What can the restoration of men's health cover?
"The restoration of men's health" is not a single protocol. This term may mean the restoration of pain, weakness, movement, the muscles of the pelvic floor, recovery after surgery or a disease of the nervous system, or the effects on function from a sexual state. A suitable plan begins from the goals and the diagnosis, not from an ideal of masculinity, "life force", or peak performance.
Sexual symptoms may be related to the blood vessels, the nervous system, hormones, medicines, sleep, the pelvic floor, psychological factors, or relationships. It should not be concluded that posture or "an imbalance of the system" is the cause of erection or ejaculation without evidence.
Sexual function and the health of the heart and blood vessels
A state of erectile dysfunction may be related to the risk of disease of the heart and blood vessels, but does not always arise from the blood vessels. The assessment may include the character of the symptoms, the sexual and relationship context, medicines and various substances, blood pressure, metabolic risk, physical examination, and laboratory tests in particular cases. The EAU guidelines (opens in a new tab) recommend assessing the risk to the heart and blood vessels when a state of erectile dysfunction from the blood vessels is suspected.
The treatment depends on the cause. It may include caring for the risk factors, reviewing the medicines involved, treatment of erectile dysfunction that has evidence, psychological and sexual support, and having the partner join in the care when the person themselves wishes it. Consent must be continuous, and penetration should not be regarded as the only meaningful outcome.
The muscles of the pelvic floor and physical capacity
Pelvic floor symptoms may come from weakness, too much tightness, pain, the working not being coordinated, or another disease. Giving squeezing exercises or Kegels automatically may make the symptoms worse when the muscles are already tight. The assessment and the training must be adjusted to the individual. Examination of the genitals, the vagina, or the anus is a choice; it must receive clear consent at all times, and can be stopped immediately.
Restoring general capacity may use strength training, aerobic work, balance, movement, and work specific to the goal, in a gradual way. The choice must follow the health, the symptoms, and the goals of the individual. A programme that only corrects posture cannot restore sexual function.
Hormones, energy, and body composition
Tiredness, reduced sexual desire, changed mood, or reduced muscle mass do not diagnose a state of testosterone deficiency. The Endocrine Society (opens in a new tab) recommends diagnosing it when there are symptoms that correspond together with a consistently low level of testosterone from repeated testing in the morning while fasting, and then assessing the cause. Screening the general population as a routine is not recommended.
Testosterone is not a programme for slowing ageing or increasing performance in general. The treatment may suppress fertility, and the contraindications, the risks, the goals, and the follow-up must be reviewed by someone with suitable qualifications.
Plan according to the evidence
The plan may coordinate rehabilitation medicine, urology, endocrinology, cardiology, pelvic floor physiotherapy, primary care practice, and psychological or sexual health support according to necessity. The goals that can be measured may be walking, strength, pain, sleep, continence, confidence, or sexual outcomes that the individual chooses.
PMS, shockwave, laser, platelet products, stem cells, injections called "regenerative", and neurovascular or "alpha transformation" packages are not a standard path for the health of every man. The evidence and the regulatory status depend on the product and the disease. It should not be said that a device or an injection restores the blood vessels, the nerves, the hormones, or life force over the long term, unless there is evidence supporting that treatment and that diagnosis directly.
Symptoms that must be assessed urgently
Urgent care should be received when there is chest pain or great difficulty breathing while exerting effort or having sexual intercourse, an erection lasting four hours or more, sudden severe pain in the testicles, injury to the genitals together with swelling or deformity, weakness of the limbs increasing quickly, abnormal continence of urine or faeces, numbness in the area of the genitals or the buttocks, or fever together with acute pelvic or urinary tract symptoms.