Journal of Men's Health

Fewer men than women are diagnosed with depression, although commentaries about men's depression suggest that the lower reported rates may be due to the widespread use of generic diagnostic criteria that are not sensitive to depression in men, as well as men's reluctance to express concerns about their mental health or access professional health care services. This article provides an overview of the connections between depression and masculinities and, based on that literature, recommendations are made for how we might better understand, identify and treat men's depression in gender-sensitive ways.

Background

Gender and ethnocultural affiliation can have a significant impact on peoples’ beliefs about, and their capacity to manage, their health. We aimed to describe the gender- and ethnoculturally-based influences associated with the process that Sikh men undergo when faced with managing coronary artery disease (CAD) risk.

Methods

This was a grounded theory study with 10 Sikh men. Data were collected through audio-taped semi-structured interviews. The transcribed interviews were analyzed using constant comparative methods.

Results

The core variable was ‘meeting the challenge’. There were three main phases that encompassed the process of managing CAD and its associated risks. These included: pre-diagnosis or event, the liminal (changing) self, and living with CAD. The most salient risk factors that Sikh men reported included ongoing stress, high levels of alcohol intake and reduced physical activity. The challenges to managing these risk factors included economically-driven change in status within the family, language barriers, and religious beliefs regarding destiny.

Conclusions

Older immigrant Sikh men may encounter difficulty accessing the healthcare system due to language barriers and religious beliefs, and they are disinclined to investigate the causes of their illness. Health-care providers, and those that create health policy, should work with the Sikh community to develop ethnoculturally sensitive care, and to develop resources to increase health promotion.

Background

The aim was to estimate the efficacy and safety of androgen replacement therapy (ART) in a retrospective cohort study of a group of patients with signs and symptoms of hypogonadism who had undergone radical retropubic prostatectomy (RRP) for localized prostate cancer (PCa).

Methods

The results of treatment in 16 patients who had undergone RRP for localized PCa at stage pT2N0M0 during the years 2001–2005 were analyzed. Both prior to and following the ART, serum total testosterone (T), and prostate-specific antigen (PSA) levels were evaluated, and signs and symptoms were assessed using the Aging Male Symptoms (AMS) Scale.

Results

With a mean ART duration of 15 months, the mean test level increased from 6.5 ± 1.98 nmol/l to 19.2 ± 5.1 nmol/l (from 188 ± 57 ng/dl to 555 ± 198 ng/dl) (p < 0.01), while the AMS symptom score decreased from 40.4 ± 5.4 to 20.8 ± 3.8 points. None of the patients had evidence indicative of biochemical or clinical progression of localized PCa.

Conclusion

Our experience of the treatment of 16 patients and the relevant literature data suggest that in the carefully selected patients with the signs and symptoms of hypogonadism following RRP, the safe use of ART with a good clinical effect is feasible. To formulate the clinical guidelines on ART in patients who have been surgically cured of PCa, prospective, multicenter studies with large numbers of patients are required.

Background

Leptin is a hormone produced in adipocytes. It has been suggested that leptin directs metabolic fuels towards utilization and away from storage. Few related studies have been conducted on a homogeneous diabetic cohort. The aim of this study was to examine the gender differences in leptin level in a homogeneous Type 2 diabetic cohort and the factors contributing to such a difference.

Methods

Out of 1306 registered diabetic patients, 116 subjects who met the following criteria, (1) aged between 35 and 74 years, (2) Chinese, (3) having Type 2 diabetes for more than 1 year and (4) having been taking gliclazide and metformin for more than 6 months, were enrolled into the study. The main variable studied was the plasma leptin levels in relation to quartiles of body mass index (BMI) and insulin levels in various age groups of men and women. Factors affecting plasma leptin level in men and women were determined using multiple linear regression analysis.

Results

This study demonstrated that Type 2 diabetic women had higher plasma leptin concentrations than their male counterparts (p < 0.001). Insulin level (β = 0.50, p < 0.001), BMI (β = 0.44, p < 0.001) and triglyceride levels (β = 0.16, p = 0.04) were found to be the main predictors of leptin level for Type 2 diabetic men.

Conclusions

These initial findings reveal that men had lower leptin levels than women, and seem to indicate that insulin concentration is the main predictor of leptin level in both Type 2 diabetic men and women.

Obesity is the consequence of how the body regulates energy intake, energy expenditure and energy storage. Evolutionary mechanisms have rendered mammals capable of surviving scarcity of nutrients. The present abundance of food has led to an epidemic of obesity in the developed and in the developing world. Adipose tissue has long been considered an inactive reserve depot of fat but it appears to be an active tissue, directly and actively involved in the control of body weight and energy balance via the secretion of a large number of molecules with regulatory potential (adipokines), explaining the biological mechanisms of the relationship between an excess of body fat and metabolic disturbances, diabetes mellitus, and cardiovascular disease. There is also a relationship between obesity and cancer. Sex steroids are involved in the sexually dimorphic pattern of fat distribution. Testosterone induces a visceral fat depot. Paradoxically, a decline in testosterone, such as that observed with aging, leads to an accumulation of fat in the visceral depot favorably responding to normalization of plasma testosterone. Treatment of obesity is disappointing. The present cornerstones, caloric restriction and exercise, are rarely maintained in the longer-term. Pharmacological treatment is modestly helpful. It is probably public education and the production of healthier food by the industry that might be successful. The latter might be spurred by the costs of obesity-related disease to the health care system.