Raising awareness of male health: ANDRONET COST Action to improve research, education, and public awareness in the field of andrology
Andrology is a medical speciality that studies male health, with focus on the diagnosis and treatment of conditions affecting male reproductive organs and functions. In other words, it covers male infertility, hypogonadism (shortage of male hormones), testicular and prostate cancer, male contraception, erectile dysfunction, and ageing.
Little public health attention has been devoted to andrology in contrast to its counterpart, gynaecology (that deals with issues related to female reproductive health.) There are several reasons for that, including lack of awareness and traditional focus on a woman as the ‘guilty’ part in case of couple infertility. Stereotypically, women also speak openly about health issues, while men remain hesitant to discuss their physical health or emotional well-being. Male ‘potency’ and fertility are regarded as taboo subjects because of persisting stereotypes of macho-masculinity. Another important reason is the success of assisted reproduction techniques, such as in vitro fertilisation (IVF), with most people believing that ‘one sperm is enough to produce a baby’. Hence, the male partner is seen just as a source of sperm, ignoring the fact that his fertility problems can be a manifestation of serious health problems.
Male infertility is a multifactorial and complex disease. Known genetic abnormalities can explain 20-25% of cases, but there are likely many more. Infertility can also be associated with adverse lifestyle and environmental factors, some acting during fetal life or childhood, but also infections, occupational exposures, and ageing. To understand the causes, more research in the field of andrology is needed. The urgency is enhanced by worrying evidence of the rising incidence of infertility and testicular cancer, and an association of poor reproductive function with poor general health. There is male preponderance to many serious diseases, including cancer and COVID-19, leading to shorter life expectancy.
To speed up the research in andrology, a more structured approach is needed to facilitate interaction between research labs and clinical centres that have large numbers of well-characterised patients and controls. Unfortunately, clinical andrology has been largely fragmented among various specialities, including urology, endocrinology or gynaecology, and only a minority of specialists received appropriately comprehensive andrology education. To address these issues, ANDRONET COST Action was launched in October 2021.
Introducing ANDRONET
“Research to identify the causes of male infertility will benefit from international collaboration provided by ANDRONET. A large number of samples and datasets are needed to address this multifactorial problem with a myriad of factors possibly playing a role. There are excellent basic and clinical teams around Europe, and ANDRONET will help reach a critical mass for better connection and collaboration among them.”
Prof. Rafael OLIVA, Chair of ANDRONET
ANDRONET currently brings together 239 experts representing 41 countries, and the network can further increase within the next few years.
The network will strengthen interaction between participants across Europe and will also raise awareness of male health and fill the gap with the lack of public portals dedicated to men’s health in Europe. The third major aim is to improve education in andrology.
ANDRONET is a welcome addition to the existing organisations providing educational programmes in some aspects of andrology: the European Society of Human Reproduction and Embryology (ESHRE), which focuses on fertility issues, the European Urology Society Section Andrological Urology (ESAU), and the European Academy of Andrology (EAA), which is the only organisation that developed a structured education and comprehensive curriculum in andrology. However, this curriculum is only available in a few countries and has no legal value. Europe-wide recognition of andrology by national and EU-based health boards and institutions is still needed.
“We must improve professional education in andrology. A clinical andrologist should acquire specific skills to manage all andrological conditions, including reproductive and erectile dysfunctions as well as male-specific neoplasia. Among the ANDRONET’s objectives, we put at first place the co-organization of different Schools (in conjunction with the EAA), aimed at improving the diagnostic and therapeutic skills of clinicians working in the field of andrology. Specialised training is available in 27 highly qualified EAA centres, but it is mandatory to increase their number to provide easy access to andrological education across the EU. Our ultimate aim would be to obtain the recognition of andrology as a medical subspecialty in all EU countries”, adds Prof. Csilla Krausz, the Action Vice-Chair.
Branching out
European Testis and ANDRONET Workshop (ETW2023) taking place in Montreux, Switzerland this June is the main forum for networking of researchers interested in testis biology and dysfunction, matching one of the main aims of ANDRONET. 31 March is the deadline for early bird registration and for miniposter abstract submission.