Studies published in last two years have shown many men who come up with this issue due to Covid, Dr (Prof) Anup Kumar, Chairman, Dept of Urology, Robotics and Kidney Transplant, Safdarjung Hospital.
How important is it for a man to maintain a good sexual and reproductive health?
Dr Anup Kumar: Maintaining a good sexual and reproductive health does not only affect their psychological aspect, but the overall quality of life including their job, their relationship with their spouse and other family members. But it is often ignored in India. Most men have a social stigma attached to it due to which they do not discuss it with a doctor.
What are the factors related to decreasing male fertility?
Dr Anup Kumar: 50 per cent of the infertility causes are in males. One of the reasons is genetic, which means that their spermatogenesis is defective by birth due to which they have immature sperms in their testes which is why they are not able to produce a child. Secondly, there is a condition known as varicocele which is dilation of the veins due to which temperature regulation of the testes is lost that affects the production of sperms and initially there is a decrease in sperm count and quality and eventually, they are unable to produce a child. Thirdly, extreme exposure to heat also affects spermatogenesis in the testes. Consumption of alcohol and tobacco produces free oxygen radicals which hampers spermatogenesis in the testes. Certain acquired causes like viral infections affect testes and decreases their production capacity. These are some of the causes but 30 per cent of the patients have no detectable cause which is idiopathic infertility that has been on the rise for the last many years and that is something we are worried about. These patients have some genetic causes, chromosomal defects and more so due to lifestyle issues like stress and anxiety. Covid has affected fertility in many males. Studies published in last two years have shown many men who come up with this issue due to Covid.
Explain a little more on that.
Dr Anup Kumar: Sars CoV infectiona causes generalized inflammation throughout the body hence affecting all the body parts and even forming blood clots in blood vessels. It affects the sperm production in the testes. It has been proved that Covid is detected in many body secretions including semen. Once the virus reaches the testes, it damages the spern production and causes inflammation throughout the tract and ultimately blocking it.
What are the implications of stress?
Dr Anup Kumar: Stress hampers the coitus potential of the male. They develop problems like Erectile Dysfunction, low libido, and when talking about ED, it is all psychological. When we perform tests on erectile reflex, they come out to be normal but when we analyse the stress and anxiety levels, men suffer the same due to financial or social issues which affects their sexual potential. Thirdly, they have premature ejaculation. All of these further decreases their morale which resists them from having sexual intercourse with their wife and ultimately the wife suffers and the male develops depression. This is therefore a vicious cycle.
Do men with infertility have recurring reproductive problems and is there a cure to this?
Dr Anup Kumar: Firstly they need a proper consultation with a doctor. Whenever a patient comes to us with ED or infertility, we rule out all the possible factors through methodical protocol. We eventually reach a conclusion that the person does not have an organic cause, but a psychological cause. Then we reach out to psychologist also and we give them proper counselling. Along with that we give them some medications also.
How does one protect oneself from STDs and how often should a male get himself tested for the same?
Dr Anup Kumar: We always counsel our male patients to use condoms during sex. Try to avoid multiple partners because the more partners you have, the more risk you develop of having a sexual infection.
If someone comes up with these problems, we first take the discharge from the patient’s urethra that is mostly a false malign discharge. We perform a microscopic examination on it for different responsible bacteria like chlamydia. If the patient suffers symptoms like loss of appetite or weight, we send the patient for the HIV test. Once we detect the problem, we prescribe the treatment accordingly. We have a set course of antibiotics for trychomonas and chlamydia that goes on for 10 to 14 days and we ask the patient not to have sexual intercourse with anyone for atleast 3-4 weeks. For HIV, we have different treatment called ART that is performed in a different clinic.
Are STDs contractible through any other factor than intercourse?
Dr Anup Kumar: Most of the time the cause for this is unprotected intercourse. HIV can also be procured through contaminated needle or blood transfusion.