Madeeha Syed

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The Six Quintessential Suits Every Man Should Have In His Closet

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ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

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Time For Men To Share The Burden Of Pregnancy

Introduction

A fast-growing population is one of the greatest challenges currently faced by Pakistan. Increasing poverty, food shortage, health challenges, depletion of natural resources, and overcrowding are just some of the problems associated with overpopulation. According to the 2017 Census of Pakistan, with a population of more than 207 million, the country is the fifth most populated country in the world<a href="#accordion">[1]</a>. Therefore, effective birth control methods are a need of the hour to prevent the risks associated with overpopulation.

However, the use of contraception is largely stigmatized in Pakistan due to various reasons. As per the Pakistan Demographic and Health Survey (PDHS), the current contraceptive prevalence rate (CPR) is only 34%<a href="#accordion">[2]</a>. Moreover, the use of contraceptive methods among men is extremely low. Thus, resulting in the burden of pregnancy and contraception lying largely with women. This could probably be due to a lack of awareness among men regarding various contraceptive methods that are readily available. Raising awareness about these methods is the first step in ensuring that the financial and emotional burden of <a href="https://merisehat.pk/article/how-to-practice-safe-sex">safe sex</a> is shared among both partners in a couple.&nbsp;

Almost 200 years ago, humans invented the world&#39;s first condom, and for a long time that was the greatest discovery in the world of contraception. However, scientists soon discovered methods specifically designed for women that could aid further in population control. Several female contraceptive options ranging from hormonal pills to invasive tubal ligation were introduced. However, each of the proposed methods comes with its side effects. Contraception methods have been widely politicized and various speculations exist regarding the reasons behind the disparity among male and female contraceptives. However, it is important to mention that male contraceptive methods are generally safer than their female counterparts, which is why in recent years significant work has been done to search for effective male contraceptive options. This shift in tide is also perpetuated in part by the increasing awareness among men and their willingness to use contraceptives.&nbsp;&nbsp;

&nbsp;

Understanding Male Contraceptives

Currently, two widely acceptable male contraceptive methods exist: condoms and the invasive vasectomy.

&nbsp;

<h5 dir="ltr">Condoms</h5>

These are a form of barrier method and stop the sperm from entering and fertilizing the egg. Along with being an effective and inexpensive birth control, condoms also prevent sexually transmitted infections (STIs). However, incorrect use is associated with a high failure rate, and they can easily break or get damaged. In Pakistan, condoms are the most used form of contraceptive method, with a frequency of 65.5%<a href="#accordion">[3]</a>.&nbsp;

In recent years, the Pakistani government has stepped up its social media campaigns in a bid to educate the public regarding the use of condoms and other effective family planning methods. This is aimed at controlling the growing population by promoting birth spacing and awareness of women&#39;s fertility. Doorstep availability and affordable prices have significantly increased the use of condoms among the general population.&nbsp;

Unfortunately, misconceptions about condoms and other family planning methods still need to be overcome.&nbsp;

&nbsp;

<h5 dir="ltr">Vasectomy</h5>

Also called male sterilization, the surgical procedure has been in use since the 1970s. The procedure involves cutting or blocking the vas deferens that carry sperm to the urethra. As a result, the semen is devoid of sperm and the egg cannot be fertilized. It is not easily reversed; therefore, it is mostly advised to men who are sure of not wanting children or who believe their family is complete.&nbsp;

With a success rate of 99.85%, it is the most reliable contraceptive option. Moreover, compared to tubal ligation in women, it is less invasive, has fewer risks, and has a quicker recovery time. However, only 2.4% of men around the world have undergone the procedure<a href="#accordion">[4]</a>. In Pakistan, the prevalence is only 0.4%<a href="#accordion">[3]</a>.&nbsp;

The lack of knowledge regarding vasectomy plays a major role in its low acceptance. Moreover, a majority of men hold the view that it leads to impotency or reduces sex drive. However, a recent study has found that men in Pakistan are becoming more accepting of vasectomy and recognizing their role in sharing the responsibility of family planning<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

While female birth control pills have been around for more than 50 years, researchers have only recently started looking into pills for men.&nbsp;

In 2019, a team of scientists conducted a clinical trial for a male birth control pill among 82 healthy men<a href="#accordion">[6]</a>.&nbsp;They administered dimethandrolone undecanoate (DMAU) in varying doses over a period of 28 days. The two active hormones, progestin, and modified testosterone, helped suppress levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the study participants. Thus, suppressing sperm production without causing symptoms of low testosterone levels.&nbsp;

Although the study did not measure sperm count, the pill was found to be safe, even in high dosages. The team is currently conducting a longer trial to assess the drug&#39;s effect on sperm production and any long-term effects on the body.&nbsp;

However, men are often hesitant to use hormonal options due to the presence of adverse effects. Therefore, a team at the University of Minnesota have developed a non-hormonal male contraceptive pill. According to early results from a trial in mice, the contraceptive was 99% effective at preventing pregnancy<a href="#accordion">[7]</a>. Moreover, it had no obvious side effects in the mice.

Called YCT529, the non-hormonal pill works by targeting a protein called the retinoic acid receptor alpha (RAR-&alpha;). Through inhibition of this receptor, the retinoic acid in the body is unable to cause cell growth and differentiation, both of which contribute to sperm formation. As a result, the contraceptive helped cause reversible sterility in male mice.&nbsp;

Researchers now plan to conduct human trials for the compound. However, it is too early to tell whether the results in mice will also translate to humans.&nbsp;

&nbsp;

Conclusion

Pakistan faces several challenges to the acceptability of various family planning methods. These range from religious and cultural beliefs, low literacy levels, misconceptions about side effects, lack of knowledge regarding various options for men and women, and reluctance to adopt a method. According to a study from Karachi, fear of side effects was the most common reason for low prevalence among users<a href="#accordion">[8]</a>.&nbsp;

Several trials are currently underway to look for safe and effective male contraceptive pills. However, it can take years till a pill is available in store. Even then, its availability will not matter until there is a change in beliefs regarding family planning.

Despite the safety and availability of male contraception, men are reluctant to use the contraception methods due to various reasons ranging from misconceptions about side effects to a lack of knowledge about safe sexual practices.&nbsp;

Therefore, there is a need for campaigns aimed at educating men about the importance of adopting contraception methods.&nbsp;

&nbsp;

Key Points

<ul>
</ul>

<ul>
	<li>A growing population poses several challenges to a country&#39;s health and economic stability.</li>
	<li>Effective implementation of family planning measures can help control overpopulation.</li>
	<li>In Pakistan, use of contraceptives is highly stigmatized due to various reasons.</li>
	<li>While several advances have been made in the search for female contraception, men have only been presented with two options: condoms and vasectomy.</li>
	<li>Condoms are the most commonly used form of contraception; however, there is a need to raise awareness on its correct usage.</li>
	<li>Vasectomy is the most effective male contraceptive method, but the lack of education and widespread myths regarding its side effects has resulted in a low frequency (0.4%) of the procedure in Pakistan.</li>
	<li>Recently, scientists have begun testing various hormonal and non-hormonal compounds as male contraceptive pills.&nbsp;</li>
	<li>In 2019, a team of scientists tested varying doses of dimethandrolone undecanoate (DMAU) among healthy males and found it was well-tolerated. They are now planning long-term clinical trials to test the compound&#39;s effect on sperm production.</li>
	<li>Recently, a team at the University of Minnesota developed a non-hormonal contraceptive pill. They tested the compound in mice and found it to be 99% effective, with no observable side effects. The team now plans to conduct human trials of the compound.</li>
	<li>The development of male contraceptive pills can help men share some of the burden of contraception and pregnancy.</li>
</ul>

&nbsp;

[1] Statistics, P. B. o., 2021. Brief on Census - 2017. [Online].

[2] Meherali, S., Ali, A., Khaliq, A. & Lassi, Z. S., 2021. Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys (PDHS) dataset from 1990 to 2018. F1000 Research, Volume 10.

[3] Shattuck, D., Perry, B., Packer, C. & Quee, D. C., 2016. A Review of 10 Years of Vasectomy Programming and Research in Low-Resource Settings. Global Health, Science and Practice, 4(4), pp. 647-660.

[4] Siddiqui, M. et al., 2020. Prevalence and Predictors of Contraception Usage in Karachi, Pakistan. Cureus, 12(10).

[5] Hatesh, H., Maheshwari, B. K., Shah, S. Q. & Kumar, D., 2020. Males’ perception and motivation for Vasectomy. Pakistan Journal of Public Health, 10(4).

[6] Thirumalai, A. et al., 2019. Effects of 28 Days of Oral Dimethandrolone Undecanoate in Healthy Men: A Prototype Male Pill. The Journal of Clinical Endocrinology & Metabolism, 104(2).

[7] Society, A. C., 2022. A non-hormonal pill could soon expand men’s birth control options. [Online].

[8] Bibi, S., Memon, A., Memon, Z. & Bibi, M., 2008. Contraceptive knowledge and practices in two districts of Sindh, Pakistan: A hospital based study. Journal of the Pakistan Medical Associatio, 58(5).

Nimrah H. Sattar

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The Bald Truth

Overview

The bald truth is that hair loss in men can happen easily and quickly, and usually it&#39;s out of their control. While the reasons why hair loss occurs in men are somewhat murky, there are some things that can exacerbate the effects of natural balding. The good news is there are things you can do about it. We&#39;ve compiled a list of several ways for you to deal with baldness if it hits you or your loved ones. 
&nbsp;

Understanding the causes of hair loss

To start off with, lets first understand what causes hair loss in men. These include: 
&nbsp;

<ul>
	<li>Family History: A big chunk of the diseases or the disorders a person face is because of their family medical history. If your family has a history of male pattern baldness, there is a very slim chance for you to escape it.&nbsp;</li>
	<li>Hormones: We know you might feel like every other issue is now blamed on hormones but they have a crucial impact on our bodies. These <a href="https://merisehat.pk/article/what-is-hormonal-acne">hormones</a> are often imbalanced due to some medical condition or medicines that are taken for it that may lead you to lose your hair.</li>
	<li>Stress: This is another culprit of many issues in our body. However, losing hair due to stress is relatively temporary and is reversed in most cases.</li>
	<li>Hairstyles And Treatments: Too much product, styles that pull your hair, etc., may cause traction alopecia and causes your hairline to go backwards. This type of hair loss is permanent in many cases. 
	&nbsp;</li>
</ul>

Options For delay the process

If we are being blunt, there is no cure or a reversal of baldness or extreme hair loss. However, there are several options out there that may either delay the process or provide you with other options to copy with the issue.&nbsp;

&nbsp;

<ul>
	<li>Minoxidil: Originally created to treat high blood pressure, the side effect of the medicine included excessive hair growth with made the experts reconsider the use of the drug and target it towards treating baldness. The results are best shown in people who are 40 or under.&nbsp;</li>
	<li>Finasteride: Finasteride is a drug that can help fight male pattern baldness. It is available in both oral and topical forms, and works by decreasing the amount of DHT in the scalp. DHT seems to cause hair follicles to become thinner, so reducing DHT may help promote hair regrowth and slow hair loss. Unlike minoxidil, finasteride does not affect hair growth on other parts of your body.</li>
	<li>Surgery: If you&#39;re experiencing hair loss, the good news is there&#39;s a treatment for it. The bad news is that it requires surgery. Hair transplantation works for men with male pattern baldness. A hair transplant involves removing hair follicles from the back of the head, where they are resistant to DHT, and placing them on the scalp. As with any surgery, hair transplants carry the risk of complications. The American Society of Plastic Surgeons states that the risks include excessive bleeding and wide scars. Additionally, there is a chance the skin plugs may die, which requires further surgery to fix.</li>
	<li>Laser Combs: Laser combs are a newer form of hair loss treatment. Advocates claim these devices promote hair growth by using concentrated light to stimulate hair follicles. This treatment has mixed results and may work best when combines with other forms of treatment. 
	&nbsp;</li>
</ul>

Hair loss affects all ages, races, and sexes and literally has no boundaries. No one is immune from this epidemic and will eventually witness, if not experience it for themselves. It is an unavoidable fact of life that sometimes the best laid plans, the most fervent prayers or the strongest medications cannot eradicate. While some men see their hair grow back in after years of balding, for others their hair loss is a life long battle. This makes it even more important to live a healthy lifestyle and take active measures to ensure that you are doing everything possible to prevent hair loss.&nbsp; 
&nbsp;

Common Symptoms

Some common symptoms of male-pattern baldness include thinning or receding hairline, excessive hair on the side of the head, slow hair growth and even complete baldness at the top of the head over time. All men may benefit by getting more regular exercise and increasing activity during their free time. It is also recommended to have a balanced diet that includes vegetables, fruits and protein as well as staying away from fast food. Another natural remedy that can contribute to hair re-growth is using coconut oil regularly.

Umna Salah

Ismail Munir

Boys Can Wear Pink Too!

Toxic masculinity is defined as a set of masculine behaviors that can have a negative impact on men and society as a whole. 
&nbsp;

Boys will be boys - a phrase we&#39;ve all heard countless times. It&#39;s the excuse a mother gives when the first-grade teacher complains of her son pulling a girl&#39;s hair. Or what you hear when high school boys fight it out during recess. Over the years, people have used the phrase multiple times to declare certain behaviors expected of boys and men. Not only has it hindered holding men accountable for acts of aggression, sexual assault, and other crimes, but it&#39;s also promoted flawed gender stereotypes, for men and women both.&nbsp; 
&nbsp;

It can be said that gender stereotypes have existed since forever. The early male homo sapiens were hunters and gatherers who used their physical strength to provide for their families. They relied on these traits of aggression and ruthlessness to exert their power and dominance over other men. As humans evolved, these behaviors persisted. From hunters to rulers, men then began to demonstrate their strength by waging wars, plundering cities, and leaving a trail of destruction on their way to the top.&nbsp; 
&nbsp;

Although society has modernized and evolved, these patterns of male behavior continue to be unfortunately celebrated. Behaviors such as acting aggressive, refusing to take part in chores around the house, and avoiding emotions are often labelled as &#39;manly&#39;. Anyone who&#39;s not living up to these rules is not considered masculine enough.&nbsp; 
&nbsp;

However, the way society views masculinity has greatly changed over the years, i.e., we are now aware of the &#39;toxic&#39; nature of such &#39;masculine&#39; traits and how damaging they can be for men&#39;s mental health.

&nbsp;

In 2019, men&#39;s shaving brand Gillette released a commercial highlighting the harmful effects of normalizing toxic masculine traits of bullying and sexual harassment. The video urged men to take accountability for their actions and call out fellow men acting inappropriately towards other men and women. Although the ad itself received a lot of criticism, it also started a conversation around toxic masculinity. But can men really be blamed for such toxic traits? Or are we as a society to blame for normalizing such behaviors? 
&nbsp;

Toxic masculinity is defined as a set of masculine behaviors that can have a negative impact on men and society as a whole. As per a study in the Journal of Clinical Psychology, these regressive traits promote &#39;devaluation of women, homophobia, and wanton violence<a href="#accordion">&#39;[1]</a>. Moreover, such behaviors are also associated with lower willingness to intervene among adolescents, especially when witnessing sexual harassment and homophobic bullying<a href="#accordion">[2]</a>.&nbsp; 
&nbsp;

Understanding The Dangers Of Toxic Masculinity

Traits of toxic masculinity emphasize the importance of physical strength, self-reliance, aggression, lack of emotion, sexual virility, and dominance in men. Living up to these exaggerated masculine traits can place additional stress on men and lead them to engage in harmful behaviors. 
&nbsp;

Research has shown that college men pressured to conform to masculine norms of self-reliance, sexual promiscuity, and violence have higher rates of depression<a href="#accordion">[3]</a>.&nbsp;Moreover, when men are taught dominance and risk-taking as norms of masculinity, they tend to engage in high-risk behaviors such as drug abuse, drinking, not wearing a seatbelt, and gambling<a href="#accordion">[4].</a>&nbsp; 
&nbsp;

Heterosexual ideals are often propagated among men, as part of traditional masculinity. Anything deflecting from it is viewed as feminine and socially unacceptable. Moreover, feminine ideals are thought to be equivalent to homosexuality. As a result, gay men often face internalized homophobia, and men who identify as straight but do not conform to these heterosexual ideals are often a target of homophobic bullying.&nbsp; 
&nbsp;

As a result, the American Psychological Association (APA) has introduced new guidelines to tackle these problems in boys and men<a href="#accordion">[5]</a>. These guidelines warn therapists of the psychological impact of traditional masculinity and its link to misogyny, aggression, and negative health outcomes in the male population. 
&nbsp;

So how do we address toxic masculinity?

&nbsp;

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While our genetics govern a lot of our personality, the environment around us also influences behaviors. What you see around you as a child, you tend to conform to that as an adult. For example, a boy who&#39;s seen his father work every day of the week with no breaks believes that is the norm; as a man, one must never stop and rest. Or if your father refuses to ask for directions even when he&#39;s clearly lost, you are more likely to adopt that specific quality and assume asking for help is not a very manly thing. 
&nbsp;

Therefore, a good way to address toxic masculinity is to revisit the models of behaviors set in the past and redefine man&#39;s role in society. 
&nbsp;

A father&#39;s role in a family is often limited to being the financial provider. However, over the years, this role has evolved to fathers becoming more involved in the lives of their children. A UK cohort study found that early father involvement in the form of creative play and quality time lowers the risk of subsequent behavior problems in both boys and girls<a href="#accordion">[6]</a>. According to research, altering the social role of fathers to a more nurturing and involved role can help change harmful gender stereotypes<a href="#accordion">[7]</a>.&nbsp; 
&nbsp;

This involvement can begin as early as at the time of birth. Skin-to-skin contact between the father and the neonate not only benefits the child&#39;s physiological health but also helps men ease into fatherhood<a href="#accordion">[8].</a>

&nbsp;

&#39;Men don&#39;t cry&#39;, &#39;man up&#39;, and &#39;don&#39;t be such a girl&#39; are just some of the things men grow up hearing. These phrases teach men to suppress all emotions of sadness, fear, or pain. Thus, they grow up hiding all these feelings within themselves. This inability to express emotions or share their feelings with others leads to feelings of loneliness. As per an APA study, these gender norms act as barriers to men seeking psychological help when facing mental health issues<a href="#accordion">[9]</a>. Moreover, male victims of domestic or sexual abuse may find it even more challenging to get help. 
&nbsp;

Similarly, toxic masculinity promotes the idea of being self-reliant. Therefore, men will avoid going to a physician for any type of health care<a href="#accordion">[4].</a> Thus, identifying and addressing these behaviors can be beneficial to both your <a href="https://www.merisehat.pk/article/Mental%20Health">mental</a> and physical health.&nbsp;

&nbsp;

Toxic masculinity is not a problem that can be solved overnight. These traits and behaviors are ingrained in society as a whole. Therefore, a redefinition of masculinity is needed. However, everyone&rsquo;s version of masculinity or femininity is different. And one can only arrive at this definition after holding conversations with friends and family about the problematic patterns of the past. 
&nbsp;

As the newer generations move forward, it is important to keep toxic masculinity in the past. Raising awareness among the masses and educating them on the toxic nature of certain society-defined masculine traits is a great way to achieve this. Moreover, more positive male role models can greatly impact how one views masculinity. 
&nbsp;

However, many people believe that dismantling toxic masculinity is just another way to emasculate men or make them more feminine. In reality, the whole concept actually centers around breaking down the boxes society has placed around genders.&nbsp;&nbsp; 
&nbsp;

The bottom line is you can be masculine without being toxic. Remember, you define your own identity.&nbsp;

&nbsp;

<ul>
	<li>Toxic masculinity refers to a set of behaviors that are harmful to men and society as a whole. Traits such as physical strength, aggression, self-reliance, emotional unavailability, and dominance are often promoted as part of toxic masculinity.</li>
	<li>Toxic masculinity can lead to depression, high-risk behaviors, feeling of loneliness, relationship issues, and mental health problems among men. Moreover, toxic guys are more likely to act out of aggression and engage in acts of bullying and sexual harassment.&nbsp;</li>
	<li>A father&#39;s role in the life of a child can play an important part in changing harmful gender stereotypes. A more nurturing and involved role is beneficial to both the father and child.&nbsp;</li>
	<li>Identifying toxic masculine traits and seeking help are significant steps in eliminating toxic masculinity.&nbsp;</li>
</ul>

&nbsp;

[1] Kupers, T. A., 2005. Toxic masculinity as a barrier to mental health treatment in prison. Journal of Clinical Psychology, 61(6), pp. 713-724.

[2] Ingram, K. M. et al., 2019. Longitudinal associations between features of toxic masculinity and bystander willingness to intervene in bullying among middle school boys. Journal of School Psychology, Volume 77, pp. 139-151.

[3] Iwamoto, D. K., Brady, J. & Park, A., 2018. Masculinity and Depression: A Longitudinal Investigation of Multidimensional Masculine Norms Among College Men. American Journal of Men's Health, 12(6), pp. 1873-1881.

[4] Mahalik, J. R., Burns, S. M. & Syzdek, M., 2007. Masculinity and perceived normative health behaviors as predictors of men's health behaviors. Social Science & Medicine, 64(11), pp. 2201-2209.

[5]  American Psychological Association, 2018. APA GUIDELINES for Psychological Practice with Boys and Men.

[6] Kroll, M. E., Carson, C., Redshaw, M. & Quigley, M. A., 2016. Early Father Involvement and Subsequent Child Behaviour at Ages 3, 5 and 7 Years: Prospective Analysis of the UK Millennium Cohort Study. PLOS One, 11(9).

[7]  Park, B. and Banchefsky, S. (2018) ‘Leveraging the Social Role of Dad to Change Gender Stereotypes of Men’, Personality and Social Psychology Bulletin, 44(9), pp. 1380–1394. doi: 10.1177/0146167218768794.

[8] Chen, Er-Mei et al. “Effects of Father-Neonate Skin-to-Skin Contact on Attachment: A Randomized Controlled Trial.” Nursing research and practice vol. 2017 (2017): 8612024. doi:10.1155/2017/8612024

[9] Yousaf, O., Popat, A., & Hunter, M. S. (2015). An investigation of masculinity attitudes, gender, and attitudes toward psychological help-seeking. Psychology of Men & Masculinity, 16(2), 234–237

Mid-Life Crisis In Men: What Does It Look Like Now?

Middle-aged individuals tend to go through a period where their identity and self-confidence suffer greatly. This is usually between the ages of 30 to 65 years, when these individuals start having to face their growing age as new physical ailments start popping up.&nbsp;

Some feel they have wasted their life so far and it&rsquo;s &lsquo;too late&rsquo; now. There can be a lot of <a href="https://merisehat.pk/disease/anxiety">anxiety</a>, remorse and sadness associated with it which tends to manifest in drastic decisions that don&rsquo;t really make sense for the kind of person they are.&nbsp;

This phenomenon is termed as midlife crisis. It was first coined in 1965 by Elliot Jacques. It tends to last between three to 10 years in men and two to five years in women. But it can even last only a few months in some individuals.&nbsp; 
&nbsp;

Even though it&rsquo;s mainly associated with ageing, there can be many precipitating factors along with ageing, such as a divorce, work troubles, children maturing and leaving the house, a death of a loved one etc.&nbsp;

This, however, is not a clinical diagnosis and is even thought to be a cultural phenomenon limited to western society. Studies have shown that it might not be as common as it was previously thought to be while there is also little evidence of it in other cultures, such as in Indian and Japanese cultures.&nbsp;

Men tend to go through their midlife crisis at the age of 40 and it is usually preceded by a feeling of inadequacy, being unaccomplished or having to face a crisis such as a parent&rsquo;s or a peer&rsquo;s death. It is also very abundantly portrayed in pop-culture where men are seen to pursue younger women, buying expensive things and being in denial about their receding hairline.&nbsp;

In real life, these clues might not always (mostly never) present.&nbsp; 
&nbsp;

Mid-life Crisis

<ul><li>They tend to turn into mopey individuals with more frequent bouts of sadness requiring alone time to process feelings of loss of control, disappointment and self-pity. Other markers of chronic sadness may also be there such as disturbed sleep, over eating or lack of motivation.&nbsp; </li><li>Other than sadness they might have turbulent moods where one minute they are down and next they are ready to party. These rapidly changing moods are usually the first time you will observe these men on an emotional roller-coaster.&nbsp; </li><li>They tend to become complainers who find fault with everything and have a largely pessimistic view of the world. They will nag everyone around them about the tiniest of things and nothing can ever make them happy. At the root of all this is a lack of satisfaction they tend to feel with their own life and self.&nbsp; </li><li>These men also tend to display poor judgement and might make impulsive decisions or purchases. This can be affected by their turbulent moods as well.&nbsp; </li><li>Some men will inevitably end up using substances to cope and deal with the crisis. This can lead to other poor choices such as gambling.&nbsp; </li><li>These men are also highly irritable in all areas of life. You can find them throwing a tantrum at the office and at home and it’s increasingly obvious that everything tends to frustrate them now.&nbsp; </li><li>Some men might also become withdrawn and give up on their relationships and goals. They stop doing the activities they usually keep themselves busy with and go into hermit mode. There is a sense of boredom with the life they have created for themselves so far and want to run away from it. &nbsp; </li><li>An acute and heightened sense of awareness and self-consciousness about their marital, work, health or economic and social status.&nbsp; </li></ul>These midlife crises usually have a peak after which they end and most people come out on the other side better and changed individuals. They tend to become more comfortable with the new normal and make their peace with it. There will be a re prioritising and refocusing of their perspective but they are ready for the challenge and the next phase of life.&nbsp; So how do these lucky ones navigate something so precarious?&nbsp;

How to Cope

<ul><li>Acknowledge that you have these feelings and they tend to be overwhelming enough to lead you into a crisis.&nbsp; </li><li>Let your partner, colleagues and friends know and reach out for help. Chances are they are also feeling the same way and might have some groundbreaking insight. If nothing, you will at least realise you're not alone in this.&nbsp; </li><li>Accept that it’s completely normal to feel this way and it’s the natural progression of life. It’s just another stage in your growth and it too shall pass.&nbsp; </li><li>Try not to make any big decisions by making sure you consult either your partner or a trusted friend/mentor beforehand. This reduces your chances of making any impulsive decisions you might come to regret later.&nbsp; </li><li>Invest in your physical and mental wellbeing. Join a gym or pick up one physical activity that you enjoy doing and stick with it. Being active also makes you feel better emotionally. Meditation and yoga can also help calm down those recurrent feelings of anxiety.&nbsp; </li><li>Embrace the oncoming changes and appreciate the effect of time on circumstance. Recognise that ageing might not be the worst thing in the world and you can still continue to enjoy life in your older age.&nbsp; </li></ul>

The process of ageing can be daunting and life can seem quite overwhelming at any point in time. Some people tend to suffer through these crises earlier in life, which is happening more and more lately thanks to social media and the impending threat of climate change, food and water shortages and the general upheaval in society.&nbsp;People feel they are not only stuck behind while their peers have progressed and achieved so much more in life, but they also think any effort is futile since the world is ending anyway. This is what we call a ‘quarter life crisis’ which looks almost the same as having a mid-life crisis but in your 20s and 30s.&nbsp;In either scenario, taking a step back and looking at the whole forest instead of the trees might help and calm you down. It’s never too late to make any changes or achieve anything.&nbsp; However, if none of these things work it is likely that you're depressed and can benefit from seeking professional help. Although a midlife crisis is not the same as depression, it can still precipitate it.Recognising that with each stage of life there needs to be a readjustment and you’re more than capable of it can be a huge task. You don’t have to accomplish it alone.&nbsp;Another interesting concept to acknowledge here is that some renowned psychologists have deemed a midlife crisis as the process that leads to self-actualisation, the last need on Maslow’s hierarchy. Integrating all your knowledge, intuition, thoughts and feelings into a newer version of you can be daunting and can rightfully lead to a state of crisis. However, there is hope on the other side of it where your identity achieves a much more solid footing.&nbsp;

Dr. Safia Mehmood

Humza Khizer

Check Yourself Before You Wreck Yourself

&ldquo;A checkup can tell your inside story&rdquo; is something we have seemed to have forgotten over time. Sometimes it is due to a family commitment, and sometimes it is because of a work commitment. We have reached a point when we won&rsquo;t go for a checkup even when we are not feeling well!

&nbsp;

But did you know there is a list of diseases that can be prevented, or caught on early, if proper routine <a href="https://merisehat.pk/page/sehat-scan/">health checkup</a> is done? For starters, a routine <a href="https://merisehat.pk/page/sehat-scan/">health screening</a> would allow you to track any mild symptoms that might not seem dangerous initially. It also allows your health care practitioner to look for diseases that are notoriously asymptomatic.&nbsp;

&nbsp;

People nowadays have honestly started to take their health for granted. They only visit their doctors once a disease has settled in. Some of us even want to challenge the illness and see how far we can take it before we need to get admitted!

&nbsp;

Like any other medication a healthcare practitioner may prescribe for treating the disease, a <a href="https://merisehat.pk/page/sehat-scan/">health checkup</a> is necessary for preventing it. And as many of us will agree, &ldquo;prevention is better than cure&rdquo;.&nbsp; &nbsp;&nbsp; 
&nbsp;

&nbsp;

Understanding The Importance Of Regular Medical Check Ups

It is important to understand that males and females have different types of bodies physiologically. Hence, screening is essential for a range of different diseases, and, in some cases, it is solely dependent on the gender or age.

<h5>Blood Pressure</h5>

If you are a male aged between 18 and 39, you should control your blood pressure by getting it checked once every 2 years. If during these checkups your upper pressure (systolic) is above 120 and the lower pressure (diastolic) is more than 80, the monitoring has to be on a yearly basis<a href="#accordion">[1]</a>.

&nbsp;

<h5>Cholesterol</h5>

Due to dietary and lifestyle habits, cholesterol monitoring becomes crucial, particularly for men. The recommended age for cholesterol screening is 35 for men with no known risk factors for coronary heart disease, and 20 for men with known risk factors for coronary heart disease. If there are any comorbidities involved, you should get it checked more often. However, if the results are normal, the screening could simply be repeated after a span of 5 years<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

<h5>Diabetes</h5>

Diabetes and hypertension often go hand in hand. So, if you are a known hypertensive patient, you are more likely to be screened for diabetes. HbA1c is usually tested along with the oral glucose tolerance test (OGTT).&nbsp;

&nbsp;

For OGTT, blood sugar levels between 141 mg/dL and 200 mg/dL (7.8 - 11.1 mmol/L) is considered impaired glucose tolerance, whereas a result above 200 mg/dl (11.1mmol/L) means the person is diabetic. A normal HbA1C level is below 5.7%, levels of 5.7% - 6.4% indicates pre-diabetic condition, and 6.5% or more is a strong indicator of diabetes<a href="#accordion">[2]</a>. After obtaining your medical history in detail, your healthcare practitioner will decide whether screening for certain infections, like syphilis, chlamydia, and HIV is important or not.

&nbsp;

<h5>Prostate Cancer</h5>

Regarding malignancies, there are some horrific statistics seen in men, which makes it all the more necessary for them to be screened on a routine basis. According to the American Cancer Society&rsquo;s estimates for prostate cancer in the United States, in 2022, 268,490 new cases were reported and 34,500 people lost their lives due to the disease. This is equivalent to 1 in 8 men, with increasing risk once they turn 65<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

The Prostate Cancer Early Detection Guidelines established by the National Comprehensive Cancer Network urges men above 45 years of age to get a screening done, and then plan a routine checkup according to the results.&nbsp;

&nbsp;

Prostate Specific Antigen (PSA) along with a digital rectal examination (DRE) is done to screen you for prostate cancer<a href="#accordion">[5]</a>. The PSA is a blood test to check for prostate specific chemicals, whereas the DRE is the insertion of a finger in the anus to feel the physical aspects of the prostate<a href="#accordion">[4]</a>.&nbsp;

&nbsp;

<h5>Bladder Cancer</h5>

Even though it&rsquo;s a disease of elderly, with the mean age being 73, bladder cancer is another malignant disease that is four times more prevalent in men compared to women<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

Data collected by GLOBOCAN in 2018 estimated that 550,000 people were diagnosed with bladder cancer<a href="#accordion">[6]</a>. The screening method for bladder cancer is done by a basic urine detailed report and urine cytology which helps detect abnormalities.&nbsp;

&nbsp;

<h5>Colorectal Cancer</h5>

Colorectal cancer is yet another cancer which takes around 27,000 lives in the US alone each year.&nbsp;

&nbsp;

It is recommended that a colonoscopy be done as a screening method in men at the age of 45 years. A family history of malignancies makes the screening even more crucial<a href="#accordion">[5]</a>.&nbsp;&nbsp;

&nbsp;

<h5>Sexually Transmitted Infections&nbsp;</h5>

Men who have sex with women should get screening for:&nbsp;

<ul>
	<li>Chlamydia, gonorrhoea, syphilis, herpes, HIV, and hepatitis B and C&nbsp;</li>
</ul>

&nbsp;

Men who have sex with men should get screening for:&nbsp;

<ul>
	<li>Chlamydia, gonorrhoea, syphilis, herpes, HIV, HPV, anal cancer, and hepatitis B and C&nbsp;</li>
</ul>

&nbsp;

Women also need to be screened for their overall health. Reason being that a woman has to go through menstruation, pregnancies, and then post-menopause, all of which can cause multiple relevant health condition like dysmenorrhea, premature delivery, and increased risk of malignancies, respectively.&nbsp;

&nbsp;

Following are a few vitamins and minerals, and their recommended daily allowance which a woman can take to ensure optimal health<a href="#accordion">[7]</a>:

<ul>
	<li>Iron: For those aged 19-50 years, it&rsquo;s 18 mg/day whereas for those aged 51 and up, it&rsquo;s 8 mg/day</li>
	<li>Magnesium: If aged 19-30, then 310 mg/day; if aged 31 years and above, then 320 mg/day</li>
	<li>Vitamin D:&nbsp;If aged 1-70 years, 15 mcg/day (600 IU or international units)</li>
	<li>Vitamin C: 75mg/day</li>
	<li>Vitamin E: 15mg/day</li>
</ul>

&nbsp;

<h5>Lung Cancer</h5>

If you smoke one pack a day, it is necessary for you to be screened for lung cancer.&nbsp;Screening is done by a Computed Tomography (CT) and has to be done annually.&nbsp;

&nbsp;

<h5>Cervical Cancer</h5>

Cervical cancer is the 4th most common malignancy found in women worldwide. Around 604,000 new cases and 342,000 deaths were reported in 2020, with 90% of this data being sourced from low and middle income countries<a href="#accordion">[8]</a>.&nbsp;

&nbsp;

In order to screen a woman with cervical cancer, a Pap test is recommended every 3 years for women aged 21-65 years. A Pap smear test is one in which your health care practitioner takes samples from your cervix and evaluates them under a microscope.&nbsp;

&nbsp;

<h5>Breast Cancer</h5>

Another alarming malignancy in females is breast cancer. A total of 7.8 million cases, diagnosed between 2015-2020, made it the most prevalent cancer worldwide. In 2020 alone, there were 2.3 million women who were diagnosed and 685,000 deaths worldwide that occurred due to breast cancer<a href="#accordion">[9]</a>.&nbsp;

&nbsp;

Screening for breast cancer is done through mammography (an x-ray of your breast) every 2 years from the age of 50 years onwards<a href="#accordion">[10]</a>.&nbsp;

&nbsp;

<h5>Sexually Transmitted Infections&nbsp;</h5>

Women who are 24 years and older and sexually active should get screened for sexually transmitted infections like chlamydia, gonorrhoea, herpes, trichomoniasis, HIV, HPV, cervical cancer, hepatitis B, hepatitis C, and syphilis. Chlamydia screening particularly should be done every year once girls turn 24.&nbsp;

&nbsp;

Pregnant women should be screened for chlamydia, gonorrhoea, herpes, HIV, HPV, cervical cancer, hepatitis B, hepatitis C, and syphilis.&nbsp;

&nbsp;

Screening for diseases in children is another ball game and one that&rsquo;s quite important too.&nbsp;

&nbsp;

<h5>Severe Acute Malnutrition</h5>

Severe acute malnutrition (SAM), also known as severe wasting, is the most crucial form of undernutrition and has a mortality rate of 10-30%.&nbsp;

&nbsp;

Studies show that children in developing countries have a strong correlation of undernutrition and development outcomes. It should be noted that even if the child survives the undernutrition at the moment, it would have a drastic effect on adulthood, especially with regards to physical and cognitive development.&nbsp;

&nbsp;

According to the Pakistan Demographic Survey (2017&ndash;18), 37.6% of children under 5 years were stunted, with 17% severely stunted. Furthermore, 7.1% were found to be wasted, with 2% severely wasted and 23% were underweight<a href="#accordion">[11]</a>. Hence, it becomes necessary to monitor a child who is 5 years or under, to counteract any existing deficiencies .&nbsp;

&nbsp;

Developmental Screening Test II (Denver), also known as DDST II, is used to screen a child for his or her development. DDST II has 4 components: personal-social behavior development, fine motor development, language, and gross motor development.&nbsp;

&nbsp;

Apart from this, anthropometric measurements are also taken to check for physical development. Anthropometric measurements include height, weight, head circumference, body mass index (BMI), body circumferences to assess for adiposity (waist, hip, and limbs), and skinfold thickness.

&nbsp;

It can be settled from the statistics mentioned above that some diseases are silent killers and need to be identified as early as possible. Anything could happen to anyone, so the best way to look out for yourself is to give yourself a fair opportunity. Just going to your doctor reduces your risk by 50%. Some diseases like pancreatic cancers are usually symptomatic at advanced stages. However, if routine blood work is done, it can warrant for early on imaging and, hence, diagnosis. There can be a lot of examples like this, but the main question remains, “do you love yourself enough?”&nbsp;&nbsp;

<ul>
	<li>A health screening routine allows to track any mild symptoms that might not seem dangerous initially.</li>
	<li>Screening is important for different diseases and in some cases it&rsquo;s solely dependent on the gender or your age.</li>
	<li>If you are a male, aged between 18 and 39, you should keep your blood pressure in check by getting it checked once every 2 years.</li>
	<li>The recommended age for cholesterol screening is 35 for men with no known risk factors regarding coronary heart disease, and 20 for men with known risk factors for coronary heart disease.</li>
	<li>Blood sugar levels between 141 mg/dL and 200 mg/dL (7.8 to 11.1 mmol/L) is considered impaired glucose tolerance, whereas above 200 mg/dl (11.1mmol/L) is diagnostic of diabetes in an OGTT.</li>
	<li>A normal HbA1C level is below 5.7%, whereas a level of 5.7-6.4% indicates pre-diabetes. 6.5% or more is a strong indicator of diabetes.</li>
	<li>2022 studies show 268,490 new cases were reported and 34,500 people lost their lives due to prostate cancer in the US.</li>
	<li>Prostate Specific Antigen (PSA) along with a digital rectal examination (DRE) are done to screen one for prostate cancer</li>
	<li>Bladder cancer is 4 times more prevalent in men compared to women.</li>
	<li>Data collected by GLOBOCAN in 2018 estimated that 550,000 people were diagnosed with bladder cancer.</li>
	<li>The screening method for bladder cancer is a basic urine detailed report and urine cytology.</li>
	<li>Colorectal cancer is the 4th most common cancer in the US which takes around 27000 lives each year.</li>
	<li>Colonoscopy should be done to screen men around 45 years.</li>
	<li>Women need to tend to their overall health as vigilantly as possible, to ensure proper menstrual cycle and pregnancies.</li>
	<li>Lung cancer screening is done by a Computed Tomography (CT) and has to be done on an annual basis.</li>
	<li>Cervical cancer is the 4th most common malignancy found in women worldwide. Around 604,000 new cases were reported in the year 2020 and 342,000 deaths, with 90% of this data being sourced from low- and middle-income countries.</li>
	<li>Pap test is recommended every 3 years for women aged 21-65 years, for screening for cervical cancer.</li>
	<li>In 2020 alone, there were 2.3 million women diagnosed with breast cancer and 685,000 deaths globally.</li>
	<li>Screening for breast cancer is done by mammography every 2 years from the age of 50 years.</li>
	<li>Sexually active men (included males who have sex with males) and women (including pregnant women) should get screened for sexually transmitted infections.</li>
	<li>According to the Pakistan Demographic Survey (2017&ndash;18), 37.6% of children under 5 years of age were stunted, with 17% severely stunted. Furthermore, 7.1% were found to be wasted, with 2% severely wasted, and 23% were underweight.</li>
	<li>Developmental Screening Test II (Denver), also known as DDST II, and anthropometric measurements are used to screen a child for his or her development.</li>
</ul>

&nbsp;

[1] Health screenings for men ages 18 to 39: Medlineplus Medical Encyclopedia. MedlinePlus.

[2] All about your A1C. Centers for Disease Control and Prevention.

[3] Key statistics for prostate cancer: Prostate cancer facts. American Cancer Society.

[4] What is screening for prostate cancer? Centers for Disease Control and Prevention.

[5] 5 most common cancers in men. Roswell Park Comprehensive Cancer Center.

[6] Saginala K, Barsouk A, Aluru JS, Rawla P, Padala SA, Barsouk A. Epidemiology of Bladder Cancer. Med Sci (Basel). 2020;8(1):15. Published 2020 Mar 13. doi:10.3390/medsci8010015

[7] Vitamins and minerals: How much should you take? WebMD.

[8] Cervical cancer. World Health Organization.

[9] Breast cancer. World Health Organization.

[10] What is a mammogram? Centers for Disease Control and Prevention.

[11] Saleem, J., Zakar, R., Bukhari, G.M.J. et al. Developmental delay and its predictors among children under five years of age with uncomplicated severe acute malnutrition: a cross-sectional study in rural Pakistan. BMC Public Health 21, 1397 (2021).

Arbaz Ansari

Can Men Get Yeast Infections?

We all have heard of women getting yeast infection, but rarely do we hear anything about men getting yeast infection. Quite unfair, don&rsquo;t you think? Since this makes room for the misconception that men are immune to it. And that&rsquo;s not what you&rsquo;d want to believe. It&rsquo;s baseless and untrue; men are also susceptible to yeast infection.

&nbsp;

1 in every 25 men catch the infection at least once in their lives, with 1 in every 30 uncircumcised males and uncircumcised boys under 4 being more at risk of developing the condition<a href="#accordion">[4]</a>.&nbsp; 
&nbsp;

Understanding Yeast Infection in Men

A yeast infection is caused by a fungus called candida,&nbsp;also known as candida balanitis<a href="#accordion">[3][4]</a>. Balanitis is the inflammation in the head of the penis.&nbsp;

&nbsp;

According to research, almost 20% of women have candida in their vagina, but do not experience infections<a href="#accordion">[1]</a>. In contrast, 16-26% of men have yeast on the head of the penis out of which 37% don&rsquo;t experience any symptoms while 27% of men develop infection<a href="#accordion">[6]</a>. According to a report, men over 40 and <a href="https://merisehat.pk/disease/diabetes-type-1-and-2">diabetic </a>are especially prone to candida balanitis<a href="#accordion">[6]</a>.

&nbsp;

Typically, candida thrives in moist environments. It makes you restless. Often, the condition can be easily treated with common over-the-counter (OTC) drugs, given that it is attended to on time. If you maintain proper hygiene, keep the area dry, and practice safe intercourse, you can actually prevent it.&nbsp;

&nbsp;

Most people hesitate discussing this topic with their doctor because of the taboo associated with it. Especially since it questions your personal hygiene routine. Don&rsquo;t be that person; you need to seek medical help as soon as possible for a better shot at recovery. 
&nbsp;

While the main cause of yeast infection is candida, there are other conducive situations that allow it to manifest:

<ul>
	<li><a href="https://merisehat.pk/disease/obesity">Obesity</a></li>
	<li>Long term use of antibiotics or steroids&nbsp;</li>
	<li>Diabetes</li>
	<li>Weak immune system</li>
	<li>Unhygienic conditions</li>
	<li>Sex (if the partner is infected)&nbsp; 
	&nbsp;</li>
</ul>

Common symptoms of inflammation are:

<ul>
	<li>Redness</li>
	<li>Swelling of foreskin</li>
	<li>Pain or itchiness on the foreskin or tip of penis 
	&nbsp;</li>
</ul>

Other symptoms include:

<ul>
	<li>Moist feeling on the tip of penis</li>
	<li>Thick, white discharge that may have unpleasant smell</li>
	<li>Burning sensation while peeing&nbsp;</li>
	<li>Sores or white patches of skin</li>
	<li>Difficulty in having or holding erection 
	&nbsp;</li>
</ul>

When the yeast infection is left untreated for a long time, systemic symptoms appear, like<a href="#accordion">[4]</a>:

<ul>
	<li>High-grade fever</li>
	<li>Chills</li>
	<li>Headache</li>
	<li>Stomach upset</li>
	<li>Narrowing or scarring of penis&nbsp;&nbsp;</li>
	<li>Increased risk of penile cancer&nbsp;</li>
	<li>Difficulty while pulling back the foreskin of penis 
	&nbsp;</li>
</ul>

This can lead to complications, such as:

<ul>
	<li>Balanitis, which can cause fatigue and weakness and lead to swollen, painful glands</li>
	<li>Candidemia or invasion of candida in bloodstream, which further affects other parts of the body including heart, bones, and brain 
	&nbsp;</li>
</ul>

Those who have a weak immune system are susceptible to candidemia. According to the CDC, candidemia is one of the most common blood infections in the US<a href="#accordion">[2]</a>. 
&nbsp;

Your health practitioner will perform a physical exam. They may check the foreskin of your penis or they may take a swab sample to identify the pathological condition under microscope<a href="#accordion">[4]</a>.

&nbsp;

Additionally, they may order a few laboratory tests<a href="#accordion">[5]</a>:

<ul>
	<li>Serum glucose test (diabetes)</li>
	<li>STD testing (<a href="https://merisehat.pk/disease/hiv-61">HIV </a>and HPV)</li>
	<li>Bladder scan and ultrasonography (urinary obstruction in severe balanitis) 
	&nbsp;</li>
</ul>

Fungal and yeast infections are quite stubborn to get rid of. They may go away on their own or they may require treatment; it&rsquo;s different for every individual. If the infection is treated on time, it can last for a week. If it&rsquo;s moderate to severe, it takes almost 2-3 weeks to clear up<a href="#accordion">[2]</a>. However, in case of uncircumcised individuals, a frequent relapse of yeast infections is possible.&nbsp; 
&nbsp;

The first thing you should do is avoid having intercourse with your partner if they have a yeast infection. Secondly, you should also keep away from any sexual activity if you yourself are suffering from yeast infection.

&nbsp;

The follow steps are also recommended to reduce your chances of contracting yeast infections:

<ul>
	<li>Use condoms&nbsp;</li>
	<li>Adopt and Maintain good hygiene to ensure clean and dry genitalia</li>
	<li>Opt for unscented soaps</li>
	<li>Wear breathable underwear to prevent moisture 
	&nbsp;</li>
</ul>

<ul>
	<li>Any sexual contact with a person who has yeast infection.</li>
	<li>Not being circumcised&nbsp;</li>
	<li>Lack of hygiene and improper cleaning of genital</li>
	<li>Using antibiotics for long durations&nbsp;</li>
	<li>Extremely low immunity 
	&nbsp;</li>
</ul>

The earlier you begin your treatment, the more likely you are to avoid complications. Do NOT self-diagnose and begin treatment on your own; always consult a doctor!&nbsp;

&nbsp;

Mostly, topical preparation, including the following, will effectively treat an infection<a href="#accordion">[2][4]</a>:

<ul>
	<li>Corticosteroid cream containing betamethasone can be used to treat certain yeast infections in combination with clotrimazole</li>
	<li>Anti-fungals (e.g., miconazole, imidazole, clotrimazole)&nbsp; 
	&nbsp;</li>
</ul>

Oral fluconazole and hydrocortisone cream are prescribed for serious infections leading to complications like balanitis<a href="#accordion">[2]</a>.

&nbsp;

If medications don&rsquo;t help, your doctor may recommend circumcision<a href="#accordion">[4]</a>.

&nbsp;

Note:&nbsp;Betamethasone should NEVER be used as stand-alone treatment for yeast infection because it weakens the immune system and makes the infection worse<a href="#accordion">[7]</a>. 
&nbsp;

As per research, penile yeast infections mostly occur due to poor hygiene and unprotected sex. Redness, swelling, itchiness, and discomfort are common signs. If you have any of the aforementioned symptoms, it should not be neglected and treated as prescribed by your physician. Corticosteroids and anti-fungal topical preparations can be used according to the degree of infection. A decent hygiene and avoiding scented products can help protect yourself and others. 
&nbsp;

<ul><li>Penile yeast infections are caused by candida. A moist environment promotes growth of candida.</li><li>Common signs and symptoms are redness, swelling, itching. A yeast infection can lead to balanitis, which causes unpleasant smell and thick white discharge.</li><li>Doctors may perform physical and order pathological testing as well to diagnose the infection.&nbsp;</li><li>Treatment includes topical corticosteroids and anti-fungal medication; for serious illness, oral antifungals are helpful. </li></ul>

[1] Sobel JD. Vulvovaginal Candidosis. The Lancet.

[2] Roland J. Male yeast infection: Symptoms, treatment, and more. Healthline.

[3] Yeast infection in men: How can I tell if I have one? Mayo Clinic.

[4] Male yeast infection (candida balanitis): Symptoms, causes & treatment. Cleveland Clinic.

[5] Mark J Leber MD. Balanitis workup. Laboratory Studies.

[6] Men also get yeast infections. WorldHealth.

[7] Can betamethasone be used for a yeast infection? Drugs.com.

Sarah Mhowwala

10 Essential Shirts Every Man Should Have In His Wardrobe

<ul>
	<li>Dress Shirt: A dress shirt is an elegant and simple garment that needs to be starched and crisp for a perfect look. A well-fitted dress shirt is comfortable for anyone who wears it, but the fit can vary for different men. A looser fit is suitable for larger men, while a more form-fitting cut suits thin and petite men. Dress shirts are perfect for impressing bosses at work or a lady at a nearby caf&eacute;. 
	&nbsp;</li>
</ul>

<ul>
	<li>Polo: A polo shirt is neither a t-shirt nor a dress shirt and is a must-have for both casual wear and more dressed-up occasions. It is the perfect garment for many non-formal events in life and casual events where dressing up is not necessary. Feel free to tuck or untuck depending on personal preference and the given situation. 
	&nbsp;</li>
</ul>

<ul>
	<li>Classic Short Sleeve: A classic short-sleeve t-shirt is the most &#39;bad boy&#39; thing a man can have in his wardrobe. This classic t-shirt is popular among both men and women and is perfect for all ages. These sleeves are slightly longer than cap sleeves and typically extend to the elbow or just above it. Make sure the t-shirt is plain and dark in color unless it is white. 
	&nbsp;</li>
	<li>Denim: A denim shirt is a timeless and stylish option for days when you want to feel comfortable but look cool at the same time. It is made from cotton fibers using twill weave and has diagonal ribbing that is iconic to the denim material. The denim shirt is a piece of clothing that can instantly tie an outfit together, be it a casual gathering or a smart-casual event. 
	&nbsp;</li>
	<li>Linen: Linen shirts are made from thread made from the fibers of the flax plant, making them completely natural and sustainable. Linen is known to be the strongest natural fiber on earth and is 30% thicker and stronger than cotton. It is a shirt that instantly makes you cooler and feel amazing when worn due to its expendable and breathable structure. Linen dries faster than cotton, making it a valued asset to have in your wardrobe. 
	&nbsp;</li>
	<li>Oxford: An Oxford shirt is perfect for semi-professional settings, and a pair of wingtip Oxfords is a wonderful choice for a business casual wardrobe. Oxford shirts are always made with oxford cloth, a unique type of basket weave that creates extremely soft and durable fabric with a hearty feel that is both durable and naturally resistant to wrinkles. Roll up your sleeves and get to work while looking effortlessly smart. An Oxford shirt sends a message to its wearer that it&#39;s ready for a sporting event or work. 
	&nbsp;</li>
	<li>Henley: Henley shirts are a step up from other forms of t-shirts when it comes to attraction factors. They give a casual sophistication to your daily wear and could be easily added to your wardrobe. Henley shirts fit the male figure perfectly, showing off those nice arms and a broad chest. They are usually very soft and stretchable, allowing freedom of movement, and the neckline helps your body breathe even on hot sunny days. 
	&nbsp;</li>
	<li>Chambray: A Chambray shirt is a great option if you like the look of denim but find it a bit too much. Chambray is a cotton plain-weave fabric made with a dyed warp yarn and a white filling yarn, similar to denim but much lighter in weight. Chambray shirts are versatile and can be dressed up or down, worn to a business-casual office, date night, or to the bar for a night out. A great way to dress down a suit or mix it up with your casual attire. 
	&nbsp;</li>
	<li>Hawaiian Shirt: This is a bold statement, and many people may not agree with it. But there just has to be a shirt that adds bright colors to your life and spices up your wardrobe. Contrary to what many people think, this shirt is not only useful for one hot Sunday on the beach. It&#39;s a great piece to have whether you&#39;re at parties, dinners, or just chilling at a casual barbecue. The brighter they are, the better the chances that they look good. The best thing about the Hawaiian shirt is that it doesn&#39;t need to fit perfectly, and in fact, it can be worn a little loose. 
	&nbsp;</li>
	<li>Mandarin Shirt: Mandarin shirts are very unique and are becoming increasingly popular. While the use of this collar dates back centuries, it has received a new boost in this modern era. Not only is the mandarin collar shirt a great alternative to your standard go-to attire, but it also adds an element of class to your overall appearance, which does wonders for those who prefer something urban and modern over the very conventional look we are accustomed to. You can wear a mandarin shirt to formal events like weddings, galas, dinners, and ceremonies. This provides a very clean, minimal, and refreshing look as opposed to a folded collar. Mandarin shirts are more eastern than western and will instantly make you stand out from everyone else. 
	&nbsp;</li>
</ul>
<quillbot-extension-portal></quillbot-extension-portal>

The shirt you wear is the most powerful message you are signaling when you do not have your blazer on. Your shirt is nonverbally communicating and speaking for you to make sure about your intentions, whether you like it or not. Hence, every time you wear a shirt, making sure it&#39;s perfect is an absolute no-brainer. 
&nbsp;

Rafay Zafar

Men, Are you Rolling Up Your Sleeves The Right Way?

Rolling up your sleeves has a trick. Most men simply fold their cuffs over once or twice to get the required length.

That is wrong.

There are certain problems with that approach. It has a messy appearance and a tendency to unravel at odd times. Additionally, it will lay in an odd spot on your elbow giving an overall bad look. 
&nbsp;

Turn your sleeve inside out and up your arm in its place. After that, fold it over on itself a second time, beginning at the bottom. When you get to the shirt cuff, halt. Voil&agrave;. It won&rsquo;t come undone and it will stay at the right place&hellip; exactly where it needs to be for full movement. 
&nbsp;

Your appearance and the social signals you convey can be greatly improved by mastering this straightforward art. It can give the impression that your arms are muscular. Ahem. 
&nbsp;

Significance Of Rolling Up Sleeves

In the past, men have rolled up their sleeves before working or getting into fights. 
This was done to avoid any damages to the garment, as clothing was expensive. Any old Western movie will show how men will fold their sleeves first before throwing a punch. 
&nbsp;

Nowadays, rolling up your sleeves has become a fashion statement. Your rolling of the sleeves suggests:

<ul>
	<li>Cooling down in hot weather</li>
	<li>Relaxed attitude: at the end of the day, after work or a tiresome event, rolling up sleeves convey <a href="https://merisehat.pk/article/how-to-use-relaxation-techniques-to-improve-sleep-quality">relaxation</a> signs.</li>
	<li>Preparation for some hard work. 
	&nbsp;</li>
</ul>

While some could argue that there is only one correct technique to roll up your sleeve, we&nbsp;recommend several approaches and, based on the situation, you may choose which style to go with. 
&nbsp;

‘Style’ Your Sleeves

The &lsquo;style&rsquo; your sleeves can follow: 
&nbsp;

<ul>
	<li>Master Roll: How is a master sleeve rolled?</li>
</ul>

<ol>
	<li>Once the sleeve is rolled up to roughly two cuff widths, smooth out any wrinkles or folds in the cloth.</li>
	<li>Roll the sleeve once more from the bottom end to cover the cuff, leaving only the top end of the cuff exposed.</li>
	<li>If the inside of the cuff is decorated or colored differently, only reveal a little portion of it.</li>
	<li>To undo the fold, pull down while holding the top edge of the cuff. 
	&nbsp;</li>
</ol>

Pro Tip: When your shirt has a contrasting lining or design pattern on the inside of the cuff, do this to roll up your sleeves. Only when you use the master roll can you see the strong difference. Flaunt off your flannel shirts and chambray inner cuffs.

<ul>
	<li>Aifa Roll</li>
</ul>

<ol>
	<li>Once, about the breadth of the cuff, fold the sleeve bottom.</li>
	<li>Repeat one more using a similar width and the folded cuff.</li>
	<li>You shouldn&rsquo;t smooth the fabric. The Aifa roll should appear casual and effortless. 
	&nbsp;</li>
</ol>

The AIFA Roll is&nbsp;the simplest method for folding your shirt sleeve.

Men with short, slender arms should use the Aifa roll. By using this method, you can make your arms appear proportionate to the rest of your body. This roll is ideal for a family day out because it ends just below the elbow. The only drawback is that it can unfold itself&nbsp;easily! 
&nbsp;

<ul>
	<li>The Basic Roll</li>
</ul>

<ol>
	<li>Fold the cuff once and use it as a measuring point.</li>
	<li>To ensure that the cloth is straight and smooth, go back and forth through the first step multiple times.</li>
	<li>Up till you reach the elbow, roll up. 
	&nbsp;</li>
</ol>

This technique, often known as the Basic roll, is the natural way to roll sleeves.&nbsp;The time it takes to perform the Basic roll depends on the shirt and fit. However, in this type of roll hand movements are limited and it is difficult to undo.

The Basic roll is a good option when your shirt sleeves are significantly wider than your arms.&nbsp;The remaining extra fabric can allow for the third roll. 
&nbsp;

<ul>
	<li>High Roller</li>
</ul>

<ol>
	<li>Place your shirt on a flat surface.</li>
	<li>Fold your sleeve, about the width of a cuff</li>
	<li>Repeat the first step once more, this time covering the folded area of the cuff.</li>
	<li>To completely enclose the cuff, roll the sleeve a third and fourth times. 
	&nbsp;</li>
</ol>

The High Roller looks best with shirts that are casual or semiformal. Do you have arms that are worthy of showing off? So, when it comes to rolling up your sleeves, think of following the High Roller way!

Men with large biceps and tattooed arms&nbsp;should use this technique of rolling the sleeves above the elbows. This type of roll works best with the fitted formal shirts. 
&nbsp;

In general, avoid rolling sleeves with a tie. Wearing a tie signifies that you&rsquo;re dressed formally and rolling sleeves is more of a casual move, so this might contradict. However, in situations like where you need to work or move equipment in the office, you&rsquo;d have to roll up your sleeves. 
&nbsp;

Secondly, rolling up sleeves at work could also be an indicator of signing off, that now you just want to head home and relax. It is good to experiment with different folding styles and see what works the best for you. 
&nbsp;

Namwer Rao

A well-fitted suit is an essential component of any gentleman&#39;s wardrobe. A suit offers versatility, style, and an air of sophistication that can elevate a man&#39;s look. However, with so many suit combinations out there, it can be overwhelming for men to know which suits to invest in. 
&nbsp;

Six Quintessential Suit

In this article, we&#39;ll explore the six quintessential suit combinations that every man should have in their closet. 
&nbsp;

<ol>
	<li>The Classic Navy Suit: A navy suit is a must-have for any gentleman&#39;s wardrobe. The color is versatile and can be worn year-round to almost any occasion, from job interviews to weddings. A navy suit can be paired with a crisp white shirt and a tie in a complementary color for a classic, professional look. Alternatively, it can be dressed down with a light blue or pink shirt and a pocket square for a more relaxed look. 
	&nbsp;</li>
	<li>The Timeless Charcoal Suit: A charcoal suit is another classic choice that every man should have in their wardrobe. This suit is perfect for formal events, such as black-tie affairs or weddings. It pairs well with a white shirt and a black tie for a timeless, elegant look. A charcoal suit can also be dressed down with a patterned shirt and a colorful tie for a less formal occasion. 
	&nbsp;</li>
	<li>The Versatile Gray Suit: A gray suit is an excellent addition to any wardrobe. It can be worn in any season and can be dressed up or down depending on the occasion. A light gray suit is perfect for summer weddings, while a dark gray suit is ideal for winter events. A gray suit pairs well with a white or light blue shirt and a tie in a complementary color. 
	&nbsp;</li>
	<li>The Bold Burgundy Suit: For the man who wants to make a statement, a burgundy suit is a great choice. This suit is perfect for evening events, such as galas or fundraisers. It pairs well with a black shirt and a tie in a complementary color. A burgundy suit can also be dressed down with a white shirt and a patterned tie for a more casual look. 
	&nbsp;</li>
	<li>The Stylish Tweed Suit: A tweed suit is a stylish addition to any wardrobe. This suit is perfect for fall and winter events and pairs well with a light blue or white shirt and a tie in a complementary color. A tweed suit can be dressed down with a knit tie and a sweater for a more casual look. 
	&nbsp;</li>
	<li>The Dapper Double-Breasted Suit: A double-breasted suit is a bold, dapper choice for the fashion-forward man. This suit is perfect for formal occasions and pairs well with a white shirt and a solid tie. A double-breasted suit can also be dressed down with a patterned shirt and a knit tie for a more casual look. 
	&nbsp;</li>
</ol>

These six suit combinations are the quintessential pieces that every man should have in their wardrobe. By investing in these versatile, classic suits, any gentleman can create a range of different looks for any occasion. Remember to always choose a well-fitted suit that compliments your<a href="https://merisehat.pk/article/your-body-after-giving-birth"> body </a>type and personal style, and invest in quality fabrics and tailoring for a suit that will last for years to come. 
&nbsp;