Men’s Health

My previous post was about women’s health. In this post I am going to review a couple of aspects of Men’s health. Most of the things men should be doing are things  people of both genders should be doing to stay healthy: stop smoking, exercising, eating a healthy diet, maintaining a healthy weight (or loosing weight if overweight).  Staying up to date with immunizations, such as yearly flu vaccination, is also important. Getting screened yearly for hypertension is important. Skin cancer screening is also important, though this might only need to be done every 2 years depending on whether you have any suspicious moles or lesions, prior history, you and your dermatologist’s comfort levels for yearly vs every other year screening. Cholesterol screening at appropriate intervals is important (a healthy male in his 20’s with no risk factors for heart disease only needs his cholesterol checked every 5 years or so. Older men and those with risk factors require monitoring more frequently and perhaps yearly if risk factors are present or if on treatment to lower cholesterol). I won’t get into more details about screening or other issues covered already in other posts.

Perhaps the biggest controversy in mens health is prostate cancer screening. The U.S. Preventive Services Task Force actually recommends against routine screening for prostate cancer in healthy men of all ages. Even the American Urological association recommends against screening for prostate under the age of 64 and in men with life expectancy of less than 10 years. For screening, a conversation with your primary care doctor is warranted before getting the test. The main reason it is controversial is that one runs the risk of finding a prostate cancer which is indolent (slow growing), non aggressive that one is likely to die with than of – meaning one is likely to die of some other disease before the prostate cancer becomes a problem. At this time we don’t have enough information to know what low grade/early prostate tumors are going to become aggressive and turn into problems. One therefor runs the risk of over treating something that would not be a problem.

Occasionally I’ve had patients ask for testosterone levels and had to talk to patients about testosterone replacement. Testosterone levels are not something  routinely checked unless there is a clinical reason (if there is loss of libido, erectile dysfunction, and so forth, then it’s worth getting). Testosterone replacement has been associated with an increased risk of heart disease so replacement benefits needs to be worth the increased risk.

Although I probably run the risk of repeating myself by saying this, but reducing the risk of heart disease, lung cancer, colorectal cancer by exercising, watching what one eats and getting appropriate screening applies to men’s health as well.

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