Don't panic if your urethra turns red; why do men tend to gain weight after marriage?

Don't panic if your urethra turns red.

In andrology clinics, an increasing number of patients are coming in with "redness at the urethral opening" as their chief complaint.

We often encounter patients who, despite prolonged treatment, urgently request a thorough examination and a complete cure. This is especially true for those with a history of unprotected sex or previous sexually transmitted urinary tract infections (such as gonorrhea or non-gonococcal urethritis). These patients, misled by quack doctors who claim that "only incurable STDs cause urethral redness," become deeply anxious and seek treatment everywhere. Consequently, they not only bear a heavy psychological burden but also, over time, are prone to developing dizziness, irritability, insomnia, and even erectile dysfunction, premature ejaculation, and decreased libido, severely impacting their work and marital relationships.

So, why does the urethral opening become red? Is redness at the urethral opening a sign of illness? The answer cannot be generalized. Common causes include: If redness is due to phimosis (tight foreskin), circumcision is recommended. This reduces the likelihood of balanitis and urethritis, and also lowers the risk of gynecological diseases in female partners, thus improving the quality of sexual life. If redness is caused by factors such as poor working environment and dietary habits leading to increased local temperature and excessive sweating, drink plenty of water, reduce alcohol consumption, and avoid spicy and irritating foods; symptoms will gradually improve. If the redness is caused by unprotected sex or indirect transmission of a urinary tract infection, seek timely treatment at a reputable hospital for a complete cure to prevent recurrence.

These "mandatory" fat-burning and energy-consuming "sports" classes are very helpful in maintaining a man's physique.

Married men develop a sense of belonging and feel that "starting a family and establishing a career" are the two most important tasks in life. Therefore, this sense of belonging is often stronger after marriage, and they are more "family-oriented".

Not only do his wives prepare three meals a day for him, making his meals enjoyable, but he also goes straight home after work, eats dinner, and then relaxes on the sofa, either smoking and reading the newspaper or snacking and watching TV together. Married men generally no longer care much about their so-called "image," and things like exercise and fitness have long been forgotten. In their view, no matter how many benefits exercise or fitness may have, nothing is as practical as a good night's sleep after a full meal.

This is analogous to saving money. The calories in the food we consume are like income, and the calories burned are like expenditure. Fat is like savings. More income and less expenditure means more savings; more calories consumed and less burned inevitably lead to fat accumulation. Dr. Wu Xueyan says he often encounters obese patients in the hospital complaining, "I've eaten so little, but I'm still fat, I just can't lose weight!" Although they feel they've eaten enough, relative to their energy expenditure, it's still more than they've burned. In other words, although they've "earned" very little, they've spent even less, so they still have a lot of "savings." In short, there are no shortcuts to weight loss; it can only be achieved by maintaining a long-term balance in energy metabolism, just like maintaining a balance between income and expenditure.

Aging also contributes to weight gain. As middle-aged and older men age, their basal metabolic rate decreases, and they also exercise less, unlike children and young people who are more active. To use the analogy of savings, if you earn the same amount of money but spend less, you will inevitably have more savings.

**Stress Leads to "Apple-Shaped Obesity"**

Increased stress leading to hormonal changes is another important reason why men gain weight after marriage.

Before marriage, men often indulge in the carefree life of a "single aristocrat," with fewer worries and less pressure. However, once married and becoming the "head of the household," all the troubles and burdens of life, along with a sense of responsibility, come crashing down on them like a continuous autumn rain. Moreover, most men at this time are also in the "climbing phase" of their careers. Thus, life, along with career, house, car, money, wife, and children, all these things intertwine to create a "harmony of pressure."

Increased mental stress leads to an increase in glucocorticoids in the body's adrenal glands. This is a stress response, and it also demonstrates the amazing nature of the human nervous and endocrine system. This hormone's normal function is to raise blood sugar levels, making the mind more alert and clear, and its increase helps in dealing with various complex matters that bring stress.

However, excessive secretion of adrenal glucocorticoids can alter the distribution of fat tissue in the body. This hormone acts like a diligent transporter, moving fat from other parts of the body to the abdomen in a short period, causing a large accumulation of fat around the abdominal organs and on the abdominal wall. This results in men developing a large, protruding belly, medically termed abdominal obesity or "apple-shaped obesity." In contrast, women's obesity is mostly concentrated in the hips, known as "pear-shaped obesity." Compared to women's "pear-shaped obesity," men's "apple-shaped obesity" is more harmful.

Furthermore, men and women react and behave differently under immense pressure. Many women, when experiencing significant psychological stress, often become so distressed that they lose their appetite, can't sleep, and have no desire to eat or drink; some even develop what is medically termed "anorexia nervosa." Men, on the other hand, tend to relieve their stress and distress by indulging in large meals and drinks, resulting in the accumulation of excess fat.

**Obesity leads to decreased androgen levels.**

Obesity itself can also cause obesity. This statement, at first glance, seems grammatically incorrect, but it actually means that obesity itself leads to an increase in new fat. Dr. Wu noted that while we are generally familiar with the dangers of obesity, most people cite common risks such as high blood pressure, diabetes, and heart disease, while knowing less about another important danger.

In fact, obesity has another significant harm: it leads to a decrease in androgen levels in men, affecting male reproductive function and further causing increased fat accumulation. Obesity lowers androgen levels while significantly increasing estrogen levels in men. In obese individuals, the activity of aromatase, a protease within fat cells that converts androgens into estrogens, is significantly enhanced, resulting in elevated estrogen levels. This increased estrogen level, in turn, counteracts the effects of androgens, causing muscle loss in men, promoting fat formation, and even breast development-a vicious cycle. Furthermore, obese individuals often experience sleep apnea, leading to oxygen deficiency, which in turn lowers testosterone levels, further reducing androgen levels and causing increased fat accumulation.

Normal sexual activity between couples is not the cause of post-marital obesity in men. In fact, a harmonious sex life increases physical activity, relieves stress, and improves mood-all of which are beneficial to health.

So what is a standard weight? Dr. Wu provides a simple formula: Standard weight (kg) = Height (cm) - 105. A result within ±15% is considered normal. To prevent post-marital obesity, the most important thing is to maintain a healthy lifestyle, exercise regularly, maintain a balanced energy metabolism, learn to manage stress, and eat a diet rich in whole grains and simple foods.

Author: Wang Peng

Supporting Expert: Wu Xueyan, Deputy Chief Physician, Department of Endocrinology, Peking Union Medical College Hospital