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men's health

What should a man over the age of 50 be concerned about when it comes to his health?

Men should be concerned about their health before age 50, but they often put off routine doctor visits, adopting the "if it ain't broke, why fix it?" approach. However,  when men are advised to get a colonoscopy at age 50 to screen for colon cancer, this often triggers a new found interest in their health and a visit to the doctor. This physical is very important and you want to come prepared for an open and honest discussion about your health. While not a comprehensive list, here is a list of some of the more common issues men over 50 should discuss with their physician:

 

  • Weight
  • Blood Pressure
  • Cholesterol
  • Blood Sugar
  • Smoking / Alcohol / Tobacco / Drugs
  • Medications and Supplements
  • Heart Disease and Stroke Risk
  • Exercise
  • Skin Cancer
  • Mental Health and Mood
  • Sleep
  • Testosterone level
  • Sexual Function
  • Fatigue / Stamina
  • Diet / Nutrition
  • Urinary / Bladder Function
  • Muscle and Joint Health
  • Colon and Gut Health

 

A comprehensive evaluation requires a thorough history, review of systems, physical examination, diagnostic testing, and a care plan with follow-up.

 

How does lifestyle impact a man's health over 50?

 

Lifestyle choices such as diet, exercise, smoking, drinking, and drug use (including non-prescribed medications/supplements) play a major role in men's health. It should go without saying that regular moderate exercise, smoking cessation and limiting alcohol consumption are paramount to achieving optimal health.   The "man-bod" or "beer belly" is actually a risk factor for cardiovascular disease. Increased waist circumference, abnormal cholesterol, high blood pressure, and high fasting blood sugar are some of the major components of "metabolic syndrome". Metabolic syndrome almost certainly increases one's risk of heart disease. Insulin resistance and inflammation, closely linked to metabolic syndrome, also contribute to one's risk of CVD. Comprehensive lab testing and a physical examination are advised to establish a baseline risk for CVD. Implementing a plan to optimize one's health and reverse metabolic syndrome takes a multi-disciplinary approach -- physician input, accountability, nutrition and exercise coaching, and follow-up.  Medications may or may not be advised depending on the severity of abnormal findings. Fortunately, medications may be discontinued after one makes noticeable strides with lifestyle changes.

 

How does one lose weight?

 

"Fat burns in the flame of carbohydrate" is what my medical school biochemistry professor would always preach. Indeed, weight loss is 80% diet, 20% exercise -- more or less.  And frankly, carbohydrates contribute the most to unwanted weight gain. Common culprit carbohydrates are sugary foods, pasta, bread, and rice.  If not utilized for energy, carbs rapidly convert to fat. Excess fat stores lead to weight gain and development of metabolic syndrome, fatty liver, insulin resistance, and an inflammatory state --  a perfect storm for heart disease and/or stroke. While there are myriad diets and exercise programs out there, generally most authorities recommend consuming whole, unprocessed foods low in carbohydrate (e.g. vegetables), moderate protein (e.g.lean meats), and high in unsaturated fats and omega-3 fatty acids. Portion size and keeping an eye on calories are important, but weight loss is more complex than simply calories in vs. out.  Exercise should be introduced after dietary adjustments have been made and the initial phase of weight loss achieved since exercise may cause an increase in appetite and muscles need protein to repair and build.

 

Weight loss doesn't come easy for everyone. Genetics, mental health, gut health, medications, and other factors play a role. It is always best to discuss a weight loss plan with your physician.

 

Is it common for men over 50 to feel not like their usual self?

 

More tired than usual? Less stamina? Brain fog?  All of these vague symptoms are very common with the aging male. Fatigue is almost a universal complaint. Inability to keep up with the younger guys (think co-workers) is also a common complaint.  Evaluation requires a head-to-toe evaluation. It is not too uncommon to have normal routine labs yet still feel that something is "off". While mental health, including depression and anxiety, can play a significant role in sense of well being, it often pays to look deeper into other causes of fatigue including:

  • Hormone and testosterone loss
  • Sleep disorders like sleep apnea and insomnia
  • Thyroid dysfunction
  • Autoimmune conditions
  • Gut health
  • Diet/lifestyle...and more

 

I'm being bombarded by ads for erectile dysfunction treatment. What's the deal with medications for ED?

 

Interest in erectile dysfunction (ED) treatment has, um, exploded over the last 10 years thanks to Viagra and the like. Men are more comfortable discussing sexual health and are seeking ways to enhance or optimize their performance. Though it may be tempting to spring for a one-size-fits-all pill, sexual function is complex. Not all medications work the same with all men. It is important to be aware of potential side effects, drug interactions, and the effect of underlying medical conditions when considering medication therapy for erectile dysfunction. There may be safer and less expensive alternative therapies available. When in doubt, get a proper evaluation and discuss treatment options with your physician.