Male Reproductive Health Risks

Environmental toxins that affect sexual reproduction or reduce sperm count and fertility, are still being identified. But if, in fact, they exist, these dangers may turn out to be avoidable, once identified.

Still, other problems, such as prostate or testicular cancer, whether preventable or not, do not endanger the health of others.

The emergence of AIDS has drawn attention to the danger of STDs. “Before the appearance of incurable and even fatal viral STDs, there were not many men who cared about STDs, because they were often asymptomatic and easily treated with antibiotics. But some of these STDs affected men indirectly: by infecting their partners, they could make them infertile.

Now, these STDs are known to compromise male fertility as well. They can block the vas deferens or cause epididymitis, inflammation of the channels through which sperm travel from the testicles to the vas deferens. STD-causing microorganisms, particularly Neisseria gonorrhoeae and Chlamydia trachomatis, are the most common cause of epididymitis in heterosexual men under 35 years of age. When the ducts carrying sperm are affected on both sides, the infertility rate is close to 40 percent.

We often ignore, or forget, that infertility affects both men and women. In developing countries, women are often blamed and forced into divorce because they are believed to be solely responsible for the fact that they have no children. But among the 5,800 infertile couples studied by the WHO between 1979 and 1984, men were solely responsible, or at least largely contributing to infertility, in more than half of the cases. This multicenter study carried out in both industrialized and developing countries led to the following conclusions: the man is responsible for 8 to 22 percent of infertility throughout the world, the woman in 25 to 37 percent and the two in 21 to 38 percent of cases.

Infertility is common in developing countries, but it could often be prevented. It can be due to various infections including parasites, to unsuitable gynecological and obstetrical practices, to the fact of not respecting the rules of hygiene, or to vascular injuries during an awkward intervention for hernia in men. 3 However, STDs are the most preventable cause of infertility. The WHO study in 25 countries showed that African couples more often than couples from other regions of the world had a history of STDs, which were very likely the cause of their infertility.

Family risks

Of course, in the era of AIDS, infertility is no longer a major risk. The state of health of men and their behavior has a decisive influence on the health of women and children. Men who have unprotected sex outside marriage are at risk of becoming infected and infecting their wives.

The physiology of the female reproductive system is one of several factors that make a woman’s risk of being infected by a man much greater than the reverse. Once the woman is infected, the unborn children can be infected. A woman can transmit various STDs to her child through the placenta, during childbirth or during breastfeeding.

In both sexes, STD pathogens can induce cancer. Almost all cancers of the anus, penis, cervix, vagina and vulva are now thought to be caused by human papillomavirus (HPV) STDs.

In the field of STD prevention, men play a crucial role because the main means of prevention we have is the condom, which requires the cooperation of the man. If used correctly and consistently, the male latex condom provides substantial protection against bacterial and viral STDs, including HIV. Fortunately, its use appears to be increasing among young people.”

Even the female condom, whose ability to protect against viral STDs has not been sufficiently studied but which probably protects against some bacterial STDs, requires some male cooperation. In addition, some men refuse the use of spermicides, which protect against certain bacterial STDs.

Educating men and encouraging them to change behaviors that put them at risk of STDs remains a safe strategy. But many behaviors resist change. Where condom use is not common, where the number of partners is not declining, and where men are separated from their families for long periods, the risk of STDs remains high. Migrant workers, truck drivers and miners are examples of groups of men who are often separated from their families by their work and who tend to associate with prostitutes during these intervals, putting them at high risk of contracting HIV.

Environmental hazards

Several environmental factors have been studied. For example, chronic exposure to high doses of arsenic in drinking water in parts of Mexico is thought to have contributed to the infertility problem. The same is thought to be true of high levels of aflatoxins resulting from the contamination of crops by fungi. Aflatoxin was detected in the semen of 40 percent of men in a Nigerian group consulting for infertility and only 8 percent of a fertile control group.

The results of certain epidemiological studies suggest an association between paternal exposure to certain toxins and adverse effects on children, whether miscarriages, congenital anomalies or childhood cancers, but the data are limited. In addition, the results of the different studies are difficult to compare with each other because the methods of data collection and analysis differ. Similarly, data collected in animals exist but are limited and inconclusive.

“Geneticists tend to think that the likelihood of toxin-induced sperm mutations leading to a birth defect is low enough to discourage further research on the subject,”. “But serious research needs to be undertaken on a large number of toxins, to end the debate.”

In 1992, researchers at the University of Copenhagen reviewed data from 61 articles published between 1938 and 1991 covering 14,947 men worldwide. They concluded that the average sperm count had declined by 50 percent (from 113 to 66 million per ml) over the past half-century.7 This review has been widely criticized for ignoring variations in geographical and temporal aspects of sperm count and included selection bias. Other researchers claim that in some place sperm counts have stayed the same or have increased8; others argue that there are no reliable data. However,

Animal data suggests that certain compounds, such as pesticides that act in a similar way to hormones, could cause a drop in sperm counts and have other negative effects on reproduction. However, any danger capable of threatening the human reproductive system remains theoretical.

In recent years, it has been suspected that diethylstilbestrol (DES) is responsible for the infertility of women whose mothers had been treated between 1940 and 1970. DES, a synthetic compound similar to estrogen, was then used to prevent certain complications of pregnancy. It has also been used in some developing countries. It is now known to induce very rare cancer of the vagina and cervix in young girls whose mothers took DES during pregnancy and to increase the risk of infertility in girls, miscarriage delivery, prematurity and death of the fetus or baby.

Although the largest and most serious study of men exposed to DES in utero did not include sperm counts, it did not show impaired fertility or sexual function in these men. However, these men more often have testicular abnormalities at birth, including undescended testicles. However, we know that undescended testicles, if they are not operated on quickly, are linked to a higher risk of testicular cancer.

Stress also has a role in inhibiting the male reproductive system. For example, a Population Council endocrinologist found that elevated glucocorticoid hormone in rats secondary to stress inhibited the enzyme responsible for facilitating the production of testosterone, which in turn initiates spermatogenesis. men, combat training has been found to decrease testosterone levels and death in the family reduces sperm motility. For more information and expert advice contact us.

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