Men’s Health Week

Men’s Health Week is June 9-15, 2008. This provides a great opportunity to look at the issues that prevent men from being as healthy as possible and one health problem which, although probably not life-threatening, certainly keeps men from enjoying life to the fullest.

Why do men, on average, live 5.3 years less than women? Men die from heart disease at nearly twice the rate of women and from suicide and other violence-related deaths at four times the rate of women. A study conducted in 2000 reported that while eight percent of women had not seen a doctor in the previous year, 24 percent of men had not seen a doctor in the same period. In addition, when men seek health care, they are more likely to go to an emergency room or clinic rather than to a doctor who knows them and their health histories well. Twenty-one percent of men do not have a regular source of health care, compared to 11 percent of women.

Twenty-four percent of men currently smoke (compared to 18 percent of women) and 70 percent of men are overweight (compared to 62 percent of women). Furthermore, men are more likely to have an unhealthy body fat distribution around the abdomen (apple-shape) than women, who tend to accumulate fat around the hips (pear-shape). Experts do not agree on why men don’t live as long as women do, but by recognizing threats to your good health and reducing your risks, you can take steps to avoid the leading causes of death.

On another note – according to a study of men over 50, low testosterone levels may lead to a 33 percent greater risk of death. Testosterone levels normally decline with age, and as many as five million American men may have low levels. Some men with low testosterone levels have symptoms including low sex drive, erectile dysfunction, bone loss or fracture and vague symptoms including sleep disturbance, hot flashes, depression, lethargy and fatigue. One study found that three to seven percent of men under age 70 and almost 20 percent of men over age 70 have symptomatic testosterone deficiency. These symptoms may be corrected by taking a testosterone supplement. Many men with symptomatic low testosterone levels report that supplements restore sexual function and muscle strength and increase their sense of well-being. The supplements can also prevent bone loss. However, the supplement itself has some unappealing side effects including sleep apnea, balding, acne, breast enlargement and perhaps increased prostate disease, including cancer.

Testosterone deficiency can be diagnosed by your doctor after a careful history and physical exam. These results may lead him or her to order simple blood tests – including total testosterone, LH and FSH. In some situations, including obesity and old age, a free testosterone level might also be checked. In men suspected of having low testosterone levels who are also being evaluated for infertility, a semen analysis should be performed.
Interestingly, only about half of men with low testosterone levels actually have symptoms. Are these men in any danger and should they be treated with supplementation? Men with a testosterone deficiency have a higher risk of the metabolic syndrome – characterized by abdominal obesity, high blood pressure and insulin resistance – that increases the odds of developing diabetes and coronary artery disease. A recent British study suggests that men who have higher naturally occurring levels of testosterone are protected from fatal heart attacks and strokes. Unfortunately, although testosterone therapy can restore your blood levels to normal, there is no evidence that a higher level of testosterone from artificial sources can help you live longer.

Dr. McMahon, a graduate of Yale University and the University of Pittsburgh School of Medicine, is board-certified in Internal Medicine. She is a member of the American College of Physicians and the Allegheny and Pennsylvania Medical Societies. She is in solo practice in the North Hills.