September 17, 2024 – We know that men are more hesitant than women with regards to looking for health care and self-care. But even amongst men, there are differences in who gets regular care and who doesn’t.
Despite signs that the gender gap could also be slowly changing – Cleveland Clinic study Although it was recently found that almost all men within the United States prefer a healthy lifestyle and greater than half of Generation X and Baby Boomer men reported having an annual physical exam, statistics paint a distinct picture.
Last yr a study A study by Harvard researchers found that the difference in life expectancy between men and girls has grown to as much as 6 years. Men are four times quite a Abdominal aortic aneurysmThey get more often than women chronic diseases corresponding to gout or bladder cancer, and so they die from suicide, drug overdoses or heart disease. And they go for preventive check-ups less often than women.
As men become old, they have a tendency to take their health more seriously, and that trend needs to vary, experts say. Younger men, a lot of whom say they don't have a primary care doctor or have never had their blood pressure, cholesterol or weight checked, should start getting involved earlier.
Sean Cavanaugh, a 55-year-old visual artist in New York City, said that after his primary care doctor left his insurance network, he still hasn't searched for a alternative.
“I know I should get a shingles vaccine. I haven't had a colonoscopy yet. I need a full workup – blood work, etc. I'm not unrealistic, but I feel like I spend most of my time taking care of others,” he said. “If there's really something wrong with me, I'll [seek care].”
Scott Stephens, a 62-year-old retired consultant from Middleburg, Virginia, said he didn't start thinking about his health until he was in his 40s, when his father was diagnosed with prostate cancer.
“I don't get sick. I've never had the flu and never needed antibiotics. All I've taken to the doctor for are self-inflicted broken bones, stitches and things like that,” he said. “It's only recently that I've been really proactive,” he said, saying he takes blood pressure medication and has a leaky heart valve that his doctors are monitoring.
Hindsight is always 20/20
There are a number of reasons why some men are not as proactive about their health as their female peers. Strong ideas about masculinity (for example, the need to be stoic, “get through the pain,” and provide for loved ones) play a significant role, as does a perceived stigma about showing potential weaknesses. There is also a superhero factor, particularly among younger men.
“When you're in your 20s or 30s, you're indestructible, you're Superman,” Stephens said. “It's also an award for bravery; why would I'm going? I don't need to call my doctor,” he added. “There needs to be a life-changing event, whether it's an illness, someone near you dying of a heart attack at a young age otherwise you having children.”
This mindset is widespread, says Dr. Ryon McDermott, a professor of clinical and counseling psychology at the University of South Alabama in Mobile and former chair of a division of the American Psychological Association that studies the psychology of men and masculinity.
“These really traditional gender roles, like the concept men can't seek help and need to fend for themselves, are by far the strongest predictors of stigma around looking for health care and avoidance of looking for health care,” he said.
“From a young age, we are taught to internalize everything,” Stephens notes. “So-called real Men do not seek mental health [care].”
But McDermott warned that this kind of rigidity tends to backfire.
“Medical problems are exacerbated by mental health problems and vice versa,” he said. “The link between depression and diabetes is a classic example. Men also are inclined to channel much of their mental health distress into really problematic behaviors — for instance, PTSD, excessive drinking, overwork, unprotected sex — which in turn create their very own medical problems, from heart disease to sexually transmitted diseases and HIV,” he said.
Fear also seems to play a role.
“I've had many patients up to now who can have been combating something for a very long time and it took years to get the motivation to return to the doctor. Somehow they knew something was incorrect but were afraid to go to the doctor,” said Petar Bajic, MD, a urologist at the Cleveland Clinic and director of men's health at the Glickman Urological and Kidney Institute in Cleveland. “Sometimes time is of the essence, and the earlier we are able to intervene, the higher these problems can actually be fixed. If you place things off too long, you possibly can do damage that's irreversible.”
Old dog, new tricks
Most athletes wouldn't walk onto a field and play a game without first talking to the coach or reading the playbook. The same is true of health care, which has its own rules about when, if and how to get tested for certain diseases. And those rules aren't kept in an emergency room, a common and convenient place to go when problems arise.
Too many men go to the emergency room for treatment that should be provided by a primary care doctor, says Dr. John Messmer, a family medicine and geriatrician at Penn State Health in Hershey, Pa. “Their job just isn't to take care of your long-term health, and so they may not even take the time to ask you for those who've had various preventive care tests.”
Another important and fairly common issue is where men — particularly Gen Z and millennial men — get their health information. Technology has its limitations, Messmer said. Depending on the source, “it's like diagnosing health problems from the angle of a first-year medical student (who might actually be higher at it),” he said. “People are self-medicating, self-regulating, and never necessarily going to a primary care doctor,” he said.
If you lay a foundation early, it may not be too late to learn a new trick or two, and you'll also ensure that you stay as healthy as possible throughout your life.
In your 20s or 30s?
This is a good time to escape the tech fever and schedule an appointment for basic work.
“Men should are available in for his or her first general health check at about age 21,” Messmer said, noting that this is also a good time to start measuring cholesterol, especially if there is a family history. “Maybe they've a father or grandfather who died of a heart attack, never had an issue, but had high cholesterol their whole life. That's where we see a risk of dementia, and for those who're depositing cholesterol in your arteries your whole life, you're going to exacerbate problems that might have been prevented,” he said.
Other concerns include weight, blood pressure, diabetes and discussions about diet, physical activity, smoking and drug/alcohol use. This is also the time to start testicular self-examination to prevent testicular cancer, Bajic said.
If nothing is found that requires further investigation, Messmer recommends one or two more appointments for men in their twenties and three or four for men in their thirties.
In your 40s?
“We're seeing colon cancer in younger patients, which is why the rules now recommend screening at age 45 as an alternative of fifty,” said Raymond K. Cross, MD, director of the Center for Inflammatory Bowel and Colorectal Diseases at Mercy Medical Center in Baltimore. But beware! There are noninvasive alternatives to traditional colonoscopy, such as tests that look for hidden blood in stool samples.
Like others, Cross stressed the need for primary care physicians who can spot the development of sudden digestive symptoms, low blood counts or anemia. But Cross said colon cancer, like high blood pressure, can go unnoticed. “The later it's discovered, the more likely it's to spread outside the colon into the lymph nodes, where it is probably not curable,” he said.
Colorectal cancer screening should begin in men aged 40 and then be repeated every 10 years. For men with a family history, Cross says the first screening should be done 5 years before the age at which the relative was diagnosed and repeated every 5 years. The same goes for prostate, bladder and kidney cancer, Bajic says, pointing out that family history should not be ignored.
At least two routine check-ups are recommended in your forties.
In your 50s or 60s?
“People have told me that if they had known they would live this long, they would have taken better care of themselves,” Messmer said.
Aside from the usual bone and muscle problems that rear their ugly head in the form of arthritis in a man's later years, Messmer stressed that urological problems are most common in the 50s and 60s. And while things like erectile dysfunction might bring men into the office, he said those visits often provide an opportunity to discuss sexually transmitted infections and prevention, which data shows has shown have increased alarmingly among older people.
Older men should schedule a physical exam at least once a year, depending on their overall health, Messmer said. Vaccinations, particularly against flu, COVID-19 and shingles, are also important, especially for men with other medical conditions.
Finally, no matter your age, it's never too late to take care of your mental health. “The brain and the body are obviously closely connected,” McDermott said.