Men's things XXXV: A Man's Search for Dignity

Pursuing a Diagnosis

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I have found myself at the intersection where solutions designed for women seem to be just as suitable for men.

Many years ago, this first arose when I set about addressing folic acid deficiency anaemia. It was flagged when I noticed an out-of-range and irregular reading of my MCV (Mean Corpuscular Volume) blood test, which pointed, in the first instance, to a possible nutritional deficiency of folic acid, iron, or vitamin B12.

At my insistence, I persuaded my GP to order the specific tests for serum folate (folic acid), serum ferritin (iron), and serum B12. It was discovered that my folic acid levels were quite low; hence the diagnosis of folic acid deficiency anaemia.

Since then, I have requested the granular serum tests that sit beneath the headline MCV.

Pills Made for Mothers

I bought over-the-counter folic acid tablets, each with a strength of 400 micrograms. The label on the container carried the message, “Supports the overall health of your baby during conception and pregnancy.”

Well, I did a double take. The ability to conceive or carry a baby is not one I possess. My GP then gave me a prescription for folic acid at a strength of 5 milligrams, twelve and a half times that of the over-the-counter tablet. It meant I was not going to fix my deficiency by popping chemist pills.

A New Reality

Anyway, we have grown inured to watching adverts for sanitary towels and pads on television, and to seeing what the women using such protection get to do once their fear of leaking, and of embarrassingly revealing their flow, has been overcome by advances in sanitary towel technology.

Now, following treatment for prostate cancer with radical radiotherapy, I have experienced occasional bowel incontinence and regular bladder incontinence.

Once, in the case of the latter, it was the cover of darkness and a long overcoat that spared my blushes when my red chinos were soaked through.

Searching for Protection

For anatomical reasons, I could not simply start wearing feminine sanitary pads, just as I had taken to correcting folic acid deficiency anaemia with pills marketed primarily to fertile and pregnant women.

The male incontinence underwear I found was expensive, and it did not contain the urgency to the extent needed to forestall embarrassment.

The protection did not entirely eliminate the fear of emission or excretion; it offered only temporary safety, in the hope that you might reach the refuge of a convenience before the dam burst.

Adverts Not for Men

It goes without saying that the strain of advert music with the line “body formed for you”, or the tagline “Always with wings”, does not pertain to menfolk. Either we are too poorly served, or I need better discreet guidance when I visit a department that accounts for dignity in its solutions, without public spectacle.

So, imagine how I felt when a new advertisement came on television this afternoon for the Always Discreet Maxi Comfort Pads 9 Drop, offering the highest-absorbency pads designed for heavy bladder leaks, with a wider back for 50% more coverage and OdourLock technology. If only that catered for me too.

What We Actually Need

You might ask why I have not considered nappies for adults. It is a valid point, but that also suggests a level of incapacity and loss of control that is probably excessive for my current situation. It is a concession I do not think anyone, adult female or male, would make willingly if nature had not imposed it without option.

Minimal, unintrusive, anatomically aware, fully absorbent, and effective is what we need: coverage, protection, and odour lock without bulking out your trousers. There, I have written the advert for a product that serves bladder incontinence in men.

Breaking the Silence

My own route to this predicament was prostate cancer, but I am hardly the only man walking about with a secret and a spare pair of trousers in mind. Age brings it, an enlarged prostate brings it, so too do surgery, diabetes, neurological conditions, and plain bad luck; the company is far larger than the silence would suggest.

That silence is convenient for everyone but the men living it, and it is worth naming the circular trap at its heart: manufacturers under-serve men because men under-report, and men under-report because they find themselves so poorly served. Somebody has to break the loop, and it will not be the men, who have every reason to say nothing.

Which leaves the people who make and sell these things. I have, after all, written their advert for them; the product is the easy part, and dignity costs no more to design in than to leave out.

A slim thing built for male anatomy, an honest range of absorbencies, odour locked away, trousers uncreased, and a shelf a man can reach without rehearsing an explanation, none of this is beyond an industry that manages it handsomely for women.

A Matter of Dignity

The country decided, from January 2021, that period products should carry no VAT, recognising them as a plain necessity of life rather than a luxury; a woman buys them relieved of tax and relieved of explanation.

Incontinence products, as it happens, can also be had free of VAT, but only once you have declared yourself “chronically sick or disabled”, the very badge of incapacity I was at pains to avoid. [The UK Parliament: VAT on incontinence products (PDF)]

So, the tax is not quite the point. The point is that one necessity is met with a shrug and the other with a form; that dignity, for some of us, still comes conditionally. These things need thinking about, even if men's things rarely get talked about.

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