June 2, 2011
Written By: Jesse Mills, M.D., men’s health and male fertility specialist, The Urology Center of Colorado
June is National Men’s Health Month. What is men’s health and why should we only have a month of it in June? I think it has something to do with basketball and hockey winding down, baseball not quite heating up yet and football being a long, hot summer away (if the NFL season even takes place this year). I’m a urologist who specializes in male fertility, hormone therapy and sexual medicine. I’m the doctor you need when man parts stop working well. It’s difficult to get a guy to lower his blood pressure or cholesterol levels just by telling him it’s good for his health. If you tell him it’s good for his sexual health, well, then that gets his attention. For example, growing evidence suggests a correlation between impotence (what erectile dysfunction was called prior to the endorsed admissions of Senator Dole and others) and early onset coronary disease. In other words, impotence can be a sign of impending or future heart trouble. So, the way to a man’s heart may not necessarily only be through his stomach. Pay attention guys.
As it currently stands, men don’t have annual screening milestones until age 50. Women begin annual gynecologic exams at age 18 and are therefore indoctrinated early into the world of preventive care (aka invasive and initially embarrassing exams.) Current screening standards suggest an annual colonoscopy at age 50 and PSA (a simple blood test to assess prostate cancer risk) and prostate exam at age 50. Urologists and the American Cancer Society recommend screening for prostate cancer beginning at age 40, especially for men with a strong family history. But by age 40, many men may have already developed a lot of health problems that can adversely impact their life spans. Not to mention no routine physician visits to help intervene before guys run into trouble. The three leading causes of impotence I see in my practice are high blood pressure, diabetes and obesity. Smoking is a close fourth, but, fortunately, Colorado is a state with a smaller population of smokers. All four of these causes are preventable conditions.
Doctors know that the causes of impotence are difficult to change. My message is to start slow. I ask patients how long it took for them to gain 50 pounds. No one has ever said they did it in a month or two. Most commercial diet plans tout how fast their clients can drop the weight. This is wrong. We don’t get fat fast, so we shouldn’t expect to get skinny fast for a couple of reasons. First, most diet plans are drastic and difficult to maintain. Nearly every plan cuts out a major food group. That’s tough to stick to. Second, humans are good at storing fat. This is a survival mechanism that helped our ancestors survive days or weeks without eating and then over eat when food was plentiful to prepare for the next famine. Tomorrow, eat less than you ate today. Not much less. Don’t weigh yourself for at least two weeks. While you’re at it, do more tomorrow than you did today. If your office is on the 6th floor, take the stairs to the 2nd floor and take the elevator the rest of the way for the first week. Then go up two flights the next week. And so on. If you stick with the simple stuff, you will start seeing benefits without having to drastically change your lifestyle. Trimming your weight and improving your fitness will serendipitously lower your blood pressure and greatly reduce your risk of diabetes. If you’re a guy reading this and you’re already noticing sexual problems, you may start seeing improvements just by altering your lifestyle and save yourself a visit to see me.
What about male menopause/andropause and its effects on men’s health? Low testosterone (low T) is the most under-diagnosed hormone disorder today. Symptoms of low T are not life threatening. Men with diabetes or thyroid disease typically have undeniable symptoms that often cause them to seek urgent care. Low T is insidious and vague in its onset and symptoms. Whereas women have a sentinel event in their changing hormones when they stop their periods, men don’t. Men with low T can be cranky, lethargic, lack sexual interest or ability, gain weight, lose muscle or lose interest in daily activities. Most write this off as “getting older.” But low T can affect men of all ages. There are no established values for testosterone dependent on age. The normal range is extremely wide, which makes diagnosing low T tough for many physicians. This is where patients have a chance to take charge and inform their physicians that they may be suffering from this condition. I ask all of the guys who see me if they’ve lost their morning erections. This is an excellent screening question for men with low T. If a man is diagnosed with low T, treatment is pretty simple. First, I screen all men for prostate cancer with a physical examination and a blood test. If they are at low risk for cancer, I get them started on testosterone replacement. The vast majority of guys are prescribed a daily testosterone gel. It’s easy to apply, absorbs quickly and men start seeing positive effects in days. By positive effects, I mean their sexual interest and performance increase, their weight loss improves, muscle mass goes up and fat mass goes down.
I often see men whose wives or partners make the appointment because they notice a change where men don’t. Again, men aren’t the best at taking care of themselves or paying attention to their bodies. If men get the message that taking care of their overall health can benefit their bedroom lives, this may be a stronger motivator. So, for the month of June, while you’re waiting for at least college football to start, see your physician, get your blood pressure checked, get your blood sugar and cholesterol checked, get screened for prostate cancer (in preparation for September, Prostate Cancer Awareness Month,) and talk with your doctor if you’re feeling any of the symptoms of low testosterone.
For more information on men’s health and prostate cancer, please visit www.tucc.com or call 303.825.TUCC (8822).