poverty, but also increases overall national productivity and innovation, by generating far greater opportunity for all people to develop their skills, find their niche and define their future areas of work,” said the study.

Today, 95% of the world’s births to adolescents occur in developing countries. That must change.

“According to the Guttmacher Institute, each year in developing countries, there are 89 million unintended pregnancies, 48 million abortions, 10 million miscarriages and 1 million stillbirths. An estimated 214 million women in developing countries have an unmet demand for family planning,” says the study.

When it comes to reproductive and sexual healthcare policies having women represented among lawmakers as well as within major health institutions is going to make a world of difference. The recent inaugural Women Leaders in Global Health conference held at Stanford University discussed ways to ensure we see more women in leadership positions.

“At least 75% of the health workforce are female, and looking around this room…there is no shortage of talented women in the pipeline. But the picture looks different at the top,” Michele Barry, MD, director of the Stanford Center for Innovation in Global Health and senior associate dean for global health at Stanford University in California, told the audience.

“With every step up the ladder, the proportion of women shrinks. The World Health Assembly is 68% men; 70% of health leaders are men; and, at least in US medical schools and public health schools and global health institutes, men predominantly hold the top positions, despite the fact that global health has become increasingly feminized. In Fortune 500 countries around the world, 26 out of 27 health center [chief executive officers] are men. How can we succeed when half of the talent sits on the bench, and how can we have a robust dialogue?” she asked.

The leaders present at the conference stated that gender matters when it comes to global health due to certain issues faced by women that were outlined in the UNFPA study – childbirth, reproductive disorders, cervical cancer, violence, and poverty. Every 2 minutes a woman dies in childbirth, and 60% of these deaths are preventable.

Dr. Afaf Meleis, PhD, dean of nursing emeritus, University of Pennsylvania, Philadelphia, spoke about the US not being immune to these problems, considering we have the highest maternal mortality rate in the developed world. However female genital mutilation is still common in some parts of the world, and many women die from abortions. Almost all abortion deaths are due to unsafe abortions, and not the procedure itself, she added.

The recent announcement of the new World Health Organization leadership team being made up of more than 60% women reiterated how certain organizations are realizing the importance of having women’s voices at the table when it comes to healthcare initiatives, studies and policies.

The UNFPA study concluded with action items that are in line with the UN’s 17 Sustainable Development Goals agenda. Noting how the intersection of health, education and gender must be addressed in order to truly alleviate global poverty, they have listed a number of ways each person can do their part to break down barriers that stop women from reaching their full potential.

“Intersecting forms of inequality may have huge consequences for societies as a whole, with large numbers of women suffering ill health or being unable to decide whether, when or how often to become pregnant, and thus lacking the power to enter the paid labour force and realize their full potential. The damaging effects may span a lifetime for individuals and reach into the next generation,” the study says.

You can read an overview of the ‘Worlds Apart’ study by clicking here, and downloading the full report on the website.