June is Men's Health month. Dr. William Strohman is here with some common-sense, big-picture areas to focus on for men who want to make sure they expand not only their lifespan, but also their healthspan.

As June is Men’s Health month, I’d like to briefly discuss some of the more common male health issues to be aware of. While we can't prevent every single event, we can do our best to mitigate your statistical chance of these, and much of that starts with education and awareness. 

I see many patients on the other side of 'the diagnosis' – after a cancer diagnosis, in the weeks following a sudden heart attack, or days after having a stroke. 

Routinely, everyone says: I wish I would have done this [insert behavior/habit] differently.

Whether it’s something they realize now they should’ve done more, or something they should’ve done much less. 

Seeing these patients, and hearing these statements thousands of times makes me ponder my own health, while at the same time giving me a unique perspective on my habits and routine. 

So, in honor of men's health month, I encourage you to take the first step and come back into the office. Complete that study I recommended you to do six months ago, seek immediate care if you are having chest pain (because it's not always the Taco Bell you had last night), and stop procrastinating on starting that exercise program or dietary changes you've been thinking about. 

Now is the time.

Now, I’ll dive into some of the more common male issues I encounter on a monthly basis.

Low Testosterone

I wish it were as simple as having a blood test, discovering a low or low-normal testosterone, and then going on medication to improve it. Unfortunately, it is not that simple. There are reasons for low testosterone that we must investigate first like sleep apnea, pituitary tumors, medications, and patterns of sleep. It is only after this investigation that we consider treatments. 

From many studies I've reviewed, moving from a low-normal testosterone level to a high-normal level didn't have a significant effect on erections, mood, or energy. However, we must be careful with our path forward, as testosterone can raise one's risk of clots for the first 3-6 months of treatment.

Prostate Cancer

Unfortunately, most men, at some point in life, will develop prostate cancer - but most of those men will die with it (and likely die of something else).

Regardless, given its prevalence, we have good methods to catch it early. I highly recommend PSA blood screening tests starting at 50 years old for average risk OR starting 40-45 years old if strong Family history, Black, or BRCA carrier status.

Mood/Depression

I'd just like to say - if you find you’re more irritable than usual, things are bothering you more than in the past, you're quick to anger or more than one person has asked you, "are you OK" -  please come into the office. 

Together we can review your overall mental health and how your physical health may be impacting it. Mental health can affect your overall happiness and aggravate a number of other serious health issues like heart disease and dementia.

The Big 4

Moving on from the male-only reasons I was focusing on, I'd like to review The Big 4. 

While the Four Horsemen of the Apocalypse in the book of Revelation in the Bible represent different aspects of the end times. (traditionally interpreted as symbolizing conquest, war, famine, and death), the Big 4 of health are the four most prominent causes of death in humans. 

This includes: Heart Attack, Stroke, Cancer and Dementia.

Because of their prevalence, we should dedicate the most time, effort, and resources to preventing and mitigating our risks of these.

Prevention & Overall Men’s Health & Well-Being

While it’s important for you to be familiar with the most common conditions and causes of death, as a man of science and statistics, and a doctor trying to extend not only your lifespan but possibly more so your healthspan, it would be irresponsible to not also mention the most impactful way to influence and prevent these conditions. 

Which brings me to my final point: moderation is the KEY to life.

And, anything done in excess can hurt you.

I find myself returning to these several basic points of advice in most of the education I provide my patients:

1. Stop Smoking - This is the only one I don't want moderation. YOU NEED TO QUIT. Hopefully you never picked it up but if you did – my #1 advice point – take ANY means to quit. The damage smoking does to your body is immense and raises risks of heart attacks, strokes and cancer!
   
   We can agree that McDonald's is bad for us - especially after The SuperSize Me movie. So, I pose this question to you: Would you eat this EVERY DAY? I'd venture that 99% of you smokers would say no, but yet choose to smoke cigarettes daily. Consider these examples to legitimize usage of smoking and alcohol.
   
   
2. Limit Alcohol – Sure, it's fun to have some drinks with friends but if there is one thing in America that we overdo, it's this. The heart healthy observations about alcohol related to reduction in heart disease is now well proven to be wrong.
   
   I've started going into more detail at my general annuals with patients on the recreational drugs we use. It surprises most of my patients to learn that alcohol is a major carcinogen (the body’s attempted breakdown of the product acetaldehyde is another carcinogen - so a double hit!).  Even low to moderate alcohol use (< 7 drinks for females) can cause some neurodegeneration, which in the end can cause dementia. The ways in which alcohol promotes cancer development are complex and can include DNA damage, increased production of harmful metabolites, disruption of normal hormone regulation, and impaired immune function. Please review with your provider to review these risks.
   
   Reducing alcohol intake offers benefits that positively impact both physical and mental well-being, including reducing the risk of various alcohol-related diseases such as liver damage, heart disease, and certain types of cancer
   
   
3. Get in Daily Exercise / Movement - You don't have to perform intense exercise seven days a week to make an impact. There are a number of studies that show we should do a few things. For example, just 50 minutes of walking per week reduces all-cause mortality by 20%.
   
   So, to start, focus on some aerobics, some resistance or weights and some flexibility.
   
   Think of exercise as training to be 80 years old. What do you want to be able to do at 80? Likely you’ll want to be able to walk around, lift up your grandchild, or travel and handle your baggage. 
   
   In addition, regular physical activity helps maintain a healthy weight, strengthens muscles and bones, improves cardiovascular health, boosts energy levels, enhances mood, reduces the risk of chronic diseases and has been shown to alleviate symptoms of depression and anxiety, promoting better mental health.
   
   
4. Make Heart-Healthy Dietary Decisions – Consider a whole food, mostly plant based diet. I’m not pushing veganism, but rather that you think of your dinner plate as a circle or pie chart, you should be filling your plate up with veggies, grains and a small portion of meat. Another means is to incorporate vegetarian meals during the week.
   
   
5. Connectedness - The most important predictor of human happiness and longevity is having strong social connections and a sense that you are giving back to your community. Consider volunteering, joining a spiritual group, or meditating. These tend to ground you and give you a larger sense of yourself.
   
   Consider too, that it's not about the volume of friends, but the quality of your friends. You should leave a social gathering or dinner and feel like your 'friend' lifted you up or is moving you in a positive direction. In contrast, if you consistently leave lunch a little more depressed or morose- maybe reconsider hanging out with them.

While men’s health is at the forefront of our mind (being Men’s Health month), truly most of the items discussed here - and recommendations provided - are ‘human health’ for all individuals to consider.

If you take anything away from this article – it's to pay attention to moderation – it is likely the most impactful way to positively influence your health and prevent some of the most common men’s health conditions.