Tabloids Exaggerate Hair Loss Drug Risks for Men

According to British tabloid newspaper The Sun, men who take the hair loss drug known as finasteride in order to try to fight baldness are up to five times more likely to experience erectile dysfunction. Those statistics sound scary, and are probably more than enough to put many men off from ever trying such a drug. 

However, with this article the media have (not for the first time) been caught putting an exaggerated spin on the actual story. In fact, the evidence produced by the research is nowhere near as alarming as it would seem to be according to The Sun article.

The facts

The original research, which was conducted in the United States, used a medical records database in order to study the commonality of erectile dysfunction in men who were prescribed a pair of drugs, finasteride and dutasteride. Both of these are used to treat prostate enlargement which is not the result of cancer. 

The drugs block the male hormone known as testosterone, and finasteride is also used in low dosages as a treatment for male pattern baldness. The results of the study discovered that one in 17 of the men who were prescribed one of the two drugs had developed erectile dysfunction, a figure that shrank to one in 31 for those men who were given a finasteride prescription in order to treat baldness. 

There was a generally higher risk for those who made use of the drug for a longer period of time, but in almost 100 percent of the men, the problem disappeared as soon as they stopped taking the drug, which somewhat undercuts any inherent risk exaggerated by the media. The new research merely highlights a side effect of the drugs that was already well understood – and in the minority of cases where sexual problems did occur, in almost all cases the problem was resolved simply by stopping the intake of the drug.

The origins of the story

Researchers from the Italian University of Catania and Northwestern University in Chicago carried out the research with the aid of grants that came via the National Institutes of Health. The Post-Finasteride Syndrome Foundation also provided additional funding, with the study finally being published in PeerJ, a peer-reviewed medical journal. It’s available to download or read online free of charge. 

The results were exaggerated both by The Sun and by the Mail Online. While their stories of a greater risk of erectile dysfunction for men using the drug were generally true, they failed to point out that there is an incredibly small risk of any such sexual problems continuing after stopping the treatment. The claim, made by the Mail Online, that the erectile dysfunction caused by the drug could not be treated with the use of Viagra also appears to be completely unsupported by any of the scientific evidence in the study. The researchers only examined whether or not that drug was prescribed, and made no mention of its success or failure in treating the condition.

The nature of the research

The research was in the form of a cohort study, which was intended to determine if the amount of time in which certain drugs (referred to as 5a-reductase inhibitors) had any impact on the risk of developing erectile dysfunction. 

The drugs finasteride and dutasteride both inhibit testosterone by blocking the enzyme used in its metabolism, and finasteride has also been licensed to treat male pattern baldness when given in low doses. Side effects of erectile dysfunction and decreased libido have already been determined in both drugs; the aim of the study was to find out whether the conditions persisted following cessation of the drugs, and if there was any varying effect caused by the duration of exposure.

Conclusion

Less than one in 100 men continued to suffer erectile dysfunction after stopping taking the drug, meaning that any report alleging that the problem is permanent is something of a distortion of the facts. The study also only examined medical records from just one US region, a limitation that may not accurately reflect the commonality of erectile dysfunction in men prescribed the drugs. The results of the research do not in fact give particular cause for concern.

Older HIV patients being let down by social care sector

Research by the Terrence Higgins Trust into the care requirements of older individuals who are HIV positive has shown that the social care sector is letting them down. The evidence suggests that there is a real need for social care staff to be better trained, according to the National Care Association chairwoman. 

The Uncharted Territory report from the charity looked at the experiences of more than 300 people who are living with HIV and are over the age of 50. It came to the conclusion that their needs are not currently being met by the social care sector. 

The report discovered that there is no routine HIV training given to social care professionals during their basic inductions. Furthermore, there is no requirement at any time in their professional development to remain current with HIV research.

Older HIV sufferers facing discrimination

The report also noted that older people with HIV continue to face discrimination, including in care homes. In one instance, a man who had been hospitalised was not able to leave, as he was refused entry to two care homes due to being HIV positive. A third care home only offered to take him in if they received double the normal payment. 

In another incident, a woman in a care home in London who was HIV positive was encouraged to remain in her room, rather than interact with other residents. After using the TV remote control in the lounge, it was taken from her and scrubbed with antibacterial wipes. 

The report denounces this kind of conduct as being completely unacceptable. It says that HIV positive individuals in care homes should not be given different treatment to their peers, as such behaviour only further fuels the stigma and myths that surround the condition. The result is frequently the increased isolation of older residents living in residential care with HIV. The charity is now recommending that staff of social care providers receive continual professional training and development in HIV issues.

“Stark and disturbing”

The findings of the report were described as being “stark and disturbing” by the chairwoman of the National Care Association, Nadia Ahmed. Ahmed says that it is vital for social care services to be able to meet the needs of people. She also states that it is clear that there is a pressing requirement to give support, and appropriate training, to social care staff to make them aware of the facts of the condition. This will enable them to care for those in need of support and help. 

Ahmed added that the recommendations relating to greater awareness of training connected to HIV would be enforced by the National Care Association. She said that they would work to make sure that access was available to all of their providers and associated workplaces.

There was one more recommendation made by the report from the Terrence Higgins Trust. It said that England’s strategic body for the development of the adult social care workforce, Skills for Care – and its Welsh and Scottish equivalents – should ensure that dealing with both ageing and HIV should be a mandatory part of all induction and entry level training for social care workers.

According to the head of sector development at Skills for Care, Andy Tilden, the publishing of the study has been welcomed by the organisation. Tilden says that although HIV is not specifically mentioned in the Care Certificate, there is an expectation (on the part of Skills for Care) that employers make sure that all of their staff members have the kind of skills necessary for coping with the needs of anyone who accesses care and support services – including older HIV patients. 

Tilden went on to note that Skills for Care is willing to work with other organisations to ensure that all employees of the expanding adult social care sector are able to gain access to the most current learning and information. This will help them to offer the necessary amount of care and support that is required. Older people who may be worried about their HIV status can order a test online from the The STI Clinic, see their GP, or visit any NHS sexual health centre.

Erectile Dysfunction: What You Should Know

Erectile dysfunction, also known as impotence, is the inability to acquire and maintain an erection in order to be able to engage in sexual intercourse. Men do not have to be concerned about infrequent erection problems that occur occasionally, but erectile dysfunction that is becoming an ongoing issue can be a serious problem, resulting in relationship difficulties, affecting self-confidence and causing stress.

Difficulties in acquiring and maintaining erections may also be an indication of a more serious health problem that may require medical treatment, and can even be a risk factor for heart disease later on.

Symptoms

Symptoms of erectile dysfunction can include difficulty getting and keeping an erection as well as a general reduction in sexual desire. You should see your family doctor if:

  • You are worried about your erections, or have other sexual problems such as delayed or premature ejaculations
  • You have other symptoms that go together with erectile dysfunction
  • You have a known health condition such as diabetes or heart disease that may be linked to erectile dysfunction

Causes

Sexual arousal in males is a complicated process involving the brain, emotions, muscles, blood vessels, hormones and nerves, and problems with any of them can result in erectile dysfunction. Erectile dysfunction can also be caused or worsened by mental health concerns and stress. It can sometimes be caused by a combination of psychological and physical issues, such as the slowing of a sexual response caused by a minor physical complaint causing anxiety and stress, that in turn then makes the condition worse.

Physical causes A physical cause is the most common reason for erectile dysfunction, but there can be any number of conditions responsible such as:

  • Heart disease
  • High cholesterol
  • Obesity
  • Parkinson’s disease
  • The development of scar tissue inside the penis (Peyronie’s disease)
  • Use of tobacco
  • Sleep disorders
  • Injuries or surgeries affecting the spinal cord or pelvic area
  • Atherosclerosis (clogged blood vessels)
  • High blood pressure
  • Diabetes
  • Metabolic syndrome (involving high insulin levels, high cholesterol, high waist body fat and increased blood pressure)
  • Multiple sclerosis
  • Some prescription medications
  • Substance abuse including alcoholism
  • Enlarged prostate and prostate cancer treatments

Psychological causes

The brain has an important role to play in the sequence of physical events that result in an erection, which begins with feelings related to sexual excitement, but those feelings can be interfered with by a number of things that can cause erectile dysfunction or increase its severity, including:

  • Relationship problems caused by poor communication, stress and other factors
  • Stress from work or other sources
  • Anxiety, depression and other mental health conditions

Diagnosis

A physical exam and medical history will be all that is required for doctors to be able to diagnose erectile dysfunction in most men, and recommend a course of treatment. Consultation with a specialist (and sometimes more tests) may be required, if your doctor believes an underlying condition may be responsible, or if you suffer from chronic health problems. These tests could include a physical examination, ultrasound, urine and blood tests and a psychological exam. Another option is an overnight erection test which checks if men are having erections while asleep.

Treatments

There are a number of options for treatment for erectile dysfunction, which will depend both on the severity and the cause of the condition, and whether there are any underlying health problems.

One successful treatment for erectile dysfunction for a lot of men is in the form of oral medications. The medications, including the famous Viagra, increase blood flow and enable an erection to form due to sexual stimulation, by enhancing the normal effects of the natural chemical produced by the body known as nitric oxide, which relaxes the penis muscles. Other medications include self-injections into the penis, testosterone replacement, penis pumps, penile implants and blood vessel surgery, although the latter is very rare. A new analysis from Portugal’s University of Porto has also found that men with erectile dysfunction could benefit from physical activity or exercise, with researchers finding that men who exercised experienced an improvement in their condition. Exercise may be used alone or with medications for erectile dysfunction.

New device may help with urinary incontinence

Urinary incontinence is the term given to poor bladder control. There are a number of different kinds of incontinence that can have different causes, so it is important to consult a doctor if suffering symptoms.

The most common kinds of incontinence are:

  • Stress incontinence
  • Incontinence related to chronic retention
  • Functional incontinence
  • Urge incontinence

Stress incontinence

Stress incontinence refers to small amounts of urine leaking in the midst of activities that cause increased pressure to be put on the abdomen, which then pushes down on the bladder. This usually occurs in women, but it can also happen to men, particularly those who have undergone prostate surgery. Stress incontinence often occurs during activities such as coughing, laughing, playing sport, sneezing or lifting. Diabetes, constipation, obesity and chronic coughing connected to the likes of asthma, bronchitis or smoking can also be a contributing factor to stress incontinence. In women, stress incontinence can also be caused by childbirth, menopause and pregnancy.

Incontinence related to chronic retention

Incontinence related to chronic retention refers to the inability of the bladder to properly empty, which results in the leaking of small amounts of urine on a frequent basis. Indications that the bladder may not be emptying completely can include:

  • The feeling of having to strain in order to pass urine
  • Feeling the urge to urinate even immediately after a toilet visit
  • Passing urine during sleep
  • More urine dribbling out immediately after a toilet visit
  • A slow or weak stream of urine
  • No or little warning prior to an urgent desire to urinate
  • Frequent bouts of cystitis or urinary tract infections

Functional incontinence

Functional incontinence is an extreme form of incontinence where the affected person does not appreciate the desire to urinate or recognise where to urinate, which can result in urine being passed in inappropriate places. Functional incontinence can be caused by a number of factors such as dementia, poor mobility, environmental factors such as low chairs that are hard to get out of, difficult-to-access toilets or poor lighting, poor eyesight, poor dexterity with regard to fine motor skills, or just a refusal to go the toilet because of issues relating to anger, anxiety or depression.

Urge incontinence

Urge incontinence is the term for a sudden and very strong desire to urinate, also sometimes referred to as an overactive or unstable bladder, and as detrusor instability. The bladder muscle, in a bladder that is functioning in the correct manner, stays relaxed as the bladder begins to fill, with the desire to urinate beginning to form when it’s around half full, though the desire is usually not immediately urgent.

With urge incontinence however, the bladder can feel as though it is fuller than it really is; it contracts at an earlier stage than necessary resulting in a sudden and alarming need to urinate and even possible early leaking. Urge incontinence is more common in older people and is also believed to be associated with stress, alcohol and caffeine, although in some cases it can be linked to more serious causes such as stroke, multiple sclerosis, and Parkinson’s disease.

The ATOMS device

The ATOMS device, also known as the adjustable transobturator male system, can help to treat men suffering from incontinence after invasive prostate treatment. A recent study, assessing the efficacy and long-term safety of the device, has found an overall success rate of 90 percent after 31 months, as well as a 64 percent dry rate.

There are some major advantages to the ATOMS device in comparison to other options; dislocation is prevented by the the fixed anchoring as well as the adjustability of the outpatient setting. The most recent generation of the devices came with the non-disturbing and small scrotal port system, which is fully covered with silicon, and demonstrated excellent results with a short median operating time of 26 minutes, and overall ease of implantation. The median daily pad use and test fell from 4 and 400ml to just 1 and 18ml respectively for patients, resulting in a significant improvement in their quality of life.

The survey results leave little doubt that the ATOMS device will play a major future role in the treatment of male stress urinary incontinence.

Welcome to Academy Care

As you have probably guessed by now the new ‘academy care’ website is now live so we would like to take this opportunity to welcome you to it!

Over the coming weeks and months we will keep you updated as to what we have been up to, what happened at our recent events and where the project is is going.

Please check back soon for our regular updates and news as it happens.

Thank you for your interest in the Academy Care!