THE STAR, TUESDAY 26 NOVEMBER 2019
YOUR HEALTH
Pressing play on the pause in life
By NGEH CHEE YEN
MOVEMBER, an annual event
involving growing moustaches
throughout the month of
November, aims to raise awareness
of men’s health. Men’s health takes
centre stage, and efforts are taken
to spread awareness and help men,
covering topics including prostate
cancer, testicular cancer and
mental health. However, there is
another enemy to an ageing man’s
health – the male “menopause”,
also known as andropause.
A 2013 article titled Andropause:
Current concepts published in
Indian Journal of Endocrinology and
Metabolism defines andropause as
a syndrome associated with a
decrease in sexual satisfaction or a
decline in the feeling of general
well-being, caused by low levels of
testosterone in older men.
Testosterone does more than fuel a
man’s sex drive, as it also affects
changes during puberty, mental
and physical energy, muscle mass,
the fight-or-flight response and
other key evolutionary features.
Public awareness for
andropause is very low and is still
debated among some in the
medical community on whether it
should be considered an actual
condition. This is because
andropause differs vastly from
female menopause, namely
because not all men experience it,
and it does not involve a complete
shutdown of your reproductive
organs.
Change does not come
easy
A drop in testosterone levels
usually occurs in men aged
between 40 and 55 years old.
Healthline Media Incorporation, a
US-based provider of health
information, explains that when
this happens, men may experience
symptoms such as low energy,
depression or sadness, decreased
motivation, lowered self-
confidence, difficulty
concentrating, insomnia or
difficulty sleeping, increased body
fat, reduced muscle mass, physical
Changes in your body should not deter you from living a normal life with
your loved ones.
Share your life experiences with trusted ones and support one another as you go through life together.
weakness, breast tissue
development, decreased bone
density, erectile dysfunction,
reduced libido and infertility.
It is also important to note that
certain symptoms are precipitated
by changes in the man’s life, such
the sudden disability or death of
parents, friends or colleagues,
children leaving the home, job
changes or fear of job loss, slowing
down or loss of physical abilities,
sexual dysfunction and worries
about virility, concerns about
future goals and directions, and
financial worries.
Walking a lonely road
Overall, andropause causes a lot
of changes in a man’s life.
However, issues that stem from
andropause are sometimes made
worse because men generally find
it harder to share their problems
with someone else. Rotundus, a
UK-based community interest
company set up to support those in
need of help with mental health,
wrote Why Men Are Rubbish At
Sharing Their Feelings? last year
explaining the complexities that
dictate men’s interactions and
expressions of vulnerability.
In the article, three factors were
mentioned – stereotype/image,
nurturing and security. In
summary, men find it harder to
share their problems because:
l It can denote weakness in a
world where “true” men are
stereotyped to be strong
l Most boys build coping
mechanisms for negative
experiences by example of how
other men around them act when
faced with negative experiences
l Bottling up emotions may be a
What is hormone replacement therapy?
A 2002 study titled Andropause
and quality of life: findings from
patient focus groups and clinical
experts published in Maturitas
found that patients generally felt
testosterone or hormone
replacement therapy (HRT) led to
improved andropause
symptoms, including better
energy levels and, to a lesser
extent, improved libido and
erectile function.
HRT replaces the testosterone
in men through oral tablets,
injections, long-acting slow-
release pellets, patches or gels.
MyHealth under the Malaysian
Health Ministry explains that
men will have to undergo
evaluations before carrying out
the treatment to ensure the body
survival mechanism so as to not
appear weak and helpless
The article cautions, however,
that these behaviours are not
healthy as long-term pent up
emotions can end up in anger
outbursts or mental breakdown,
and their loved ones will bear the
brunt of it. Therefore, it is
important for men to share with
a loved one or trustworthy party
to ensure their problems can be
handled sooner rather than later.
Better coping with
understanding
Andropause is a stealthy
condition, and most of the time,
men do not realise the changes as
they are happening. Jed Diamond,
a licensed psychotherapist and
is healthy enough to withstand
the extra testosterone. This is
because testosterone stimulates
prostate growth and can
exacerbate existing prostate
cancer. Therefore, tests must be
done by your urologist before
HRT can be prescribed.
The Health Ministry also
recommends follow-ups to
ensure your testosterone dosage
and side effects are monitored.
In Malaysia, if you think you
have andropause symptoms, you
can see healthcare professionals
at Government clinics, Klinik
Nur Sejahtera LPPKN clinics or
Family Planning Associate clinics
for advice and assessment. You
may then be referred to a
urologist if HRT is required.
director of MenAlive, a health
programme focused on men’s
health, says many men and their
loved ones do not understand the
inevitable changes that go on in a
man’s body, mind, and spirit in
their mid-life.
Therefore, he illustrates how
andropause can affect a man and
his loved ones so they can better
understand and cope with the
condition as a family.
l Men and women often go
through mid-life changes at the
same time. A great deal of mutual
understanding is needed to support
each other’s process.
l Parents often go through
menopause or andropause while
their children are going through
adolescence. Conflicts can arise if
changes on both sides are not
understood.
l Andropause generally arises
slowly over a number of years.
Symptoms may be difficult to
recognise and interpret, and
sometimes arise and abate very
quickly.
l Andropause shifts the male
identity, so such a change can be
terrifying to any man.
l Andropause has less research
done in comparison to menopause
in women, so some medical
professionals may not fully
understand or accept the concept of
andropause.
l Andropause can be treated
with a number of methods,
including hormone replacement
therapy, exercise, diet, medication,
cognitive and psychotherapeutic
support, and couples and family
therapy.
Taking back control
Awareness on men’s health has
slowly increased in time with the
help of efforts such as Movember
and growing usage of the Internet
among the elderly. However, Carol
Bradley Bursack, an eldercare
consultant and author for website
AgingCare, says there is still much
work to be done to fully lift the
taboo and sensitivity of discussing
men’s health, especially when it
involves changing male identity as
they age.
Her article, Andropause: A taboo
topic for many men, notes that one
factor that can be improved is the
way society and media portray the
condition. While we do see erectile
dysfunction medication
advertisements on media, little is
spoken about what causes it among
other issues. Therefore, she urges
men to regain control by finding a
balance in life, such as looking for
new goals to aim for and sharing
life experiences with people you
trust and love. Seeking help from
therapists, psychiatrists, doctors,
nutritionists or fitness experts can
also help in certain areas of your
life.
As we move forward in men’s
health globally, men themselves
must recognise, step up and take
charge of the changes in their body
as they age. These may be the first
steps you can take to ensure healthy
ageing and stronger relationships
with your loved ones down the line.
2 Your Health
Safe for babies
PARENTS usually use regular dishwashing
liquid detergent to clean their babies’
accessories, including drinking cups,
feeding bowls, spoons and toys. However,
if these accessories are not thoroughly
rinsed with clean water, babies will end
up ingesting dishwashing detergent
residue, which is harmful and can affect
babies’ health.
For baby accessories
Pureen Liquid Cleanser is carefully
formulated with plant-based surfactants
that are safe, mild and gentle. Parents can
rest assured that Pureen Liquid Cleanser is
effective in washing away milk fat and
stains on baby accessories. It can be rinsed
off easily and does not leave harmful
residue. The formulation is so gentle that
parents’ hands will be protected against
dryness, which may happen with regular
dishwashing detergent.
To use, mix half a teaspoon of Pureen
Liquid Cleanser into one litre of water and
immerse baby accessories into the
solution, then rinse thoroughly with clean
water.
For fruits and vegetables
The pesticides found on the surfaces of
fruits and vegetables may cause adverse
health effects. Pureen Liquid Cleanser
removes the chemical residue on fruits
and vegetables. When tested, it effectively
removed more than 99% of pesticides
commonly found on the surfaces of fruits
and vegetables.
To use, mix a quarter of a teaspoon of
Pureen Liquid Cleanser into five litres of
water, soak fresh fruits and vegetables for
about five minutes, then rinse thoroughly
with clean water.
Pureen Liquid Cleanser is a mild, gentle
formulation, ideal for cleaning baby
accessories, fruits and vegetables. It comes
in three variants – No Flavour, Orange
Flavour and Mint Flavour, and is also
available in 600ml refill packs. Pureen
Liquid Cleanser is available in all
leading hypermarkets, supermarkets,
departmental stores, medical halls and
pharmacies.
n For more information, visit
www.pureen.com.my
Pureen Liquid
Cleanser helps
you ensure your
baby’s accessories
and the fresh
fruits and
vegetables you
eat are free of
detergent residue
and pesticides.
THE STAR, TUESDAY 26 NOVEMBER 2019
Nutrients for eye health
IN recent years, several clinical trials and
epidemiological studies have been conducted
to evaluate the role of nutrients to improve
A previous study showed that the
inflammation of macular pigment among
heavy smokers was higher than light or non-
or prevent visual loss in the elderly. Many of smokers. The finding showed that serum
these nutrients are strong antioxidants. concentrations of lutein and zeaxanthin are
Among the causes of visual loss worldwide essential for smokers because they have
is age-related macular degeneration (AMD). lower macular pigment optical density than
AMD is the second most common cause of non-smokers. Dietary intakes of lutein and
blindness after cataracts in all regions. The zeaxanthin also differ with age, sex and
rising prevalence of eye disease causes a ethnicity.
major social and economic burden to There is still no established recommended
countries’ healthcare costs. daily intake for lutein and zeaxanthin, but
AMD affects the macula, which is
responsible for high-acuity daylight vision in
there have been health benefits observed in
studies with a daily intake of 10mg lutein
the central area of the retina. The causes of and 2mg zeaxanthin, according to a 2014
AMD are many, and may include genetic study titled A double-blind, placebo-controlled
predisposition, ageing and high oxidative study on the effects of lutein and zeaxanthin
stress. To date, numerous studies suggest a on photostress recovery, glare disability, and
positive association between dietary chromatic contrast published in Investigative
micronutrients and decreases of progression Ophthalmology & Visual Science.
in AMD and other eye-related diseases. Supplementation of these nutrients should
These studies have generated interest in be in moderate doses following evidence-
micronutrients with antioxidant capabilities based recommended dosages and reference
to prevent oxidative damage involved in the intakes and are advisable to be taken as
development of degenerative eye diseases. dietary supplements.
Thus, these micronutrients, including This article is brought to you by Asia
antioxidants, vitamins and minerals, are Healthcare Sdn Bhd.
attractive as promising strategies for
preventative intervention. n For more information, call 03-6156 2836
Human intervention studies demonstrate or 03-6156 2936.
that lutein and zeaxanthin supplementations
improved visual performances, such as
contrast sensitivity, glare tolerance and
photostress recovery. The results obtained
from the Age-Related Eye Disease Study 2
(AREDS 2) shows the beneficial effect of
lutein and zeaxanthin supplementation
related to AMD.
There are many factors affecting the
degeneration of the macular pigment.
Lifestyle and dietary factors are important
and should be taken into consideration for
prevention or slowing the progression of
early AMD. Poor lifestyle choices, such as
physical inactivity, poor diet and smoking
can increase the risk of AMD.
THE STAR, TUESDAY 26 NOVEMBER 2019 3
4 Your Health
The nuisance
of dry eye disease
THE tear film is an extremely important
layer on the eye surface. It maintains the
smoothness of the surface for good vision
and comfort. It is made up of three layers:
mucin, water and lipid. A disturbance in the
balance of the three components may lead to
symptomatic dry eyes.
Dry eye disease is a common pathology
affecting more than 20% of the population,
with symptoms increasing in prevalence
with age. Conditions of a modern lifestyle
(including working on computer screens,
driving cars, exposure to artificial lights and
air pollution, and wearing contact lenses)
make dry eye syndrome a more frequent
nuisance.
Generally, it is a result of a tear film issue,
either caused by insufficient tears or
excessive evaporation. It is recognised that a
majority of cases are caused by evaporation,
mainly because of an insufficiency of the
external lipid layer of the tear film secreted
by glands in the eyelids, which are known as
Meibomian glands.
Dry eye disease is an unpleasant sensory
and emotional experience for patients.
Burdened with discomfort and fear, patients
often feel miserable, not knowing how to
precisely describe what they are feeling.
Most feel exasperated because no one
understands their condition. Mild cases can
lead to frequent visits to eye care
practitioners while moderate to severe cases
are often associated with significant pain,
limitations in performing daily activities,
reduced vitality, poor general health and, in
some cases, depression.
The treatment is particularly frustrating to
THE STAR, TUESDAY 26 NOVEMBER 2019
both patient and practitioner as it often
interferes with the overall management and The latest method of
perceived satisfaction of the patient. treating dry eye disease
There are significant symptoms, which are features the use of IPL
either not treated effectively or ignored by to spark a series of
eye care practitioners. This usually happens chemical reactions that
when there is not much time or it is stimulate the glands
perceived that the complaint is insignificant responsible for upkeep
or untreatable. of the tear film.
Although lubricating eyedrops may
provide some relief, it is often not enough in
more severe conditions. Depending on the
cause of dry eyes, treatment will include
other eye drops such as cyclosporine,
steroidal eyedrops and lipid-based drops.
Manual expression, Meibomian gland
probing and a procedure called Blephex may
also need to be done.
The latest addition to these
armamentarium of treatment modalities is
intense pulsed light (IPL) therapy. It involves
applying perfectly calibrated, homogenously
sequenced and sculpted light pulses. The
energy, spectrum and time period are
precisely set to stimulate the Meibomian
glands to return them to normal function.
Each treatment session takes only a few
minutes, during which the patient is seated
comfortably. An ophthalmologist will give chemical reactions take place, stimulating all those miseries of dry eyes. – By Dr
the patient protective eyewear to put on to the nerves supplying the glands and the Norazlina Bachik Ng, cataract, refractive
shield his eyes from the light. A hydrogel will secretion and contraction of the glands, and anterior segment surgeon at KPJ
be applied onto the skin beneath the eyes for which improves microcirculation. Pusat Pakar Mata Centre for Sight
further protection. Then, a series of five The treatment effects are cumulative.
flashes is applied under the lower eyelid. They generally last one week after the first n For details, visit www.kpjcfs.com or call
The same procedure will then be repeated session, two to three weeks after the second KPJ Pusat Pakar Mata Centre for Sight at
under the lower eyelid of the other eye. session, and six months to two years after 03-4022 6222 (Kuala Lumpur)/03-7880 8222
IPL doesn’t directly affect the Meibomian the third or fourth sessions. It is a promising (Petaling Jaya)/03-6093 1051 (Rawang).
glands. After the procedure, a series of mode of treatment to help alleviate or negate KKLIU No.2720/2018
THE STAR, TUESDAY 26 NOVEMBER 2019
The pain you can’t ignore
URINARY tract stones are crystals
that form in the urinary tract and
may cause pain, bleeding, infection
or obstruct urine flow. Depending
on where a stone is located in
the urinary tract, it
may be called a
kidney stone,
ureteral stone or
bladder stone.
Consultant
urologist at Ara
Damansara
Medical Centre
Dr Sivaprakasam
Sivalingam says
No cancer left hidden
PROSTATE cancer is the most
prevalent and second highest killer
cancer in men globally. Consultant
urologist at Subang Jaya Medical
Centre Datuk Dr Tan Hui Meng
says prostate cancer occurs in one
in every nine men. This statistic
increases to one in four in the case
of men with a family history of
prostate and breast cancer.
While some may think prostate
cancer is more prevalent in
western countries, Dr Tan says it is
increasing in incidence in Asian
society because of our changing
ways of life, diet and genetics.
“Prostate cancer is now the No.1
killer cancer in certain Asian
countries, even though it is a slow-
moving cancer.”
Very little to work with
Until the last three decades, the
prostate specific-antigen (PSA) test
was the only tool available to
doctors to screen for prostate
cancer. However, one major issue
of the PSA test is that it only
indicates the chances that one has
prostate cancer instead of
confirming that the patient has
prostate cancer.
Dr Tan says, “It was a major
controversy in the medical
community as it was found that
only 20% of men benefited from
this test. Because of the PSA test’s
inaccuracy, men were often
misdiagnosed, over-diagnosed and
over-treated. The subsequent
prostatic biopsies (often done
through the rectum/anus) and
treatment following the test result
also put men at risk of erectile
dysfunction, incontinence, heart
attack, sepsis and sometimes even
death.”
urinary stones can
present symptomatically or
asymptomatically. Most people
will seek medical attention when
they notice symptoms such as pain
or a burning sensation when
urinating, blood in the urine
or incidental presence of
blood in their urine test
when they undergo a
general health checkup.
Urinary tract stones
can affect anyone
regardless of age or
gender. However, Dr
Sivaprakasam explains
Datuk Dr Tan Hui Meng.
Because of this, the United States
Preventive Services Task Force, an
independent panel of experts that
systematically reviews clinical
preventative services, urges that
PSA tests are only performed when
necessary. Now, doctors carry out
“screening” in a more focused
manner, where only men at risk
are screened. It is also emphasised
that the PSA test and the
consequence following the test
result should only be carried out as
a shared decision between men
and their urologists.
Towards better accuracy
and outcomes
In the last six years,
multiparametric magnetic
resonance imaging (mpMRI) has
changed the world of prostate
cancer diagnosis for the medical
community. Dr Tan explains that
while PSA is still used to monitor a
person’s risk of developing prostate
cancer, prostate imaging with
that the causation differs between
adults and children. Stones that
form in children are because of
metabolic diseases, congenital
abnormalities of the urinary tract
or recurrent infections of the
urinary tract. Unfortunately for
adults, it can be more complicated
as there is no specific cause or risk
factor in the occurrence of a stone.
Because of this, advising
patients on prevention is a
challenge as there are no
identifiable risk factors for adults.
He says, “We will give our patients
general health advice, such as
staying well hydrated, reducing
their salt and dietary protein
intake, especially animal protein,
as opposed to specific measures
geared towards preventing the
development of urinary tract
stones.”
Improvements over time
While urinary tract stones
are not considered a major
priority for the health
services, complications
can occur if treatment is
delayed. Dr Sivaprakasam
categorises these
complications into
early, intermediate
and late stages.
“Symptomatic stones
generally present early with
complications such as
recurring intermittent pain
even after taking painkillers and
the presence of blood in the urine.
If left to grow to a size that
obstructs urine flow from the
Early detection may be an emphasis in the fight against cancer, but it is also important for people undergoing
screening for prostate cancer to be aware of misdiagnosis and overdiagnosis, and of the efficacy of different tests.
mpMRI allows doctors to examine
the prostate tissue in more detail
to determine whether there is
presence of an aggressive cancer.
This way, more men are spared
the experience of unnecessary
biopsies, and more are saved with
accurately diagnosed killer cancer.
Improvements for biopsies are
also underway. In contrast with
the usually performed transrectal
ultrasound-guided biopsy, which
accuracy is only 50%, doctors are
now performing biopsies with
mpMRI guidance usually through
the perineum (avoiding the
contaminated rectum/anus). “We
fuse the MRI image with the
ultrasound image. This way, we
can determine the exact location
of the lesions and take samples
Dr Sivaprakasam Sivalingam.
kidney, it may then trigger an
infection in the urinary tract. In
the long term, if medical
treatment is withheld or delayed,
the patient might lose the function
of that kidney.”
In the past, Dr Sivaprakasam
says it was common for medical
doctors to see patients with kidney
failure caused by kidney stones.
This is because those patients
either neglected to get themselves
checked or were reluctant in
undergoing treatment after being
diagnosed. Fortunately, he has
observed a large decline of such
cases and provides a few reasons.
“Compared with the past, we
now have access to treated water.
Because of improving socio-
economic standards and
education, members of the public
are seeking medical attention
early when they recognise a
using a tiny needle through the
perineal skin (area between the
scrotum and anus) accordingly,”
says Dr Tan.
Dr Tan has high hopes for the
diagnosis and treatment of
prostate cancer in the near future.
“We will soon be incorporating
genomic testing and focal therapy
into prostate cancer prevention
and treatment for low grade or
intermediate grade cancer. High-
grade prostate cancers are usually
ablated with surgery or
radiotherapy. Genomic testing
helps us determine who should be
put on active surveillance, be
repeat biopsied or have their
prostate removed, while focal
therapy allows us to remove
cancerous growths in a minimally
Your Health 5
symptom instead of ignoring it.
I think this is a positive global
phenomenon where access to
media motivates us to be more
inquisitive about our health and
surroundings.”
Reducing your chances
Urinary tract stones still do
develop and need to be paid
attention to. While most doctors
focus on treatment instead of
preventative measures because
of the vague causation and risk
factors, you can take steps to
reduce your chances of
developing kidney stones.
Dr Sivaprakasam says, “The
most important thing is to stay
well hydrated, because the more
hydrated you are, the more
diluted the urine you produce.
This reduces the probability of
crystallisation in the urine. When
you consume fluids more
frequently, you will also pass
urine more frequently. Regular
fluid movement prevents the
aggregation of salt crystals and
eventual formation of stones
through stasis.
Therefore, unless you have a
medical reason for not drinking
too much water, such as kidney
or heart failure, it is
recommended that adults aim to
drink at least two litres of water a
day and monitor their urine
colour to gauge their level of
hydration.”
n For more information, call
03-5639 1212.
invasive way.”
All in all, he says prostate cancer
is still life threatening and
extremely prevalent in our ageing
population. Therefore, he
emphasises early detection of
clinically important prostate
cancer, and suggests PSA test for
men older than 50 who have risk
factors or are concerned of
prostate cancer. “When you have a
baseline PSA test done early on, we
can determine if you are at risk of
developing prostate cancer, and
help you either keep it under
control or treat you depending on
the growth rate (aggressiveness)
of the cancer.”
n For more information, call
03-5639 1212.
6 Your Health
For strong muscles and bones
ASIDE from water, protein is the second
most abundant organic molecule in the
body. An average human body consists of
15% to 18% protein. Protein is found
throughout the body – in muscles, skin, hair,
antibodies, hormones, enzymes and every
other part of body tissue.
Protein is indeed important for life and it
is involved in most biological processes
within the body. However, inadequate
protein intake may lead to several health
complications such as:
l Muscle wasting (muscle atrophy) –
Protein is essential for muscle growth,
strength and repair. Insufficient protein
intake can reduce lean body mass, muscle
strength and functions. Meanwhile, the body
will “withdraw” protein from muscle tissues
and use it as energy to support other vital
body functions when protein levels are low.
Eventually, it causes muscle wasting.
l Impaired wound healing – Good
nutrition, including sufficient protein intake,
is essential for optimal wound healing.
Protein deficiency has been shown to lower
the rate of healing.
l Premature aging – Low protein intake
can cause adverse physical changes in the
body such as wrinkled and flaky skin, hair
loss and brittle nails.
For optimal muscle growth, body strength
and physical wellness, it is crucial to ensure
one gets enough protein from her diet.
Good-quality protein is the key
driver of good health
Protein consists of building blocks called
amino acids. Good-quality protein contains
all 20 amino acids, including the nine
essential amino acids that must be obtained
from dietary sources.
Protein can be found in both animal and
plant sources. Several studies have shown
that high consumption of animal proteins
such as meats, poultry, fish, dairy products
and whey protein have detrimental effects
on uric acid metabolism, bone and heart
health.
According to a recent study from
Singapore, high consumption of animal
protein may lead to an increased risk of
gout, while plant protein can reduce the risk.
Additionally, animal protein contains higher
amounts of acid-based amino acids that can
cause greater loss of calcium through bone-
weakening and urine.
To build and maintain healthy muscle
and bone mass, a combination of protein
with calcium and other nutrients, such as
magnesium and vitamins D3 and K2 can be
beneficial. Magnesium and vitamins D3
and K2 can significantly improve bone
health as magnesium and vitamin D3
enhance the absorption and utilisation of
calcium while vitamin K2 aids in bone
THE STAR, TUESDAY 26 NOVEMBER 2019
For optimal muscle growth,
body strength and physical
wellness, it is crucial to
ensure one gets enough
protein from her diet.
mineralisation by effectively depositing
calcium to bones and teeth for proper
storage. They also help prevent calcium loss
from bones.
Biogrow HPF-5 PLUS is a new-and-
improved formula with plant protein and
digestive fibre that is fortified with bone
health nutrients (calcium, magnesium,
vitamin D3 and vitamin K2) for stronger
bones and muscles. It contains no added
sugar, is low in fat, cholesterol-free and
lactose-free. Biogrow HPF-5 PLUS is suitable
for people of all ages as well as vegetarians.
One scoop of Biogrow HPF-5 PLUS (≈16g)
daily can provide:
l More than 61% of plant protein (non-
GMO soy and pea proteins) complete with all
nine essential amino acids for protein
synthesis
l Synergistic effect with magnesium,
vitamin D3 and vitamin K2 for better
absorption, retention, utilisation and
deposition of calcium
l More than 18% of digestive fibre to
regulate bowel movement
This article is brought to you by Legosan
(Malaysia) Sdn Bhd.
n For more information, call 03-7956 2220
(Monday to Friday, 9am to 5pm) or email
info@biogrow.com.my
THE STAR, TUESDAY 26 NOVEMBER 2019 Your Health 7

Men can be affected, too

INFERTILITY is an emotional and
traumatic condition for couples,
but in most cases, the ones who
shoulder the blame are the
women. They face intrusive
questions and insensitive remarks,
be they from strangers and even
family members. On top of the
myths and misconceptions about
infertility, women often shoulder
the problem alone.
Though rarely spoken of,
infertility can also affect men.
Questioning a man about his
fertility is seen as taboo while with
women, it becomes a topic for open
discussion. International data
suggests that men account for
almost 40% to 50% of infertility
cases. Unfortunately, women are
likely to be blamed because of
cultural notions and their
childbearing ability.
Infertility in men can result from
two problems: sperm quality and
sperm delivery. Sperm quality can
be affected by sperm count,
motility, shape and size, while
sperm delivery can be
compromised as a result of many
factors, including congenital
abnormalities or urogenital tract
infections. Lifestyle factors such as
age, smoking, drinking and obesity
can also raise the risk of infertility
in men.
Men are overstudied, but
not when it comes to
infertility
Why is no one talking about
male infertility? While experts are
saying that men are over studied
in nearly every medical specialty,
infertility is not one of them. This
has led to the perception that men
are less likely to be the “problem
partner”.
Liberty Barnes, a medical
sociologist at University of Oregon,
studied how culture shapes ideas
about male infertility. In her 2014
book called Conceiving
Masculinity: Male Infertility,
Medicine and Identity, she wrote,
“The general consensus is that
‘real men’ gush sperm. Male
The focus of infertility treatment should never be on which party is
infertile, rather it should be on solving the problem itself.
infertility destabilises the
presumed fundamental basis of
masculinity, disrupts traditional
gender roles and hits personal
masculine identities right where
it counts.”
Barnes spent seven years
following infertility doctors all over
the US for her book and one of her
stark observations was that most
women have an ob-gyn who
focuses on their reproductive
health, while most men do not.
She also found that male infertility
specialists tend to shield men from
the reality of their situations by
putting effort into making men
feel more secure.
Words such as “infertile” or
“infertility” were not even
mentioned at appointments.
Instead, doctors would say, “Your
sperm count is at three million
and I was hoping for 15 million.”
When a man hears that, he could
think that’s really good, but it is, in
fact, terrible.
While there is not enough
research on how Malaysians look
at infertility in men, it is important
for people to know that infertility
is not solely a woman’s burden.
Conceiving is not a one-sided job.
If you and your partner have been
trying to start a family but efforts
have been in vain, it is advisable
for both of you to undergo
checkups and take necessary
action to overcome the obstacle.

Protection for
the growing child
TO commemorate the launch of
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GOS are a type of prebiotic
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with VitaHealth Kids Multivits
Jellybean. These easy-to-chew,
apple-flavoured jellybeans
contain 12 key vitamins and
minerals, and do not contain
any artificial flavouring and
colouring. These include:
l Vitamin A – Good for
eyesight
l Niacin and vitamin B6 –
Necessary for proper
functioning of the brain
l Vitamin B12 – Needed for
the formation of red blood
cells, which carry oxygen
throughout the body
l Biotin – Helps maintain
healthy skin, hair and nails
l Vitamin C – Maintains
healthy gums, bones and blood
vessels
l Vitamin D – Essential for
bone health and helps the body
utilise calcium and phosphorus
l Vitamin E – Strong
antioxidant beneficial for
combating free radicals in the
body
l Vitamin K1 – Aids in bone
metabolism and acts as an
anticoagulant (assists in blood
clotting)
l Folic acid – Essential for
the growth and division of cells
l Iodine – Necessary for the
production of thyroid
hormones, which help regulate
the body’s metabolism and
promote growth and
development throughout the
body
l Zinc – Plays a vital role in
strengthening the immune
system, supporting healthy
growth and facilitating wound
healing

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8 Your Health
Treating neuropathy
before the point of no return
NERVES are essential for bodily functions
and have a range of roles in sensing and
processing stimuli, then signalling other
tissues to respond, such as the involuntary
muscle movement that occurs when you
burn a finger on a hot pan. The peripheral
nervous system refers to nerves other than
the brain and spinal cord, and consists of
billions of nerve cells known as neuron.
The peripheral nervous system has two
parts – the somatic and autonomic systems.
The somatic nervous system consists of
nerves that connect the brain and spinal
cord to sensory neurons, which detect
sensory inputs such as temperature and
pain, and to motor neurons in skeletal
muscles, which control body movement.
The autonomic system connects the brain
and spinal cord to internal organs and
regulates bodily processes that require no
conscious effort, such as your heartbeat and
blood pressure.
Symptoms of peripheral
neuropathy
Peripheral neuropathy describes a group
of conditions in which the peripheral
nervous system is impaired or damaged. It
is associated with a broad range of
symptoms that vary according to the
severity of disease and the specific nerves
involved – motor, sensory or autonomic.
Symptoms of neuropathy can be divided
into two categories:
l Positive symptoms typically reflect
inappropriate spontaneous nerve activity.
Causes uncomfortable and painful
Neurobion has been the market leader of vitamin B complex/vitamin B combination products for the last two-year period on a combined
market of 74 countries worldwide, according to internal calculations based on IMS Health Midas sales for MAT 09/2015 through MAT
09/2016.
sensations that include increased sensitivity
to touch, sharp pain, extreme sensitivity to
pain, pain to non-painful stimuli, “pins and
needles” and burning pain.
l Negative symptoms are those associated
with a loss of sensation, including reduced
sensitivity to pain, loss of sensation,
numbness and reduced perception of touch.
The timing and clinical presentation of
the development of neuropathy in
sufferers or at-risk patients vary widely,
therefore preventative and treatment
measures should be started early. When
approximately 50% or more of nerve
fibres are damaged, the point of no return
occurs, where regeneration is no longer
possible.
Therefore, it is important to recognise
nerve damage and avoid that point of no
return with early treatment and
preventative measures. When nerves are
damaged extensively, the symptoms and
reduced functioning can seriously impact
quality of life.
For example, the painful sensations
associated with nerve damage, which
usually get worse at night, can cause sleep
disturbances and increased symptoms of
anxiety and depression. There are also
autonomic symptoms that should be
monitored, such as abnormal sweating
and impotence.
Populations at risk of peripheral
neuropathy
There are many potential causes of
peripheral neuropathy, including chronic
disease, environmental toxins, alcoholism,
nutritional deficiencies, genetics or the
side effects of some medications. In more
than 20% of peripheral neuropathy cases,
the cause of neuropathy may remain
unknown.
Among chronic disease cases, diabetes is
the most frequent cause. Peripheral
neuropathy caused by diabetes is known
as diabetic peripheral neuropathy.
Although diabetic peripheral neuropathy
is the most common complication of
diabetes and despite causing significant
morbidities, including foot ulcers and
amputations, it is not well recognised.
Nutritional deficiencies in the
neurotropic vitamins – vitamin B1,
vitamin B6 and vitamin B12, can also lead
to peripheral neuropathy. Populations who
are at risk of neuropathy caused by
nutritional deficiencies include those with
malnutrition, malabsorption, increased
requirements and increased loss, such as
people with gastrointestinal diseases,
advanced age and more.
Patients who have had bariatric surgery
can also develop vitamin B deficiency
states and subsequent neurological
symptoms if not monitored and
supplemented with neurotropic B
vitamins. The overall prevalence and
THE STAR, TUESDAY 26 NOVEMBER 2019
MAL19910915XZ
impact of peripheral neuropathy increases
with age and therefore is likely to increase
as the population ages.
Benefits of vitamin B in nerve
care
Neurotropic vitamins B1, B6 and B12
contribute to nerve care via different
biochemical mechanisms. They nourish and
help regenerate nerves. Each of these B
vitamins has been found to have unique
essential roles, which contribute to nerve
function.
Vitamin B1 is involved in energy
metabolism, maintaining the myelin sheath
(which covers the axon of nerves), and the
synthesis of key signalling molecules in the
nervous system, which are known as
neurotransmitters. Vitamin B6 is involved in
the synthesis of neurotransmitters. Vitamin
B12 is involved in nerve cell maturation and
regeneration, nerve cell metabolism and
formation of nerve myelin sheaths.
Neurobion is a health supplement that
contains neurotropic vitamins B1, B6 and
B12. They work synergistically and are vital
for keeping nerves healthy. If you are at risk
of becoming deficient in vitamins B1, B6 and
B12, you may need to supplement your diet
with Neurobion. It has been clinically tested
to nourish nerve cells, improve nerve
function and relieve nerve pain. Take
Neurobion today to help your nerves stay
healthy and keeping the tingling and
numbness at bay.
As part as its continuous initiative to raise
awareness on the importance of healthy
nerves, Procter & Gamble is providing nerve
tests using biothesiometers at selected
pharmacies nationwide. It hopes to
encourage consumers to take the first step
in identifying possible nerve damage and
seek further medical consultation or
treatment if needed. For more information
on the event, visit www.neurobion.com.my
or email chmymmal.im@pg.com.
The information contained in this article
is not intended or designed to diagnose,
prevent, treat or provide a cure for any
condition or disease, ascertain the state of
your health or be substituted for medical
care. Procter & Gamble encourages you to
seek the advice of your doctor or healthcare
professional if you have any questions or
concerns arising from the information in
this article.
This is a medicine product advertisement.
KKLIU No.1943/2017. MYS-NEU-1708-0123(1)