Male Sexual/Reproductive Health

I've been meaning to post about an interesting topic that piqued my interest at the Michigan Academy of Family Physicians (MAFP) Scientific Assembly -- men's health.  This talk was given by Dr. Wendy Grube, sexual health guru at Penn School of Nursing.

FUN FACT:
2/3 of female teens get STI/HIV/pregnancy counseling, compared to only 1/3 of their male counterparts.


What's wrong with this picture?  Doesn't it take two to tango?  Simply looking at it from a public health standpoint, are we really doing ourselves justice if we only really involve half of the population in discussions and care regarding reproductive health?  This is the very reason that the HPV vaccine finally was opened up to both girls AND boys.

Now, being a huge women's health advocate and feminist and just generally pro-lady, I admittedly don't think about men's health as much as I should, but it's important.  Why?  Because most of you could probably think of at least a few dudes you know who rarely go to the doctor, and some wait until they're practically at death's door until they seek care.  As a guy it's easy to avoid the doc because you don't have to worry about things like contraceptive medications, pregnancy, pap smears, etc.  But there are plenty of men's health issues that need to be addressed on a preventive and therapeutic basis!  Focusing specifically on reproductive health here, there are several issues that should be covered with male patients, to name a few:


5 P’s of the Sexual Health History


1. Practices (identifying risky sexual behaviors)
2. Partners (number of sexual partners, men/women/both)
3. Pregnancy prevention
4. Past STI history
5. Past sexual dysfunction


Dr. Grube really emphasized the importance of moving towards sexual and reproductive health equity for women AND men.  In general, we've learned to do a good job with women, to treat them as whole people, with compassion and care and sensitivity.  But Dr. Grube highlighted how important it is to approach men just as gently, moving away from the traditional “drop your drawers” approach to men and their sexual health.  Maybe then we won't scare them away so much...


Sexual health side note #1: 
The USPSTF (U.S. Preventive Services Task Force) now recommends AGAINST teaching and performing testicular exams, stating that it leads to several false positives and unnecessary interventions that cause more harm than good.  This goes along with similar recommendations regarding breast self-exams.  Still, I believe that teaching patients to have an awareness of their bodies, even without self-exams, is useful so they know when something seems off.

Sexual health side note #2:
Do you know about expedited partner therapy? It is a strategy for treating the sexual partners of people diagnosed with chlamydia, without the need for a clinical evaluation of the partners.  In other words, if a patient is positive for chlamydia, the physician can provide an antibiotic prescription for both the patient and his/her partner, even if the partner is not present to be examined/tested.  This is a public health strategy to eliminate barriers and deal with the rising incidence of chlamydia in the U.S.  There are only a few states where EPT is illegal, and Michigan is one of them!  This is a low-risk intervention that can allow for great benefit for patients and their partners, so check here to see if EPT is legal in your state, and if not, write your representatives to let them know you think this is an important issue.