DrJason

While the life-expectancy gap between men and women has decreased, it’s no secret that men still need to pay more attention to their bodies.

Several things work against men. They tend to smoke and drink more than women. They don’t seek medical help as often as women. Some men define themselves by their work, which can add to stress.

There are also health conditions that only affect men, such asprostate cancer and low testosterone. Many of the major health risks that men face – like colon cancer or heart disease – can be prevented and treated with early diagnosis. Screening tests can find diseases early, when they are easier to treat. It’s important to have regular checkups and screenings.

Screening tests can find diseases early, when they’re easiest to treat. Talk to your doctor about which preventive medical tests you need to stay healthy.

Body Mass Index

Your body mass index, or BMI, is a measure of your body fat based on your height and weight. It is used to screen for obesity.

Cholesterol

Once you turn 35 (or once you turn 20 if you have risk factors like diabetes, history of heart disease, tobacco use, high blood pressure, or BMI of 30 or over), have your cholesterol checked regularly. High blood cholesterol is one of the major risk factors for heart disease.

Blood Pressure

Have your blood pressure checked every 2 years. High blood pressure increases your chance of getting heart or kidney disease and for having a stroke. If you have high blood pressure, lifestyle modification including diet and exercise programs can cure it, if not, you may need medication to control it.

Cardiovascular Disease

Beginning at age 45 and through age 79, ask your doctor if you should take aspirin every day to help lower your risk of a heart attack. How much aspirin you should take depends on your age, your health, and your lifestyle.

Colorectal Cancer

Beginning at age 50 and through age 75, get tested for colorectal cancer.  If you have a family history of colorectal cancer, you should get tested at the age of 40.

Other Cancers

Ask your doctor if you should be tested for prostate, lung, oral, skin, or other cancers.

Sexually Transmitted Diseases

Talk to your doctor to see whether you should be tested for gonorrhea, syphilis, chlamydia, or other sexually transmitted diseases.

HIV

Your doctor may recommend screening for HIV if you:

  • Have sex with men.
  • Had unprotected sex with multiple partners.
  • Have used injected drugs.
  • Pay for sex or have sex partners who do.
  • Have past or current sex partners who are infected with HIV.
  • Are being treated for sexually transmitted diseases.
  • Had a blood transfusion between 1978 and 1985.

Depression

If you have felt “down” or hopeless during the past 2 weeks or you have had little interest in doing things you usually enjoy, talk to your doctor about depression. Depression is a treatable illness.

Abdominal Aortic Aneurysm 

If you are between the ages of 65 and 75 and have smoked 100 or more cigarettes in your lifetime, ask your doctor to screen you for an abdominal aortic aneurysm. This is an abnormally large or swollen blood vessel in your stomach that can burst without warning.

Diabetes 

If your blood pressure is higher than 135/80, ask your doctor to test you for diabetes. Diabetes, or high blood sugar, can cause problems with your heart, eyes, feet, kidneys, nerves, and other body parts.

Low T

What is Low T and how will it affect me?

Testosterone is a hormone that assists the male body in building protein and is crucial for a normal sexual drive and stamina. Testosterone contributes to several metabolic functions including bone formation, and liver function. It also plays a role in good old-fashioned vitality, or as some patients call it, “the Lion effect”. When men get into their early thirties, testosterone can start dropping at a rate of one to two percent a year. When levels drop below age average, a condition known as hypogonadism (low t) can be diagnosed. According to the US Census Bureau, approximately 4-5 million men have symptoms of low t levels. Symptoms of low t can be:

 

There can be different causes to low t that include stuff happening on the inside and/or the outside of our bodies. Also, our attitude likely plays a role, being it directly effects our internal hormonal environment.

 

External causes

External factors that can cause testosterone levels to fall include certain forms of medication, poor diet, excessive alcohol consumption, illness, lack of sleep, lack of sex, stress or surgery. There is a real possibility that toxins in our environment, like plastics, can play a role as well. It can also be a symptom of neuroendocrine dysfunction after a mild traumatic brain injury.

Internal Causes

Our internal hormonal environment has many players in the low t game. Think of testosterone as the player that scores, it gets most the attention. However, to score involves support players. These support players, among a few others, include LH and GnRH. These hypothalamic and pituitary hormones are supposed to ramp up in response to dropping testosterone levels. Well, they get lazy as we age, and can be slow to respond, and when they do, its usually to little and to late. This offensive coordinator typically begins it laziness in our early forties. This condition has also been called andropause, however, that term is not exact, meaning, its not as if men have an internal hormonal countdown like women. I, and some researchers prefer the term “ADAM” (androgen decline of the aging male).

External/Internal

Carrying an excess of fat tissue can work in favor of low t. Adipose cells produce an enzyme called aromatase, aromatase can convert testosterone into estrogen, thus contributing to the issue to low t. This mechanism can start with external causes like inactivity and overeating (none of us do this right?). It becomes a self perpetuating cycle, as low t instigates increasing levels of adipose tissue, our mind spurns us to self medicate in combat of increasing fatigue, decreasing muscle and eventual self loathing.

 

What can go wrong?

Adverse effects of testosterone supplementation may include increased hematocrit (which may require blood donation in order to treat), exacerbation of sleep apnea and acceleration of pre-existing prostate cancer growth in individuals having undergone androgen deprivation. Adverse effects may also include minor side-effects such as acne and oily skin as well as significant hair loss and/or thinning of the hair which may be prevented with 5-alpha reductase inhibitors ordinarily used for the treatment of BPH such as finasteride or dutasteride. There are also some herbs that when combined can have a mild to moderate inhibitory effect on 5-alpha reductase, without side effects. Exogenous testosterone may also cause suppression of spermatogenesis, leading to, in some cases, infertility. In my office, a popular technique known as a digital rectal exam of the prostate, along with analysis of the blood is done every 90 days, call me thorough, but not Shirley.

 

 

So, does treatment with testosterone replacement therapy (TRT) work. Yes, it can seem like magic for those with low t. It can turn things around in a timely manner, as in 6-12 hours. When TRT is managed correctly and responsibly by a knowledgable doctor, like yours truly, the experience is very safe and can be conducted long term. In my office, injectable testosterone cypionate is the only form of TRT that’s used. It’s the gold standard.

Tobacco Use 

If you smoke or use tobacco, talk to your doctor about quitting. For tips on how to quit, go tohttp://www.smokefree.gov or call the National Quitline at 1-800-QUITNOW.