When it comes to going to the doctor, men tend to wait until something needs to be fixed, according to a recent survey. The practice is risky, experts say. Reluctance to take an early and regular approach to detection may result in a man ending up with late-stage disease.
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Men are still the boys in the schoolyard, rejecting hurt unless a bone is sticking out of their skin, says Dr. Abraham Morgentaler, director of Men’s Health Boston, and an associate clinical professor of urology at Harvard Medical School, Beth Israel Deaconess Medical Center. “It’s manly to be tough.”
In fact, 63% of men surveyed say prolonged severe pain is the main breaking point that prompts a doctor visit, according to the Men’s Health Network and Abbott survey of more than 2,000 men 18 and older. The survey tracks men’s health perceptions and behaviors and compares men’s and women’s attitudes about health.
While more than three-quarters of men have a primary care physician (PCP) and 69% have had a check-up or wellness screening in the past year, only about one in three are “very knowledgeable” about the health impact of high blood pressure and glucose levels. Fewer still are “very knowledgeable” about good and bad cholesterol, their correct caloric intake, the impact of a high-sodium diet, and the implications of high PSA levels, the survey says.
“Men need to learn there’s a significant amount of accountability in good health and education is a big part of that, says Dr. Julian Anthony, a Sharp Chula Vista Medical Center-affiliated urologist.
Subtle societal shifts are helping men to take a more proactive approach to health: men’s health centers have cropped up in the U.S., albeit slowly; mobile apps provide some helpful tools; and websites like Drive for Five, related to the survey, provide disease education and self-tracking tools.
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The ability to track and record levels in five key areas—high cholesterol, high blood pressure, high blood sugar, high prostate-specific antigen (PSA) and low testosterone—at required intervals is important, experts say, because many of these conditions may be asymptomatic and not impede a man’s daily activities in any way.
Men tend to put wellness at one end of the spectrum and illness at the other, says Dr. Steven Lamm, an internist and faculty member at New York University School of Medicine and Drive for Five co-spokesperson. Typically, men have no middle ground. “They need to learn wellness is not the absence of illness.”
A man may even suspect he’s not in excellent health but be at a loss to articulate the feeling or take action, Lamm says. But because the onset of disease occurs as much as 20 years before a condition manifests, it is imperative men establish a relationship with a physician at a young age.
A regular interaction with a physician allows the exchange of information about family history and current medical information that can be assessed annually or as needed.
Other than the camp or employment physical, there are few influences to get male buy-in for regular doctor visits, Morgentaler says. Women, though, are incented at a young age to see physicians regularly and the arc starting with menstruation, reproductive and related issues and menopause keep them plugged in and vocal life-long.
Still, women’s advocacy wiring works to advantage for men, Lamm says. Girlfriends or spouses can help men prepare for medical visits by highlighting important issues for discussion, reaching out to physicians beforehand with a list of worrisome items or attending the visit with their mates.
Misconceptions about PSA and testosterone
Lamm says regular physician visits also enable clarifying conversations about medical advances or confusing, often contradictory, information about health, like the value of an annual PSA screening.
Urologists in general believe that PSA screening recommendations released by the U.S. Preventive Task Force confuse patients and their PCPs who may be a man’s first line of contact, says Anthony. Screening has decreased mortality in men as we have diagnosed cancers earlier. “But we still see too many patients with end-stage prostate cancer coming to us too late.”
Morgentaler says the medical profession is just starting to publicize the link between testosterone and general health. Prior to 1988, there was no discussion of male menopause, and it was unheard of to offer testosterone to men who showed symptoms of age.
Testosterone is not just about sex, claims Morgentaler. Men with low testosterone are at heightened risk of bone fractures and metabolic syndrome, increasing risk for heart disease, diabetes and stroke. Low testosterone also decreases longevity.
“If treated, survival goes back to normal,” Morgentaler says. Education that targets this topic and encourages vigilance pays huge dividends for men.
Here are tips to make men better health consumers:
Monitor your risk. Record your levels for cholesterol, blood pressure, blood sugar, PSA, and testosterone and BMI and share them with your physician.
Health screen regularly. Let nothing—not even work or providing for your family—eclipse the time you take for medical appointments and regular screenings.
Do your homework. Write down questions and bring a list of your current medications to medical appointments. If you presented with health issues at your last visit, return having taken appropriate measures to improve your health.
Know your family history. Sharing this information with your physician may influence areas of added vigilance or care.
Remember the rule of two. Bring your partner or a family member to your appointment to listen or take notes.
Rely on the written word. Request that your doctor write down advice shared during your visit.
Nothing is taboo. Don’t be embarrassed to discuss anything that’s bothering you—even about sex drive or performance. These can be indicators of underlying health problems.
Talk through anxiety. Internalizing stress can jeopardize your health and lead to poor health habits.
Make health a family affair. Recruit your partner or spouse to help you maintain health by eating better, improving meal planning and food shopping, and coaching—not scolding—you to exercise more and be generally health compliant