Wednesday, September 30, 2009

News headlines are no way to discuss complexities around vaccination

There has been understandable concern following the death of 14 year old Natalie Morton shortly after she was given the HPV vaccine Cervarix. We don't know whether the vaccine played a part in her death but we do know - or ought to - that sooner or later someone probably will die as a result of the HPV vaccination programme in the UK.

In the US there have been deaths linked to their HPV vaccine, Gardasil and few if any vaccines are entirely risk-free. The question is whether the number of lives saved is worth the risk. The HPV virus causes cervical cancer which kills over 1,000 women every year in the UK. These issues of balance are not easy for the news-driven media to cover.

But the debate over HPV is not going away anytime soon. Earlier this month the US Food and Drink Administration voted to recommend Gardasil for males ages 9 to 26 to prevent genital warts. Two years ago malehealth readers voted that boys SHOULD get the HPV jab. It's a complex issue - as well as genital warts, HPV is also responsible for 50% of cases of penis cancer - more serious than warts, true, but incredibly rare and, even then, rarely fatal. Vaccinating boys will, of course, protect girls from HPV too.

We need to discuss these difficult issues around vaccination. Otherwise, what will be the reaction when the first vaccinated boy dies? Killed by a vaccine against a virus that is not - in males - life-threatening.

Monday, September 28, 2009

The business case for a shorter working week

Following the fantastic news in New Scientist last week, I don't know if the mag's readers will be out of bed yet to read this. Yes, NS reported favourably on research in the state of Utah, USA in which all state employees except emergency services have been put on a four day week (same hours but worked over four days). So far it has reduced energy costs by 13%, reduced sick leave and 70% of employees prefer it. A full report is due next month.

Health campaigners have long argued that long working hours are dangerous and the Utah experiment could help demonstrate this. (I've even suggested that work will become the main cause of men's ill health in the developed world.) On the other hand it could make things worse if working days become longer and blackberryaholics continue to work over their three day week-end just as they continue to work over a two day one.

What is clear is that if businesses can see that their obsessive need to have people in the office is costing them money, this debate may finally get somewhere. At last there is a business case for a work-life balance.

Friday, September 25, 2009

Online buying: even regulators don't get the real problem

My Radio 4 Case Notes interview is now online. I'm talking about the dangers of buying drugs online without a prescription. The message is still not getting through. And not just to the men who are buying them. Even the regulators don't understand.

The interviewee on the programme from the MHRA (Medicines and Healthcare products Regulatory Agency) only talks about the fact that it is illegal and you might get counterfeit drugs or drugs that don't have the patient information leaflets or are out of date or come in a foreign language box. All true but not the main point. Hardly anyone reads the patient information sheet anyway.

The main point - and it can't be made often enough - is that diagnosing yourself may mean you miss something serious. If you're having erection problems, for example, it may be a symptom of heart disease, diabetes or depression - these are serious illnesses which if left untreated can be fatal. Simple.

We need the regulators and indeed the drug companies to make this point and stop just babbling on about illegality. This mantra misleads men and leads them to assume that all that is really at stake is drug company profits. It's not. It's their own lives. It may be a bit embarrassing to go to the doctor because you can't get an erection but it might save your life.

There's more on this in our Buying Drugs Online section.

Saturday, September 19, 2009

Help us update our award-winning websites

Malehealth was commended in the British Medical Association's patient information awards this month.

Obviously we're about communicating with patients or potential ones rather than medics but I was still delighted to see the site recognised once again by the doctors. We’re currently overhauling both the Forum’s sites to bring them up to date with modern media technology so to win an award before this is implemented is a real tribute to the “by men for men” content of malehealth.

The current websites are built on technology that is seven years old - an eon in techie terms - and are currently kept on the road with much the same combination of luck and sweat as a vintage car. But as well as rebuilding the technology behind the scenes, we're updating the design and interface of the sites for, as the marketing men say, a brand new, improved user's experience - looking up health information has never been so easy or so much fun! What do you think of our new designs? Your feedback is warmly welcomed - just post a comment by clicking on the word 'comments' below. Clicking on the image will give you the full size page dummy and then use the back button in your browser bar to return to this page. (Ignore the typos. We do know how to spell exercise - honest.)

Friday, September 18, 2009

Choice is not the issue, especially in health care

Choice is surely the weasaliest word in the modern politician's lexicon. Has choice made our education system better? No. Has it met the pushier aspirations of the handful of middle-class marginal voters who decide elections in our first past the post electoral system? Yes.

I've argued before that when it comes to health care, choice is the reddest of herrings. Yes, the opportunity to register with whichever GP is more convenient makes sense, as health minister Andy Burnham outlined yesterday but if it is accompanied by league tables or some other ludicrous 'performance indicators', it will only increase the risk of a two or even three tier health care system.

If resources follow patients what will happen to the health outcomes of those left in the less popular practices? And in what parts of the city will those practices be, do you think? Let's talk Glasgow, as an example. Are these popular practices more likely to be in, say, Calton, a deprived part of Glasgow with a male life-expectancy of just 54 or in those parts of the same city where the life-expectancy is already 28 years longer? Come on, Mr Burnham, the clue's in the question.

So let's talk about what really matters in health care. More choice never made any sick patient feel better. Quality treatment does. And that should be available to everyone regardless of who their GP is.

Wednesday, September 16, 2009

The male mid-life crisis at midnight

My odyssey round the studios of the BBC continued yesterday when I was the guest on Richard Bacon’s great little late night show on Radio 5 Live. The subject was mid-life crisis.

Of course, the desire to hang around television centre at midnight getting excited about the prospect of seeing the guests on Later might be a sign of a mid-life crisis in itself but we’ll let that pass. The advantage of a programme going out live is that no editor will cut you for not saying the right thing as happened with the vasectomy programme I posted about yesterday. The disadvantage is that you come out thinking of all the things you should have said but didn't.

I was debating with a comedy writer from New York who thought that mid-life crisis didn’t exist. I said that the mountains of very similar emails from women to malehealth proved that it did. He argued that it was just an excuse for a lot of men to behave badly. Now I can’t disagree with that, but just as swine flu is an excuse for a lot of people to skive off work for a week doesn’t mean that many other people don’t have it and that, for a minority, it may be very serious.

Clearly there is something going on at the mid point in many men’s lives. (The French date it a bit more precisely than we do by calling it la crise de quarantaine – the crisis of the 40s.) Even if a lot of these guys are just swinging the lead or refusing to face up to responsibility, it’s still interesting to ask why. But, because of the argument about whether it existed or not, we never really got onto. My take on it is that, handled properly (ie. not denied), a mid-life crisis could be one of the best things that has ever happened to you because you’ll come out of it knowing yourself better.

I don’t believe you can make yourself happy – although you can make a major mid life mess if you don't understand this point – but you can be happy. And that involves being content and comfortable with who you really are – not who you or someone else would like you to be. In some men it takes a crisis - doing something stupid - to realise this. But I never quite managed to say this during the programme.

I must admit I still find going on the radio exciting and get really nervous beforehand even though I’ve done it a fair few times now. You get caught up in the roll of the show and don’t always manage to get your point over. So was it worth traipsing up to Shepherd’s Bush at the witching hour? You bet. The sight of Jeremy Paxman running out of the Newsnight studio closely followed by a fat man with a clipboard and the Archbishop of Canterbury is not something you see everyday. The perfect image for radio, it was funny to witness but probably even funnier in your mind’s eye. Next stop: Radio 4's Case Notes and online drugs.

Tuesday, September 15, 2009

Another kick in the nuts for men with PVP

Forget yesterday's post. Email from the lovely Dawn at BBC Scotland who interviewed me for the vasectomy programme:

'I've just seem your update on malehealth and thought I should email straight away. Unfortunately in the end I did not use you in the programme as my editor wanted it to be case study heavy and to feature the actual operation.' Great radio, Dawn but what will we learn?

Mark Williams is also on the cutting room floor. 'What my editor wanted in the end was a programme that represented the normal experience of a vasectomy.'

This editor does to seem to have understood that post-vasectomy pain (PVP) and poor erections are the normal experience of vasectomy for too many men. So this decision is a bit of a kick in the crutch for them really - rather like having another vasectomy.

The BBC, eh? No, I'm not going to join in the chorus of criticism. The reason this timidity has come as such a surprise to me is that it's so rare that the beeb miss the real story. Perhaps Dawn can persuade her editor to do a future programme on PVP.

Monday, September 14, 2009

'You’d never catch a urologist having a vasectomy'

Vasectomy continues to be one of the most popular topics on malehealth. I'll be talking about it on Radio Scotland at 11.30am on Wednesday 16 September 2009.

One malehealth reader Mark Williams will also be on the programme telling his story of ‘a continuous and sometimes excruciating pain’. He was told, amazingly: 'You’d never catch a urologist having a vasectomy'. Shame then that he'd already had the operation.

What's going on here? We are building up quite a file on vasectomy at malehealth. How come this supposedly routine operation seems to leave so many men in pain? And why are there no meaningful guidelines on the procedure from any of the Royal Colleges or the National Institute of Clinical Excellence?

It seems to me that the truth is as uncomfortable as a post-vasectomy patient. We'd all like vasectomy to be a pain-free and simple as described because, if it was, it would be ideal way to avoid unwanted pregnancy. Trouble is it doesn't work like that and a lot of doctor, health campaigners, men and women are struggling to accept that we may need to talk about the more complicated alternatives.

Friday, September 11, 2009

This online service is just what we've been waiting for

Ever since malehealth's Ask the Doctor feature closed down for lack of funding we've had dozens of emails a month from men wanting to ask a doctor a question online. Prostates, erection problems and premature ejaculation have been common topics.

Now, thanks to two pioneering new websites from the European Men's Health Forum (EMHF), men can at last get an answer to these questions in complete confidence without ever going near a GP's surgery or even talking on the phone - it's all online and all anonymous. The two sites are Your Prostate ( and Malehealth Questions ( which will deal with any aspects of ED and PE.

These are among the topics we are most frequently asked about on malehealth. There's lots of stuff out there on the internet all these issues but can you trust it? The EMHF is a trusted source. The MHF are members. Nobody will try to flog you anything and nothing goes on your medical records. There's no pressure and because it's by email, you go at your own speed at your own convenience at a time that suits.

Men have been asking for this for a long time and at last it's here. In fact, I was so impressed by what they were offering that I was happy to let the malehealth name be used. The service won't be available for ever so if you have a question on prostates, erection problems or premature ejaculation - and most men will have something to ask on at least one of these - now is your chance to ask.

Tuesday, September 8, 2009

Approach your problem side on

Here's an idea that may make it easier to talk about what's on your mind: Be active to the front and talk to the side.

By focussing on an activity in front of you, something arty, fixing the car, gardening or just doing the dishes will make it easier for you to discuss what’s on your mind with someone standing or sitting next to you. This will improve your mental health and may help improve other aspects of your relationship with that person too.

Good advice? Don't thank me, thank an anonymous malehealth reader. For our Men's Health Week competition, we were looking for an original and simple health tip. And this one leapt out at me - it works and yet I'd never heard it before. It was the best of nearly 1500 entries to the competition and many of them are equally simple yet effective. It proves what I've always believed: that good health is pretty simple and rarely requires major life changes. It also proves that you can never know it all and that there are always good ideas out there.

These two ideas are at the forefront of my mind as we redevelop the malehealth website. In the future it will be easier for you to share ideas with our readers. Watch this space for news of our redesign because we'll be looking for your views.

Meanwhile check out our Men's Health Week readers' tips plus our regular tips of the month section.

Wednesday, September 2, 2009

Latest Exercises for Scott Pearson's column

This month's videos from Scott (Sept 2009). Scott's column is here.

Incline/Wall Press Up:

Chair Squat

Box - or tricep - dips:

Bodyweight lunge: