Different stages of male health


  • Health
  • Sunday, 15 Jun 2003

It's Father's Day today, so what better gift than that of knowledge about men's health to fathers, future fathers and wannabe fathers so that they can enjoy the fruits of their labour well into their golden years. COLIN KHOO has the story. 

Dato' Prof Dr Tan Hui Meng ... 'For example, one cannot pinpoint a disease to a single cause. To understand the causes one has to look at the various stages in a man's life and how he has exposed himself to various risk factors.'

TESTOSTERONE is often associated with “machismo”. A man who is driven by his testosterone to prove his male identity is described as macho. We have only to look at the reality programme Fear Factor to see what lengths some would go. Of course, there are the women, and they can be more than a match for any testosterone-driven male.  

Testosterone might rule many men's actions, but at the end of the day, it's the women who come up trumps, at least in the survival stakes. Just look at the average lifespan of men and women the world over, and women generally outlive men by a good few years. 

Ironically, the shorter lifespan of men could after all be due to this macho streak, driving them to extreme and reckless behaviour in the quest to prove themselves the stronger sex. These behaviours (you can add up the vices) accumulate and haunt men in the later years.  

Consultant urologist Dato' Prof Dr Tan Hui Meng says that below the age of 65, the mortality rate of men is higher than women. “Generally speaking, it’s simply because of the accumulated effects of years of reckless living and extreme indulgence, in the various stages of a man's life. For example, men rarely go for medical checkups till late in life, as they tend to neglect their health.  

“Most women, on the other hand, are compelled by circumstances and nature ? during childbirth for example, to go for a very through physical examination earlier in life. They are thus more aware of the various health markers such as the cholesterol levels, blood pressure, BMI – things which most men generally are not aware of till late in life.  

“No doubt genes too play a part in determining low long we live. However, that's just one of many factors. To talk about health, though, is to talk about the age sequence – the interactive and integrative manner in which behaviour at one stage in life carry on to the next.  

“For example, one cannot pinpoint a disease to a single cause. To understand the causes one has to look at the various stages in a man's life and how he has exposed himself to various risk factors,” he adds  

The years of a man's life between 15 and 30 is said to be the age of psychosocial pathology. Prof Dr Tan explains: “This stage is when a person's testosterone is at its peak. It might drive an individual to all kinds of things ? such as smoking and drinking. The reason why kids drive recklessly and think they are immortal is because of this testosterone driven nature. And though they abuse their body they don't feel the pinch, as they are still young.  

The years of a man's life between 15 and 30 is said to be the age of psychosocial pathology when testosterone levels are at a peak. It might drive an individual to all kinds of risky behaviour.

“However, these risk factors accumulate. And if the process in this stage is not properly developed (say if the individual is repressed) and the transition to mature and competent male is flawed, it would result in psychopathology. Specific issues, such as sexual issues of performance anxiety, loss of libido and depression might then result.”  

Thus, according to Prof Dr Tan, the whole environment and upbringing of a child would determine his health later on in life.  

The ages between 45 and 60 is the age of vascular and metabolic pathology where metabolic and diseases of the heart set in.

The next stage lies between ages 30 and 45 and is called the age of prodomo pathology. This is the stage where a man's testosterones take a different turn. No longer in his foolhardy days and more aware of his mortality (hopefully), his chemical urges take on the path strewn with lifestyle issues. 

“At this stage, the man would often be preoccupied with career and lifestyle issues. He would be trying to better his social status. Most of the time this stage is associated with lack of exercise, excess alcohol and high calorie intake. There is also the exposure to all sorts of stress and duress.  

“The pattern of a man's behaviour in this stage could also have been aggravated by the previous stage – for example, if he'd picked up smoking earlier, he might be smoking excessively at this stage. And smoking greatly increases the risk, later on in life, of many diseases,” explains Prof Dr Tan. 

The incidence of prostrate cancer increases with age, while testicular cancer is more common in the young.

The next stage (age 45 to 60) should be when a person reaps the fruits of his labour. It is also harvest time for the wild oats and vices that he has sown. “This is the age of vascular and metabolic pathology, in other words, the age when metabolic and cardiovascular diseases sets in. This is activated by the accumulated effects of the previous stages that underpin the metabolic syndrome.  

“High-blood pressure, diabetes, peripheral vascular and penile vascular diseases are conditions common at this stage. About 5% of men in this stage suffer from hormonal and androgen deficiency ? it is more manifest in the later stages and would result in irritability, erectile dysfunction and as a result, a loss of confidence for the person,” he adds.  

The next stage, unfortunately, is not one that most people see through merrily. According to Prof Dr Tan, this is the stage of degenerative pathology. Here, the incidence of diseases such as heart failure, prostrate disease, bowel disease, lung cancer and erectile dysfunction are higher.  

Age, however, should not be seen as a cause of these diseases, he stresses. Rather, people should be made aware that diseases are largely caused by the accumulated effects of risky behaviours throughout the previous years.  

“Erectile dysfunction, for example, which affects 50-60% of men above 50 years old is quite a good indicator of a person's health. This is so as the neurovascular bed of the penis is one of the best biological markers of a person's health. Approximately 90% of the time, in erectile problems, we can find an underlying cause for it, which could be diabetes, obesity, high blood pressure and so on. Thus, people with erectile dysfunction have a higher risk of such diseases,” he explains.  

Prof Dr Tan also notes that the incidence of certain diseases such as prostate cancer is higher in the West than in the East. “In the West it afflicts one out of every 10 men. These figures are five to 10 times lower in the East. However, the incidence of prostrate cancer is creeping up in the East, which could be due to the changing lifestyles and diet (high calorie food) of the people.  

“Though most of these diseases occur in the later stages of life, it should be mentioned that testicular cancer has a high incidence among young people. It is one of the most treatable types of cancer and it is important for young people who have a family history of this cancer to go for checkups,” continues Prof Dr Tan. 

The final stage (ages 75 and beyond) of a man's life is the age of ageing pathology. “Only 10% of people can reach this stage, achieving what is called 'successful ageing'. By successful ageing. I mean having no disease or disease-related disability while maintaining high cognitive and physical capacity as well as an active engagement with life. 

“I can only hope that these figures increase over the years as more and more people become aware of how health really adds up,” says Prof Dr Tan. 

Related Stories:Obesity and the heart 

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