Men's Health

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    A , Internal Medicine, answered
    What can men do to feel happier, less stressed out and less anxious?
    Getting annual physicals, regular exercise, and enjoying quality time at home are all ways men can lower their stress levels. Watch men's health and HIV/AIDS specialist Frank Spinelli, MD, discuss how men can feel happier in their daily lives.
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    A Internal Medicine, answered on behalf of
    According to the U.S. Centers for Disease Control and Prevention, men die at higher rates than women from the top 10 causes of death: heart disease, cancer, chronic lower respiratory diseases, unintentional injuries, stroke, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease and suicide. Research suggests that adopting the following healthy habits can do wonders for a man’s overall health:
    • consuming a diet rich in fish, whole grains, fruits and vegetables
    • eliminating sources of sugar in his diet, including soda
    • starting an exercise program to improve cardiovascular health
    • commiting to quit unhealthy habits like smoking and excessive alcohol consumption
    • making time for regular check-ups with a primary care doctor
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    A , Plastic Surgery, answered
    Many drugs cause male breast growth, technically called gynecomastia: hormones for prostate cancer, prescription drugs such as spironolactone and Propecia (finasteride), the antifungal ketoconazole, digoxin, lovastatin, verapamil, cimetidine, respirodone, methyldopa, melatonin, and the acquired immunodeficiency syndrome (AIDS) drug efavirenz. Marijuana and anabolic steroids are notorious for causing breast growth; half of steroid users develop gynecomastia.
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    The most common causes of gynecomastia are nonorganic, including psychiatric medications, alcohol and illicit drugs, such as marijuana. Your healthcare provider will first try to determine if you are being prescribed a medication or taking a substance related to gynecomastia. Medical causes of gynecomastia are liver disorders, thyroid disease and pituitary tumors. Your doctor can order lab tests to determine if any of these conditions are present.
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    A , Plastic Surgery, answered
    Breast growth in men is more common than one might expect. It is a hidden, embarrassing deformity. Men with large breasts wear shirts all the time, even on the beach. About 18,000 men underwent surgery to reduce the size of their breasts in 2005.
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    To test for andropause, or low testosterone, a man should get a total testosterone level, which should include the serum-free testosterone and protein-bound testosterone. Generally normal values are between 300-800. If your testosterone level is low, then further work up may be indicated to identify if the problem is in the Leydig cells that produce testosterone, or the cells in your brain that produce hormones to activate the Leydig cells.
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    When it comes to healthcare, men often find themselves short-changed: They die more often of cardiovascular disease and cancer. Men are also less likely to approach a physician with their concerns than women. It is therefore not at all surprising that men live on average about 6 years less than women.

    The novel concept of men's wellness intends to reach beyond the classic definition of men's health and views the male patient as a whole. Breaking from the tradition where a urologist treated a man solely for urological conditions, we have realized that problems such as erectile dysfunction or low testosterone are related to matters that affect the entire body. Patients with heart attacks, for instance, report that they started noticing erectile dysfunction about three years before they started having chest pain. Patients with low testosterone find themselves at high risk for developing diabetes, heart disease and brittle bones.

    Looking beyond a list of symptoms and ailments, our physicians individualize your health care treatment, taking into account a man’s physical and emotional wellbeing before prescribing any treatment.

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    A , Endocrinology Diabetes & Metabolism, answered

    Many factors can cause testosterone levels to decline. Before starting long-term testosterone replacement, a man should be carefully evaluated to determine the cause of his low testosterone. Pituitary or brain tumors can result in low testosterone and these may require surgery or other drugs. Failure to recognize this serious condition could be life threatening.

    Prescription drugs may interfere with sexual function and reduce testosterone levels. Other less serious but treatable causes can include nutritional factors, stress, insomnia and other life-style issues. However, the good news is that when these are recognized and treated, testosterone may normalize without the need for testosterone treatment. The goal should be to enable a man to produce his own testosterone.

    Viagra is a useful drug, which offers men an effective way to treat erectile dysfunction. However, erectile dysfunction is one of the key symptoms for low testosterone. Taking Viagra without undergoing endocrine evaluation could delay detection of a potentially treatable condition. Appropriate hormone treatment could eliminate the need for Viagra and enable the man to have normal sexual function.

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    Male menopause, or testosterone deficiency, can occur in men as they age. There are multiple symptoms that someone with this deficiency can develop, but they will not be the same for everyone. Some of the more common symptoms of testosterone deficiency are fatigue, sexual dysfunction or reduced libido, loss of muscle mass and strength with concurrent increase in fatty tissue, mood changes, depression and decreased bone density (increased risk of fractures). Although this is often considered a normal part of aging, it is recommended that you speak with your primary care doctor if you are having these symptoms or are concerned about male menopause.
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