The Medical Minute: Men's Health Week 2008

By John Messmer

It is often observed that men tend not to go to the doctor unless they are really sick or their wives encourage them to go. Perhaps that's partly why men's life expectancies have dropped compared to women's since 1920 when death rates for both genders were about equal. Compared to women, men are almost twice as likely to die from heart disease, one and one-half times more likely to die from cancer and have two and one-half times more accidental deaths. They also are three to four times more likely to die from suicide or homicide.

Since erectile dysfunction (ED) ads have become commonplace, men may make a visit because things no longer work correctly. The ads do not mention that ED is often due to atherosclerosis and may be a warning sign for developing heart disease, the No. 1 killer of men. If all men were screened for high blood pressure, diabetes and high cholesterol, it could make a major dent in the incidence of heart disease. Employers who help smokers quit and encourage more exercise for men in all walks of life could cut disability and mortality and keep men more productive at work.

Starting in the 20s, a periodic screening exam can detect problems early when intervention will be most beneficial. The frequency of screening increases with age, but is typically every few years in the 20s and 30s and annually after age 50. Recommendations for preventive services are updated frequently as new evidence is found so having a primary care physician will make it easier to stay up to date. Of course, screening is of no use unless men make an effort to fix the problems.

Colon cancer screening is now recommended for everyone at age 50. If colonoscopy can not be obtained, annual testing of stool for blood is recommended with sigmoidoscopy, which looks at the lower half of the colon, every five years.

Prostate cancer screening is more confusing. The U.S. Agency for Healthcare Research and Quality publishes guidelines for screening. They have found insufficient evidence for or against prostate cancer screening but the guidelines suggest men be educated as to the pros and cons of prostate cancer screening so that they may share in the decision. The disease, while more common in older men, is also less likely to be lethal in men over 75. So, the treatment could be worse than the disease. In younger men, particularly black men and men with a family history of prostate cancer, screening may be more likely to lead to prolongation of life. It must be an individual decision.

Smoking avoidance, regular exercise and maintaining a normal body weight are as important for men as for women. In fact, if just these three items are managed, the risk of about half of all preventable diseases can be reduced. A balanced diet with a variety of vegetables and fruits, limited saturated fats and alcohol in moderation, if at all, plus controlling blood pressure and cholesterol can improve health outcomes even further. Men can stay healthy, fit and active well into their 80s and 90s by some effort early. It’s like a health IRA -- people have to put away a little healthy living now to get it back later.

Men's health affects the lives of women, too. Consider that 80 percent of the elderly living alone are women and half of the elderly widows living in poverty were not poor before the deaths of their husbands. This month, let Men's Health Week be a reminder to men and the women who care about them that now is the time to work on achieving and maintaining good health. More information on men's health is available at the Centers for Disease Control and Prevention Web Site.

John Messmer is associate professor of family and community medicine at Penn State College of Medicine and a staff physician at Penn State Hershey Medical Center.

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Last Updated March 19, 2009