Kwame Akoto, MD, is a board-certified family medicine physician with the Mid-Atlantic Permanente Medical Group. He also is the incoming chair of Primary Care Clinical Programs.
Men’s Health Month is a good reminder of something many men already know but too often ignore: It’s time to stop putting off the doctor’s visit.
Men tend to delay care. In fact, men are about 25% to 30% less likely than women to seek preventive care or come in for an annual checkup. That delay has consequences. On average, men in the United States live five years less than women and experience higher rates of heart attack, stroke, kidney failure, and complications from chronic disease.
Why does this happen?
Some of it is cultural. Men are often encouraged to “tough it out” or put their own health last. Some of it is fear, not wanting to get a potentially scary diagnosis. And some of it is time. Work, family and other responsibilities take priority, and symptoms get brushed aside with the hope they’ll go away.
This Men’s Health Month, I encourage men to take care of themselves. And if you’re going to the doctor, here is a guide for what to discuss.
Heart Health and Your Long-Term Risk
Cardiovascular disease remains one of the leading threats to men’s health.
We now start assessing heart health much earlier than we used to. Blood pressure checks should begin at age 19, and cholesterol should be assessed regularly, typically every four to six years, or more often depending on your health.
Today, tools such as the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) calculator allow us to estimate your 10-year and 30-year risk of a cardiovascular event such as a heart attack or stroke. The calculation takes into account age, blood pressure, cholesterol, diabetes, smoking history, kidney function, body mass index and medication use. Using the calculator helps us identify risk early enough to do something about it. That might mean lifestyle changes, such as better diet, more activity and improved sleep. We may prescribe medications. The earlier we act, the better the long-term outcome.
Prostate Health and Cancer Screening
Prostate cancer screening is not one-size-fits-all. It’s a conversation that should be a shared decision between you and your doctor.
For men at average risk, discussions about screening typically begin around age 50. But for higher-risk individuals, including Black men or those with a strong family history, those conversations may start earlier, sometimes between ages 40 and 45. The primary screening tool for prostate cancer is a PSA (prostate-specific antigen) blood test.
If you’re experiencing urinary changes, such as urgency, frequent nighttime urination, difficulty emptying your bladder, weak stream, or dribbling, talk with your doctor. They could be a sign of prostate cancer or another health condition.
If you ever notice blood in your urine, tell your doctor immediately.
Urinary Changes and Bladder Health
Even outside of cancer concerns, urinary symptoms are common in men. Changes to watch for include:
- Waking up multiple times at night to urinate
- Feeling like you’re not fully emptying your bladder
- Increased frequency beyond your normal baseline
- Leakage or incontinence
- A weaker or split urine stream
If something feels different, bring it up.
Sexual Health
This is one of the most difficult topics for many men to discuss but also one of the most important.
Sexual health issues are common, and they’re nothing to be embarrassed about. As doctors, we’re not here to judge; we’re here to help. But we can only help if we know what’s going on.
Erectile dysfunction, for example, is a quality-of-life issue and can sometimes be an early warning sign of underlying conditions including vascular disease or diabetes. It can affect up to 40 percent of men by age 40. Changes in sexual function, including difficulty maintaining erections or a noticeable decrease in morning erections, can signal broader health concerns.
Sexual performance issues don’t necessarily reflect attraction or emotional connection. Physical, psychological and hormonal factors all play a role.
If something has changed, tell your doctor in a simple, honest and straightforward conversation.
Testosterone and Hormonal Health
Testosterone levels naturally decline with age. Starting around age 30, levels drop about 1% to 2% per year. But sometimes the changes are more pronounced.
Symptoms that may suggest low testosterone include:
- Persistent fatigue
- Reduced libido
- Depressed mood or loss of motivation
- Difficulty maintaining muscle mass or increased body fat
However, low testosterone is not always the root problem. Conditions such as obesity, diabetes, sleep apnea, and even certain medications can contribute to lower levels.
That’s why talking to your doctor is important. Diagnosing low testosterone typically requires more than one test done under the right conditions. Often, addressing underlying lifestyle or medical issues can improve levels naturally; in some cases, testosterone replacement therapy may be needed.
Mental Health and Emotional Well-Being
Mental health remains one of the most overlooked areas for men.
Symptoms of a mental health condition to watch for include:
- Persistent fatigue or lack of energy
- Loss of interest in activities you once enjoyed
- Changes in appetite
- Trouble sleeping or non-restorative sleep
- Increased irritability or mood swings
Major life events such as job changes, death of a loved one, relationship challenges, or new health concerns can also take a toll.
Many medical practices use screening tools, such as brief questionnaires that help identify depression or other concerns. These tools provide a starting point, but opening up to your doctor is vital in addressing mental health concerns.
Memory and Cognitive Changes
As we age, some degree of forgetfulness can be normal, but noticeable changes in memory or thinking should be discussed with a doctor.
Screening for cognitive health typically begins around age 65, but issues can show up earlier, especially if there are underlying risk factors such as diabetes, high blood pressure, smoking or certain infections or nutritional deficiencies.
Often, family members notice memory changes first. They may notice you are regularly misplacing items, missing appointments or repeating questions. If someone close to you expresses concern, take them seriously and talk to your doctor.
Simple screening tools can be done quickly in the office and provide a helpful baseline.
The Bottom Line
Too many men delay care until symptoms become severe or disruptive. But many medical conditions are more manageable when caught early. So make yourself a promise this Men’s Health Month: Make an appointment with your doctor and take care of yourself.
Feature image, stock.adobe.com
