Men’s Health: From Simple to Complex

• How to examine men’s health?

What are the main stages of such an examination?

• First of all, taking an anamnesis.

For some, it seems like a routine procedure, especially when it comes to the therapeutic part. But heredity, the presence of any pathology or damage can lead to distant consequences. It is extremely important to collect a food history. Given the close relationship between mens health disorders and metabolic disorders, this is very important. Pay particular attention to the presence of such male diseases as atherosclerosis. It is not by chance that a correlation was found between erectile dysfunction and the number of coronary arteries affected by atherosclerosis, hypercholesterolemia (high cholesterol in the blood). 90% of patients in this group had atherosclerosis of penile arteries. Consumption of large doses of alcohol has led to an increase in the number of alcoholic fatty liver disease, which is also correlated with disorders of fat, carbohydrate and protein circulation. Liver diseases combined with overeating, with large portions of red meat, lead to storage diseases (iron and copper), hyperuricemia and gout. Having iron overload syndrome, the body experiences great oxidative stress. And the most sensitive target organs are the organs of the reproductive system.

• The second is an external examination of the patient.

Posture, symmetry of the body, position of the head, physiological curves of the spine and other markers immediately reveal the constitutional type. Taking this into account, we can indicate what type of metabolism and obesity a given patient has. The constitution quite clearly reveals a behavioral pattern, indicating a predisposition to a certain range of diseases. For example, a fairly common type of modern man is an endomorph. These are people with a high percentage of excess fat, with a rather weak metabolism. In the course of the conversation, it turns out whether the person was fat from childhood or gained weight later. And here an interesting fact will be revealed – we should consider adipose tissue not only as excess weight. Adipose tissue (and this fact has been proven!) is essentially a separate endocrine organ that produces a whole range of hormones and biologically active substances, which, in turn, have an effect on the synthesis of sex hormones and, in general, on the processes of appetite regulation and substance circulation. A very important hormone is leptin, which has a direct effect on the pituitary gland, signaling it about the amount of fat reserves. The pituitary gland, in turn, sends signals to other organs, changing eating behavior as a whole. When this connection is broken, when the sensitivity of cells decreases, a state of leptin resistance appears, which makes it impossible to reduce the level of excess weight. We also know that adipose tissue produces additional portions of estrogens (female sex hormones). Estrogenization of men has become a significant problem. Several factors converge here: excess weight, metabolic disorders, an excess of phytoestrogens in the diet (beer, excess carbohydrates, broiler types of meat, peanuts, soy as a filler in sausages). That is, obesity is directly the cause of sexual disorders and dysfunction in men. At the same time, standard tests can be normal or borderline normal.

• The third is a physical examination.

Yes. These are the same basic skills from the second year of the medical university: auscultation, percussion, palpation. Sometimes it seems that in the age of high technologies it is superfluous. But routine analysis of blood pressure, pulse, heart rhythm analysis, listening to heart sounds, pulse oximetry, spirometry sometimes give more information about a person’s health than complex radiological methods. For example, we know that the main problem of humanity is the high level of cardiovascular diseases and related cardiovascular complications. But there is a direct correlation between hypertensive disease and erectile dysfunction. The development of erectile dysfunction is facilitated by the same factors that activate atherosclerosis, namely: arterial hypertension, dyslipidemia, diabetes, smoking. All this leads to a violation of the endothelial function of the vessels on the scale of the entire body. In the European hypertension guidelines of 2009, a corresponding section appeared for the first time, which emphasizes that erectile dysfunction is often found in patients with arterial hypertension and is considered a harbinger of future cardiovascular complications. Erectile dysfunction in patients with arterial hypertension can occur as a pathological manifestation of high blood pressure or as a side effect of some antihypertensive drugs. First of all, researchers associate the occurrence of erectile dysfunction with untreated arterial hypertension, as a component of the hypertensive process. High blood pressure can increase the risk of erectile
dysfunction, even in the absence of atherosclerosis, because with long-term uncontrolled hypertension, the walls of the arteries lose elasticity. In addition, according to experimental data, hypertension causes the proliferation of muscle tissue in cavernous bodies and blood vessels, causes fibrosis (densification) of cavernous tissue and increases the amount of collagen III in it. At the same time, the severity of these changes is directly proportional to the degree of increase in systolic blood pressure. Spirometry, which evaluates the external indicators of breathing, is a rather indicative study. Oxygen is the main oxidizer of proteins, fats and carbohydrates. Underestimation of such a factor as a decrease in the vital capacity of the lungs can lead to an underestimation of the metabolic state of the patient as a whole. Many people have significant sleep disorders in the form of dyspnea and apnea due to breathing disorders, and this, in turn, affects potency and fertility.

• Fourthly, laboratory and instrumental research methods.
  Of course, these methods are very important and absolutely necessary for establishing the final diagnosis and evaluation of the reproductive system of both men and women.

We include:

Urological check-up is a comprehensive examination of the genitourinary system, which allows you to assess the general state of health of a man and detect possible diseases in the early stages

1. General blood analysis (including leukocyte formula and erythrocyte sedimentation rate)
2. General analysis of urine
3. Kidney tests
4. Determination of the index of free prostate-specific antigen (PSA). It is a tumor marker according to international standards for the early diagnosis of oncological diseases of the prostate gland
5. Microscopy of secretions. Allows you to detect the presence, nature, degree of severity of the inflammatory process in the urethra, determine the nature of the microflora of the urethra
6. Ultrasound of the prostate gland. Research on the risks of functional changes and the occurrence of neoplasms, prostate adenoma.

Of course, if a man plans to become a father, these studies can be supplemented with tests on the level of the main sex hormones:

1. Free testosterone
2. Steroid-binding globulin
3. Dihydrotestosterone (DT)
4. Dehydroepiandrosterone sulfate (DHEA-c)
5. Androstenedione and Androstenediol
6. LH (luteinizing hormone) and FSH (follicle-stimulating hormone)
7. Prolactin (PRL)

Of course, if necessary, indicators of thyroid hormones, adrenal hormones, which are markers of stress and also indicate the presence of erectile dysfunction, can be additionally important.

Resume:
The main thesis of this article is that the evaluation of the urological, androgenic sphere of men’s health cannot be narrow-profile, torn from the context of a general examination of a person. A holistic approach to this issue is key. Taking into account all aspects of men’s health makes it possible to treat and, most importantly, to prevent the development of many diseases even before they develop. Most conditions are the consequences of a person’s lifestyle: overeating, stress, sedentary lifestyle. Sometimes very simple and understandable examinations and advice help no worse than complex pharmacological treatment methods and surgical interventions.