For Men, An Ounce of Prevention is Worth a Pound of Midlife Cure

with Raymond Zastrow, M.D., family practice physician, Advanced Healthcare

Posted: June 1, 2005

There are many reasons men in midlife are stopping in to see their doctors, and it’s not just because Viagra made “erectile dysfunction” a household word. According to Raymond Zastrow, M.D., a family practice physician with Advanced Healthcare, however, it could be a driving factor in the reason that the midlife crisis may be getting a facelift.

“Men are taking a more active role in their health in general, especially during midlife. I don’t know exactly what’s gotten to them,” he said.

What he surmises, however, is that one factor includes a little pressure from the important women in their lives. In addition, better health-focused messages from the media and the advent of Viagra and other erectile dysfunction (ED) medications are part of the dynamic — changing taboo health topics into locker room banter.

Raymond Zastrow, M.D., Family Practice, Advanced Healthcare "Certainly there are lifestyle issues contributing, but the idea of male menopause is a reality. There is a simple blood test to check for low testosterone levels. It’s surprising how often the test comes back positive."

These topics, like male menopause, colon, prostate, cholesterol, hypertension, and blood sugar, are all longstanding issues, albeit milestones in a man’s midlife health.

“Men who want information on ED will make an appointment to talk about other health problems,” he said. “In addition, sometimes ED can be a result of other health issues— vascular, neurologic, or metabolic conditions.”

Midlife is an important time to evaluate what’s going on in the body physically. Here are a few considerations for the over-40 crowd.

Fountain of youth
The desire to stay young is more prevalent than ever. To maintain that type of health, two basic premises have always stayed the course — exercise and diet. What changes over time however, are the specifics of those two variables.

Overall, Dr. Zastrow recommends a Mediterranean-type diet for men in midlife. That includes lots of fresh fish, olive oil, and foods rich in antioxidants and omega fatty acids.

“There is compelling evidence that taking fish oil for its omega fatty acids can improve health and help lower cholesterol,” Dr. Zastrow said. “Of course, avoid the typical pitfalls, junk food, fast food—substitute red wine (for its antioxidants) in moderation for that six-pack of beer.”

Male menopause
Male menopause, or andropause, has taken a center stage role in men’s health. Hormonal, physiological and chemical changes take place for men between ages 40 and 55.

The most obvious of those includes a potentially significant drop in testosterone levels. Men often experience fatigue, loss of muscle tone, weight gain, and resulting psychological effects like depression. The good news is that treatment for male menopause has had very positive results, and includes hormone replacement by way of injection or under a patch.

“Many men present in my clinic who are just dog tired,” Dr. Zastrow said. “Certainly there are lifestyle issues contributing, but the idea of male menopause is a reality. There is a simple blood test to check for low testosterone levels. It’s surprising how often the test comes back positive.”

Colon
Dr. Zastrow recommends that men have a colonoscopy, an examination of the large intestine (colon) at age 50, or earlier if a family history exists. Subsequent tests should take place every ten years thereafter unless a patient has pre-cancerous polyps, in which case they should return in three to five years.

“Having a colonoscopy used to be thought of as a horrible thing,” said Dr. Zastrow. “But enough men have talked about it amongst themselves that it is no longer so dreaded.”

Prostate
Prostate cancer is one of the most common types of cancer diagnosed in American men. It is also eminently treatable, according to Dr. Zastrow. The prostate should be checked once each year after age 50—earlier for high-risk groups or those with family history.

Common problems include prostatitis—inflammation; benign prostatic hyperplasia (BPH) — prostate enlargement; and prostate cancer. The prostate is tested with a simple blood test as well as a digital rectal exam. Men with BPH might experience difficulty with the urinary stream. This too can be easily treated with medications that shrink and relax the prostate.

Cholesterol
Dr. Zastrow said that the National Cholesterol Education Program recently announced new recommendations for accepted cholesterol levels. “Bad” cholesterol, or LDL, should remain below 100, while “good” cholesterol, or HDL, should remain above 40. A yearly test indicates whether medication is required, as well as whether changes to diet and exercise are indicated.

Hypertension and Diabetes
Blood pressure and blood sugar levels should be checked annually as they are leading informants in the battle against heart disease and stroke. A lesser known, but potentially devastating manifestation of vascular disease, abdominal aortic aneurysm, can be diagnosed with a simple test involving listening to the abdomen with a stethoscope for a whistling noise, or “bruit.” If indicated, an ultrasound of the aorta may be ordered.

Raymond Zastrow, M.D.
Family Practice
West Mequon Clinic
6425 W. Mequon Road
Mequon
262-242-0051

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