Your Body on Testosterone
By Whitny Doyle, R.N.
My men’s health care journey began with a heartwarming moment of inappropriate groping. During nursing school, a heavily medicated gentleman reached out from his hospital bed and cupped my butt cheek with his trembling hand, muttering “That’s nice” before passing out. He had no recollection of the event after he woke up and was just as courteous as can be for the remainder of his hospitalization.
This, however, is the only instance of ass-grabbing hilarity I've encountered during my time in health care. Most other male patients have left their mark upon my memory in less clichéd ways. For instance, one man took his last breath while I was trimming his toenails at the end of his bed bath. He decided to die immediately after I told him how lucky he was to still have a full head of thick, wavy hair. After my shift, I trudged home, saddened by the fact that he'd parted this world with nothing but my meaningless compliment ringing in his ears.
The next day, a 16-year-old brought the nurses on my unit cards and flowers. He was thanking us for taking care of him during his hospitalization following a near-fatal gunshot wound. His miraculous recovery restored my faith in the cosmic balance.
I tell these stories to illustrate the point that, although the statistical portrait of men’s health care tells us things about heart attacks and such, my focus as a nurse has less to do with numbers and more to do with narratives. In this particular instance, the narratives I’ve collected reinforce the statistical finding that men tend to avoid medical care until they’re in dire straits. Case in point: Although women visit the doctor more frequently, men spend much more on medical care after age 65.
So for all you guys out there who would rather get a bikini wax with Perez Hilton than come see me for your annual exam, I offer you the following updates on men’s health issues as a jumping-off point toward better health.
Obviously, reading a health article in an alternative newspaper is not a substitute for a visit with a health care provider. But every bit of knowledge helps. Learning about your body may be the best way to ensure that, somewhere down the road, you don’t break some young nurse’s heart by kicking the bucket while she’s yapping at you about your artful use of pomade.
• Extra web-only informational nuggets!
Male brains have dreamed up everything from Hamlet to “South Park.” However, this fertile headspace is not without its troubles. Women live longer and enjoy better health than men. Smart people at Harvard Medical School attribute most of this health inequality to men’s emotions and behavior, which include more aggression, substance abuse and social isolation. In order to close the health gender gap, Harvard docs encourage men to avoid tobacco and alcohol, eat well and exercise, reduce stress and risky behaviors, and “seek joy and share it with others.” Pretty basic.
• For more on what constitutes “exercise” and “eating well”, check out cdc.gov/family/tips.
Skin cancer wins the coveted award for most common cancer in men. Put on your birthday suit every six months and have your special friend or your dermatologist hunt for truant moles.
• Remember your ABCDs? Skin cancers are often moles that change or grow over time. They may be Asymmetric, have irregular Borders, various Colors, or a Diameter greater than 6 mm. The USPSTF did not find sufficient evidence to either recommend for or against routine skin checks by professional or by yourself. Visit cdc.gov/Features/SkinCancer for more info.
Let’s all just gaze at Rob’s chest for a moment. Did you hear that? It’s the sound of all of Albuquerque’s women simultaneously ovulating.
Unless you’ve been living inside a bomb shelter since the Gettysburg Address, you know that health is more about eating right and exercising than spending money on pills and procedures. But some procedures are worth the investment. The U.S. Preventive Services Task Force (USPSTF) strongly recommends that all men aged 35 or older get their cholesterol checked regularly. Annual blood pressure checks save even more lives.
• Men as young as 20 should consider a cholesterol check if they are at increased risk for heart disease. Increased risk means you have lots of family members with heart disease, or you have a close relative who has suffered a heart attack or died of unexplained causes before age 50. Obesity and diabetes are a few more cheerful examples of cardiac risk factors. For a full list of USPSTF recommendations, visit ahrq.gov/clinic/uspstfix.htm.
As much as you dudes enjoy slamming protein shakes around the clock, Harvard docs say even big buff guys don’t need more than 65 grams of protein a day. Overloading on protein can stress your kidneys, and a Consumer Reports investigation found that commercial protein formulations can be contaminated with potentially dangerous heavy metals such as lead. Plus they're like a billion times the cost of natural proteins (such as egg whites).
• If you like men’s health news sans the ads and metro fluff of men’s health magazines, check out the Harvard Men’s Health Watch newsletter.
An awesome new Korean study found that the ratio between the length of a man’s ring finger and his index finger is not correlated with semen quality. Science at its finest!
Abdominal problems make great medical puzzles. Is it the liver? The kidney? Col. Mustard in the pancreas with a cheese grater? These days, though, abdominal problems have less to do with internal organs and more to do with beer bellies. Men who pack fat on their abdomen are at higher risk for health problems than men who carry their extra weight elsewhere. Elevated waist-to-height ratio (WHtR) is a strong predictor of heart disease risk. A waist circumference that is 50 percent of your height or less is generally considered healthy.
The quality of your precious swimmers diminishes drastically over time. A 2010 Danish study concludes that men who want kids shouldn’t wait until retirement to start their families. But that doesn't necessarily mean young men should aspire to the esteemed job title of "baby daddy" just yet. A 2009 study found that men who become fathers too young in life suffer significantly more health problems than men who delay fatherhood until they are settled and stable.
Fathers who chill with their babies are healthier than guys who don’t. A 2010 Swedish study found that men who take paternity leave have a reduced risk of illness and death. Scientists say adopting a caring role benefits a man’s overall health.
• The HPV vaccine was recently approved for boys!
The Balls in Your Court
Unlike most cancers, testicular cancer usually occurs in young men. While the benefit of routine testicular exams is controversial, at least everyone agrees that you should seek care immediately if you experience any pain, lumps or unexplained phenomena of the scrotal kind.
There’s a lot of buzz these days about men and low testosterone levels (called hypogonadism), which has been implicated in everything from diabetes to heart disease. So far, there’s no clear indication that anyone should juice up on testosterone supplements just yet. More research is on the horizon.
• Testosterone replacement may decrease risk of things like cardiovascular disease but increase the risk of prostate cancer or other ailments.
• The USPSTF actually recommends against routine clinical testicular exams (including self exams) in those without increased risk for testicular cancer (TC), while other agencies recommend them. Increased risk means a family history of TC, history of an undescended testicle, or history of testicular trauma such as a sports injury. See cancer.gov/cancertopics/types/testicular for more info.
Ideally, a colonoscopy would be a treasured pastime of the 50-and-older crowd. In reality, it’s just something you gotta do. Silver lining: the pre-procedure dose of Valium you get.
“Digital rectal exam” does not refer to some fancy imaging technology, but rather to the probing digit on your health care provider’s hand that feels inside your rectum for your prostate. The jury’s still out on whether prostate checks actually improve outcomes. But until there’s more info, most providers still glove up once you turn 50.
• Earlier if you’re black or have family history of prostate cancer. For the 75 and older crowd: The USPSTF says you don’t need prostate exams anymore! SCORE. Want even more websites to visit? Go to mayoclinic.com/health/prostate-
Many common sport injuries involve the lower body, including sprained ankles, knee tears and the none-too-sexy groin pull. Protect your hinges with regular conditioning. Beefcakes, don’t forget to stretch before your nightly gym strut. And if you tweak a joint or muscle, remember the acronym PRICE: Protect (with a splint or pad), Restrict activity or Rest, Ice and Ibuprofen, Compression (as in an ACE bandage), and Elevation. Seek medical care for more severe injuries that don’t respond to PRICE.
• More websites! All these sites are prescreened by yours truly so you don’t waste hours hunting through Google sludge. Visit nlm.nih.gov/
Whitny Doyle is a registered nurse and family nurse practitioner graduate student. She writes the Miss Diagnosis health column for the Alibi . Her articles are not intended to prevent, diagnose or treat any diseases.
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