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"You have turned my life around"
 

I am 87 years old, with a problem of the prostate gland. Before I met Dr. Baum, I went to the bathroom every 30-60 minutes. After Dr. Baum's treatment on my prostate, I go only 5 times per day and only 1 time at night! You turned my life around. I am so very grateful!

-Sidney Daigle


I want to thank you for your due diligence. You saved my life. I highly recommend you!

-Dwight Bastian


Thank you Dr. Baum! Because of you I'm back in the "rodeo"!

-Gerald Wallace

 


From the beginning of medical history, men were studies as the basis of disease and pathology. Over the past decade, the healthcare community has begun to pay increasing attention to women's health, resulting insignificant clinical findings and exposing and correcting gender-related differences in health service delivery.

There remains a striking disparity in life-expectancy and susceptibility to certain diseases between men and women and an opportunity to improving the health of men. The average life expectancy at birth in 2001 in the United States was 74.4 years for men and 79.8 years for women.(Duncan AK, Hays JT. The development of a men's health center at an integrated academic health center. JMHG, 2005;2(1)17-20) Although the life expectancy gap between men and women has gradually fallen over several decades, it remains at approximately 5 years and warrants better understanding. Men are less likely to seek healthcare services. In 2001, the US National Ambulatory Medical Care Survey reported 520,110 outpatient visits made by women, compared with only 360,377 by men. When men do seek care, the visits are often shorted than those for women, show less relationship building between patient and doctor, and receive less prevention advice. (National Center for Health Statistics. National Ambulatory Medical Care Survey. http://www.cde.gov//nchs/about/ahcd/ahcd1.html. December 2004) Other contributors to a decrease in life-expectancy include the fact that men smoke and drink more than women. Unfortunately, some men define themselves by their work, which can add to stress.

The purpose of this article is to highlight some of the major health care problems affecting men: cardiovascular disease, cancer, obesity, and depression. I want to emphasize the economics and the politics behind these medical conditions that are so common in men and yet aren't receiving the attention they deserve in the government, the media, and within the entire healthcare system.

It has been the rule that women control the healthcare system in America. Women not only make decisions for themselves but also for their male partners or significant others. Unfortunately, most men have an attitude of "if it ain't broke, don't fix it." This may apply to servicing a man's automobile but has very little to do with the health and well being of their bodies.

Cardiovascular disease and Erectile Dysfunction

The death rate from coronary heart disease is greater for men than for women, 222.4 versus 135.8 per 100,000 respectively. The rate for acute myocardial infarction is 99.7 for men versus 58.8 per 100,000 women. (http://www.americanheart.org/statistics/index.html) Men also develop CVDs approximately 10-15 years earlier than women and these result in a shorter life expectancy for men.

The risk factors for CVD are well known and include tobacco use, hypertension, dyslipidemia, diabetes mellitus, obesity, lack of exercise, excessive use of alcohol, and exposure to increased stress levels. Recently a new risk factor has been added to the list and that is erectile dysfunction. Several studies have identified that men who have diagnosed cardiovascular disease had a history of erectile dysfunction that often antedated their myocardial infarction by two years. (Greenstein A, Chen J, Miller J, et al.. Does severity of ischaemic coronary heart disease correlate with erectile dysfunction?. Int J Impot Res. 1997;9:123-126) This explanation has been explained by on basis of the size of the vessels supplying each organ or tissue. The coronary arteries are 4-6 mm in diameter and the blood supply to the penis via the deep cavernosal vessels are 1-2mm in diameter. Therefore, any disease process that affects the endothelium is likely to cause symptoms in the smaller vessels that supply the corporal bodies of the penis than in the larger coronary arteries. This situation is an opportunity for physicians to detect occult or early cardiovascular disease by asking men about their sexual functioning and if they have ED and have risk factors for CVD, then a more extensive workup including stress testing would be in order.

In Western societies, increasing blood pressure parallels advancing age; hypertension is estimated to exist in 60% to 70% of the population aged >60 years. Although hypertension is preventable or controllable with drugs, it is often asymptomatic. Thus, only 36% of people may be aware that they have the disease, and of these diagnosed individuals, only 25% actually receive treatment. (Petrie J, Kirby M. Too much of a good thing. Br J Diabetes and Vasc Dis. 2004;4:365-368)

Certain lifestyle modifications may be helpful in preventing or controlling hypertension. Such measures should include weight reduction; reduction of dietary sodium intake; dietary inclusion of foods rich in potassium, such as fruit and vegetables; taking 30 minutes of aerobic physical activity 4 to 5 times per week; and moderating alcohol consumption. It is suggested that physicians take a more active role in motivating their male patients to lead healthy lifestyles and engage in activities that likely to reduce the risk of CVD.

Depression in Men

In 2007 nearly 6 million American men will be diagnosed with depression. However, that is only the tip of the iceberg as millions of American men suffer in silence and they are unaware that they have a problem or unaware that an effective treatment is available for most men who suffer from depression. The failure to recognize and treat depression has huge economic consequences with a loss of productivity in adults approaching nearly $100 billion annually. There are also health consequences of not treating depression in men. Depression has been linked to heart disease, heart attacks and strokes. These medical conditions may occur more commonly in men with depression and may occur at a younger age than in women. Men with depression and heart disease are two to three times more likely to die than men with heart disease who are not depressed. The suicide rate, which has been known to be related to preexisting depression, occurs four or more times the rate of women. Finally, the impact of depression also extends to the children of depressed parents. Adult children of depressed parents also have five times the rate of cardiovascular disease.

So what can the medical profession do about conquering depression in men; a common problem that can be easily diagnosed and effectively treated? Doctors need to recognize how prevalent the problem is in men and to look for signs of depression in men. These include feeling irritable or angry every day, losing interest in pleasurable activities or hobbies, abusing drugs or alcohol, withdrawing from family and friends, losing interest in work or school, eating too much or too little, and sleeping too much or suffering from insomnia. Then doctors need to initiate therapy including counseling if necessary.

Prostate Health and Prostate Cancer Screening

Benign prostatic hyperplasia (BPH) is the most common urologic disorder in men and is likely to be experienced at some point by most men reaching average life expectancy. (ref) With aging, the prostate increases in size, and degenerative changes occur in the bladder; together these cause lower urinary tract symptoms (LUTS), such as frequency of urination, poor force and caliber of the urinary stream and nocturia or getting up at night to urinate. Other complications can include urinary tract infections and urinary retention. Patients with LUTS who cannot be managed with lifestyle advice alone may be prescribed drugs such as Alpha-blockers to relieve their symptoms or a 5 Alpha- reductase inhibitor to delay progression. Studies have shown that sexual disorders and their bothersomeness are strongly related to both age and the severity of LUTS, i.e., the more severe the LUTS: the greater the likelihood of erectile dysfunction. Moreover, the relation between sexual disorders and LUTS appears to be independent of comorbidities such as hypertension, diabetes, increased cholesterol levels, and cardiac disease. (Rosen R, Altwein P, Boyle P, et al.. Lower urinary tract symptoms and male sexual dysfunction (the Multinational Survey of the Aging Male (MSAM-7)). Eur Urol. 2003;44:637-649)

Prostate cancer is among the most common forms of cancer affecting men in Western societies. Although the survival rate is relatively high, prostate cancer is the second most common cause of death in men in the United States after lung cancer, accounting for some 27,050 deaths per year. (American Cancer Society, 2006) and 2 million men in the United States are living with prostate cancer.

There is great controversy regarding screen for prostate cancer using the PSA test. The American Cancer Society recommends that both the PSA and DRE should be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy. Men at high risk, such as African-American men and men with a strong family history of one or more first-degree relatives diagnosed at an early age, should begin testing at age 45.

However, there is no unanimous opinion in the medical community regarding the benefits of prostate cancer screening. Those who advocate regular screening believe that finding and treating prostate cancer early offers men more treatment options with potentially fewer side effects. Those who recommend against regular screening note that because most prostate cancers grow very slowly, the side effects of treatment would likely outweigh any benefit that might be derived from detecting the cancer at a stage when it is unlikely to cause problems.

Because a decision of whether to be screened for prostate cancer is a personal decision, it's important that each man talk with his doctor about whether prostate cancer screening is right for him.

Obesity in Men

Obesity is reaching epidemic proportions in our country. The United States is the most obese nation in the world with 30.3% of the entire population considered overweight. (The World Fact Book. https://www.cia.gov/cia/publications/factbook/index.html) Women and men are about equally represented (64.5 million women, 65.1 million men) in the 129.5 million American adults who are overweight. Nearly 62 percent of women and 67 percent of men are overweight. These statistics mean that less than half of the American adult population is of a healthy weight! (National Institute of Diabetes and Digestive and Kidney Disease -- Weight-Control Information Network. (modified 2004). Statistics related to overweight and obesity.)

Obesity has been estimated to shorten lifespan by an average of 9 years. In the United States, 6% of all deaths are attributed to obesity. Overweight increases a man's risk of developing type 2 diabetes, high blood pressure, and some cancers. Obesity also causes disturbances in lipid levels. Additionally, overweight increases the likelihood of developing back pain, swelling of the legs, and osteoarthritis of the knees, hips, and ankles.

Summary

Men's health issues -- while they often overlap with women's concerns -- have unique aspects that the concerned male must understand. Physicians have a responsibility to encourage men to visit the doctor on a regular basis. Physicians need to make an effort to see that men have a positive experience with their healthcare provider so that they will be motivated to maintain their relationship with the medical profession.