Health Outcomes For Men Research Articles

P-030 Semen parameters as predictors of long-term health: a systematic review

Abstract Study question Do semen parameters predict long-term health outcomes in men? Summary answer Semen parameters do not have a good predictive value for mortality, diabetes, cardiovascular disease (CVD) or cancer. What is known already One in 3 men attending infertility clinics have suboptimal semen analysis. Assisted conception treatments are offered to them as treatment for infertility and their care usually ends there. There is now a growing body of evidence male infertility predicts future development of medical comorbidities. Multiple studies have looked into the association between clinical male infertility, involuntary childlessness or suboptimal sperm analysis and the risk of cancer, cardiovascular risks, diabetes, autoimmune diseases and mortality. However, there is still conflicting evidence regarding long-term health risk in men with suboptimal semen quality. Study design, size, duration A systematic review methodology was used using PRISMA guideline. The papers were selected from PubMed/MEDLINE, EMBASE and EBM from databases’ inception to May 2023. Reviews and case series were excluded. The selected studies were assessed for quality and risk of bias using QUADAS-2. Meta-analysis was done where appropriate. The scope of the analysis was to identify whether semen parameters could predict long-term health outcomes in men. Participants/materials, setting, methods Only papers reporting on health outcomes in men having at least one semen analysis result before diagnosis were included. A 2x2 contingency table was done for each study where data was available and true positives and negatives, false positives and negatives were calculated. The analysis was performed using MetaDTA, which generated estimates for sensitivity (Sn) and specificity (Sp), hierarchical summary receiver operating characteristic (HSROC) spaces and diagnostic odds ratio (DOR) with 95% confidence intervals (CI). Main results and the role of chance Twenty studies from three continents (USA, Europe and Asia) were included reporting on mortality (5), lifespan (1), cardiovascular disease (CVD) (2), diabetes (3), cancer (5), testicular carcinoma in situ (4), prostate-specific antigen (2), hospitalizations (2) and Charlson Comorbidity Index (1). Based on extracted data we could only analyse the predictive value of azoospermia and oligospermia for all-cause mortality, diabetes, CVD and cancer as there was insufficient data for other parameters. The results showed high specificity and low sensitivity of azoospermia and oligospermia for all outcomes (all-cause mortality: Sp 0.968, Sn 0.055 and Sp 0.839, Sn 0.162; diabetes: Sp 0.967, Sn 0.037 and Sp 0.902, Sn 0.046; cancer: Sp 0.964, Sn 0.135 and Sp 0.949, Sn 0.105; CVD: Sp 0.904, Sn 0.101 and Sp 0.932, Sn 0.074). HSROC model with 95% predictive region showed limited accuracy of sperm concentration as a test for any of the outcomes. DOR (95%CI) for azoospermia and oligospermia also showed that sperm concentration cannot be used as predictive test for any of the outcomes: all-cause mortality (1.72, 0.75-3.94 and 1.005, 0.59-1.693), diabetes (1.10, 0.77-1.56 and 0.44, 0.29-0.68), cancer (4.16, 1.45-11.97 and 2.18, 0.38-12.38) and CVD (1.05, 0.75-1.46 and 1.09, 0.83-1.44) when compared to normospermia. Limitations, reasons for caution Risk of Bias assessment showed high or unclear risk of bias in 14 studies mainly due to population selection. Not all laboratories adhered to WHO methodology, increasing the heterogeneity in reporting semen results and cut-offs. Concentration was the predominant parameter reported. Wider implications of the findings To answer the question whether poor semen quality is a predictor for adverse long-term health outcomes in men requires larger and well-designed studies. Until then, we should not be advising men that there are implications on long term health based on semen analysis results, with any confidence. Trial registration number not applicable

Community perceived barriers to uptake of health services among men at Sedibeng district in South Africa.

This qualitative study aimed to investigate the barriers that hinder men's utilisation of healthcare services in the Sedibeng district of South Africa. The study was conducted using flyers with questions posted on the Best Health Solutions' Facebook page for two weeks. A convenience sampling method was used and a total of 104 comments were collected from 64 respondents. The authors analysed the participants' self-reported data thematically on demographics, geographic area, and reasons for men not using healthcare services. The findings revealed that sociocultural norms played a significant role in men's reluctance to seek medical help, as it was perceived as a sign of weakness. The scarcity of male healthcare professionals hinders open discussions. Stigma and discrimination were identified as substantial barriers. Convenience, trust, and confidentiality concerns, along with the influence of intimate partners, also influence men's decision-making. This study highlights the complex interplay between various barriers that impact men's utilisation of healthcare services in the district. By addressing these factors, healthcare providers and policymakers can enhance healthcare access and promote better health outcomes for men in Sedibeng district. The manuscript's primary contribution lies in uncovering multifaceted barriers to men's healthcare utilisation in Sedibeng district. It explores socio-cultural norms, healthcare worker demographics, stigma, discrimination, convenience factors, trust, confidentiality concerns, and the influence of intimate partners on men's healthcare choices. These insights illuminate the complex factors affecting men's healthcare access, providing valuable knowledge for healthcare providers and policymakers.

Attachment, Mental Health, and Alcohol Use by Men: The Mediating Role of Cumulative Lifetime Violence Severity.

Cumulative lifetime violence (CLV) encompasses many different types and contexts of violence that occur across the lifespan and is associated with negative mental health outcomes in men; however, little attention has been paid to other factors that can influence these relationships such as attachment style. In this analysis, our focus is to understand how attachment styles directly and indirectly through CLV affect men's mental health, specifically depression, anxiety, posttraumatic stress disorder (PTSD), and alcohol use. Data from 597 Canadian men with lifetime experiences of violence who participated in our national online survey focusing on violence and health were used for mediation analysis. Results indicated that CLV severity mediated the relationship between attachment anxiety (but not attachment avoidance) and depression, anxiety, PTSD, and alcohol use. Although attachment anxiety and attachment avoidance each directly affected depression, anxiety, and PTSD, neither directly affected alcohol use. Importantly, these findings provide the first evidence that the mechanism by which anxious attachment affects alcohol use is through CLV severity. These findings highlight the importance of anxious attachment on mental health outcomes for men who have experienced CLV.

Influence of Impaired Diffusing Capacity and Sleep-disordered Breathing on Nocturnal Hypoxemia and Health Outcomes in Men with and without Human Immunodeficiency Virus.

Rationale: Nocturnal hypoxemia is common in sleep-disordered breathing (SDB) and is associated with increased morbidity and mortality. Although impaired diffusing capacity of the lung for carbon monoxide (DlCO) is associated with daytime hypoxemia, its influence on SDB-related nocturnal hypoxemia is not known. Objectives: To characterize the effects of DlCO impairment on SDB-related nocturnal hypoxemia and associated health outcomes. Methods: Data from a multicenter cohort of men with and without human immunodeficiency virus (HIV) infection, with concomitant measures of DlCO and home-based polysomnography (n = 544), were analyzed. Multivariable quantile regression models characterized associations between DlCO and several measures of SDB-related hypoxemia (e.g., total sleep time with oxygen saturation as measured by pulse oximetry [SpO2] < 90% [T90]). Structural equation models were used to assess associations of impaired DlCO and SDB-related hypoxemia measures with prevalent hypertension and type 2 diabetes. Results: DlCO impairment (<80% predicted) was associated with sleep-related hypoxemia. Participants with severe SDB (apnea-hypopnea index ⩾ 30 events/h) and impaired DlCO had higher T90 (median difference, 15.0% [95% confidence interval (CI), 10.3% to 19.7%]) and average SDB-related desaturation (median difference, 1.0 [95% CI, 0.5 to 1.5]) and lower nadir SpO2 (median difference, -8.2% [95% CI, -11.4% to -4.9%]) and average SpO2 during sleep (median difference, -1.1% [95% CI, -2.1% to -0.01%]) than those with severe SDB and preserved DlCO. Higher T90 was associated with higher adjusted odds of prevalent hypertension (odds ratio, 1.39 [95% CI, 1.14 to 1.70]) and type 2 diabetes (odds ratio, 1.25 [95% CI, 1.07 to 1.46]). Conclusions: DlCO impairment in severe SDB was associated with sleep-related hypoxemia, prevalent hypertension, and type 2 diabetes. Assessment of SDB should be considered in those with impaired DlCO to guide testing and risk stratification strategies.

Barriers and Strategies to Improve Men’s Uptake of HIV Care Services in Rural KwaZulu-Natal, South Africa: A Qualitative Approach

The 2017 Joint United Nations Programme on HIV/AIDS Blind Spot report echoes the challenges as well as the benefits of men’s effective utilisation of HIV services. However, men have been consistently missing from the HIV care cascade, leading to poor health outcomes in men and ongoing transmission of HIV in young women in South Africa. This study sought to understand key barriers to effective uptake of HIV services among men and potential strategies to address these challenges. Ten semi-structured telephone interviews and three workshops were conducted (from July to November 2020) with a purposive sample of men aged 21–65 years (N = 26) from rural KwaZulu-Natal. Broad themes were identified from the interview transcripts and analysed inductively. Masculine norms, stigma, and fear of an HIV identity were major barriers to the uptake of HIV testing among men as well as hesitancy due to perceived risks. Participants living with HIV identified various sociopsychological, structural, and COVID-related factors inhibiting the uptake of and adherence to HIV treatment. Besides condoms and circumcision, no participants had prior knowledge of pre-exposure prophylaxis. Participants suggested that men need tailored HIV/AIDS messaging and education (led by men living with HIV) about the benefits of HIV testing, treatment, and prevention. Importantly, they believed that community delivery of HIV services would encourage more men to engage in care. To achieve zero new infections and zero AIDS-related deaths of men in South Africa, efforts should be directed to developing tailored emotive educational and community-based interventions that address identified barriers to improve men’s utilisation of HIV care services.

Barriers and facilitators of supportive care access and use among men with cancer: a qualitative study.

Men diagnosed with cancer are underrepresented in existing supportive care programming and related research, with preliminary indications that men face unique challenges in accessing and engaging with such services. This study aims to identify barriers and facilitators related to the supportive care service access and use among men diagnosed with cancer. From March to May 2021, thirty-one Quebec men (Mage = 52.7, range:(26-82 years) diagnosed with various cancer types were recruited to take part in individual telephone interviews (n = 14) or online focus groups (n = 17) addressing experiences of cancer supportive care services. Content analysis of qualitative data was performed. Barriers and facilitators to men's supportive care access and use were grouped into four categories: (1) alignment between services and men's needs and preferences; (2) delivery of services in an accessible, inclusive, and responsive way; (3) communication and promotion of services in ways that are acceptable, appealing, and attractive to men; and (4) social norms and perceptions of gender and masculinity affecting men's perceptions of and engagement with services. Barriers and facilitators influencing access and use of supportive care services in men are numerous and diverse. These findings may inform the development of new and the adaptation of current supportive care strategies to better address men's needs and preferences after a cancer diagnosis. Increased adequacy of services tailored to men's needs and preferences, with an emphasis on supporting men to take an active role in their recovery, could improve access and adherence to care. Services adopting a more integrated, patient-centered, and holistic approach to service delivery could positively impact the cancer care trajectory and health outcomes of men. Larger systemic changes may be needed to support men in engaging in currently existing activities and services.

DIFFERENCES IN AMBULATORY BP LEVELS AND INTENSITY OF ANTIHYPERTENSIVE TREATMENT BETWEEN MEN AND WOMEN UNDERGOING PERITONEAL DIALYSIS

Objective: The aim of the present study was to compare the ambulatory blood pressure (BP) levels and intensity of antihypertensive treatment between men and women with end-stage kidney disease receiving long-term peritoneal dialysis (PD). Design and method: Following a case-control design, 48 male PD patients from Northern Greece were matched for age and history of heart failure with 48 female patients in a 1:1 ratio. All patients underwent 24-hour ambulatory BP monitoring with the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). The BP-lowering medications actually taken by the patients were prospectively recorded. Results: Age, dialysis vintage and the burden of cardiovascular comorbidities did not differ between men and women. There were no significant sex differences in ambulatory systolic BP (24-hour period: 129.0±17.8 vs. 128.5±17.5 mmHg, P = 0.138; daytime: 129.6±17.5 vs. 129.7±17.4 mmHg, P = 0.991; nighttime: 127.0±19.8 vs. 125.9±18.8 mmHg, P = 0.776). However, the levels of ambulatory diastolic BP were consistently higher in men than in women over the entire 24-hour period (81.5±12.1 vs. 76.8±10.3 mmHg, P&lt;0.05) as well as during daytime (82.5±11.8 vs. 78.1±10.4 mmHg, P&lt;0.05) and during nighttime (78.8±13.9 vs. 73.8±11.1 mmHg, P&lt;0.05). The proportion of patients with 24-hour ambulatory BP &lt;130/80 mmHg was numerically lower in men than in women (35.4% vs. 43.8%), despite the greater intensity of antihypertensive treatment in men. As compared with women, men were receiving a higher average number of BP-lowering medications daily (2.4±1.1 vs. 1.8±1.1, P&lt;0.05) and were being treated more commonly with beta-blockers (85.1% vs. 66.7%, P&lt;0.05) and dihydropyridine calcium-channel-blockers (70.2% vs. 43.8%, P = 0.01). Conclusions: The present study shows that among patients undergoing PD, the ambulatory BP levels and intensity of antihypertensive treatment are higher in men than in women. Prospective observational studies are needed to explore whether these sex differences in the severity of hypertension contribute to a higher risk for adverse health outcomes in men receiving long-term PD.

The Role of Restrictive Emotionality and Social Interaction Anxiety in the Association Between Muscle Dysmorphic Disorder and Masculine Depression

Muscle dysmorphic disorder (MDD) is a mental disorder characterized by men’s exaggerated self-perception as insufficiently muscular and lean and pathological preoccupation with achieving a muscular body. MDD has been recognized as a risk factor associated with negative mental health outcomes in men. However, previous studies did not sufficiently explore the link between MDD and masculine depression. Therefore, the present study examines the mediating role of social interaction anxiety and the moderating role of restrictive emotionality in the relationship between MDD and masculine depression. Structured questionnaires were distributed online among 849 Israeli men. The moderated mediation analysis indicated that a positive association between MDD and masculine depression was moderated by restrictive emotionality and partially mediated by social interaction anxiety. These findings have profound meaning in terms of the psychosocial aspects of men’s lives, underlining the risk factors inherent in the association between men’s dissatisfaction with their body and their mental health.

Psychological inflexibility mediates the relationship between conformity to masculine norms and depression: Preliminary support for a transdiagnostic approach to working therapeutically with men

BackgroundResearch suggests that rigid adherence to masculine norms is associated with negative mental health outcomes in men. However, contributing pathways between masculine norms and men's mental health are not yet well understood. It has been proposed that psychological inflexibility may function as a mediator in the relationship between masculine norms and depression in men. AimsThis study investigated whether psychological inflexibility mediated the relationship between conformity to masculine norms and depression. MethodA community-based sample of 326 men (M age = 62.33, SD age = 15.33 years) completed an online questionnaire using a range of validated scales, including the Conformity to Masculine Norms Inventory (CMNI-22), the Acceptance and Action Questionnaire (AAQ-II), the Cognitive Fusion Questionnaire (CFQ-7), the Patient Health Questionnaire (PHQ-9), and the Male Depression Risk Scale (MDRS-22). Mediation analyses and two-way ANOVAs were used to explore relationships between variables. ResultsResults indicated that psychological inflexibility significantly mediated the relationship between conformity to masculine norms and depression (both prototypic and externalising symptomology). Findings also revealed that psychological inflexibility is more strongly linked with poor mental health than conformity to masculine norms. ConclusionsThe results suggest that psychological inflexibility may be a possible pathway through which conformity to masculine norms is associated with depressive symptoms in men, providing important insights into possible therapeutic targets for psychological intervention.

Di-n-Butyl Phthalate and Its Monoester Metabolite Impairs Steroid Hormone Biosynthesis in Human Cells: Mechanistic In Vitro Studies.

The widespread environmental contaminant di-n-butyl phthalate (DBP) has been linked with reduced testosterone levels and adverse reproductive health outcomes in men. However, the underlying mechanisms of these anti-androgenic effects and the potential effects on other classes of steroid hormones remain to be elucidated. Here, we conducted mechanistic studies in human adrenocortical H295R cells exposed to 1–500 µM of DBP or its metabolite, mono-n-butyl phthalate (MBP), for 48 h. Quantification of steroid hormones in the cell medium by liquid chromatography-mass spectrometry revealed that both phthalates significantly decreased testosterone, androstenedione, corticosterone, and progesterone levels, in particular after dibutyryl-cyclic-AMP stimulation of steroidogenesis. Western blot analysis of key steroidogenic proteins showed that DBP induced a dose-dependent decrease of CYP11A1 and HSD3β2 levels, while MBP only significantly decreased CYP17A1 levels, indicating that the compounds affect early steps of the steroidogenesis differently. Both DBP and MBP exposure also lead to a dose-related decrease in HSD17β3, the enzyme which catalyzes the final step in the testosterone biosynthesis pathway, although these effects were not statistically significant. Interestingly, DBP increased the cortisol concentration, which may be due to the non-significant CYP11B1 increase in DBP-exposed cells. In contrast, MBP decreased cortisol concentration. Moreover, the analysis of superoxide generation and quantification of the protein oxidation marker nitrotyrosine demonstrated that DBP induced oxidative stress in H295R cells while MBP reduced protein nitrotyrosine levels. These findings confirm the anti-androgenic effects of DBP and MBP and reveal several differences in their toxicological mechanisms, with possible implications for future research on phthalate toxicity.

Adult Exposure to Di-N-Butyl Phthalate (DBP) Induces Persistent Effects on Testicular Cell Markers and Testosterone Biosynthesis in Mice

Studies indicate that phthalates are endocrine disruptors affecting reproductive health. One of the most commonly used phthalates, di-n-butyl phthalate (DBP), has been linked with adverse reproductive health outcomes in men, but the mechanisms behind these effects are still poorly understood. Here, adult male mice were orally exposed to DBP (10 or 100 mg/kg/day) for five weeks, and the testis and adrenal glands were collected one week after the last dose, to examine more persistent effects. Quantification of testosterone, androstenedione, progesterone and corticosterone concentrations by liquid chromatography-mass spectrometry showed that testicular testosterone was significantly decreased in both DBP treatment groups, whereas the other steroids were not significantly altered. Western blot analysis of testis revealed that DBP exposure increased the levels of the steroidogenic enzymes CYP11A1, HSD3β2, and CYP17A1, the oxidative stress marker nitrotyrosine, and the luteinizing hormone receptor (LHR). The analysis further demonstrated increased levels of the germ cell marker DAZL, the Sertoli cell markers vimentin and SOX9, and the Leydig cell marker SULT1E1. Overall, the present work provides more mechanistic understanding of how adult DBP exposure can induce effects on the male reproductive system by affecting several key cells and proteins important for testosterone biosynthesis and spermatogenesis, and for the first time shows that these effects persist at least one week after the last dose. It also demonstrates impairment of testosterone biosynthesis at a lower dose than previously reported.

Longitudinal Changes in the Composition of the Penile Microbiome Are Associated With Circumcision Status, HIV and HSV-2 Status, Sexual Practices, and Female Partner Microbiome Composition.

BackgroundPenile microbiome composition has been associated with HSV-2 and HIV in men and with bacterial vaginosis (BV) and HSV-2 in female sex partners. This study sought to 1) characterize penile microbiome composition over a 1-year period and 2) identify factors associated with penile microbiome composition over time.MethodsThis prospective study of community-recruited heterosexual couples in Kenya measured penile and vaginal microbiomes via 16S ribosomal RNA gene amplicon sequencing at 4 time points over 1 year (1, 6, and 12 months after baseline). We used longitudinal mixed-effects modeling to assess associated demographic, behavioral, and disease factors and changes in community type, meatal taxa with the highest mean relative abundance, and alpha and beta diversity measures. We estimated group-based trajectories to elucidate compositional trends.ResultsAmong 218 men with 740 observations, men had a median age of 26 years, 11.6% were living with HIV, and 46.1% were HSV-2 seropositive. We identified 7 penile community types that varied with circumcision status, female partner vaginal microbiome community state type (CST), condom use, and penile washing. Across varying analytic approaches, 50%–60% of men had stable penile microbiome compositions. Alpha diversity measures were lower for circumcised men and those who reported condom use; they were stable over time but higher if female partners had diverse CSTs or BV. BV was positively associated with the relative abundance of numerous individual penile taxa. The decreased Bray–Curtis similarity was more common for men with HSV-2, and HSV-2 was also associated with a lower relative abundance of Corynebacterium and Staphylococcus.ConclusionsOver a 1-year period, penile microbiome composition was stable for a substantial proportion of men and was influenced by men’s circumcision status, sexual practices, female partner’s vaginal CST and BV status, and men’s HSV-2 status. In the female genital tract, a diverse CST is often associated with poorer health outcomes. Our results contribute toward understanding whether this framework extends to the penile microbiome and whether diversity and the associated penile microbiome compositions influence susceptibility or resilience to poorer health outcomes in men. Focusing on understanding how these factors influence the penile microbiome may lead to therapeutic avenues for reduced HSV-2 and BV infections in men and their female sex partners.

Bride price, dowry, and young men with time to kill: A commentary on men’s marriage postponement in India

Rising numbers of young unmarried men in India reflect a marriage squeeze that goes beyond the shortage of brides created by sex-selective abortion. We describe a decline in men’s marriageability caused by their falling economic prospects at the same time as families of brides are increasingly seeking grooms with stable employment. We group young men into those without jobs or much education, those with education but no work, and the privileged few with education as well as employment. This classification resolves some of the seeming contradictions in the qualitative literature on marriage in India. Some of this literature talks about the rising prevalence of bride price and some about the persistence of dowry, while some papers reflect in general on the costs of being young, male, and aimless. Our commentary includes a review of the growing literature on the physiological and (perhaps) consequently behavioural and health outcomes of men’s anomie.

Men's health disparities: Causes and interventions.

According to the existing, extensive scientific evidence in the literature, men on average are living sicker and dying younger at a higher rate compared to women. The causes of men's infirmities are complex and multifaceted, contributing to increased morbidity and mortality rates and decreased life expectancy. Despite the statistics of the doomed health status among men, interests to eliminate their health disparities remain inconsistent and ill-defined. Therefore, efforts to eradicate men's health disparities should be positioned in interdisciplinary health education, research, and policy using sex and gender-based health frameworks. The purpose of this paper is to explore men's health generally by discussing common health disparities, the causes of the gender gap in men's health outcomes, proposing some strategies for advancing men's health, and finally providing nursing implications for education, practice, research, and health/public policy. Notably, interdisciplinary, gender-based health education potentially has significant impacts on men's health. The promotion of such initiatives can consequently address the intricacies of men's health, which will provide future healthcare professionals with the knowledge, attitude, and skills necessary to improve men's health.

The relationship between psychosocial variables and drive for muscularity among male bodybuilding supplement users

ABSTRACT Objective Given that a high drive for muscularity (DM) has been found to be associated with negative mental health outcomes for men, this research examined pathways involving social influence which may explain why some men are more susceptible to a DM than others. Method Building on previous qualitative research, this study examined psychosocial factors (self-esteem, perception of body by others, and body satisfaction during youth) and social influences (peer pressure and social media) associated with DM among young Australian men who lift weights and take bodybuilding supplements daily (N= 250) – both precursors for developing risky body enhancement strategies. This investigation extends the conceptualisation of social influence factors to include social identity (ingroup identification with a muscularity centred subculture). Results Path analysis found social media and peer pressure were directly associated with DM. Self-esteem and perception of body by others had a direct association with DM and an indirect association mediated by peer pressure and social media. Ingroup identification with a muscularity-centred subculture was associated with perception of body by others, peer pressure, and social media. Conclusions These findings highlight the mediating role of social influences on DM in young men, reinforcing the role of peers especially via online mediums. Key Points What is already known about this topic: Men are increasingly reporting body dissatisfaction, often associated with an increased drive for muscularity. Research indicates a drive for muscularity is associated with psychosocial factors (e.g., self-esteem) and increasingly social influences (e.g., social media). Questions remain as to why some men are more susceptible than others to perform muscularity enhancing behaviour.What this topic adds: An online survey of 250 young men who weight-train and take supplements found social media and peer pressure had strong direct associations with DM. Psychosocial factors had direct and indirect associations with DM, mediated by the social influences of peer pressure and social media. Ingroup identification with a muscularity-centred subculture did not have a direct association with DM but was linked via other social influence constructs.

Comparison of Patterns of Use and Clinical Outcomes Between Injections of Testosterone Undecanoate and Testosterone Cypionate: An Electronic Health Record Cohort Study

Background: Hypogonadism is characterized by low serum testosterone concentrations and the associated clinical manifestations (e.g., reduced libido, erectile dysfunction, and fatigue); testosterone therapy (TTh) is the primary treatment. This study compared treatment patterns and health outcomes in men using injection TTh with long-acting testosterone undecanoate (TU) injection versus short-acting testosterone cypionate (TC) injection. Methods: A U.S. electronic health records (EHR) database was retrospectively reviewed to identify adult men who had TTh of TU or TC (index treatment) between January 1, 2014, and December 31, 2018, and ≥1 EHR within the 12 months before and 6 months after index treatment. Results: There were 948 patients in the TU cohort and 121,852 in the TC cohort, of whom 419 and 86,219, respectively, were TTh-naive at index treatment. Hypogonadism diagnosis was documented in 81.1% and 58.8% of patients in the overall TU and TC cohorts, respectively. During the 1-year postindex period, higher adherence rates were observed in the TU versus TC cohort during months 7 through 12 (82.0% vs. 40.8%; p < 0.001), and a greater percentage of patients continued to receive TU (41.9%) versus TC (8.2%) for 12 months (p < 0.001). Variability in total testosterone levels was lower for TU versus TC in the TTh-naive population. Conclusions: In this retrospective EHR study, men who received TU demonstrated a two-fold higher adherence, a five-fold improved maintenance on index TTh, and more stable testosterone levels at 1-year follow-up versus men who received TC. More consistent TTh use observed with TU may result in improved health outcomes for men with hypogonadism.

Systematic review and meta-analyses on associations of endogenous testosterone concentration with health outcomes in community-dwelling men

ObjectivesThe overall study aim is to clarify the relation of endogenous sex hormones with major health outcomes in men. This paper reports a systematic review focusing on published estimates for...

Masculinity and men's health service use across four social generations: Findings from Australia's Ten to Men study

There is a perception that traditional masculine ideals, usually thought deleterious for men's health outcomes, are no longer as relevant for younger social generations such as Millennials as they are for older social generations such as Baby Boomers. Yet, in Australia, there remains a disparity between younger men's and women's health outcomes and use of health services. Conformity to traditional masculinity is often cited as a barrier to men's positive health behaviours but conceptualisation of the construct is contested. We analysed a selected secondary dataset (n = 14,917) of Australian males aged between 15 and 55 years from Ten to Men: The Australian Longitudinal Study on Male Health. We examined the role of conformity to traditional masculine norms in predicting likelihood of regular primary and preventative health services use for different social generations. Analyses included mediated regression and adjusted logistic regression. Conformity to ten of the eleven specific traditional masculine norms predicted likelihood of increased or decreased regular health service use depending on the generation and health service type. Specific traditional masculine norms play a complex role in men's use of distinct health service types for different generations of Australian males. Practitioners wishing to increase men's engagement with health services should consider gender-sensitive approaches that leverage specific masculine norms relevant to the age cohort to drive positive outcomes in men's health.

Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review.

Prostate cancer (PC) and its treatments lead to significant acute, chronic, or latent adverse effects that result in declines in patients' physical functions, quality of life and reduced sense of masculinities. Robust evidence shows that physical activity (PA) can improve many health outcomes in men with PC; however, less is known about the facilitators, preferences, and barriers to PA engagement in this population. The purpose of this scoping review is to document the nature and extent of literature related to these aspects of PA participation among men with PC. We conducted a scoping review of PA among men with PC. Databases searched included Medline, CINAHL, Embase, Rehabilitation & Sports Medicine Source, and SportDiscus from inception to June 30, 2020. Multiple reviewers were used in all screening and data abstractions. The search yielded 2788 individual citations after duplicates were removed. Following title and abstract screening, 129 underwent full-text review, and 46 articles were included. Quantitative data related to our research question showed that structured group exercise was the most commonly reported facilitator/preference among men with PC, whereas treatment-related effects and lack of time are the most common barriers. In terms of qualitative data, the most prominent theme noted related to masculinities and gender-specific needs within the context of having PC. Men with PC have unique facilitators and barriers concerning PA. More work is needed from the research and clinical practice perspectives to enable this population to engage and remain in regular PA.

Gender differences in information behavior during the Covid-19 health crisis in Spain

The Covid-19 pandemic has produced numerous deaths throughout the planet, although in general it has been deadlier in older people, in people with previous conditions and in males. The biomedical literature explains the difference in terms of mortality between men and women pointing to genetics and social and cultural reasons. The aim of this work is to explore information behavior, among the other sociocultural variables possibly influencing health outcomes in men and women. For this, we analyze the results of a survey with 95 people administered in Madrid the last week of strict lockdown for Covid-19 (April 2020). Questions were asked about the reasons for using traditional mass media and social media, the use of official and institutional information, the characteristics of the information that was considered useful, and different dimensions of information behavior during lockdown. Results show that the differences between men and women affect certain dimensions of information behavior and especially the information characteristics that are considered useful. Slight differences were also perceived between the two sexes regarding social media, that men appeared to use more for entertainment than communication.