Three of the Most Misunderstood Health Issues for Men

Internal medicine physician Sam Fellin, D.O., clears up a few things about:

  • One health concern that most men seriously underestimate
  • One test that every man should discuss with his doctor
  • One health issue that may not be as big a threat as men are led to believe

One health concern you may have underestimated

Think of all the men you know – your good friends, your family members, the guys you work with. Now imagine half of them developing heart disease. Devastating, isn't it? And yet, statistically, that's what will happen. Heart disease is a much more serious and prevalent problem than most men understand. Fifty percent of all men eventually develop some form of it. Will you be one of the men who does, or doesn't?

That may sound like a rhetorical question, but you actually have a lot of power to influence the answer. Why? Because most of the things that cause heart disease are within your control. Smoking, being overweight, having high cholesterol, high blood pressure or high blood sugar – you can do something about all of these. If they get out of control, they increase your risk, and the more that apply, the higher the chances that you'll end up with heart disease.

Here are three ways to improve your odds:

  1. Don't smoke. If you smoke, the most powerful thing you can do for your heart, and for your health in general, is to quit. It should be your first priority over everything else. Get help quitting.
  2. Get a checkup. If you're older than 30 and it's been more than a year since you last saw your primary care provider, make an appointment to get your cholesterol, blood sugar and blood pressure checked. All of these can be elevated without your knowing it; all increase your heart risks when they are elevated; all are controllable, and all are easy to check.
  3. Go for a quick walk every day. Exercise is essential to both weight management and heart health, and you don't have to become a gym rat to see benefits. Studies show that aerobic exercise, such as brisk walking, can improve the condition of the heart in as little as 20 to 30 minutes a day. This is really important to your heart. Make the time.

One health test that you should discuss with your doctor

We've all heard about men whose lives were saved by a PSA (prostate-specific antigen) test or a digital rectal exam that discovered prostate cancer. But we've also heard about men who've had false positives or false negatives from tests and biopsies. And we've read about studies showing that screening makes no difference in the overall risk of dying from prostate cancer, or that it spurs unnecessary treatment for small, slow-growing cancers that would not have affected a man's life anyway. Trying to sort through all the conflicting data and recommendations surrounding prostate cancer screening is frustrating enough to prompt any man ready to forget the whole thing. But we know that screening does offer some benefits, to some men. So what do you do?

Only one recommendation has universal support: talk to your doctor about whether or not prostate cancer screening is right for you. Do you have risk factors for prostate cancer? Does it run in your family? Should you be one of the men who gets screened more frequently, or less, or not at all? These are questions that every man should discuss with his primary care provider. If you don't have the talk, you can't make an informed decision.

One health issue that may not be as big a threat as you thought

If the pages and pages of advertisements are to be believed, low testosterone is a threat to every man, and hormone replacement therapy is the miracle cure. Well, not so fast. Here's what you really need to know.

All men experience a decline in testosterone levels as they age – that's just natural, and in most cases, it doesn't cause problems and doesn't require medication to correct. Most men do not need to have their testosterone levels checked. The exceptions are those who are experiencing significant symptoms that suggest serious declines. These symptoms may include the following:

  • Sexual dysfunction
  • Low bone mineral density (a risk for osteoporosis)
  • Increased body fat
  • Decreased muscle strength
  • Psychological changes or depressed mood
  • Decreased cognitive function
  • Metabolic syndrome (a combination of obesity in the belly, high insulin levels and high blood pressure)
  • Unusual fatigue

If you have any of these symptoms, they may be markers for low testosterone, or they may be signs of an unrelated health problem, or they could just be the results of an inactive lifestyle. In any case, they should be checked out with your physician. If low testosterone is the culprit, then hormone replacement may help, but proceed with caution. Surprisingly little research has been done to demonstrate the benefits or to define the risks of treatment. Potential risks of testosterone replacement may include enlargement of the prostate, sleep apnea, and increased red blood cell count, which can lead to heart problems. There are a lot of unknowns, so if you choose to try hormone replacement therapy, make sure that your doctor monitors you closely.


Is there a men's health issue you'd like to understand better? Our online Men's Health Library provides clear information on many health issues, medical tests and medications related to men's health.


Internal medicine physician Sam Fellin, D.O., sees patients at Providence Medical Group-Scholls.