Sessions and outcomes

Formal debate 

The formal debate "Is it time for a large trial of testosterone replacement therapy for older men?" aroused much interest. The two speakers presenting the case for "Yes" said that small, short-term studies have already demonstrated benefits and safety, and that it is therefore time to move on to a large, long-term study. Their debate opponents argued "Not yet", questioning the quality of the research to date, and saying that a large trial would be of poor value without first resolving the many outstanding basic scientific issues (including whether hypogonadism in older men is a stable condition). At the end of the four presentations, which are planned to be published in the jmhg, a quick poll of the audience showed a 50%:50% split.

Further sessions

In other sessions at the congress:

• Dr Jean Bonhomme (Men's Health Network, USA) described how a tetrad approach addressing men, women, children, and minorities, is necessary to optimise health outcomes. "A failure in any one will cause failures in the other three," he said. 
• Dr Markus Hengstschläger (Medical University of Vienna) described research on very rare sets of monozygotic twins in which the two individuals are of different sexes - they are clones, except for their sex chromosomes. He said preliminary findings suggest that in the brains of such twins, 15% of genes are differentially expressed.  
• Dr John McKinlay (Institute for Community Health Studies, Watertown, USA) said men's health could be improved by focusing more on prevention, particularly through national policy interventions. He used a river analogy to argue that, instead of being downstream, continually "rescuing" drowning men on a 1-1 basis, "we need to move upstream to see who is pushing them in". 
• Dr Bert-Jan de Boer (Medical University of Utrecht, Netherlands), after discussing the link between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), advised GPs and specialists to "include a question on ED in history taking in a male patient with LUTS".  
• Dr Ulla-Britt Lilleaas (University of Oslo, Norway) presented findings from a qualitative study of handball players and suggested that homophobia is relatively common in closed groups of male sportsmen.  
• Peter Baker (Men's Health Forum for England) described the Forum's recent work tackling obesity in men. This included an ongoing "Work Fit" programme developed for a large British company, in which employees who sign up are given 16 weekly tasks by email. He said about 14,000 people, three-quarters of them men, had signed up in the first 3 weeks.