Empowering men
HUMAN civilisation started out in hunter- gatherer tribes, where differences in physical ability led to the creation of gender- specific roles: men typically did the hunting while women gathered resources from the wild.
The physical size and strength of men have placed them in positions of power throughout history, all of which laid the foundations of what we now consider masculinity.
Masculinity is known by a variety of terms, including manliness and machismo. Aggression and sexual arousal became traits that are commonly associated with men and have become used as identifiers to distinguish men from women.
Therefore, being masculine became about fitting into a certain box, the building blocks of which were strength and sexual prowess.
As a result, boys grow up with a certain pressure to live up to ageold expectations or risk becoming “less of a man”.
Timely shift of attitudes
The role of sexual ability in determining masculinity has perhaps led to the belief that failure to perform sexually calls a man’s very identity into question.
Even with the advanced state of healthcare today, some men suffer from all kinds of health issues, including sexual disorders, in silence because seeking medical assistance is considered a sign of inadequacy or weakness.
It comes as no surprise then that men have shorter life expectancies and a well- documented history of poor health compared to women.
The situation is not all doom and gloom though – andrologist Dr Mohd Ismail Mohd Tambi says that awareness of sexual and reproductive issues among men has been on the rise, although the hesitance to visiting a doctor regularly is still visible.
“Most men wait too long then come to see me expecting an overnight cure, which is just not how it works,” he says.
For example, Dr Mohd Ismail explains that the treatment of erectile difficulties often involves investigating and curing the root cause, which may take some time.
“Sexual dysfunction can be caused by health conditions or medication used to treat those conditions. It is usually an indicator of an underlying issue, which must be addressed primarily,” he explains.
Consultant urologist and transplant surgeon at Columbia Asia Hospital Puchong Dr Arumuga Kumar observes that partners play an increasingly important role in men bringing their sexual issues to light.
“We see a trend of spouses pushing men to seek treatment, and some patients even come with their partners now instead of suffering alone without being able to express it,” he says.
This highlights the importance of support and understanding within relationships, which go a long way in dismissing thoughts of inadequacy or shame among men with sexual issues.
Stress and anxiety are known contributors of sexual dysfunction but can also be the product of it, thus trapping men in an unfortunate cycle that they find tough to break out of on their own.
More than meets the eye
According to Dr Arumuga, a common condition faced by Malaysian men is erectile dysfunction, both psychogenic ( caused by psychological or emotional stressors) and vasculogenic ( caused by blood vessel dysfunction).
The former is commonly associated with premature ejaculation, occurring more often among younger men.
Psychological stressors are not the only contributor. A 2011 profile on Malaysian men’s health challenges published in the Asian Journal of Andrology emphasised the holistic approach adapted in modern healthcare, which includes male psychological, social and physical health.
“We have to take overall health into account when discussing sexual health. More often than not, these sexual conditions are the result of other diseases,” says Dr Mohd Ismail.
These include major noncommunicable diseases such as diabetes or blood pressure and cardiovascular complications. Diabetics, for example, may experience nerve control issues that can cause ejaculatory disturbances.
“Diabetes also affects microcirculation, which can then affect bodily functions, including those of sexual organs,” says Dr Sendhil Kumar, consultant ophthalmologist at Mahkota Medical Centre.
The eyes can be an indicator of a person’s general health condition because of the micro blood vessels they contain, which make them the “window to a body’s microcirculatory network”.