Essentials of Men’s Health is unique in being the first comprehensive textbook on men’s health that is directed primarily at practicing clinicians—primary care providers, family physicians, internists, endocrinologists, andrologists, and urologists—who care for men with these problems. The textbook emphasizes an evidence-based approach to disease management, integrated models of patient-centric treatment, and a pathophysiological basis of major men’s health problems; it offers useful guidance on optimizing workflow, includes many patient education tools and resources, and its management strategies are well aligned with recent trends in health care delivery. The textbook has been authored by internationally recognized experts in the content areas.
The emergence of men’s health as a distinct discipline within internal medicine is founded on the wide consensus that men and women differ across their lifespan in their susceptibility to disease, in the clinical manifestations of the disease, and in their response to treatment. Furthermore, men and women weigh the health consequences of illness differently and have different motivations for seeking care. Men and women experience different types of disparities in access to health care services and in the manner in which health care is delivered to them because of a complex array of socioeconomic and cultural factors. Attitudinal and institutional barriers to accessing care; fear and embarrassment due to the perception that it is not manly to seek medical help; and reticence on the part of male patients and physicians to discuss issues related to sexuality, urogenital tract problems, drug use, body image, and aging have heightened the need for a textbook tailored to address the issues that are specific to men’s health.
A confluence of historical factors has rendered such a textbook timely. Gender-specific integrated clinics have long existed for women, but men’s health centers have emerged only recently as a novel practice model. In a reflection of the growing attention on issues related to men’s health, men’s health clinics have mushroomed all over the country. Although the major threats to men’s health have not changed—heart disease, cancer, and unintentional injury continue to dominate the list of major medical causes of morbidity and mortality in men—the men who attend men’s health clinics do so largely for sexual, reproductive, and urological health concerns involving common conditions, such as androgen deficiency syndromes, age-related decline in testosterone levels, sexual dysfunction, muscle dysmorphia and anabolic-androgenic steroid use, lower urinary tract symptoms, and medical complications of cancer treatment, which are the focus of this textbook.
For much of human history, societal views of reproductive health and human sexuality were dictated by religious dogma, and issues of sexual health or urogenital problems were rarely discussed in public. The discovery of Viagra and the appearance of Senator Bob Dole in Viagra advertisements helped remove the stigma from genitourinary and sexual problems and have made it easier for men to discuss and seek treatment for their sexual, reproductive, and urogenital problems. The growing interest in men’s health is also reflected in the extraordinary increase in prescription sales of testosterone and products for erectile dysfunction, such as Viagra. As our population ages and greater focus is placed on a holistic approach to men’s health, there is a clear need for all practicing clinicians, but particularly primary care physicians, who are on the frontlines, to have a clear understanding of the issues affecting men’s health, including their sexual, reproductive, and genitourinary health. As a reflection of the growing societal interest in men’s health, there are over 100 lay books on this topic on Amazon’s website, but these books are written as selfhelp books for the lay public.
The book is contemporary and comprehensive in its coverage of topics related to men’s health, including androgen disorders, various types of sexual dysfunction, reproductive problems associated with aging in men, sexually transmitted diseases and high-risk behaviors in men, body image disorders and the use of appearance- and performance-enhancing substances, infertility, contraception, reproductive problems among cancer survivors, and urological problems in primary care practice. The section on transgender health offers guidance on integrated care of transgender people and optimization of gender-affirming therapies.
The coverage of these topics that are specific to men’s health in textbooks of internal medicine and in medical school curricula has remained limited in spite of the high prevalence of these conditions and their known impact on overall health, well-being, and quality of life. Primary care providers and internists receive little training in managing these problems and find themselves inadequately prepared to care for these patients. Recognizing this unmet need, several professional organizations, such as the American Urological Association, the American Society of Men’s Health, and the American Society of Andrology, have deemed the development of curriculum in men’s health a national priority. Essentials of Men’s Health was developed to fulfill this mandate and address an unmet need in medical education.
Shalender Bhasin, MB, BS
Professor of Medicine, Harvard Medical School
Director, Research Program in Men’s Health:
Aging and Metabolism
Director, Boston Claude D. Pepper Older
Americans Independence Center
Brigham and Women’s Hospital