Sexual function is often a vane of health for middle-aged and older men, and many diseases such as diabetes, hyperlipidemia, and hypertensive disorders often present first with a decline in sexual function and only later with clinical symptoms of these major diseases. Therefore, there are many diseases associated with sexual function that are first detected in the male clinic. Sexual dysfunction is often superficial, and more diseases are likely to manifest themselves successively with the appearance of sexual dysfunction. The first detection of sexual dysfunction is a wake-up call for men’s health conditions, and with medical guidance and treatment, other serious diseases can be prevented. On this level, the emergence of sexual dysfunction is still relatively fortunate. Most middle-aged and older men with sexual dysfunction may have metabolic syndrome and androgen deficiency.
I. Metabolic syndrome and sexual dysfunction
For many middle-aged and elderly men, a big belly like wrapped swimming ring, eye areal puffiness like lying silkworms, is definitely not the performance of poise and temperament, may be suffering from the metabolic syndrome. It is only in the last 10 years or so that people have started to recognize metabolic syndrome. The incidence of metabolic syndrome has increased significantly in recent years and has become a major health hazard for middle-aged and elderly people due to factors such as over-nutrition, excessive social pressure, reduced exercise, faster pace of work and life and stress. Many studies at home and abroad have confirmed that people with erectile dysfunction (ED) are more likely to suffer from metabolic syndrome. Therefore, middle-aged and elderly men who develop ED must be alert to metabolic syndrome.
So, what exactly is metabolic syndrome a disease?
The following recommended definition from the National Cholesterol Education Program (NCEP) qualifies metabolic syndrome as meeting any three of the following four conditions.
That is, abdominal obesity, high cholesterol, high blood sugar and high blood pressure. Metabolic syndrome is a complex syndrome of physical dysfunction caused by obesity, elevated blood glucose, elevated blood pressure, and impaired lipid metabolism.
The main hazards of metabolic syndrome are.
1, metabolic syndrome is a preview signal of diabetes, metabolic syndrome can cause insulin resistance, leading to type II diabetes, nearly 50% of diabetic patients are developed from metabolic syndrome.
2, metabolic syndrome is a warning signal of coronary heart disease, 1/4 of patients with metabolic syndrome will newly develop coronary heart disease.
3, metabolic syndrome will aggravate coronary heart disease and other atherosclerosis, due to lipid metabolism disorders, bad cholesterol such as triglycerides and LDL rise, good cholesterol such as HDL fall, insulin resistance, etc., will seriously accelerate the disease process of atherosclerosis. Since metabolic syndrome is often the simultaneous presence of four risk factors, these risk factors can overlap and synergize, exacerbating the likelihood of developing serious diseases and increasing the morbidity and mortality of developing coronary heart disease, myocardial infarction, and cerebrovascular accidents. It has also been confirmed that metabolic syndrome increases the death rate of gastrointestinal malignancies, so some scholars call these four risk factors the “death quartet”, which has a poor prognosis and poses a great threat to health and life. Therefore, there is a saying that metabolic syndrome is one of the three major social problems that seriously endanger human health, together with AIDS and drug addiction.
The main causative factors of metabolic syndrome are abdominal obesity and insulin resistance, and its pathogenesis is generally considered to be related to a variety of factors such as genetics, environment and lifestyle, and is the result of the interaction of multiple factors. So, how to deal with metabolic syndrome?
The prevention of metabolic syndrome requires adjustments in the following areas.
First, adjust the dietary structure, balanced intake of protein, fat, carbohydrates, control salt intake to avoid excessive salty, and moderate consumption of vegetables, fruits, dairy products, etc. Secondly, moderate exercise is very important, such as walking, jogging, swimming, tai chi, etc., sedentary and lack of exercise is harmful to health, long-term moderate exercise is very beneficial. Thirdly, good habits are beneficial to the prevention of metabolic syndrome. Smoking, alcoholism, irregular work and rest, especially staying up late, is the cause of many diseases in daily life. The key to preventing metabolic syndrome is to control alcohol and stop smoking, and to have regular rest and relaxation. Fourth, maintain a good state of mind. A healthy state of mind, positive but not jealous, relaxed, this is the Yellow Emperor’s Classic of Internal Medicine called “calm and void, the true energy from the”, is conducive to the prevention of metabolic syndrome. In addition, the middle-aged and elderly people can have moderate sex to relieve their emotions, which is good for physical and mental health, and is also very important for the prevention of metabolic syndrome. If you are suffering from this disease according to the definition of metabolic syndrome, there is no need to panic, you should do the above mentioned points at the same time, consult a professional physician for treatment.
Second, androgen deficiency and sexual dysfunction
As we age, middle-aged and older men are growing in experience and rising in career, but often sexual function is declining. The report from the Massachusetts Male Aging Study confirmed that the incidence of ED in men aged 40-70 is 52%, which is more than half of the population is quite large. The reason for the decline in sexual function of middle-aged and elderly men, in addition to mental factors, the impact of metabolic syndrome, there is a significant proportion of people with gonads (testes) secretion androgen level is insufficient. This is the so-called “partial androgen deficiency syndrome in middle-aged and elderly men”, which is currently called “late onset gonadal dysfunction (LOH)”, similar to the commonly known “male menopause syndrome It is similar to what is commonly referred to as “male menopause syndrome”. The increase in the aging population has increased the incidence of LOH. As the saying goes, “a man is a flower at forty”. Men in this age group are at the stage of blossoming ideals and successful careers, but their organs are aging and their body functions are showing fatigue, which is manifested in the aging of skin, cardiovascular, gastrointestinal tract, urinary system, reproductive organs and sexual function, nervous system, bones, etc. Skin Wrinkles, muscle relaxation, hot flashes, reduced food intake, frequent urination, reduced libido, ED, impatience, sensitivity, depression, anxiety, insomnia, inability to concentrate, back and knee pain, hunchback, etc. These symptoms are all common syndromes of LOH. According to a study conducted by the Institute of Science and Technology of the National Population and Family Planning Commission, the prevalence of LOH in men aged 40-49 years is 19%; in men aged 50-59 years, the prevalence rises to 38%; and in men aged 60-69 years, the prevalence is 56%. Studies in Brazil have shown that diabetic men have lower levels of free and total testosterone than healthy people, and that diabetic men should have their testosterone levels tested more often.
The above two sets of figures on ED and LOH at home and abroad show that it is very urgent to pay attention to the health of middle-aged and elderly men, and to raise the attention of society and the public to ED and LOH. So, how to detect LOH? The internationally accepted androgen deficiency in middle-aged and older men (ADAM) self-assessment chart can help people diagnose themselves.
The ADAM self-test form covers 10 questions, which are.
1. Is there any loss of sexual desire?
2. Is there a decrease in physical performance?
3. Is there a decrease in physical strength and/or endurance?
4. Is there a decrease in height?
5. Is there a decrease in enjoyment of life?
6.Is there any sadness and/or bad temper?
7.Do you have erectile dysfunction?
8.Is there a recent decline in physical activity?
9.After meals, do you doze off and feel exhausted?
10, the recent work performance is not good?
The assessment criteria are.
A “yes” or “no” answer to each question, and a “yes” answer to question 1 or question 7 or any 3 other questions is considered a positive answer, i.e. a self-diagnosis of LOH. The simple design is ideal for middle-aged and older men to self-assess their androgen levels and understand their health status.
Studies have shown that when men reach the age of 30, the testosterone level in their bodies decreases at a rate of 1%-2% per year, which is an ageing change that starts to take place in the body. Obesity, especially abdominal obesity and visceral fat accumulation, is the most obvious feature of declining androgen levels, because excess fat will accelerate the conversion of testosterone to estradiol, causing testosterone levels to decline and libido and erectile function to diminish. Regular exercise and adequate sleep can promote testosterone secretion, so adhering to long-term moderate exercise, reasonable dietary structure, weight control and a disciplined lifestyle can help delay the onset of LOH.
After a lot of basic and clinical research, the academic community has reached a consensus on exogenous testosterone supplementation to prevent premature aging and treat LOH. Testosterone supplementation can be administered orally, by subcutaneous injection, by topical patches and gels, etc. At present, oral testosterone undecanoate is the most commonly used method in clinical practice, which is effective, safe and easy to use. Testosterone supplementation is prohibited for those with prostate cancer, and testosterone should be applied with caution for those with prostate enlargement with severe lower urinary tract obstruction, severe respiratory sleep apnea syndrome, severe heart failure and liver disease. According to Chinese medicine, the identification of LOH is in line with the Chinese medicine of kidney deficiency, liver depression and blood stasis obstruction, which belongs to the original deficiency and the actual symptoms. Using the treatment method of tonifying the kidney and draining the liver and activating blood stasis to open the ligaments can effectively control a series of symptoms brought about by LOH, thus improving the quality of life of patients. In conclusion, the decline of sexual function in middle-aged and elderly men will not simply affect family life, but more importantly, it will affect physical health, and is even a precursor to many serious diseases. Therefore, early diagnosis and treatment of sexual function problems is advisable, and the diagnosis, guidance and treatment by doctors will bring vitality and renewed physical function to patients.