THE BLOG
05/29/2010 05:12 am ET Updated Nov 17, 2011

Bend Over and Take It Like a Man

Why is it that men are half as likely as women to go to a doctor for a check-up? What are men afraid of? When I ask patients who are seeing me after not having been to a doctor in many years, there are two top answers: 1) I felt okay, so I didn't need to come in; 2) I knew I'd have to have a prostate exam, so I put it off.

In response to the former, I ask them if they take their car in for routine maintenance. Every single one does. "So," I say, "the health and continued good functioning of your car is more important and worth more time than your own health and continued good functioning?"

In response to second most common reason for avoiding the routine check-up, I say: "So, you'd rather risk having prostate cancer than having a doctor stick his finger up your butt once a year?" What if women said that about pelvic exams? The rate of cervical cancer would skyrocket.

What I don't go into, is how important that visit to have the infamous rectal exam really is - and not only because of the possibility (and controversial benefit) of early diagnosis of prostate cancer, but because a lot more happens than that quick uncomfortable exam. A men's general physical, or well health visit, is about prevention of health problems, early detection of potential "red flags" that could indicate the beginnings of a problem and early treatment for problems that may not be causing symptoms, but could lead to bigger problems if ignored. A classic example is blood pressure. Hypertension, or high blood pressure, is a problem for 21 million men in the United States. It is a significant risk factor for heart disease, meaning that a man with hypertension has a much greater risk of having a stroke or heart attack as a man with normal blood pressure.

Another potential red flag is erectile dysfunction (ED). Getting Viagra online, and avoiding a medical visit for ED, eliminates the chance for the doctor to examine the underlying cause of ED. ED could be a symptom of atherosclerosis - clogging of the arteries - which could indicate an elevated risk of heart attack and a need to check cholesterol, blood pressure and blood sugar to see why ED is even a problem. ED could be the result of low testosterone, in which case it would be far better to have your testosterone checked and treated than to just treat the symptom with Viagra.

For all you men out there, I've created a top 10 list of why you should keep up with the recommended maintenance schedule for your body as well as you do (or better) than for your car.

1 - Your sex life could be better
If your testosterone is low, often your libido and erections will be as well. It is easy to test for and to treat testosterone issues. Ask to have your total and free testosterone checked by your primary care provider if you have any symptoms of low T. (see my previous blog for a list of symptoms.)

2 - Your muscles could be bigger
See number one. Low T causes loss of muscle mass.

3- Your bones could be stronger
Many men have low vitamin D levels. Low vitamin D causes many problems including bone loss and increased risk of fractures. Have your 25-hydroxy-vitamin D level checked.

4 - You can decrease your risk of having a stroke or heart attack.
Just as in the examples described above, high blood pressure or high blood sugar increases your risk greatly of having a heart attack or stroke. These would be routinely checked during an annual physical.

5 - You could have a pre-cancerous mole removed before it turns into actual skin cancer.
Skin cancer is the most common type of cancer in the US. Most forms are relatively easy to treat with a simple office procedure if they are found early. A skin cancer that grows may require a larger surgery with much more physical deformity.

6 - You could avoid getting the flu, shingles, pneumonia, hepatitis or tetanus.
Adults need vaccines too. Many men are at risk for complications from the flu or for getting hepatitis, shingles or pneumonia. Tetanus boosters should be given every 10 years. These would be updated during your annual physical.

7 - You could learn how to eat better.
Two thirds of men are overweight in this country. Your doctor should check your height and weight and calculate if you are overweight or not. If you are, he or she can recommend healthier eating and physical activity habits that are likely to be more beneficial than what you might hear from your friends or find on the web.

8- You could identify colon polyps or cancer at an early and easily treatable stage.
While it is not exciting to find you have any sort of growths in your colon, it is always better and easier to treat them early before they turn into something deadly.

9 - You can save money on supplements.
I end up taking my patients off more supplements than I put them on. Guys start taking all sorts of things that sound good in an ad or on the web. Your doctor can help you to identify what is worth the time and expense and what is just creating expensive urine.

10 - You can learn what you need to do to feel better.
Your health care provider is the best source of information for what you can do or take to feel your best. Bring in a list of questions and have a frank discussion with your doctor about what you should be eating, how much you should be exercising and what tests you should have done. Information is power.

We don't have built in warning lights for our health, so it is up to you to stay on your preventive maintenance schedule and get yourself thoroughly checked out regularly by your provider.