She says Chief Freelance Specialist of the Ministry of Health of Russia for Reproductive Health, Corresponding Member of the Russian Academy of Sciences, Director of the Research Institute of Urology and Interventional Radiology named after N.A..
Lydia Yudina, AiF: According to the Social Policy Committee, Oleg Ivanovich, since 2006, the number of infertile men in our country has increased by 80%: to 4 million people. What are the reasons for this jump?
Oleg Apolikhin: Everything is not so critical. Previously, the diagnosis of "infertility" was based on the negotiation of men. To date, data is presented to men who have turned to a specialist for a different reason and have been diagnosed with "infertility" during the examination. The exact number of infertile men is uncertain today, because the statistics that would be kept in the register do not yet exist in our country. On behalf of Health Minister Skvortsova V.I. proposals have been put forward and such a register has been launched since the fact that the number of infertile men is growing is an undeniable fact.
– How can we collect accurate statistics if men's consultations have been removed more than 10 years ago, and urologists are only at large public clinics?
– Men's consultations themselves were never. Such treatment was a medical task and was commercial. Currently, the situation is changing rapidly. In some regions, projects to protect men's health are already being implemented. But they are scattered and proactive. Within the framework of the Ministry of Health and the Federation Council, a federal program is being actively under the National Demographic Project.
As far as the number of urologists is concerned, it is not that there are few, but there is an established system of therapeutic, screening and preventive measures in our country. So far, specialized state clinics and specialized urologists are very few: 5-7 thousand for the whole country (for comparison, there are 40 thousand gynecologists in Russia). Men must seek help from private health centers, but the economic system is based on the physician's interest in treatment and not on prevention.
Meanwhile, men are more vulnerable to social risks, including the length of male life in our country 10 years shorter than women (this is the highest number in Europe). This is a feature of physiology: a man is a sprinter and a woman is staying. But the main thing is the duration of a healthy life.
– How long men's health is related?
– A study conducted in our center has shown that for example, erectile dysfunction (impotence) not only inhibits self-esteem but also serves as a dangerous prognostic sign. It has been shown that men with erectile dysfunction are more likely to prevent myocardial infarction (within 5-7 years of development).
Fading sexual functions negatively affects men's performance. In menopause, one loses interest in life, loses leadership, perseverance and entrepreneurship, and many diseases that are not identified in time cause early menopause in men.
– For a long time it was believed that menopause just didn't exist …
– Climax – the natural extinction of sexual and reproductive function – is inevitable for both women and men. But in the male half of the population it comes later and does not manifest itself in the same way as women.
One of the most significant symptoms of male menopause is the occurrence of prostate adenoma, which develops in all men after 45-50 years of age.
If a person is physiologically healthy, the prostate adenoma later develops and does not cause changes that require surgery. Today, the treatment of prostate adenoma can be treated conservatively. However, this is possible provided that a person visits a doctor before starting complications. Unfortunately, most men lose their help when the operation cannot be avoided.
Another feature of male menopause is the large age range. Normally, menopause occurs after 70 years in a healthy person, but the current trend suggests that menopause is "younger" and develops in men after 40 years.
And those who have spent turbulent youth are at risk. For men, being overweight is extremely dangerous, which is primarily a hypothesis. Obesity is made up of a female type, fat deposits in the abdomen work as a gland with internal secretion: estrogens are released, which suppresses male sex hormones. In fact, such a person is castrated: he becomes slow, effeminate, depressed, loses interest in sex and becomes unconditionally unconditional.
It is believed that the female reproductive system is extremely vulnerable and one can become a father at any age and in any condition.
– It is not. The ability to conceive in men persists for a long time (up to 65-80 years). However, with age, disease, genetic damage, toxins accumulate, which impair the quality of genetic material and lead to the birth of children with severe pathology. The best thing a father can do for his child is to imagine him young (under 40-49 years).
One can also become barren and do a barren woman. Diseases such as chlamydia, trichomoniasis and mycoplasmosis prevent the onset of pregnancy and induce its interruption in the early stages. Or the fetus develops, but the baby was born with abnormalities. Human papillomavirus causes cervical cancer in young women, but is no less dangerous for men. This disease is one of the main causes of mortality in women of childbearing age.
Sexually transmitted diseases often occur in men of reproductive age. The age of male sexual debut is now 16–17 years (and in 20% of cases it is 14 years) and the age of marriage is 26-28 years. Before marriage, the average man has a connection with 3-10 so-called Sexual Partners.
– But they say that prolonged abstinence for men is harmful …
– Abstinence has less harm than extramarital sex. In addition, the rules are largely determined by the male sexual constitution. What is harmful to humans and what is useful is best discussed with the doctor.
– At what age do you have to visit a doctor?
– On order Health Minister Skvortsova V.I. We are preparing proposals for the concept of "Male and Female Reproductive Health and Active Social Longevity", a male health pass, a young family certificate that defines three ages when men are advised to undergo 18 to 49 year olds followed by step 4 years at the expense of OMS. Also suggested age frame observation. First visit – from 18 to 25 years to assess their functional and reproductive ability. The most common diseases at this age are sexually transmitted diseases and injuries (pelvic bone fracture, urethral rupture).
The second compulsory examination is 40-45 years of age, where sexual function disorders are most common. The third is in adulthood (55+), with degenerative processes associated with aging, prostate disease and cancer.
However, if you experience pain, discomfort, sexual dysfunction and urination, consult a doctor immediately. Since early detection of diseases can protect against dangerous complications.