June marks the start of Men’s Health Month, a month dedicated to helping men take control of their health and take better care of their bodies. A great way to start better managing your health is to have an open and honest conversation with your doctor about your risk factors for certain conditions or any current symptoms you may be facing. These conversations, however, may be intimidating when it comes to certain health issues.
“Some of the most common health concerns that I hear from men are about urinary function and sexual function,” says Michael Johnson, MD, a specialist from Washington University Urology. “As a urologist, we specialize in these areas. These are intimate areas in a man’s life, things they don’t always feel comfortable mentioning to their primary doctor.”
Many men ignore health issues out of anxiety, fear or embarrassment, but it is important to keep in mind that doctors want to help you find solutions that best fit your needs. Often times, health problems don’t go away on their own, and catching them early can be beneficial in the long run. While bringing up sensitive topics may seem awkward at first, these conversations can lead to the resolution of symptoms and conditions, effective preventative measures before the onset of symptoms, and even an improved quality of life overall.
“Your health is very critically important,” says Washington University urologist Charles Nottingham, MD, MS. “Any new or different symptoms can be very anxiety provoking. But that’s why we’re here – to answer questions for you.”
Learn the answers to five common questions mean have about their health and how to start the conversation with your doctor below.
When should I start screening for prostate cancer?
While it is often recommended that men start getting regular prostate cancer screening around age 55, other factors may contribute to the need for earlier screening. Men with African-American ancestry and men with history of prostate or breast cancer in their family may need to start screening at a younger age.
Cancer screening is an excellent method to catch cancer in early stages before symptoms appear. Screening and early treatment can help prevent cancer from spreading and can even lead to a lower risk of mortality from prostate cancer. The most common method of prostate cancer screening involves a blood test called a prostate specific antigen (PSA) test. PSA testing measures the level of PSA in the blood. Elevated PSA levels may indicate certain problems with the prostate including prostate cancer. If elevated levels of PSA are detected, your doctor may recommend a biopsy to further investigate the cause or to confirm if cancer is present.
Treatment for prostate cancer can range from simple observation of the condition to medication or surgical intervention. Some low-risk cases of prostate cancer do not require medical treatment in early stages and can be managed by keeping a close eye on the development of the disease. In some cases, patients may require nonsurgical options including radiation treatment or surgical removal or all or part of the prostate. Surgical treatments are often performed with a minimally invasive approach to reduce complications and side effects. Following a prostate cancer diagnosis, your doctor will discuss your options to find the best treatment for you.
Starting the Conversation
Though recommended for all men ages 55-70, the choice to start prostate cancer screening is an individual one. Ask your doctor about your potential risk factors for prostate cancer to discuss whether screening is a good option for you.
Could my urinary problems be caused by an enlarged prostate?
There are many conditions that can contribute to urinary symptoms such as urinary incontinence, urgency, or frequent urination. One of the most common sources of urinary issues in men is benign prostate hyperplasia (BPH), also called enlarged prostate or benign enlarged prostate.
“Many men over forty experience some growth of their prostate gland over time,” says Nottingham. “That growth can cause symptoms related to urination. The symptoms are not exactly the same for every single patient: some men may experience one symptom or a cluster of symptoms, others may have a different symptom or cluster of symptoms. Ultimately, these problems with urination are caused by the bladder and your pelvic floor muscles trying to compensate for the growth of your prostate gland.”
Symptoms of BPH can include frequent urination, intense urinary urgency, trouble urinating or maintaining a strong stream of urine, or frequent urination at night or while asleep. Diagnosis of BPH can include analysis of a urine sample or prostate tissue sample. If a BPH is found to be the cause of your urinary issues, there are a variety of treatments that can help relieve a wide variety of symptoms. Medication is often the first step and can reduce the size of the prostate or relax the muscles which control or restrict the urinary tract. Many minimally invasive surgical techniques which shrink the prostate or help open a restricted urinary tract are also available in cases when medication does not effectively treat symptoms.
Starting the Conversation
If you are experiencing problems with urination, enlarged prostate may be a contributing factor. Other factors, such as sleep apnea or diet, can contribute to similar symptoms. Discuss your symptoms with your doctor as honestly and accurately as you can to better evaluate the root cause and discover what treatment options are best for you.
Am I at risk of developing or reforming kidney stones?
Anyone can develop kidney stones, but some types of kidney stones are more commonly found in men. The most common kind of kidney stone, calcium stones, are often found in men aged 20-30 and are caused by calcium in the body combining with certain substances in food. Uric acid stones, often found in patients with a history of gout or going through chemotherapy, are also more common in men than in women.
The easiest way to prevent kidney stones from developing in the first place is to stay hydrated. Urine that is clear in color is a good indication that your body is well hydrated. Good hydration can help flush your system and prevent the build-up of certain chemicals in the kidneys that can lead to the formation of kidney stones.
Some kidney stones are asymptomatic, meaning patients do not notice any pain or symptoms and may not realize they have developed kidney stones at all. The first sign of kidney stones many patients notice is a burning sensation or sharp pain in the lower back. This pain is often caused by a build-up of urine in the kidneys or ureter when the pathway from the kidney to the bladder is blocked by a solid kidney stone. Other symptoms can include nausea, painful urination, or blood found in urine. Treatment for kidney stones varies depending on the size and location of the stones and the severity of symptoms. Some kidney stones can be passed on their own at home (sometimes assisted by medication), and some require more medical intervention to break up or remove the stones directly. A CT scan is often used to determine the size and locations of kidney stones, and from there, your doctor can help determine your best options for treatment.
Many patients who have developed kidney stones in the past worry whether their stones will reform. “There is a 50% likelihood of recurrence over a five to ten year period for someone experiencing a kidney stone for the first time,” says Nottingham. “Ideally, we want to keep you in the top half of the class to make sure your kidney stones don’t come back.” In order to prevent recurring kidney stones, doctors will first make sure all the stones and may conduct analysis on urine collected after passing or removal. Patients with a history of kidney stones are also encouraged to keep a close eye on their hydration and diet. Drinking about three liters of water per day is recommended for patients who have experienced kidney stones in the past to help prevent stones from coming back.
Starting the Conversation
Diet, medication, or certain health conditions can put patients at increased risk of developing kidney stones. Ask your doctor whether you have any specific risk factors and what can be done to prevent the development of stones. If you find yourself suffering from symptoms such as sharp back pain, painful urination, or blood in your urine, ask your doctor whether kidney stones may be the cause. Your doctor will help you determine the best treatment for your kidney stones and advise how to best prevent them from developing again in the future.
What can I do about erectile dysfunction?
Erectile dysfunction is a very common condition in men defined by persistent inability to achieve and/or maintain an erection. Risk of developing erectile dysfunction increases with age. This condition can come from a myriad of causes, and your doctor can help you understand your risk factors and possible causes to find a treatment that best suits your needs.
“Men who have erectile dysfunction have numerous treatment options these days,” says Johnson. “Medication is often a good place to start, but other options such as injections or surgical treatment can also help men regain their sexual function.”
Treatments often depend on the cause of erectile dysfunction. Common nonsurgical options include medication to increase blood flow to the penis to help maintain an erection and injection therapy to dilate blood vessels and create a maintainable erection before sexual activity. Surgical options can be pursued if medication or nonsurgical options fail. These options can include inflatable or semi-rigid prosthetic implants or penile revascularization surgery. Once you and your doctor determine the cause of your erectile dysfunction, your doctor can recommend treatment options most likely to fit your needs.
Starting the Conversation
Asking your doctor about erectile dysfunction can seem intimidating, but it is an extremely common issue faced by many men for a wide variety of reasons. If you have been experiencing sexual concerns such as erectile dysfunction, it is important to be honest with your doctor to start finding solutions. Be up front about your symptoms – your doctor is there to help.
How can I address fertility concerns?
Infertility is a problem faced by both men and women. Some men have questions about their fertility and want to explore options to increase or maintain fertility. Others may be curious about male birth control methods. Regardless of your concerns or questions, an honest conversation with your doctor can provide answers you may be looking for.
Investigating male infertility involves examination of health history and physical examination. There are many possible causes of male infertility, including problems with sperm production, exposure to environmental factors, anatomical abnormalities, problems with sexual function, or issues related to disease or other health conditions. Treatment options for male infertility vary depending on the cause of infertility, but can include options such as microsurgical varicocelectomy and sperm banking. Microsurgical varicocelectomy is a surgical procedure wherein dilated veins in the scrotum, which can impede fertility, are tied off to help increase fertility. Sperm banking may also be an option for many men. This option involves the preservation of sperm retrieved via ejaculation or surgical sperm harvesting. Sperm can then be frozen and preserved indefinitely or used for assisted reproductive techniques.
Vasectomy is a great option for male birth control. It is often a very simple and relatively painless procedure and is considered the single most effective form of birth control for men. Vasectomies can also be reversible, although the decision to undergo vasectomy should be made with understanding that this procedure can be permanent and result in total infertility. Vasectomy tends to have considerably less adverse side effects and be more effective than many forms of female birth control, and can be a great option both for couples seeking effective birth control as well as men looking to take control of their own personal birth control options.
Starting the Conversation
Fertility can be a tricky subject. It is important to be open with your doctor about your needs and desires when it comes to your fertility, be it a desire to increase or maintain fertility or a desire to pursue birth control options such as vasectomy. Come prepared to discuss your long term goals with your doctor to find the best options for you and your fertility.
Schedule an appointment with Washington University Urology
Washington University urologists offer some of the most advanced and innovative urologic treatments in the world. Our specialists are not only experts in handling the sensitive conversations about urologic health concerns, but also offer cutting-edge care and technology to help men regain their confidence and care for their health. Washington University urologists offer the most updated surgical and nonsurgical options for an array of medical conditions including prostate cancer, enlarged prostate, kidney stones, sexual dysfunction and more.
Washington University urologists see patients at convenient locations across the St. Louis area. To find a urologist near you and schedule an appointment, see the link below: