Thursday, September 17, 2009

Men Want To Know




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    Since so many men are afraid to go to the doctor, and embarrassed to ask health questions in front of the women in their lives, a doctor conducted a private forum for the 330 men. So where are the women headed? The women who accompanied their husbands were upstairs in a screening room.

    "This is a no-embarrassment zone, there's no topic that's off limits, there's no question I won't answer," the doctor tells the men. "I want you to keep one memory in the back of your mind. There are three times more widows than widowers. Now why is that? Because when we're little boys and we scrape our knee, we're told to suck it in and not talk about it. We need to change that culture because there's a lot we can do for men's health."
    We're going to start with what is undoubtedly the number one topic men want to know about—the penis," The doctor says. First, he has the first man.

    "Dear Dr.: When the girl I was seeing excitedly sat on my lap, I heard a painful pop and immediately felt intense pain. I now have five scarred rings at the base of my penis. I'm unable to achieve a full erection, and when my girlfriend and I are making love, I don't feel anything. What should I do?"

    To get an answer, The doctor calls on another doctor, an anesthesiologist from Texas. "Probably the only man in America brave enough to admit that he broke his penis," Dr. says. The Doctor explains that just as he was getting ready to go fishing in 2004, his wife told him that she was ovulating and that it was time to have sex.

    "To make a long story short, we proceed. I'm not happy about it because there's no romance to it. It was just a mission that she wanted to accomplish," he says. "We get there, we started doing the intercourse and the next thing you know, I feel a pop."

    That pop, Dr. explains, was a rupture. "Imagine the penis is like a sausage. Now, if you get a running start at the person you love and you miss, you push this penis into something hard, it can crack. … So physicians will actually take a little stitch and close up that little hole that you've made."

    The doctor rushed to emergency room for surgery. Was it successful? "It was so successful that I have two kids," he says.

    Another topic many men wonder about—but are often afraid to discuss—is circumcision. The doctor says the rate of circumcision in the United States has dropped from 90 percent to 57 percent in the last 40 years.

    He says there are some reasons that circumcision makes sense—religious or family traditions, hygiene, and reduced risk of transmitting sexually transmitted diseases and viruses.

    There are reasons to not circumcise as well. Some people consider it disfiguring, and doing it will reduce sensation during sex. "In a circumcised male, the bottom part, the underneath part of the penis, is the most sensitive part," The doctor says, using a cucumber wrapped in a sock as a demonstration. "If you've not been circumcised, about half of the erogenous tissue on the penis is actually that foreskin area. Plus the foreskin covers over the glans—that front part, and that's the most sensitive part of the penis—so it doesn't get rubbed on, so it stays a little bit more preserved for when the foreskin eventually does pull back during intercourse."

    The American Academy of Pediatrics doesn't take a position on circumcision. "They say it's up to you," the doctor says.

    For boys who haven't been circumcised, it is important to learn the proper way to clean themselves. Uncircumcised boys are 10 times more likely to get an infection than those who are circumcised, Dr. Oz says.

    To do it correctly, "You pull the skin back and you can actually get under here and clean this corner out. Now these edges are where something called smegma resides, and that stuff can get pretty nasty if you don't clean it up," Dr. says. "But here's the bigger issue—as a doctor I care about this. Most guys who are uncircumcised have the foreskin leading off. This touches the pants and it gets scarred after a while. It can get pretty taut. Sometimes it goes over the tip of the penis and squeezes down on it and that can actually strangle the tip of the penis. That's called a phimosis. When we see it, that's an emergency."
    Dr. says that keeping a penis healthy isn't just important for making sure your love life is working…it's important for making sure your entire body is working. "The penis really is the dipstick of the body," he says. "The penis tells you if everything's working, because if it's not working, the odds are stuff inside of you is not functioning the way it's supposed to be."

    To know if everything's functioning, you need to know an erection works. First, arteries leading to the penis open up and they let the blood rush in and it engorges the penis. "But something else happens that is really subtle," Dr. says. "What drains the penis are these very thin veins. They get squeezed off so the penis can't let the blood come out again. That's why it gets big and hard and stays that way."

    This process is controlled by a gas called nitric oxide, which relaxes the arteries and allows the process to start…and is what all those erectile dysfunction drugs treat
    If you've watched any professional sporting event on television in the past few years, you've certainly seen an advertisement for drugs that treat erectile dysfunction. In fact, Dr. says that it is estimated that more than half of men over age 40 have had some difficulties getting or maintaining an erection at some point.

    While erectile dysfunction drugs affect nitric oxide levels, they do have some side effects. "There are issues with some of the heart drugs folks may be on," Dr. says. "And [men] ought not to use it for recreational purposes—because if everything's working down there, it's only going to be a placebo effect. And you're not going to get a bigger or a harder erection by taking it." Does a vasectomy result in a loss of testosterone and energy, or any other negative side effects?

    Vasectomies are incredibly safe and actually don't block ejaculation at all and won't cause impotence, Dr. says. Instead, the procedure prevents your body from adding sperm to your semen, making it sterile.

    The only danger, Dr. says, is "sometimes you get a little soreness from the vasectomy because they go up through the scrotum to cut it. … However, you've got to make sure your sperm count has dropped after the operation before resuming relations."


    But is there any way to prevent problems like that before they start?

    One thing that can help keep your body working is garlic, due to a chemical called allicin, which works only when it's raw. "You need something that's an antidote to [the garlic]. So parsley, for those of you who are going to try this, will actually block some of that taste," Dr. says. "Because otherwise you're not going to be close enough to anybody to figure out if it makes a difference."
    The next man is 47, has a question about urination. "I have been experiencing a decrease in flow, and when I think I'm empty, I'm not. There's always that little bit left over," he says. "Is it normal for urination patterns to change, slow down, even when at your end you need to shake off a little bit?"

    Dr. says the person is describing an enlargement of the prostate, and these symptoms generally start around age 40.

    Here's how the prostate works: Its goal is to make chemicals that mix with sperm in order to allow the sperm to do what it needs to do. The prostate also shuts off the bladder so urine doesn't mix with sperm.

    Dr. shows the man an actual prostate and has him feel the area that shuts off the bladder so the urine can't go anywhere. "It's still stuffed, right? It's a little taut. This person had what's called BPH, benign prostatic hypertrophy, it's a big, thick prostate," he says. "So what ends up happening when the prostate gets larger is you can't start to go to the bathroom. You just can't get it going. Once you get going, it's dribbling along, right? When you finish, you still feel like you're full."

    Dr. also shows the man another part of the prostate and has him feel a firm, walnut-like growth. "Now, that is prostate cancer," he says. "It's a little nubbin on top of the prostate. That's why the doctor does a rectal exam on you. They're looking for that."

    Prostate cancer is easy to detect with a rectal exam or a PSA (prostate-specific antigen) test. The test measures the level of protein in the blood produced by the prostate. If the levels are elevated, it could be an indicator of a simple infection or a tumor. This is why it's important for men to know what their normal PSA number is, Dr. says. "You've got to get a baseline number. One of the big mistakes men get is they never get started. If you're 40 years of age, you ought to know what your PSA is."
    Another man has two questions for the doctor about testicular cancer. "Number one is, 'How often should men check for testicular cancer?'" he asks. "And number two is, 'What is the exact technique?' I mean, what are we really looking for and what are we trying to feel?"

    Dr. says testicular cancer is the number one cancer for young men from 15–35. "That's why it's so tragic, because you've got these young, virile, vital guys and they end up with a cancer that, by the time they do something about it, it's often the size of a softball. That puts you way behind the eight ball trying to catch up and treat the person—often it's spread to the other testicle which means they become sterile," he says. "You've got to know how to examine yourself."

    Every man should start self-exams at age 15, Dr. says. "You can do it whenever you take a bath and you're feeling for subtle differences, and it's an eminently treatable problem when you encounter it. … You're feeling for nodules. You're feeling for enlargement of the testicle. You're looking for sort of a full feeling down there. Sometimes you get fluid," he says. "And what a lot of folks don't think about, which is important, is you actually get sensitivity of the breasts because testicular cancers are often endocrine cancers. They send out chemicals that can change the way you look. Pay attention to those subtleties and you can save your or someone else's life."
    The next man had this question for the doctor. "I have a question for you about lack of sleep. Here's the problem. It used to be one of my strengths, sleeping, but I don't know what happened," he says. "I tried everything. I mean, I'm up till 3:00, 4:00 in the morning. I've tried watching TV. I've tried reading books. I don't know what the answer is. I'm tossing. I'm turning. This is pretty much an everyday thing."

    What's the number one rule for sleeping better? "For four or five hours before you go to bed, you shouldn't have any caffeine," he says. "Remember that being asleep is a natural state. You're supposed to be asleep. There are chemicals that actually jazz you up."

    Also cut out late-night television, Dr. says. "Watching television is the worst thing to do late at night, because it gets you psyched up again. Plus the bright lights keep you awake."

    If you still can't sleep, do what your mother always told you to do and drink some milk. "It's got a little bit of protein, including something called tryptophan, which becomes melatonin and serotonin," he says. "But you need a little bit of insulin to get it into your brain. So milk's got a little bit of sugar in it also that stimulates insulin so it gets into your brain. That's why milk works."

    If you often travel to different time zones, like this man does, Dr. says to stay on a regular schedule. "No matter what time your game was on, go to sleep at the exact same time. It makes a big difference because at least your circadian rhythm is functioning the way it needs to."
    The next man needs some nutrition information. "I'm a professional athlete. I train anywhere between two and three times a day. … What kind of foods can I add to my diet to help me maintain high energy levels throughout my diet and not crash after I'm finished working out," he says.

    Dr. recommends that the man eat more foods with antioxidants. "What happens to a lot of great athletes is they are creating so much oxidation in their body from working out all the time, especially if you're working out for more than two hours a day—you're doing this for sure—that you don't have the oxidant stores to keep up with that. So you've got to build up those antioxidant stores by taking leafy green vegetables."

    Bright colored fruits, like goji berries, are also great, Dr. says. "They grow in the Himalayas. They're the most potent antioxidant fruit that we know," he says. "Remember, foods are drugs. They work just like that. But especially for an athlete that's moving fast all over the place, you've got to keep the antioxidant stores in your body high and the best way to do it is through the foods you eat."

    Do men pass more gas than women? Dr. settles the debate once and for all with an explosive experiment from the Discovery Health series The Truth About Food.

    Two wranglers have agreed to settle this age-old question. They put on special rubber pants with a tube attached. The gas is directed into airtight bags strapped to their backs like backpacks.

    After 24 hours, researcher the man releases the gas into a measuring jug to see how much wind they produced. The difference is slight—the woman produced 3 liters, the man produced 3.3 liters.

    Now that we know men and women have roughly an equal amount of hot air, what exactly is the anatomy of a human-produced gas? Billions of bacteria live deep inside the colon and feed on our undigested food. "In fact, you have more bacteria in your gut than cells in your own body. They do something that's really very important. They actually make things like vitamin K and folic acid, key nutrients you have to have. They actually digest some of the foods that we can't otherwise digest," Dr. says.

    The side effect of this digestion, however, is gas. "There's no way of getting around it. And so for most of us out there, you realize that a little gas is probably good for you," Dr. says. And by the way, men and women in every major study have the exact same amount of flatus. Don't feel bad, guys."
    Just off the top of your head, do you know what causes hair loss?

    To explain what really happens, Dr. has to bust two hair loss myths. First, don't blame your mother. "Half of you is from your dad. Half of you is from your mom. The genes can come from either side," Dr. says. Second, if you cut your hair short, it's not going to grow back faster. "That works for hedges. That is not going to work for us. The hair will grow a half an inch a month. That's the way it grows out."

    Dr. says hair loss really happens when two hydrogen molecules called DHT (dihydrotestosterone) attach to testosterone. "That poisons the hair follicles and causes them to change from making normal hair to this sort of peach fuzzy material, which is what going bald is all about," Dr. says.

    The amount of hair you lose also has to do with the weather. "Springtime, which is when your testosterone levels are actually at your lowest, is when you lose the least hair." he says.

    Men have been desperate to hang onto their hair since the beginning of time, but forget about home remedies like baking soda or lemon. "Desperate men do desperate things," Dr. says. "None of those home remedies, I repeat, none will work."

    The only real solutions to hair loss, Dr. says, are medications that block DHT production. "They don't put new hair on your head. They will help prevent the hair that's about to fall out from falling out," he says. "And because of that, since you're already normally growing hair, hair grows in different cycles, you'll actually sometimes feel like you have more hair on your head."
    The next man says he heard that, ideally, people should have sex four times a week. Can Dr. confirm this…for his wife?

    "The average time that we have sex today in America is once a week," says Dr. "Now we have pretty good data—if you can get that number to four times a week, you're going to live longer."
    Very few men admit to having a facial, but Dr. says that facials aren't just for women! "I actually got a facial a couple months ago," Dr. O says. "Actually, it's pretty cool." The skin is exfoliated to allow younger skin to come through, resulting in a great glow.

    Extra points for the men who don't wash their faces every day! "The other thing that men don't think about very much is how we actually keep our faces clean. And you don't want to wash your face every day. That's a mistake. If you're working under an engine, go ahead. But if not, don't."

    To keep your hands from chapping and cracking, Dr. gets down to the source of the problem. "What generates a lot of the dryness is we don't have enough of the omega-3 fatty acids in our bodies," Dr. says. Omega-3s are found in a variety of sources, including flaxseed oil, walnuts and oily fish such as salmon. "That helps take care of some of that scaling skin that a lot of us have," he says. "Hand cream obviously helps a little bit, depending on the job that you have."

    What nutritional supplements do men need on a daily basis?

    Dr. says he takes what the average man needs for the basic foundation of healthy living—vitamins B, C, D, E, omega-3 fatty acids, calcium and magnesium.

    While vitamin D is important in preventing cancer, many people in America are vitamin D deficient, Dr. says. "In America, especially if you live north of Atlanta, you do not get enough sun in the winter months," he says. "You will be vitamin D deficient, especially if you've got darker skin."

    Dr. says that some men may want to add more supplements, depending on their background and health needs. "For a lot of guys, they may want to add things like aspirin and vitamin A—and you can go on and on and on with this stuff, but that is actually a pretty good place to start living your healthy life," he says.

    Dr. says beyond what vitamins men need every day, there are 10 tests all men should have. Testosterone level, testicular screening, digital rectal examination (DRE), STD screening, colon cancer test, blood pressure, skin cancer screening, eye exam, prostate-specific antigen (PSA) test, and a routine physical exam.

    Is there a way to clean out the colon to prevent colon cancer?

    First and foremost, Dr. makes the man asking this question promise that he will get a colonoscopy. The next thing Dr. says he can do is clean out his colon by eating more fiber. "Here's the deal," he says. The best way to clean the colon is not through these enemas that folks sometimes get."

    Dr. explains that most men only get about seven grams of fiber in their current diet—but need to be getting 35 grams every day. "The fiber washes out all the junk so it doesn't lay in the colon, irritating the cells and becoming toxic by rotting in there," Dr. says.

    Aside from getting more fiber, Dr. recommends adding more leafy green vegetables and broccoli to your diet. "Those kinds of foods are incredibly powerful at reducing the chance of cancer," he says.

    Do men go through menopause like women do?

    "Absolutely," Dr. says. Call it man-o-pause, male-o-pause or whatever you like—the official term is andropause—but Dr. says it does exist.

    Dr. explains that women go through menopause when their ovaries stop producing eggs and cause estrogen and progesterone levels to change. Similarly, when men go through andropause, testosterone levels begin to drop. "The amount of testosterone you have at age 60 is a fraction of what you have at age 20. So when that testosterone level begins to drop, you start to see the changes that often afflict men as they get older. They start to lose their muscle mass. They don't have the vitality they used to have. They don't have the virility either. They're not as sexually active."

    Fortunately, at least a quarter of men do not experience these symptoms, Dr. says. "The reality is, things like sleeping—which is critically important to restoring growth hormones and allowing you to maintain normal hormone levels—and things like exercise—especially if you can do it for an hour a day—are incredibly important in changing your life cycle so that you start to behave like you're 20 years younger."

    The last component is aspirin, which Dr. says helps prevent colon cancer without causing heart attacks, like some drugs did in the past that had to be taken off the market. "So aspirin, leafy green vegetables, stuff like broccoli, and get a colonoscopy because you can save your life."

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