The male exam. What is the purpose of the male exam? It should incorporate evidenced-based guidelines, focus on prevention and health care promotion, ask about substance abuse, sexually transmitted diseases, diet, exercise, safety and depression screen.
Men aged 50-74 are doing poorer health wise than in the past. This is often due to self-imposed factors: substance abuse (tobacco, alcohol, or drugs) and not being safe.
Your physician should be a support system for you and should help with depression intervention.
In fact, well men often do not come in to see a physician. So, a physician’s should address possible depression.
What screenings should be done?
1. Blood pressure. The bp goal is less than 135/85,
2. Cholesterol screen (if older than 35),
3. Abdominal aortic aneurysm. An ultrasound of the abdomen is warranted for men aged 65-75 if they have ever (!) smoked.
4. Prostate cancer. Should you have PSA screening? There is insufficient evidence to screen for prostate cancer with a PSA lab test. You and your doctor should talk about should YOU be tested. If the patient has BPH with increasing symptoms or a strong family history of prostate cancer, this may be a warranted lab test. We also have to consider how good are the treatments?
5. Colon cancer. Should you have colorectal screening? Yes! If you are between 50 and 75 years of age. Colonoscopy is the gold standard (meaning the best test).
6. Lung cancer. Low dose CT scan of lung, if you have a 30 pack year history of smoking and you are between the ages of 55-80.
We no longer screen for testicular cancer and COPD. Although, patients should know their bodies… if they feel a lump on their testicle or have lung issues, tell your physician for an appropriate work up.
Physicians should Ask about safety issues: helmet use (motorcycle and bicycle and horseback riding), gun use (store guns and ammunition separately in locked safes), risky behavior including drugs, tobacco and alcohol.
And, obesity. 35% of men older than 50 are obese. Obesity is considered a BMI > 30. Want to know your BMI? https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
Alcohol intake should take in 2 drinks or less per day to maintain health. When binge drinking men should drink 4 or less drinks at a time.
Make sure you have age-appropriate vaccinations. We suggest the influenza vaccine every fall. Tdap vaccines should be given once as an adult (or if you have exposure to infants) and even though it is a needed vaccine, your insurance may not pay for it. Td should be given every 10 years. Shingrix (2 vaccines) should be given after age 50 and be prepared for needing to be on a waitlist at your pharmacy to get this. Two pneumonia vaccines should be given: one vaccine at age 65 and one at 66. Your vaccine schedule may differ from the above if you have specific risk factors. Talk to your physician.
Statistics: 48% of men do not exercise regularly. 33% are obese. 32% have 5+ alcoholic drinks at least once. 31% have hypertension. 22% of men smoke. 20% of those under age 65 do not have insurance (How do they get routine medical care?). 12% of males rate their health as “poor.”
How to be healthier?
1. Drink less than 14 drinks per week.
2. Address depression.
3. Eat a healthy diet (4 helpings of veggies, decrease sodium and saturated fat and cholesterol and sugar).
4. Decrease lifestyle risks. Exercise 30 minutes most days of the week (The goal is 150 minutes or more). Cross-training is helpful. As we age, our muscle mass decreases and so strength training is important. Balance training over the age of 70 will help you not fall (and break a hip or have a head injury.)
I hope this helps…