Jiang Hui, an expert in andrology in the first Hospital of Peking University: it's not serious to see ≠ of andrology! 40% of the men over 40 years old have ED problems. They should seek medical advice in time and do not need to cover it up.
It refers to the career, health, family, marriage and other hurdles and crises that men may experience at the age of 39 to 50 (that is, 40 to 65). Male health, especially male reproductive health problems are more difficult to talk about. this makes the severity of the problem greatly underestimated-although the World Health Organization and many countries have reported a significant decline in sperm concentration and quality. However, the incidence of many male diseases represented by sexual dysfunction is increasing day by day, and men of this age group may have the least fertility problems. In China, more than 40% of adult men over the age of 40 suffer from erectile dysfunction (ED). The demand for andrology treatment is greater than public awareness. What is the difference between the health needs of men and women: gynecological diseases are the organs that men do not have go to the department of gynaecology, smoking, drinking, staying up late and socializing lead to a higher incidence of many other diseases than women, but the performance of sexual dysfunction is far different between men and women.
Every reporter: Lin Zichen, every editor: Dong Xingsheng
"midlife crisis" refers to the career, health, family, marriage and other hurdles and crises that men may experience at the age of 39 to 50 (or 40 to 65). However, male health, especially male reproductive health, is more difficult to talk about than mental fragility, which makes the severity of the problem greatly underestimated-although the World Health Organization and many countries have reported a significant decline in sperm concentration and quality, and male and female factors account for the same proportion of marital infertility.
Jiang Hui, an expert in andrology at Peking University first Hospital and president of the Chinese Sex Society, gave an exclusive interview to the Daily Economic News (hereinafter referred to as "NBD") on the occasion of the 23rd Chinese Men's Health Day.
Jiang Hui photo source: the interviewee provided the picture.
Jiang Hui said that for a long time, society has paid attention to women's health, but the increasing incidence of many male diseases represented by sexual dysfunction is also worthy of attention. A lot of common sense needs to continue to popularize science. For example, 25-35 years old is the golden childbearing age for men, and men in this age group may have the least fertility problems. In China, the proportion of adult men over 40 years old suffering from erectile dysfunction (ED) is more than 40%. There is no need for men to be afraid or cover up this common disease.
The demand for andrology treatment is greater than public awareness, and men under the age of 40 buy more Viagra.
NBD: what are the differences in health needs between men and women?
Jiang Hui:Generally speaking, gynecological diseases are all organs that men do not have, such as ovaries, uterus, fallopian tubes and vagina, while masculine diseases are organs that women do not have, such as penis, testis, epididymis, vas deferens and prostate.
It can be said that there are as many gynecological diseases as there are gynecological diseases, and there are nearly 40 million more men than women in China, and the demand for men is even greater. In addition, because men are given more stress and responsibility, there are more bad lifestyles, and smoking, drinking, staying up late and socializing lead to a higher incidence of many other diseases than women.
In terms of reproductive health, the incidence rates of women and men are similar. Infertility, 40% are male factors, 40% are female factors, and 20% are common factors or can not find the cause.
However, the performance of sexual dysfunction in men and women is far different, male penis can not be erectile, can not complete sexual life; women with sexual dysfunction, as long as the vagina is normal, can also complete sexual life. Therefore, the needs of the two are different, and the willingness to treat is not the same.
NBD: why does society pay less attention to men's health than women's health?
Jiang Hui:For a long time, the national level has been concerned about women's health screening, census. All aspects pay more attention to women's health and less attention to men's health. Gynecology has developed for more than 100 years, and gynaecologists are tens of thousands, but male diseases have been seen in urology before. In the age of not having enough to eat, the main problem is to solve diseases. The concept of "healthy China" promotes the change of public concept from "disease-centered" to "health-centered". Society must pay more attention to the function of andrology: "sexual" happiness, family harmony, reputation and so on.
The second is concept. The public's understanding of andrology is relatively backward, and they always think that if someone looks at andrology, it means that this person is "indecent", which is unfair. In addition, men pay far less attention to their health than women, they have fewer channels to vent their negative emotions, and they are reluctant to see a doctor. Therefore, we need to pay more attention to this aspect in the future.
In addition, medical insurance across the country can now reimburse the medical expenses of most gynecological diseases, but male diseases are at their own expense, there is also this kind of deviation.
NBD: from a clinical point of view, which diseases are high in men?
Jiang Hui:A lot. For example, the abortion rate of conceiving boys is higher, and the mortality rate of boys is higher than that of girls within a month of birth. 50% of men smoke, and 80% and 90% of alcohol goes to their stomachs. Because of these bad lifestyles, the incidence of high blood pressure, heart disease and diabetes in men is higher than that in women.
In the field of reproductive health, we all know that men have sexual dysfunction and women have menopause, but in fact, men also have menopause.
(reporter's note: 1. According to an analysis from the Australian Institute of Health and Welfare, boys tend to account for 75 per cent of sudden infant death syndrome, 60 per cent of infant deaths and 54 per cent of babies diagnosed with cancer, and boys are more likely to develop disabilities associated with preterm birth.
two。 The "China smoking hazards report 2020" released by the National Health Commission and World Health Organization (WHO) 's representative office in China shows that the smoking rate among men is as high as 50.5%.
3. Data in 2008 have shown that the incidence of male menopause is 10%-30% in men aged 40-70, but the clinical missed diagnosis rate is as high as 90%. Mental workers with high stress and long-term mental tension are easy to become high-risk groups for men with early menopause, and they may begin to enter menopause after the age of 30. )
NBD: what is the trend of male reproductive diseases in recent years?
Jiang Hui:The incidence is generally getting higher and higher, such as sexual dysfunction. According to survey data in the United States, 52% of adult men over 40 have sexual dysfunction. A survey of more than 2200 adults over 20 years old in three cities in Beijing, Shanghai and Guangzhou showed that the prevalence rate of ED in adult men aged 20 to 70 was 26.1%, while that of men over 40 years old was 40.2%.
However, although middle-aged and elderly men are more likely to have severe ED, the majority of people who buy and use Viagra are men under the age of 40, and those who go to the male department of the hospital are getting younger. In addition, diabetes, hypertension, heart disease, hyperlipidemia and depression all have a younger trend.
Over the past 60 years, the average male sperm concentration has dropped by 86%. Who is to blame and how to fix it?
NBD: some people say that the golden childbearing age for men is between 25 and 35. How do you understand it?
Jiang Hui:Both males and females have golden childbearing ages, which are 25 ~ 35 years old and 22 ~ 28 years old respectively. It means that at this age, it may take three months to six months to conceive, while it may take eight months to a year to be over 35 years old, so this is an indicator.
The second is that when pregnant at this age, his wife has a spontaneous abortion, the fetus is least likely to stop, and the child is least likely to have birth defects. So from the pros and cons, this is the best age. But it doesn't mean you can't get pregnant beyond this bottom line, and it's not recommended to get pregnant at this age. However, there are relatively few fertility-related problems (at this age).
NBD: it seems that there are scientific reasons for a lot of "birth theory".
Jiang Hui:What you do at what age is very important. We originally said that family planning means late marriage and late childbearing. This understanding is wrong. Family planning refers to planned childbearing. If a man is engaged in a high-risk job, has a family history, or for other reasons, he should make a birth plan early.
However, the best childbearing age does not mean that you can't have children after that age. In the process of giving birth, men are responsible for providing sperm, the fertility cycle is much longer than women, and some people are still fertile when they are 80 years old, but now we advocate the concept of "eugenics". If people are willing to have children, they should have children as early as possible.
Photo Source: photo Network-501161734
NBD: when it comes to sperm quality / concentration, does the decline seem to be a global trend?
Jiang Hui:With regard to sperm quality, it was first studied by Professor Karlsson of Denmark, who integrated some normal parameters of 15000 semen from more than 20 countries publicly reported from 1939 to 1991 and found that the average semen concentration of men decreased by 49% over the past 52 years. Caused a big stir.
The relevant institutions of our country have also done research and found that the value of semen published in China showed a downward trend from 1981 to 2006, and there was a statistical difference in the data from 1981 to 1996.
The World Health Organization publishes an edition of the normal value of human semen every 10 years. The concentration of male ejaculatory semen is about 100 million / ml in the first edition, 60 million / ml in the third edition, and 15 million / ml in the fifth edition. This is just like fighting a war. With fewer troops, the odds of victory are lower, so fertility must be affected.
NBD: is there a recognized reason for this in the academic circle?
Jiang Hui:There are many reasons. The first is evolution. We all know that the Y chromosome and the X chromosome were the same size 100 million years ago, but what we don't know is that now the Y chromosome of a man has become the same size as the X chromosome. Some people say that this is because women's two X chromosomes have mirror effect, there are mistakes can be corrected, self-conditioning, while men have only one Y chromosome, if there is a problem, it will be passed on to the next generation, and there is no chance (to correct). Of course, there are many evolutionary explanations.
From the physical structure, the testis is the only male organ outside the body, because the lack of protection is easy to get hurt, easy to infection. And it likes a lower temperature (35 degrees) and a body of 37 degrees, so when the temperature rises, it is easily affected, so the sperm produced may also be destroyed.
In addition, air, environment, diet and other factors affect the human body, male and female reproductive function decreased to a certain extent. Poor ovarian function is also common among women in their 30s in hospitals, which may be closely related to reproductive health.
Chinese men's department runs on the road, and pharmaceutical companies participate in the co-construction of men's health ecosystem.
NBD: in recent years, there are more and more male therapeutic drugs represented by domestic ED drugs. What do you think of this market?
Jiang Hui:In the past, enterprises sold drugs in order to make enterprises bigger, but now enterprises have figured it out. If this field is not bigger, and the cake is not bigger, no one can live. So our country from the first domestic "Viagra", to now so many, no one died, are living very well, indicating that this cake has become bigger. The education of the common people has also been effective, and the demand is far greater than originally imagined. So many potential people, as long as the publicity is good, everyone can take medicine early and be healthy as soon as possible. So now the manufacturers have been mobilized and the experts have been mobilized.
NBD: what do you think of the younger users of ED drugs?
Jiang Hui:More than 50% of American men over the age of 40 have ED, so it is mainly for the middle-aged and elderly. In the United States, after the launch of Viagra, the incidence of sexually transmitted diseases in the elderly has increased by 10% to 20%, indicating that first, he has a need, and second, that it works.
Our country used to see the male department of men are also middle-aged and elderly, but now buy Viagra are mainly men in their 30s and 40s, this is because young people are under great pressure, but also want to pursue happiness.
However, there is no abuse of this drug, because it mainly activates nitric oxide synthase in the penile sponge and has a vasodilating effect, which is now over-the-counter in foreign countries. When our country was introduced at that time, it was very strict. At the beginning, it was managed according to drugs and anesthetics, and it had to be in hospitals at or above the second level, and only urologists opened it. Later, geriatrics and cardiovascular departments could open it, and then all doctors could prescribe it. Now it's open to Internet sales. We are now also trying to turn it into an over-the-counter drug for the convenience of people.
Photo Source: photo Network-500802625
NBD: what is the construction trend of male departments and hospitals in the future?
Jiang Hui:There was no andrology in the past, and most andrologists grew up in urology. Now many diseases are specialized, and more and more detailed, more and more intersecting, then andrology also includes psychology, endocrinology, psychiatry, and so on. Now many hospitals have andrology. If you add the andrology of traditional Chinese medicine, there may be tens of thousands of andrologists across the country.
It is certain to continue to increase specialization in the future. I personally suggest that the functional consultation of andrology should go out of third-class hospitals to engage in specialties and open clinics. Third-class hospitals are mainly responsible for large-scale difficult and complicated diseases and rescue. For example, endocrinology departments that prescribe diabetes drugs have to go to the community and to two hospitals. This should certainly be the trend in the future.
NBD: the theme of this year's Men's Health Day in China is "promoting healthy living and protecting Men's Health". What suggestions do you have for men's healthy living habits / styles?
Jiang Hui:The report of the 20th CPC National Congress clearly proposes to promote a healthy lifestyle, which is the lowest-cost means to protect health.
We should realize that male diseases are common and frequently-occurring diseases. For example, sexual dysfunction occurs in 40% of men over the age of 40 in China, and there is one in every other person in the queue. Since it is a common disease, there is no need to be afraid or cover up if you have a problem and go to the hospital in time.
In addition, we all know that there should be less smoking and less alcohol during pregnancy, but we do not know that men go to the hospital to do a routine semen test, and it is very necessary for women to do a reproductive examination, so that some problems can be detected as early as possible, such as varicose veins. Prepuce, balanitis infection can be prevented in advance to prevent these diseases from being passed on to the next generation.
Over the years, we have strongly promoted men's health because we have not done enough and there are "debts". We all know that the average life expectancy of men is lower than that of women, and recent data show that this difference tends to widen. With the improvement of work stress and life stress, the difference in the incidence of chronic diseases is increasingly apparent in countries with different health education efforts. Under the concept of "healthy China", everyone should be the first person responsible for their own health.
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