It's a Guy Thing

According to WebMD (November 13, 2008), “women are programmed by society to be ‘into’ preventative health.They go to the OB-GYN young in life. They go to the doctor for checkups. Women are the leaders in health care in this country. Almost all health care decisions are driven by women. When men are young, they think they are going to live forever—nothing is going to get in their way. As men get older they get into this pattern of reactive care. They don’t understand about proactive health care.” GuysThing_teaser.fw.png

So in recognition of June as Men’s Health Month, we are addressing this issue head-on by providing information on how men can remain active and healthy as they age and how to prevent many health problems through early detection and treatment.

Health Facts

  • Women are 100% more likely than men to visit the doctor for exams and preventive services.
  • Not only does exercise improve your body, it helps your mental function.
  • Exercise also helps ease some aspects of the aging process.
  • Research has shown that exercise can slow or help prevent heart disease, stroke, high blood pressure, high cholesterol, type 2 diabetes, arthritis, osteoporosis (bone loss) and loss of muscle mass.
  • In 1920, women lived one year longer than men. Now women live five years longer than men.

Top Six Men’s Health Concerns

Dr.Todd Newberger, a specialist in Internal Medicine with a busy practice in Evanston and a CJE Board member, finds that the top six health concerns of the men he sees are: Heart Disease, Prostate Cancer and Enlarged Prostate, Erectile Dysfunction and Low Testosterone, Weight Management, Diabetes and Stroke. Since most of these are preventable and/or treatable, here’s some information from Dr. Newberger and the Centers for Disease Control website to get you on the road to a healthier lifestyle.

  1. Heart Disease—Heart Disease refers to several types of heart conditions, the most common being coronary artery disease. Others involve valves in the heart, or the electrical system of the heart. Symptoms can include exercise intolerance, shortness of breath, feeling faint, chest pain, left arm pain, nausea, excessive sweating, a racing heart, exercise intolerance, excess fatigue and a feeling similar to indigestion, especially if related to activity. You must see your doctor, especially if heart disease runs in the family. There are many treatments, including medication, catheter interventions, and surgeries. You can prevent heart disease by not smoking, maintaining a healthy weight, eating a healthy diet, being sure your blood pressure is controlled and exercising regularly.
  2. Prostate Cancer (including BPH, or enlarged prostate)—When cancer starts in the prostate, it is prostate cancer. You are at risk for prostate cancer if you are over 50 and have a family history of it. The incidence does increase with age, though in much older men, intervention is often unnecessary. Symptoms include difficulty starting urination, weak or interrupted flow of urine, frequent urination especially at night, difficulty emptying the bladder completely, pain or burning during urination, blood in the urine or semen, pain in back, hips or pelvis and painful ejaculation. See your doctor as soon as possible for diagnosis and discussion of treatment options. A blood test for PSA (prostate specific antigen) might tell if you have prostate cancer.
    BPH or Enlarged Prostate—This is caused by continuous prostate growth after puberty. Cell growth causes the prostate to become enlarged. It does not increase your risk of getting cancer, but the symptoms can be similar. If the symptoms are bothersome it can be trated by drugs or surgery.
  3. Erectile Dysfunction and Low Testosterone Levels—Erectile Dysfunction is the inability to achieve an erection that’s firm enough for sex. ED can cause low self-esteem, performance anxiety, depression and stress. Causes include medications, diabetes, high blood pressure or cholesterol, smoking, poor blood flow to the penis and surgically removed prostate (prostatectomy). Because men who have ED that is due to vascular disease or diabetes can be more likely to suffer a heart attack or stroke, discuss cardiovascular factors with your physician before asking for ED medications. Treatment for ED depends on what is causing it, but the best known treatments are oral drugs.
    Low Testosterone Level—Testosterone is the sex hormone that is key to the development of male physical features and can affect men’s sex drive and erections. Some symptoms of low testosterone levels are fatigue or weakness, depression and lost sex drive and increased breast tissue (gynecomastia). Low levels are detected with a blood test. Testosterone replacement, which is most likely lifelong therapy, has been shown to improve energy level and mood and increase bone mineral density.
  4. Weight Management—As your metabolism slows it’s more important than ever to eat less and to exercise, which is critical for maintaining flexibility and mobility. Being overweight or obese increases your risk of Type 2 diabetes, heart disease, stroke, fatty liver disease, kidney disease and other health issues. Talking to your health care provider about your weight is an important first step, especially if you need a plan to keep the weight off over the long run and guidance on how to develop healthier eating and physical activity habits. For ongoing feedback, monitoring, and support for slow and steady weight-loss goals it might be helpful to look into weight-loss programs. The recommended amount of weight loss is usually ½ to 2 pounds per week (though weight loss may be faster at the start of a program). When considering a program, if it seems too good to be true, it probably is!
  5. Diabetes—Diabetes is a disease in which blood glucose levels are above normal. Type 2 is the most common diabetes. It can lead to heart disease, stroke, kidney failure, vision loss and loss of limbs. Symptoms of Type 2 diabetes include: increased thirst and hunger, unintentional weight loss, dry mouth, nausea and occasional vomiting, frequent urination, fatigue, blurred vision, numbness or tingling of hands and feet and infections of skin or urinary tract. You are at risk for Type 2 diabetes if you are overweight or obese, are age 45 or older, have a family history of diabetes and are not physically active. A simple blood glucose test measures the amount of glucose (sugar) in your blood. If you are diagnosed with diabetes, you will have to manage your diabetes. Sometimes you can avoid medication by losing weight and staying active. If medication is necessary there are many oral medications available.
  6. Stroke—A stroke occurs when blood flow to an area of the brain is cut off. It’s important to learn the signs of a stroke. They include weakness or numbness in the face, arm(s) or leg(s), confusion, difficulty with speaking or comprehension of what people are saying to you, slurred speech, vision loss, dizziness or problems with walking, balance or coordination. Some risk factors for stroke are: high blood pressure and high blood sugar, high cholesterol, unhealthy eating habits, untreated heart disease, smoking, excessive alcohol intake, obesity, family history of stroke and being older than 65.

 

The Market for Men’s Drugs

Erectile Dysfunction drugs have been available since 1998 and enjoy considerably widespread use among men, possibly due to their reduced stigmatization over the years.

Researchers predict that the global erectile dysfunction drug market could reach over $3 billion in sales by 2022, while testosterone drug revenue in the U.S. is projected to grow to $3.8 billion in 2018. Asked to comment on the huge growth and interest in these drugs, Dr. Newberger explained that “as soon as you have a solution for something that works, you see the problem much more frequently.”

When there was no drug for erectile dysfunction, Dr. Newberger did not have men coming to his office, just to let him know that they couldn’t get an erection. “The issue really came to the fore once there was medication for erectile dysfunction. However, you can’t just write a prescription for it; you have to consider the other medications a patient is on and any potential adverse effects of the medications, as well as investigate the root cause, which could be vascular disease, depression, adverse effects of other medication the patient is taking or other hormonal imbalances.”

He continues, “I think that the ED drugs responded to a definite need that existed. But all this push to get one’s testosterone screened often can be attributed to the pharmaceutical company trying to sell medication. There are many commercials on TV and in print suggesting men ask their doctor for the test if they are low energy. To be honest, there are not many working men over 50 just bursting with energy. Actually, you can be pretty sure in advance that they’re going to have a normal testosterone level just by taking their history. But you can’t know anything 100%, so you’ve got to do the test if the patient desires.”

The Testing and Screening Controversy

What are the main challenges of aging for men? Dr. Newberger believes they are similar to the ones men and women have throughout life: “Just continue to concentrate on living a healthy life by eating good food, getting a moderate amount of exercise and avoiding dangerous situations.” However, the best way to go about this is not always clear. Many times, patients read two articles with conflicting recommendations and come to him confused. In such cases, says Newberger, “You have to involve the patient in the decision-making. Even standards for cholesterol management have become profoundly different in the last few years compared to the preceding 20.”

Since we’re dealing with prostate cancer quite a bit, the issue of screening can’t be ignored. There are many different recommendations on testing for numerous diseases. He says that “The risk of over-testing can be as bad as under-testing. Often patients hear about a certain test and they want to have it, even though it’s not really appropriate. It can send you down a road where you go from a simple blood test that gives you an equivocal result, and that leads you to something potentially harmful where you have to have an invasive procedure to explain why the blood test returned that result.” Dr. Newberger thinks a good discussion between doctors and patients is important before going forward with questionable tests, because, as he says: “Other than smoking being bad for you and exercise being good for you, everything else has some controversy associated with it.”

Your Cheat Sheet for Men's Cancer Screenings and Good Health

Type of Cancer Screening  Method When to Get Screened
Colon cancer Colonoscopy, sigmoidoscopy, or fecal occult blood testing (FOBT) If you are 50 to 75 years old, get tested. The schedule depends on the type of test used.
Lung cancer Low-dose CT scan If you are 55 to 80 years old and are a smoker or a past smoker who quit within the last 15 years, get a low-dose CT scan every year.
Prostate cancer Digital rectal exam (DRE) and prostate specific antigen (PSA) test Talk to your doctor. The US Preventive Services Task Force (USPSTF) recommends against PSA screening for men who do not have symptoms.
Skin cancer Periodic total-body examinations by a clinician Talk to your doctor. The USPSTF has concluded that there is not enough evidence to recommend for or against routine skin cancer screening.

 

Prevention Checkups

 

Dr. Newberger believes that one key to prevention is having regular checkups. You need checkups even if  youfeel healthy, because conditions like high blood pressure and high cholesterol don’t have symptoms, but are serious risk factors for heart disease. They can vary depending upon individual situations, but Dr. Newberger suggests these generally recommended intervals for checkups:
Blood Pressure—Every year
Cholesterol—Every year
Diabetes—Every year
Weight—Every year
Vision—depends on age, this should probably be directed by the eye doctor after your initial exam.

DrNewberger.jpgTodd Newberger, M.D., F.A.C.P., attended Northwestern University Feinberg School of Medicine and is board certified in Internal Medicine. He is Medical Director of Occupational Health and Senior Attending Physician at Evanston Hospital. He is a CJE SeniorLife Board member with medical privileges at Lieberman Center.

This “Cheat Sheet” from the CDC provides suggestions as to when men should start screening for specific cancers. Talk with your doctor about when and how often you should be screened. Depending on your personal health history, family health history or screening results, your doctor may recommend a different screening schedule.

While these screenings and checkups are important, there’s more to your health than just tests, screenings and checkups. Dr. Newberger has these recommendations to get or stay heathy:

Maintain a healthy weight.

  • Exercise regularly. A minimum of 30 minutes a day, 5 days a week.
  • Get adequate high quality sleep.
  • Don’t abuse alcohol. Consuming more than 2 servings of alcohol daily has been shown to be unhealthy.
  • Don’t smoke—ever.
  • Protect your skin from the sun. Use SPF 30 for all exposed skin, and reapply generously.

CJE’s Center for Healthy Living offers programs and classes to promote health and wellness, as well as occasional diabetes and blood pressure screenings. Also, our Licensed Clinical Social Workers are available to provide you with professional mental health support. Call 773.508.1000 or go to www.cje.net for