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Mens health – How to ask for help

By Physio Thomas

“Oh, I get by with a little help from my friends.” – The Beatles.

At Vital Core Physiotherapy, we hope to help men with a variety of physical ailments. These can range from sore necks from carrying their newborns, post-op knee replacement stiffness, to our sponsored Norwood Flame basketballers, booking in to increase their explosiveness on the court. More uniquely, Vital Core Physiotherapy specialises in Pelvic Health, helping men with difficulties of bladder, bowel or sexual function. This includes overly frequent or painful urination, incomplete bowel movements, difficulty getting or maintaining erections, and recovery post-prostatectomy.

It is well documented that men are less likely to talk about their health than women (Wang et al. 2013). They are also less likely to seek help from their friends and family, or even book in with the GP for a health check. Combining this with the social taboo of talking about our sex organs and potential dysfunctions, it is unsurprising that the biggest barrier to mens pelvic health is the unwillingness for men to address it. This blog will analyse why men may be less likely to seek help, and how it may affect their mental and physical wellbeing.

“Men are meant to just get on with it!”

The concept that men should not need help can be dismantled when we consider that a) the gender roles, in general, are antiquated and b) everybody, regardless of gender, may have challenges to their well-being at some point, and it is okay to ask for assistance.

Firstly, considering gender roles, the stoicism of masculinity is ingrained in us from the stories we’re told; consider the fearless and muscular deities saving the contrastingly svelte and hysterical women – our social tropes derive from folklore, outdated social structures and, frankly, poor science (seriously, look up the etymology of ‘hysterical’). This is also compounded by the historic social differences between men and women, and that being male meant to have more power and authority.

As research has highlighted the confinements of these stereotypes, society is now moving away from prescribed gender roles. Now, we can embrace the recently inconceivable: stay-at-home-fathers, women in sport and positions of authority, and the spectra of both gender and sexuality. This social shift has chipped away at the stereotypes of masculinity, like erosion in Michalangeo’s David – men (and women) can be or act how they want to. If you want to be muscular, brooding and heroic, while guzzling some beers and shouting at the footy – great, enjoy that – but being a man is no longer solely defined by this, and that is okay.

Simultaneously, mental health awareness is also increasing. It is now more appropriately addressed in the education system, with a focus on why it is important to seek help, and how to do it. It is not uncommon for younger generations now to be more cognizant and expressive of their mental struggles and anxieties. As such, they have a better understanding of the concepts of mental health (specifically, better mental health literacy) compared to older groups (Hadjimina & Furnham 2017).

So, this stereotype existed because of old-fashioned social structures, but is slowly being dispelled through the questioning of predisposed gender roles, and the increase of mental health literacy. These social changes are promising for a more autonomous and healthier life.

So what if I don’t get help?

The combination of less defined gender roles and increased awareness of mental health means the younger generations are less likely to conform to the stereotype that men should not seek help. However, it is important to recognise that the older generations are left behind due to how entrenched these ideologies are and the lack of education towards it.

To illustrate how far they have been left behind, consider the Australian suicide rates from 2020 (from AIWH 2022):

  • 3,139 deaths by suicide in Australia
  • 76% of these were men
  • The suicide rates were highest amongst middle-aged men (40-49) and older men (85+)
  • Men aged 50-54 are 4x more likely to die to suicide than women, and men aged 85+ are almost 6x more likely
  • Contrastingly, men aged 15-19 are 2.7x more likely to die to suicide than women, the lowest of any age bracket.

There is a strong correlation between unwillingness to ask for help – or denying the need – and suicide (Mental Health Association 2022). Note that the highest suicide rates in Australia are amongst middle-aged men. There is no coincidence that the men who didn’t grow up with the mentality that it’s okay to ask for help – the ones for whom masculinity meant to harden up and that crying is for babies – are also the ones most likely to suicide. It is at these age brackets where the disparity between male and female suicide rates is at its greatest. Compare this to the youngest generation, who has been educated on the importance of asking for help and who have less defined gender roles, where the suicides rates for men and women are at their closest. Ultimately, while suicide is a complex and multifaceted issue, the fallacy that men should not seek help is a definite contributor.

And physical health?

The unwillingness for men to seek help and that notion that everything will be fine also plays a role in their physical health. Men are less likely than women to see allied health professionals in general (Wang et al. 2017), and this is worse at around 40+ years old, when men should be seeing a doctor more, as they are getting slightly older, have increased stress with work and family, and have less time for healthier lifestyles. As such, many preventable diseases, such as cardiovascular disease and Type II Diabetes, mentioned in the last infographic, are not diagnosed and managed as early as they could be.

More specific to physiotherapy, at Vital Core Physiotherapy, we hope to be a pioneer for Men’s Health by helping raise awareness and treatment of pelvic dysfunctions, such as painful urination and sexual difficulties. Once again, the patients most likely to require help with these issues – the middle-aged, stoic man – are also the one least likely to want to address it.

We understand that it will be hard to make that first step and ask for help. So much is against you: the entrenched stereotype, the limited education for men about pelvic health, and the social taboo and embarrassment of talking about your bladder or sexual function. While the younger generations are more comfortable seeking help for previously considered ‘taboo’ topics like sexual dysfunction or endometreosis, there are still a few demographics who fall behind and don’t get the help they need. So, here are some pointers that may remove those barriers and make it easier for you to seek help from us:

  • Do a quick body scan of yourself, and look for some symptoms, like pelvic discomfort, painful urination, or impotence. Check if you have any symptoms discussed by our Physio Danae in this blog here, and learn how physiotherapy might help: https://vitalcore.com.au/mens-health-issues-in-the-bathroom-or-the-bedroom/
  • Remember that pelvic health is our speciality. We pride ourselves on creating a comforting and supportive environment for both men and women with pelvic challenges. We liaise with general doctors, specialists, surgeons and psychologists in order to best consider your care and management.
  • If you’re embarrassed, consider your pelvis like any other part of the body: you have muscles and nerves in your shoulder, so you see a physio; you have muscles and nerves in your pelvis, so why would you not see someone for this? Evidence shows that retraining the pelvis – just like you would do your shoulder rehab – helps improve erectile strength, sexual sensation, and bladder and bowel control (POGP 2015).
  • We understand what you’re going through. Our knowledge considers the biological and psychological issues that may arise from pelvic dysfunctions, gathered from patients or our staff’s own experiences.
  • Consider why you may be unwilling to seek help with this? Are you worried? Or do you think this will just get better on its own? Is there any harm in having an appointment?

Conclusion

Are men just meant to get on with it? Honestly, you can do whatever you want, but the research doesn’t lie: if we want men, collectively, to have better health, bladder and sexual function, and a reduced risk of suicide, it is important that we continue to dispel this myth for both younger and older generations. Seeking help is not emasculating; it is simply recognising that you want to live your life to the fullest, or, in the worst cases, considering you still want to live at all.

Resources, for anonymous phone or online chat, include:

  • Men’sLine Australia 1300 78 99 78
  • Beyond Blue 1300 22 46 36

https://www.sciencedirect.com/science/article/abs/pii/S016517811630854X