Zwykle mężczyźni cechują się dobrze zachowaną rozrodczością do 70. roku życia, gdyż seksualność z upływem czasu i zmianami hormonalnymi, w okresie andropauzy maleje, ale całkowicie nie zniknie. Aby jak najdłużej cieszyć się zdrowiem należy regularnie wykonywać podstawowe, jak i rozszerzone badania.

Wyzwaniem dla andrologów jest okres w życiu mężczyzny, który zaczyna się po pięćdziesiątce. Wiele zmian dotyczących tego okresu zostało już zaobserwowanych przez lekarzy i naukowców kilkadziesiąt lat temu i uważano je wówczas za nieuchronne. Teraz już wiemy, że tak nie jest. Niektóre są ostrzeżeniem, np. zaburzenia erekcji mogą wyprzedzać o wiele lat zawał serca. Wczesne ich rozpoznanie może zmienić bardzo wiele w życiu mężczyzny i jego rodziny.

Postępujący proces starzenia się społeczeństw szczególnie dotyczy mężczyzn, którzy przeciętnie żyją krócej od kobiet i nie mają swojego „lekarza-opiekuna”. Ostatnio pojawił się problem późnego ojcostwa, gdyż panowie właśnie po 50. roku życia, decydują się na potomstwo, mając już niekiedy dorosłe dzieci. Mężczyzna w tym wieku nie wykazuje najczęściej jeszcze zaburzeń w sferze rozrodczości (jest dobrze zachowana do 70. roku życia), ale pojawiają się symptomy zmian ogólnoustrojowych – zmiany naczyniowe, w układzie kostnym, w układzie moczowo-płciowym. Przed decyzją o późnym ojcostwie mężczyzna powinien zapoznać się ze stanem swojego zdrowia.

Badania.
Organizm mężczyzny (podobnie jak jego samochód) także wymaga od czasu do czasu kontroli. Duże znaczenie ma wykonanie niektórych badań nawet w wieku średnim, kiedy nie ma teoretycznie podstaw do nieprawidłowości. Wykonane teraz badania mogą, po kilku latach, być punktem odniesienia, w sytuacji, kiedy pojawią się jakiekolwiek problemy zdrowotne. Niezależnie od wieku jest kilka badań, m.in. morfologia krwi, badanie moczu i badanie OB, które należy wykonywać co pewien czas, np. w jednym z laboratoriów sieci Diagnostyka.

Morfologia krwi.
Krew to tkanka, która zespala cały organizm, a sama spełnia wiele funkcji, m.in. transportuje tlen. Morfologia obejmuje badanie wszystkich rodzajów komórek krwi (krwinki czerwone, białe i płytki). Pozwala na wykrycie wielu chorób, takich jak: niedokrwistość, niektóre nieprawidłowości w krzepnięciu krwi czy różnego rodzaju białaczki.

Badanie hsCRP.
Wydaje się, że obecnie lepszym niż OB wskaźnikiem toczącego się stanu zapalnego jest badanie hsCRP (białko ostrej fazy, oznaczane wysokoczułą metodą). Badanie to dodatkowo ma znaczenie jako marker podwyższonego ryzyka wystąpienia choroby wieńcowej.

Badanie układu moczowego.
Badanie moczu to ocena pracy nerek i pęcherza moczowego, które pozwala na wykrywanie chorób nerek czy zakażeń układu moczowo-płciowego. Badanie układu moczowego należy uzupełnić o oznaczenie: mocznika, kreatyniny, kwasu moczowego i badanie elektrolitów (Na, K), ważnych w ocenie gospodarki wodno-elektrolitowej.

Oznaczenie poziomu glukozy.
Podstawowym badaniem z krwi jest oznaczenie poziomu glukozy. Badanie to pozwala na wczesne wykrycie jednego z najgroźniejszych schorzeń XXI wieku, cukrzycy – choroby powodującej wiele poważnych powikłań – m.in. uszkodzenie nerek, wzroku.

Lipidogram.
Pewne badania można wykonać w grupach. Badanie z zakresu gospodarki lipidowej to profil lipidowy (lipidogram). Jest to oznaczenie poziomu cholesterolu, jego frakcji HDL („dobrego” cholesterolu) i LDL („złego” cholesterolu) oraz triglicerydów. Pozwala na ocenę ryzyka rozwoju miażdżycy – podstawowej przyczyny chorób krążenia – szczególnie choroby wieńcowej. Bardzo ważnym elementem tego badania jest prawidłowe i właściwe przygotowanie się przed jego wykonaniem. Wymagane jest spożycie ostatniego posiłku przed godziną 18, w dniu poprzedzającym badanie i bycie na czczo.

Próby wątrobowe.
Próby wątrobowe to grupa badań, która pozwala na ocenę funkcji wątroby i dróg żółciowych. Podstawowymi parametrami są oznaczenia poziomów enzymów wątrobowych (ALT, AST, GGTP, ALP) i bilirubiny.

Oznaczenie poziomu PSA.
Typowo męskim badaniem jest oznaczanie PSA. Marker ten jest charakterystyczny dla przerostu gruczołu krokowego lub procesu nowotworowego tego narządu. Badanie to można poszerzyć o wykonanie dodatkowego oznaczenia tzw. wolnego PSA (fPSA). Iloraz wolnego PSA do całkowitego PSA pozwala na bardziej precyzyjną diagnostykę w przypadku podejrzenia procesu nowotworowego.

Oznaczenie poziomu testosteronu.
Bardzo ważnym badaniem dla mężczyzn jest oznaczenie poziomu testosteronu, które ma szczególne znaczenie u mężczyzn po 50. roku życia. Testosteron jest odpowiedzialny za sprawne funkcjonowanie całego organizmu, za stan fizyczny i psychiczny, ale przede wszystkim za libido i sprawność seksualną.

Badanie kału.
Szczególnie proste w wykonaniu jest badanie kału na obecność krwi utajonej. Badanie to ma na celu wykrycie krwawienia z przewodu pokarmowego, które może być pomocne w diagnostyce (niekiedy bardzo wczesnej) polipów i nowotworów jelita grubego.

Życie seksualne w wieku dojrzałym.
Starzenie się to nie tylko zmiany fizyczne i zmiany wykazywane w badaniach laboratoryjnych. To także wiele zmian w psychice. „Starość to najbardziej nieoczekiwana z rzeczy, które spotykają mężczyzn” (Lew Trocki).

Istnieje także wiele innych pytań, np.: jak to jest z seksem w wieku dojrzałym? Badania, przeprowadzone w Polsce przez prof. Zbigniewa Izdebskiego, wskazują, że 60% mężczyzn i 35% kobiet po 50. roku życia jest zainteresowanych seksem i ma on dla nich istotne znaczenie. Seksuolodzy uważają, że nawet w późniejszym wieku, jeżeli życie układa się dobrze i pozwala na to stan zdrowia, można przeżywać erotyczne uniesienia i spełnienia.

Oczywiście, seksualność z upływem czasu i zmianami hormonalnymi, w okresie andropauzy maleje, ale całkowicie nie zniknie przy ogólnym dobrym samopoczuciu. Ogólny stan zdrowia ma wpływ na seksualność mężczyzn. Wiele schorzeń: nadciśnienie, przebyte zawały, cukrzyca, osteoporoza (nie tylko kobiety chorują) osłabia poszukiwania doznań seksualnych, ale co istotne, niektóre leki, stosowane w tych schorzeniach, mają znaczący, negatywny wpływ na libido mężczyzn.

Ostatnio wiele mówi się o dużej roli internetu w zmianach dotyczących seksualności Polaków. Internet ułatwia zdobywanie wiedzy i kontaktów, ale także znajdowanie partnerów. Internet również w dziedzinie seksualności okazuje się „oknem na świat”. Podsumowując, dbając o zdrowie psychiczne i fizyczne, można długo cieszyć się satysfakcjonującym życiem seksualnym.

Ogólnopolska sieć laboratoriów medycznych Diagnostyka przez 2 lata prowadzi kampanię pt. „Jestem kobietą i dbam…”, z której do tej pory skorzystało i zarejestrowało się na stronie akcji prawie 50 tys. osób. Jej celem jest popularyzacja badań profilaktycznych, od wieku dziecięcego, aż do późnej starości, a skierowana jest do kobiet, gdyż zwykle to one dbają o zdrowie nie tylko swoje, ale i domowników. W 2014 i pierwszej połowie 2015 odbywały się trzy etapy poświęcone kolejno: samym kobietom, ich partnerom, a także kobietom i ich dzieciom. Natomiast 1 września tego roku rozpoczął się IV, ostatni etap kampanii, który skierowany jest do rodziców kobiet. W jego ramach kupić można bon na pakiet przekrojowych badań dla osób dojrzałych, tj. na 15 badań dla kobiet lub 12 dla mężczyzn, który po 70% zniżce kosztuje 70 zł.

Aby uzyskać bon na badania wystarczy zarejestrować się na stronie kampanii kobieta.diagnostyka.pl i odpowiedzieć na pytanie „dlaczego biorę udział w kampanii”. Dodatkowo do wygrania są atrakcyjne nagrody: tygodniowy pobyt dla całej rodziny w domu wakacyjnym z oferty Novasol w wybranym kraju i wybranym terminie, dwa 14-dniowe pobyty dla 2 osób z wyżywieniem, konsultacją lekarską i 5 zabiegami dziennie w Hotelu Słoneczny Zdrój Medical SPA&Wellness w Busku Zdroju, 3 iPady Air 2 od sieci Plus, a także 20 luksusowych zestawów naturalnych kosmetyków Secret Soap Store. Vouchery może pobrać każdy do końca listopada, kiedy to zakończy się ten etap kampanii, natomiast badania należy zrealizować do końca roku, dlatego może to być prezent mikołajowo-gwiazdkowy dla seniorów.

dr n. med. Leszek Bergier

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