MEN'S HEALTH MATTERS:Memory loss and how to avoid it as we get older, writes Thomas Lynch
Q Recently I have had difficulty remembering names. I also find that I lose the train of a conversation and my concentration is not as good as it used to be. I am worried in case I am developing dementia or Alzheimer's disease?
ANot being able to immediately remember names and not picking up all the details of a conversation can be a normal experience, particularly as we get older when mild forgetfulness can occur, and your memory may not deteriorate any further to any significant extent.
If, however, you are worried about a failing memory, or particularly other members of your family or close friends are concerned that your memory is failing, then you certainly should consider being reviewed by a specialist.
One finds that in most cases, such as yours, a clinical review and investigation will reassure you that your memory is normal but it is important that a mini-mental state examination is carried out by your doctor.
Then if further testing is required this can be undertaken. Your doctor may decide to do a number of blood tests and may also do a brain scan. An MRI of the brain is usually much more sensitive than a CT of the brain, particularly for picking up mini-strokes.
Mini-strokes can contribute to memory loss, and mild forgetfulness may in fact be the only manifestation of mini-strokes and the person may not develop any other signs such as a facial weakness, limb weakness or a speech defect.
If there is any evidence of brain thinning, which can occur in a patient with Alzheimer's disease, then this may also show up on an MRI brain scan.
Your doctor will also check on folic acid and B12 levels plus thyroid status, and ensure that you have normal biochemistry and endocrine blood results.
It is also imperative that you have a normal clinical examination to make sure that you have a normal blood pressure and no risk factors such as an irregular heart, which could contribute towards events such as mini-strokes.
If your doctor discovers that you have had a mini-stroke, then he can give you medicine that will significantly lessen the possibility of further events. The prevention of mini-strokes has been one of the great success stories of modern medicine with the focus on optimising blood pressure, stopping smoking, using blood thinning agents and cholesterol lowering therapies.
Drugs are also available that can enhance memory, but your doctor will decide whether or not any such medications would be helpful in your case, after all the results come to hand.
It is important to realise that the vast majority of people who worry about memory have no cause to be concerned but if in doubt - particularly if it is interfering with daily living or your social interaction with others - then it is important that it is fully assessed and investigated and any appropriate treatment instituted.
Q I am considering having a vasectomy, but would like further information before I make a decision. Is it better to have it done under a general anaesthetic or a local anaesthetic?
AVasectomy is a simple, safe surgical procedure for permanent male fertility control and is most commonly performed with a local anaesthetic. It is best to avoid a general anaesthetic and its associated side effects. It is an operation to divide the vas deferens, which are the tubes carrying sperm from the testicles to the penis. Although it is possible to have a vasectomy reversed, it is often very difficult and as such must be considered as a permanent method of contraception.
A vasectomy will leave you unchanged except for the fact that the vas is blocked. You should not feel any different physically than you did before your operation. The level of male hormones remains the same, and all sexual characteristics remain the same. You should still have the same quality of erections and climax as you did prior to the procedure.
The amount of fluid in your ejaculation should be no different except that there will be no sperm. Vasectomy is only suitable for a man who is sure that he does not want any more children.
If you are in any doubt whatsoever, then you should not have a vasectomy. You should discuss the issue with your general practitioner or make arrangements to be seen at the hospital urology clinic or a vasectomy clinic.
Vasectomy has no effect on sperm production itself. The testicles continue to generate approximately 50,000 sperm per hour. These sperm will continue to develop and leave the testicles, but again, they are blocked in the vas deferens at the site of the vasectomy. Eventually the sperm die and the body absorbs them. It is 10 times more effective as birth control than tubal ligation (sterilisation). It takes approximately 14 weeks for all sperm to be cleared from the system and two negative sperm counts are needed before the operation is deemed successful.
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This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin with a contribution from Prof Bernard Walsh, consultant physician, St James's Hospital, Dublin