Male Menopause or Andropause - Does it exist?

Menopause is the time in a women's life when her period stop. This usually occurs between the ages of 45-55. Andropause on the other hand is a gradual and highly variable decline in male hormones, especially testosterone. This may lead to symptoms and may start as early as middle age. It is a highly variable physiological decline and not every man will develop a low hormone state called hypogonadism.

Testosterone level in men will decline with age. A relatively low testosterone level associated with symptoms leads to a state of andropause or late onset hypogonadism.

There are many causes of low male hormones or low testosterone. They range from chronic illness such as diabetes; psychological problems such as depression or testes problems such as testicular atrophy.

Symptoms of male menopause include decline in general energy level, libido (interest in sex), erectile dysfunction, poor short term memory, unrestful sleep and build up of abdominal fat.

Treatment is available in the form of testosterone replacement therapy. This must be coupled with life style changes such as weight reduction, smoking cessation, increase in exercise and healthy diet.

Commonest cancer in young males - Testes cancer

Testes cancer or cancer occurring in the testicles of men is the commonest malignant cancer in men between the ages of 15 to 34.

It is usually diagnosed when a small and painless lump is felt in either of the testes. Sometimes, an unrelated incident such as trauma or infection of the testes would bring the patient's attention to this area, leading to the discovery of the lump. If left alone, the lump may grow very rapidly to the size of an orange in a few weeks. It may also spread to other regions of the body.

Men who are born with undescended testes have a higher chance of developing testes cancer.

Any discovery of a lump in the testes must be verified by a family doctor or urologist. An ultrasound scan of the testes will be performed to confirm the lump. This is a painless examination which takes only about 15 mins.

Blood tests for cancer markers will also be done.

Upon confirmation of a solid lump, the patient will have to undergo surgery to remove the affected testis. This is a simple day surgery with a small incision made over the groin.

Further treatment would depend on the type and stage of the cancer.

New - Green light laser surgery for prostate

Green light laser or Photoselective vaporization of prostate (PVP) is a relatively new treatment for prostate enlargement or BPH. BPH treatment is usually by prostate medications to either relax the urine tube or decrease the size of the prostate gland. However, surgery may be required in patients with more significant obstruction that is not responding to medical treatment or who have developed complications.

It is a form of minimally invasive surgery that evaporates prostate tissue which is blocking the flow of urine from the bladder. Green light laser uses a unique high power energy which is selectively absorbed by blood within the prostate tissue which leads to vaporization and removal of the tissue, leading to an open channel for passage of urine. As it is selectively absorbed by blood, green light laser seals blood vessels beneath the area of vaporization which results in substantially less bleeding, compared to traditional traditional transurethral resection of prostate (TURP). There are much fewer side effects and recovery is much quicker.

Circumcision may protect against transmission of HIV virus

Data presented during the American Urolgical Association, New York Section meeting in 2008 support the beneficial effect of circumcision in protecting against the transmission of the HIV virus.

About 30% of adult men would have undergone circumcision surgery. It is believed that the inner surface of the foreskin is keratinized and moist, making it is more susceptible to the HIV virus. Dr Sadghi-Nejad presented data from 3 studies which demonstrated the protective effect of circumcision. (Wawer, et al.; 15th Conference on Retroviruses and Opportunistic Infections; Boston, MA Feb 2008).

WHO and UNAIDS Consultation in March 2007 recommended circumcision be recognized as an effective preventative method for men who have sex with women (MSW) and that it be offered in addition to (not as a substitute for) other prevention strategies.”

About Dr Ho Siew Hong

Dr Ho Siew Hong obtained his basic medical degree from National University of Singapore in 1993. He went on to obtain fellowships in surgery from the Royal Colleges of Surgeons of Edinburgh and Glasgow before being admitted to the International College of Surgeons.

He underwent advanced training in urology and was admitted to the chapter of urologist of the Academy of Medicine, Singapore. He spent a year in Westmead Hospital, Sydney, Australia as a fellow in the endourology and laparoscopy. Returning to Singapore, he served as a consultant urologist, initiating and developing percutaneous and laparoscopic urological surgery. In pursuit of his interest in advanced laparoscopy, he further trained in Institut Mutualiste Monstsouris, Paris, France in techniques of extra peritoneal laparoscopic radical prostatectomy.

Dr. Ho is a keen researcher and teacher. He is a clinical teacher and examiner for National University of Singapore, Nanyang Polytechnic and Edith Cowan University of Western Australia (off-campus).

He is the Medical Director and Senior Urologist at S H Ho Urology and Laparscopy Centre, Singapore which was established in 2007. This is a specialized urology centre based in Gleneagles Hospital.

Urology Clinic in Singapore

S H Ho Urology and Laparoscopy Centre is the practice of Dr Ho Siew Hong. We are located at Gleneagles Medical Centre, Singapore.

We are an urology clinic providing care to adult and child for urology conditions such as prostate problems; cancer of the kidney, prostate, bladder and testes; kidney, bladder and ureter stone problems; urine incontinence. We are also strong in the area of men's health, especially in management of erectile dysfunction, low male hormones and male fertility problems.

Our strength in the techniques of minimally invasive surgery such as laparoscopy, percutaneous surgery and endoscopy surgery. This results in less discomfort after surgery and a quicker recovery.