Northwest Health | SPRING 2007 By Linda Thomas

What inspires most men to go to the doctor? Is it 1) a keen interest in preventive care, 2) worrisome symptoms, or 3) a loved one who practically drags them there, kicking and screaming?

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The answer is "3," says Tony Posch, MD, a family physician at the Group Health Renton Medical Center. In fact, some men admit that their mother or partner often makes their doctor appointments for them. "Even when men know they have a medical problem, they usually don't see a doctor unless they have someone in their life, often a woman, urging them to make — and keep — the appointment," says Dr. Posch.

The rate of women's visits to a doctor, not including pregnancy-related appointments, is 56 percent higher than the rate for men, according to the Centers for Disease Control and Prevention (CDC). Women are also more likely to talk to their friends about medical issues, read health magazines, and watch health-related TV programs.

"A man who's watching a baseball game with a male friend isn't going to pipe up and say, 'My blood pressure is mildly high and I think I should get my lipids checked. Have you had yours checked lately?' That's not going to happen," says Group Health Poulsbo Medical Center's Jeff Brodie, MD, a family physician.

If you're a man, do you know enough about men's health issues to steer clear of major pitfalls? And women, do you know enough to de­cide when to prod your husband, son, or grandson to see a doctor? Check your knowledge with this Q & A.

Test Your Knowledge
If you're a man, do you know enough about men's health issues to steer clear of major pitfalls?

When should a man go to the doctor immediately?
When he has persistent pain, or bleeding from some unusual place. "These are signs that something is out of whack," says Brian Budenholzer, MD, a family physician at South Regal Medical Center in Spokane. For example, pain that starts around your navel may be a sign of an inflamed appendix. Blood in the urine may signal a kidney infection or an inflammation of the prostate. Blood in the stool may be a symptom of colorectal cancer, which generally affects men over the age of 50.

"Men shouldn't experience any bleeding unless there's an obvious reason for it, such as a cut," says Dr. Buden­holzer. "The earlier we discover the reason for bleeding or pain, the easier the treatment probably will be."

Why are brushing and flossing your teeth so important?
Being loyal to your oral health helps fend off periodontal disease, which can cause inflammation in the arteries and hamper blood flow to the heart. People with periodontal disease are more likely to suffer a stroke or a fatal heart attack. Dentists say you don't have to floss all your teeth — just the ones you want to keep.

Who's at highest risk of sexually transmitted diseases (STDs)?
People aged 15 to 24. The CDC estimates that 19 million new STD infections occur every year, and almost half are among young people. Chlamydia, genital herpes, gonorrhea, and syphilis are just a few of the more than 20 known STDs.

"Ask a new sex partner if she or he has an STD, or has been exposed to one. This can be awkward, so ask your doctor how to do it tactfully," says Dr. Budenholzer. "Don't have sex with anyone who has symptoms — such as genital rashes, sores, or discharge. Use condoms at least until you're in a committed relationship that you expect will be monogamous — and use a new condom every time you have intercourse." Most STDs can be treated with medication, and some can be cured.

Which are the biggest health threats for men under age 45?
While cancer and heart disease are leading killers for men over age 45, younger guys are more likely to die from accidents caused by macho, daredevil behavior.

"Men in their early 20s think they're invincible, and they do things that guys in their 40s and 50s have figured out aren't too smart," explains Dr. Budenholzer. Men are at least twice as likely as women to die in a car accident. They account for 80 percent of drowning deaths. They're victims of 92 percent of workplace deaths, and have a greater chance of becoming homicide victims.

The solution is pretty much common sense: Take time to think about the consequences of your actions before you do something risky. Make your health and longevity a priority, rather than getting caught up in the thrill of the moment.

Which are the biggest health threats for men under age 45?
Testicular cancer — the disease Lance Armstrong, seven-time Tour de France cycling champion, suffered from. It's one of the most curable forms of cancer, according to the National Cancer Institute, but it needs to be diagnosed at an early stage.

"Lance Armstrong was probably so busy with his life that he ignored the symptoms," says Dr. Brodie. "He ended up having to go through radiation and chemotherapy, but it doesn't have to be that way."

The first sign of testicular cancer can be a slight enlargement of one of the testes. There also may be a feeling of heaviness in the testicles, and possibly a dull ache in the lower abdomen or groin. So check your testicles periodically. Feel for any changes in size or weight, and make sure there are no visible changes. If there are, it's time to see your doctor — and don't drag your heels about it.

What's wrong with having belly fat?
That excess fat you can grab around your middle is a sign of visceral fat — which is part of the omentum, a drape of tissue that hangs down from the intestines. If there's too much of it, it presses on the kidneys and releases hormones that increase blood pressure. High blood pressure (hypertension) is one of the leading risk factors for heart disease. And heart disease is the top cause of death for both men and women over age 40, according to the American Heart Association.

"My number one concern for patients is their cardiovascular health," says Dr. Brodie. "The best case I can make for men to see their physician periodically is to identify risk factors and catch problems early." Daily exercise and some moderate weight loss — even 10 or 15 pounds — usually shrinks a big belly fairly quickly.

Is depression a serious disorder for men?
Yes — especially since men are less likely than women to admit to some of the symptoms of depression, such as feelings of sadness, worthlessness, and guilt. Depression is a brain disorder that impacts your body and moods.

Other symptoms include loss of interest in favorite activities; restlessness, irritability, or anger; changes in appetite or sleeping habits; persistent physical pain, such as headaches or digestive disorders; difficulty concentrating; and thoughts of suicide. Talk to your personal physician right away if you have any of these symptoms for more than a couple of weeks.

The good news, says Greg Simon, MD, MPH, a psychiatrist and Center for Health Studies researcher, is that the stigma related to depression is decreasing.

"Now the challenge is getting patients to stick with treatment," he says. "About one-third of people stop using their medication, either because they don't like the drug's side effects or they start to feel better. The same holds true for counseling. One-third of those who enter counseling programs don't return for a second visit."

Online Tools
Sometimes you need to see your doctor. Other times, Group Health's online services can help you get solid health information without leaving your computer. For example:

Our new Health Profile on MyGroupHealth includes a health assessment questionnaire you can fill out online. After you submit it, you'll get a personalized report that assesses your risks in various health categories. You'll also get links to articles and self-management resources on each topic, and a phone number to access 24/7 healthy lifestyle coaching.

If you receive care at a Group Health-operated facility, you can exchange secure e-mail messages with your personal physician or the Consulting Nurse Service, view your online medical record and lab results, and request doctor appointments. Read about these enhanced services.

The Healthwise® Knowledgebase provides reliable information about more than 5,000 health topics. It also gives you details on tests and exams for medical conditions, prescription and nonprescription drugs, complementary and alternative medicine, and self-help and support groups.