An Unloved Subject During Doctor Visits: Men's Sexual Health

An Unloved Subject During Doctor Visits: Men's Sexual Health
by Michelle Andrews - NPR
August 28, 2012

We need to talk.

If men could become pregnant, they'd probably visit the doctor more often.

But without a compelling inducement like contraception to get them in the door, they often miss out on sexual and reproductive health services that could protect not only them but also their partners.

In 2009, 66 percent of women ages 18 to 44 visited a primary care provider, compared with 52 percent of men in that age group, according to the Centers for Disease Control and Prevention's National Center for Health Statistics.

A study published in 2007 found that a tad less than half of men aged 20 to 44 received any sexual or reproductive health services in the previous year. Of those, the most commonly reported service was a testicular exam.

At the same time, more than a third of men who were sexually active but unmarried or living with someone said they hadn't used a condom during sex in the previous month.

Condom use decreased with age: 26 percent of teenagers aged 15 to 19 reported they didn't use condoms, while 73 percent of men aged 40 to 44 didn't use them. Nearly a quarter of men said they'd had sex with 15 or more women over their lifetimes, increasing their risk of contracting sexually transmitted diseases.

The health care overhaul makes many preventive services related to women's sexual and reproductive health available free of charge. But it doesn't do the same for many services men may need.

When men visit the doctor, "One of the things that is absolutely missing is screening for sexual health and sexual activity," says Dr. Arik Marcell, an assistant professor at the Center for Adolescent Health at the Johns Hopkins Bloomberg School of Public Health. "If you don't know if (the patients) are sexually active, you don't know what may be at risk," he says. Depending on the individual, patients may need reproductive health planning, screening for sexually transmitted diseases or other sexual health services.

Part of the problem is that there are no comprehensive guidelines that spell out which sexual and reproductive health care services men should receive at various ages and stages in their lives. "Providers don't have any organized approach for addressing what are men's needs," Marcell says.

Marcell hopes to change that. He's leading a group of that's developing clinical guidelines for men related to family planning and sexual and reproductive health for the federal Title X family planning program. The group is on track to release a white paper that previews their recommendations at the beginning of September, he says.

"For the first time, across the lifespan of men, we're articulating reproductive health services and family planning needs," he says. "We hope it will become the standard of care."