Men’s health crisis: Infertility, microplastics, and click-bait
This morning’s Plenary Session on the ‘Global men’s health crisis’ explored the underlying factors of declining men’s health – some well known, others still emerging as research evolves. Experts debated the best approach to tackling obesity, the role of exercise and lifestyle habits, GLP-1 receptor agonists, and testosterone therapy. The second half of the session turned to the influence of social media, and the modern pressures of the idea of masculinity, work, relationships, and social pressures.
Dr. Marij Dinkelman-Smit (NL) presented a ted-talk style lecture on the decline of testicular health - the downward trend in sperm quality, testicular dysgenesis syndrome, cancer incidence and hypogonadism.
Following this, Dr. Rossella Cannarella (IT) presented on ‘The future of fertility: social, economic, and genetic drivers of declining birth rates’ with the major development from last year with the World Health Organisation (WHO) releasing a guideline on preventing, diagnosing and treating infertility. A chapter was created for identifying factors that contribute to infertility, which included maternal age, lifestyle (smoking, excessive alcohol intake, obesity or underweight), and sexually transmitted diseases. She noted that the guidelines also addressed exposure to environmental endocrine-disrupting chemicals (EDCs), which may interfere with the reproductive system, resulting in poor quantity or quality of gametes, though definitive conclusions remain limited.
She referenced the Amico-Andrologo survey, which found testicular hypotrophy in 14% of 18- year-old Italian males, with health risk behaviours (such as alcohol consumption in adolescents) emerging as a significant predictor.
Dr. Cannarella also discussed a report she is contributing to, examining key chemicals of concern in the EU that have negative health outcomes on men. Their research has a strong focus on timing of exposure (the sensitive windows). Their aim is to support a more comprehensive implementation of the EU Chemicals Strategy for Sustainability.
Her key call to action was the need to start educating boys early about factors that shape reproductive health, ideally in high school. She stressed the importance of understanding lifestyle‑related risks, including exposure to endocrine‑disrupting chemicals during sensitive developmental periods. She also emphasised the value of monitoring testicular development early, incorporating semen analysis when appropriate, and ensuring HPV vaccination as part of a proactive approach to male reproductive well-being.
Microplastics and sperm count?
Another possible contributor to infertility is the ingestion of microplastics. Animal studies have shown that higher microplastic levels correlate with lower sperm counts, a decrease in sperm movement, oxidative stress, hormonal distribution, and DNA fragmentation. Dr. Philippa Sangster (GB) presented on ‘Environmental toxicity and microplastics’ and the hidden threats they poise to the reproductive health. She noted that researchers have yet to examine a human tissue or organ without finding microplastics present, including the testes and semen. In her view, this is a serious concern for future generations, and she stressed the need for large-scale human studies to be conducted, alongside better education for both urologists and patients on the risks involved.
The devil in the algorithm
Several presentations examined how social media is shaping men’s health – its benefits in raising awareness, but its pitfalls in spreading misinformation. The consensus from the roundtable discussions was that urologists have a professional obligation to act as gatekeepers of accurate, evidence‑based information in social media. But how is the big question.
In her talk show presentation, Dr. Fenwa Milhouse (US) highlighted the sheer volume of false information, with viral content lacking professional expertise and only around 10-12% of content coming from physicians. Clinicians must bridge the between noisy digital culture and vulnerability, with evidence-based patient care. She noted that patients are increasingly arriving to her clinic with information they have seen on TikTok or Instagram rather than referrals from their doctors, and this creates a new type of patient altogether. Dr. Millhouse asked the question, “Are we prepared as urologists for the patients’ that social media is now sending us?”
The session was chaired by Dr. Christian Jensen (DK) and Prof. Giorgio Russo (IT). You can watch the webcast of the full Plenary Session online at the EAU26 Resource Centre, which includes lectures, debate, talk show presentations, audience voting, and round table discussions.