10 Men's Health Questions in Honor of Movember

It's November, which mean it's #Movember. This month, many men will grow a moustache or beard to "change the face of men's health" by bringing awareness to men's health issues, including prostate cancer, depression and other general health topics. As a part of our monthly "Ask the Doctor" series, you submitted men's health questions to INTEGRIS physician, S. Christopher Shadid, M.D.. Click on a question below to read the answer.

1. My son, who is 44, says he gets up at least 2 to 3 times a night to urinate. His father has prostate cancer and my father had prostate cancer. We keep telling him he should get checked because of his family history. It doesn't mean he has prostate cancer, but it could be BPH. What do you think?
2. I am a younger gentleman that has low testosterone. I'm curious about the long term risks of hormone therapy as opposed to just living with low testosterone. Specifically the link between testosterone and prostate cancer/heart disease. Is there any new information around this topic? 3. I'm a 35-year-old professional and my back is always sore and painful by the end of the work week. What recommendations do you have to reduce the pain and improve my relationship with my back?
3. How can I overcome mental stress?
4. Now that I’m older, do I always have to watch my diet? I do exercise regularly. I’m not very overweight, although I am a little round in the belly. 6. Why do I need to exercise?
5. Does my sexual health affect the rest of my health? 8. Should I be worried about my issues with constipation or diarrhea?
6. Is there such a thing as male menopause? 10. Which types of cancer should concern me most?

1. My son, who is 44, says he gets up at least 2-3 times a night to urinate. His father has prostate cancer and my father had prostate cancer. We keep telling him he should get checked because of his family history. It doesn't mean he has prostate cancer, but it could be BPH. What do you think?

Waking up at night to urinate is known as “nocturia.” The most common causes for nocturia (at least what we as physicians think of first) are drinking too much liquid too close to bed, abnormalities in the urinary tract (ie. prostate issues, bladder issues, UTI, etc.) and Diabetes Mellitus. These are the things that should be considered first.

Even with his significant family medical history of prostate cancer, I would not necessarily be concerned about cancer as the source of his issue, although it is possible. The other previously mentioned diagnoses are more likely than cancer. With that said, he should see his health care provider. A thorough workup would include urinalysis, blood work, a physical exam, along with a prostate exam.

2. I am a younger gentleman that has low testosterone. I'm curious about the long term risks of hormone therapy as opposed to just living with low testosterone. Specifically the link between testosterone and prostate cancer/heart disease. Is there any new information around this topic?

This is a great question! Low testosterone is an issue affecting a large proportion of the male population. It happens naturally as we age, but can affect young men as well. The effects of low testosterone can include fatigue, sexual dysfunction, increased body fat mass, decreased muscle mass, hair loss and mood changes.

One of the best ways to naturally replace or increase your testosterone level without artificial supplementation is by increasing activity. Sedentary lifestyle is a major risk factor for low testosterone. Regular physical activity including cardio and weight lifting is known to increase testosterone levels and curb the previously mentioned effects of low testosterone.

Just as any other hormone, testosterone can be artificially replaced. There are various ways to do this including orally, topically and injection. This is typically a safe practice although there are some risks. The major risks that must be considered prior to therapy are prostate cancer and cardiovascular effects. Testosterone must be thought of as a stimulant and thus in excess it ‘stimulates’ the cardiovascular system. This can lead to increased blood pressure, heart rate, etc. This increased load over time can potentially increase the risk for heart attack, stroke and kidney disease. The risk for prostate cancer comes from the fact that testosterone is the driving hormone for the prostate. If you over-produce or artificially increase the testosterone level, you can potentially overstimulate the prostate, and this unfortunately can lead to cancer. Keep in mind, this typically happens if the testosterone level is raised too high. If kept in moderation, the risk for prostate cancer is there, but lower. For this reason, physicians will typically order a PSA (Prostate Specific Antigen) level test prior to treatment and then follow that level throughout your treatment.

3. I'm a 35-year-old professional and my back is always sore and painful by the end of the work week. What recommendations do you have to reduce the pain and improve my relationship with my back?

This is a difficult question to answer without knowing more about you and what work you do. In general, the most common causes for back pain are obesity, sedentary lifestyle and arthritis. Obesity causes back pain due to the increased amount of weight and stress that is placed on the back itself. Our spines were designed to manipulate our ideal body weight. When we become overweight we put increased pressure on our spine. This is also how the sedentary lifestyle can lead to back pain. When we become sedentary (decreased activity/exercise) our muscles become de-conditioned. With weak muscles, we again put increased stress on the spine. This is why two of the most effective treatments for back pain are weight loss and physical therapy. Physical therapy helps train and strengthen our muscles as to decrease the amount of strain on the spine itself and therefore decrease pain.

One other significant cause for back pain is poor posture. If you are someone who works at a desk all day you must make sure that your posture and ergonomics are optimal or you may be contributing to back pain.

4. How can I overcome mental stress?

Mental stress is a significant problem plaguing the majority of people. In general, mental stress can be decreased with knowing and limiting your triggers, taking time out for yourself, prayer/meditation and therapy/counseling. If these strategies are implemented appropriately, rarely do we need to add medications to help control symptoms. The most important thing to keep in mind is that mental stress can lead to severe depression and or anxiety, which can be life-altering ailments. Ideally, we decrease mental stress before it gets to this point. Please see your mental health provider or physician if these are a concern.

5. Now that I’m older, do I always have to watch my diet? I do exercise regularly. I’m not very overweight, although I am a little round in the belly.

It is always important to monitor your diet at all ages. Even with regular exercise a poor diet can lead to adverse outcomes such as high cholesterol, diabetes, hypertension and other significant medical problems. Anything is okay in moderation, but ideally you should limit your intake of fatty food, fried food, starches, sugar, salt and processed food. You should increase, as much as possible, your intake of fruits, vegetables and lean meats.

6. Why do I need to exercise?

Exercise is important for many reasons. Primarily it keeps your body conditioned giving you more energy and feeling healthy, decreases blood pressure and cholesterol levels, and increases endorphins, leading to good mental health.

7. Does my sexual health affect the rest of my health?

Yes, your sexual health can affect your physical and mental health. Studies have shown that having a healthy active sex life can lead to happiness and fulfillment in your marriage. In general, happiness in life can lead to a more active lifestyle and improved physical health.

8. Should I be worried about my issues with constipation or diarrhea?

Constipation and diarrhea are symptoms of something abnormal going on inside your gastrointestinal tract. It can be caused by anything from poor diet, to food allergies, to hormonal imbalance, to inflammatory disease, to infection, to cancers. With that said, it is important to seek the counsel of a medical professional with these symptoms. Eating a healthy diet rich in fiber can help to neutralize these symptoms if your diet is the source.

The more concerning diagnoses would typically include blood in your stool. If you have blood in your stool or black tarry stools you should seek medical consultation ASAP.

9. Is there such a thing as male menopause?

The term “male menopause” (or “andropause,” as testosterone is an androgen) would typically be referenced in regards to a naturally occurring decrease in testosterone level as we age. It is not known if this is an actual physiologic process that can be expected in the normal male, as is expected in females, and there is much research being done. For information regarding low testosterone please see question #2.

10.Which types of cancer should concern me most?

Cancer can affect any organ at any stage of life. Cancer remains the #2 most common cause for adult death in the U.S. The most common cancers affecting men are lung, prostate and colorectal. The most dangerous cancers are lung, prostate, colorectal and pancreatic.

If you have other men's health questions, schedule an appointment with Dr. S. Christopher Shadid or your primary care physician.