Hey, Dude, It's Time To Get A Clue

Men may be thinking more about their health these days, according to the Men's Health/MSNBC survey , but too many rough and tough guys are still ignoring their bodies.

Women tend to worry too much about their weight, but guys typically think they're just a few sit-ups away from being in the shape they were in college or high school.

They think because they feel fine, there's nothing to worry about. The "if it ain't broke, don't fix it" theory may work for cars, but not always for people. "Men are not prevention-conscious," says Dr. David Crawford, a professor of urology at the University of Colorado in Denver.

The reality is men on average die six years earlier than women, according to the Centers for Disease Control and Prevention. For leading causes of death — heart disease, cancer, diabetes and stroke — men have higher death rates.

Still, men put off going to the doctor, even if they suspect something might be wrong. "Most men, more often than not, fear the doctor," says Dr. Raul Seballos, preventive medicine specialist at the Cleveland Clinic. "They just don't want to know."

Dude, it's time for an attitude adjustment. As part of the MSNBC series on men's health, we present some of the major myths men believe about their health.

*I'm too young to worry about heart disease
“The biggest mistake men make is thinking that heart disease doesn't start until they get older," says Dr. Matthew DeVane, a cardiologist at Cardiovascular Consultants Medical Group in Walnut, Calif.

“Men think if they look healthy and exercise, they're not at risk. Looks can be deceiving,” says DeVane, author of “Heart Smart” (Wiley), being published in February.

Arteriosclerosis, or hardening of the arteries, can begin developing while a man is still in his teens, but symptoms may not show up until he's 50. By the time a man has symptoms like shortness of breath or weakness, the disease is already advanced. About one out of three people who dies from heart disease dies suddenly.

“People like David Letterman and Bill Clinton look fine and healthy and have the best medical care and all of a sudden, they need a bypass,” says DeVane. “The process of arteriosclerosis starts early so lifestyle matters early on.” That means controlling weight gain and getting regular exercise. It's also important to know blood pressure and cholesterol levels.

*Sunscreen is for wimps
Skin cancer is the most common form of cancer diagnosed in men and women in the United States, but men are more likely to die from the disease, according to the American Cancer Society. That's because men are more reluctant to wear sunscreen and more likely to ignore the symptoms, if they even do monthly skin exams. Men over 40 also spend the most time outdoors and have the most exposure to the sun.

Since more than 90 percent of skin cancer comes from ultraviolet rays, the Skin Cancer Foundation advises men to regularly use a sunscreen with a sun protection factor (SPF) of 15 or higher.

*Flossing is a waste of time
There's growing evidence linking periodontal disease and heart disease, yet men are less likely to visit the dentist or floss, studies show. That puts men at greater risk for gum disease, called gingivitis in its early stages.

Mouth infections can increase the levels of inflammation in the blood and lead to clots, which can decrease the blood supply flow to the heart.

According to the American Dental Association, the best prevention for periodontal disease is to brush twice a day and clean between the teeth with floss each day.

*What mid-life crisis? It's all in my head
Feeling grumpy? Do you have a lack of energy? Noticing a decrease in libido or less strong erections? Women aren't the only ones who go through a “change of life.” Men don't want to think about an end to their glory days, but there is a subtle drop in testosterone, the hormone that puts the macho into manhood, after age 40, doctors say.

About one-quarter of those men suffer a significant enough decline in testosterone to lead to loss of muscle mass, cognition problems and osteoporosis, says Crawford. Low testosterone levels can increase prostate cancer risk and if a man is diagnosed with prostate cancer, low testosterone can worsen the condition, he says.

The condition can be treated with testosterone gels, although “detecting the problem can be sticky because many men don't want to admit their sex drive isn't what it used to be,” says Dr. John Morley, chairman of the division of geriatrics at St. Louis University School of Medicine.

There's also controversy whether men should risk hormone-replacement therapy, which has been associated with side effects such as infertility.

*Lifting weights is all the exercise I need
Some structured weight-lifting routines can improve cardiovascular fitness, but the “best cardio exercise is aerobic,” says Dr. Louis Teichholz, chief of the division of cardiology at the Hackensack University Medical Center in New Jersey.

Aerobic exercises include jogging, biking or using a treadmill, Stairmaster or an elliptical trainer.

At the same time it's important to include strength-training in a regular routine because men lose muscle power as they age.

Too many guys also think they have to train like they're going for a marathon when just walking can be enough, doctors say.

“Any exercise is better than no exercise,” says cardiologist DeVane.

“For preventing heart attacks it's the best thing you can do," he says, "just try to be consistent.”

*Prostate cancer treatment is worse than the disease
Macho men like to play dare devil, but even the toughest guys turn squeamish when it comes to their prostate, the small reproductive gland located above the rectum and below the bladder and controls ejaculation of seminal fluid.

Prostate cancer is the most common cancer for males over 40 and is expected to kill an estimated 30,000 men in 2005, according to the American Cancer Society. African-American men are more likely to be diagnosed with advanced prostate cancer disease and to die from it.

But many guys are still too timid to discuss it with their doctors.

"Men fear that if something is wrong and you find it, the consequences of the treatment would be worse than the disease," says Dr. Bruce Crawford, professor of urology at the University of Colorado in Denver. Fears of impotency and incontinence keep older men from getting tested, even though they may face greater risk because of family history or age.

There is debate whether prostate cancer screening saves lives or not, but many doctors are pushing men to get tested regularly. "Because men are living longer, the amount of prostate cancer we're diagnosing is increasing," says Dr. Raul Seballos, preventive medicine specialist at the Cleveland Clinic.

While the prostate-specific antigen blood test can produce false-positives, when used with a digital rectal exam, it can be effective at catching prostate diseases that need to be treated.

Treatments have improved and survival is most likely when cancer is caught early. As Crawford explains, "the biggest cause of impotency is death."

*I don't have to worry about fertility
It is commonly assumed that men's behaviors will not affect the conception process — that fertility issues are up to the woman. Wrong, says fertility specialist Dr. Lawrence Werlin of Coastal Fertility Medical Center in Irvine, Calif. Behaviors like smoking, binge drinking or strenuous heat-conducive exercise like cycling can all negatively impact male fertility.

The occasional beer is no problem, but for men who drink heavily on weekends, the sudden toxic effect can impair sperm, says Werlin.

Also, hot tubs, Jacuzzis and saunas can be damaging to sperm, so men should be careful to avoid submerging in anything hotter than body temperature. “If it feels hot on your skin, too hot for the sperm,” says Werlin.

The good news is, a man's sperm regenerates about every 90 days. The bad news is, if you damage the boys now, it could take three months to impregnate your partner.

Reference Source 135
December 15, 2005

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