The Medical Minute: Men's Health Week 2009, June 15-21

By John Messmer

Enter the term “Men’s Health” into a search engine and the top result is likely to be about erectile dysfunction or prostate cancer. Too bad; the top result should be heart disease, the leading killer of men. Heart and vascular disease also carry high rates of chronic health problems from poor circulation. This brings us back to erectile dysfunction, which in most cases, is due to poor circulation and is caused by the same things that cause heart disease: smoking, diabetes, high blood pressure, high cholesterol, obesity and lack of exercise.

Men’s Health Week is an annual observance designed to focus our attention on getting men to think about health and prevention. Overall, women make more visits to physicians than men, but that is probably not because women are more health conscious as the difference in visit frequency is greatest during the reproductive years.

Health maintenance or preventive health screenings, what used to be called the “annual physical,” should be considered every few years for men in their 20’s and 30’s if they have not had the opportunity to see their physicians for any other reason. During a preventive exam, the physician or other health care provider can evaluate for high blood pressure, and when appropriate, diabetes and high cholesterol. Smoking cessation counseling, dietary evaluation and exercise recommendations during health maintenance visits can pay dividends in reducing the risk of our most serious and common medical problems.

At age 50, the statistical risk for various health problems increases. Although men who have followed their doctors’ recommendations should have less chance of health issues, age itself increases some risks. Colon cancer screening begins for most men at age 50, but it can begin earlier with a family history of colon cancer in a close relative before age 60.

Prostate cancer screening is more controversial. The United States 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.

Staying healthy need not be difficult. The most important rule is to avoid tobacco. Next, engage in regular exercise, eat a diet that includes a variety of vegetables and fruits and grains with limited saturated fats, and maintain a normal weight. Screen for high blood pressure, diabetes and high cholesterol and treat if they develop. Have a primary care physician and ask about periodic health maintenance exams.

Men also should be aware of many other aspects of health from violence to safety issues, sexually transmittable diseases, hearing protection, depression and suicide risks, and more. Test your knowledge of men’s health issues with a quiz at the Centers for Disease Control and Prevention Web site.

One day men may have their own Web site for health issues, but for now, the Department of Health and Human Services Men’s Health site (http://www.womenshealth.gov/mens/) is a page on the Women’s Health site. Maybe this is because so many men go to their doctors because their spouses insist.

Men should be responsible for their health. Families expect it and it’s the right thing to do. Let this be the month that all those men who have not attended to their health take the first step toward improving their future and reducing the risk of chronic disease.

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.