Is Viagra the answer to erectile disfunction? Do Well Man clinics make a difference? Men's health advice can be downright useless, says Dr Keith Hopcroft
1. Well Man clinics are a good idea
WHAT ARE THEY? These are clinics, run by GPs and private companies, that offer health once-overs for men, checking their hearts, weight and all the bits that women don’t have.
WHO SAYS THEY’RE A GOOD IDEA? Men’s health enthusiasts with too much time on their hands and private screening companies trying to drum up business.
HOW WRONG IS IT? Totally, and will remain so until the average unhealthy male has a lobotomy.
GIVE ME THE FACTS The main problem is that Well Man Clinics attract only well men. So, those motivated enough to attend are precisely those who don’t need to; lardy, fag-toting, burger-chomping slobs remain welded to their sofas. Besides, a well-person “screen” will rarely tell the typical bloke anything useful. All of which probably explains why the evidence that these clinics do any good is thinner than the average fitness freak.
WHAT SHOULD YOU DO? Forget regular health MoTs. The only relevant routine checks for blokes middle-aged and above are cholesterol and blood pressure tests; your pharmacist or GP will oblige. But only bother if you’d be inclined to act on the result, otherwise you’ll just fret and drive everyone barmy.
LAST WORD “I’ll go to the clinic when I’m well ill.”
2. Men don't use health services as much as women
WHO SAYS? Everyone; this myth is repeated so often you’d assume it’s gospel. Your other half will delight in using it as a stick with which to beat you all the way to your GP’s door.
OW WRONG IS IT? It’s a distortion of the truth.
GIVE ME THE FACTS Women do use health services more than men, but that’s because they have more reason to. As a bloke, you’d get funny looks if you booked for a smear, ante-natal check, Pill prescription and so on. True, you’re the proud owner of a prostate and pant-tackle that the girls don’t have. But these are easily trumped by lady’s problems involving breasts and gynaecology. Now do the maths: subtract from female health service use the strictly girlie stuff, then do the same for men. You’ll find that at least 60 per cent of the apparent male v female difference in doctor door-stepping vanishes.
WHAT SHOULD I DO? Don’t feel as though you’re neglecting the health service but use it when you really need to. And if she says you should have a health MoT, refer her to the forthcoming myth: “Blokes would be healthier if they visited the doctor more often”.
LAST WORD “It’s not so that men use health services less; it’s just that women use them more.”
3.Men should regularly examine their testicles
WHO SAYS? Men’s health support groups and charities, all of whom need something to write about or campaign for. But, notably, not cancer and screening boffs and profs who can spot a myth quicker than you can say “Scan my testicles”.
WHAT’S THE TRUTH? Thankfully, testicular cancer is even rarer than Saturday appointments; the average GP sees two or three new cases in his entire career. When it does occur, it usually produces a symptom, a heaviness, ache or obvious swelling, to draw your attention to it. So the chances of finding an unsuspected cancer via a routine feel-around are about the same as winning the lottery. Whereas the odds of finding something harmless, a cyst, swollen veins, normal bits of gristle, are high. Cue anxious males clutching their privates pleading for appointments and tests, thereby lengthening waiting times for the poor sods who really need them.
WHAT SHOULD YOU DO? Certainly give your tackle a check if you think you’ve noticed a symptom. And don’t delay seeking help if you then reckon that you’ve discovered a lump. But don’t become a ball-watching neurotic. Alternatively, get your other half to oblige, but only to confirm that they’re working.
LAST WORD “It’s cobblers.”
4. Viagra is the answer to erectile dysfunction
WHO SAYS? The media: every Viagra story has newspaper editors throbbing with excitement. Drug companies don’t mind erectile dysfunction being medicalised, either.
HOW WRONG IS IT? Partially. Viagra and similar drugs don’t work for everyone; about 20 per cent of men don’t respond. The magic pills may not be necessary at all.
GIVE ME THE FACTS Medication for erectile dysfunction has saved many from the sexual doldrums. But the rush to pop pills obscures a few basics. For example, a sudden failure to rise to the occasion, especially in young men, is usually a temporary blip caused by stress or exhaustion. It isn’t a slight on masculinity, it doesn’t signify disease and it will probably right itself. Persistent erectile dysfunction can be a sign of trouble, such as diabetes, circulation problems, or a medication side-effect. If properly treated erectile dysfunction pills may be unnecessary. Besides, what goes on in your pants often reflects what’s going on in your head. So the therapy needed for a lasting cure may be psychological rather than pharmaceutical.
WHAT SHOULD YOU DO? Stay calm if you suffer a bedroom flop. If it persists, don’t rush into pills – get a proper check from your GP.
LAST WORD Viagra et al aren’t a penile panacea.
5. Men should go to the doctor more often
WHO SAYS? Everyone. It’s a men’s health mantra.
HOW WRONG IS IT? Very; it’s based on the idea that men use the health service less than women. But a previous MHM revealed that much of this apparent difference between the sexes is an illusion.
GIVE ME THE FACTS Boys old and little seek medical help just as much as the girls. It’s only the 20 to 50-year-old males who steer clear of the doc. In this age group the vast majority of symptoms are harmless. Encouraging the slightly ill to book appointments could even cause harm: waiting times would rise and, besides, hospitals and surgeries are full of nasty germs.
WHAT SHOULD YOU DO? Ignore the trivial and focus on the important, such as chest pains or testicular lumps. And remember that the only routine health checks possibly worth fretting about – blood pressure and cholesterol – are available at the chemist.
LAST WORD The more you go to the doctor, the iller you’re likely to be, or to become.
6. Male fertility is falling
WHO SAYS? The media, who seem to think we’ll have to start cloning soon. And, possibly, private health clinics trying to drum up business.
HOW WRONG IS IT? It’s uncertain, but it’s not the universal truth most people believe it to be.
GIVE ME THE FACTS This hinges on the assertion that sperm counts are falling. Yet the evidence for this has more holes than a dodgy condom. There’s hardly any reliable information pre1970, and the data since is skewed by problems with lab techniques and variation geographically. Besides, sperm counts and fertility aren’t the same thing. It takes only one of them to do the deed and quality is as important as quantity. Which is why many experts report that there have been no significant changes in male fertility.
WHAT SHOULD YOU DO? Stay chilled, especially given that sperm counts increase as testicles cool.
LAST WORD I demand a recount.
7. Longevity means looking after your heart
WHO SAYS? It’s a given that the male heart is his Achilles’ heel, as many charities and most doctors will tell you.
HOW WRONG IS IT? Depends on how you look at the stats. True, heart disease strikes blokes at a younger age than women. But crunch a few numbers and things get more interesting.
GIVE ME THE FACTS Women certainly win in the lifespan lottery; on average by about four years in the UK. Surprisingly, though, the big player in this difference isn’t heart disease, it’s violent deaths and accidents. A testosterone-fuelled love of fast cars, dangerous sports, closing-hours brawls, plus suicides and work-related hazards, mean that men are far more likely than women to meet a sudden, unpleasant demise. Admittedly, these events are rarer than deaths from dodgy tickers in later life. But as they happen at such a young age – typically 15-35 – they skew the life expectancy stats, contributing disproportionately to the difference between the sexes.
WHAT SHOULD YOU DO? Take care of your health, but don’t break the speed limit getting to your GP appointment. And don’t get depressed or into a fight with him if he won’t prescribe you a cholesterol buster.
LAST WORD Maybe “health” and “safety” aren’t dirty words after all.
8.The male menopause in later life
WHO SAYS? A few flushed enthusiasts and those trying to flog blokes testosterone.
HOW WRONG IS IT? Very. “Menopause” means, literally, that your periods stop. Men don't have periods, so they can’t have a menopause.
GIVE ME THE FACTS The real question is whether an “andropause” exists: a drop in testosterone sufficient to cause symptoms. Levels of this hormone do fall with age, but whether this matters is debatable. Genuine testosterone deficiency can create menopause-type symptoms, yet many men with an apparently low level continue to strut around like healthy stallions. Besides, these mid-life symptoms have many other possible causes, such as depression, stress, alcohol problems, diabetes and sheer knackeredness. American doctors aren’t known for their restraint, but even they urge caution in using testosterone, particularly given the red faces of erstwhile enthusiasts for female HRT.
WHAT SHOULD YOU DO? Don’t jump to male menopause conclusions. Rule out other physical and psychological problems and take a long, hard look at your lifestyle before you go anywhere near a dose of testosterone.
LAST WORD HRT for men? OTT more like.
9. Sex can cause heart attacks
WHO SAYS? Scriptwriters are guilty of promoting the idea that you can easily bonk off this mortal coil. Overprotective partners perpetuate it.
HOW WRONG IS IT? Statistically speaking, sex does increase the risk of a heart attack. As soon as you crunch the numbers, though, you realise you can sleep easily, and postcoitally, in your beds.
GIVE ME THE FACTS The average 50-year-old nonsmoking, otherwise well male has a one in a million chance of having a heart attack in any one hour. Almost no chance, in other words. And though sex doubles that risk, twice virtually nothing remains virtually nothing. Those who are “higher risk” because of previous cardiac problems will find that sex also doubles their chances of further trouble, from 10 in a million per hour to 20. Most would reckon those odds acceptable.
SO WHAT SHOULD YOU DO? Carry on canoodling. But bear in mind that regular exercise lowers the risk further.
LAST WORD “What do you mean, No? It’s safe and I need the exercise.”