Oh, Well!

The Manual

This is Men’s Health Month and Dr. Jamin Brahmbhatt is driving awareness toward a better, healthier you.

Men live five fewer years than women. And it may be because we’re not reading our body’s operations manual.

I had this epiphany several years ago: You can drive up to 10 cars in your lifetime, but you’ll only ever get one body. All cars come with an owner’s manual, detailing its operation, maintenance, and safety, so your car can last as long as possible.

But come on, guys. Who ever reads the manual?

In my years as a board-certified urologist, co-founder of the global men’s health movement Drive 4 Men’s Health, and past president of the Florida Urological Society, I’ve learned a thing or two about men. We are masters of efficiency, wanting to get the most done in the least time and effort. Most of the time, it works out. But when we try pulling that stunt on our health, those short-term efficiencies lead to long-term losses—five years’ worth, to be exact.

So, what better time than Men’s Health Month to make men’s health easy to understand? And what better way than showing you how to value your body just as you value your car?

I’ve put together some interesting info on just a handful of your body’s various “parts,” so you can maximize your mileage and maybe have a greater appreciation of your marvelous machinery. With this brief manual in hand, you can start driving toward a better and longer-living you.

Engine

The cardiovascular system is one of nature’s finest pieces of engineering. Like the movement of an engine’s pistons converting fuel and heat to energy and motion, the contracting of your heart’s chambers moves oxygen and nutrients through every cell in your body.

In-line, horizontal, and V-engines are built with all the same parts, but are arranged to perform differently for different types of vehicles. The same is true for men’s hearts, which are larger, have thicker veins and artery walls, and pump more blood in fewer beats per minute than women’s. According to a report published in Advances in Physiology Education, male and female cardio systems even have different responses to stress and strain—in women, the heart rate rises, while in men, the blood pressure rises.

These differences mean men tend to have more room for plaque buildup, leaving them more susceptible to heart attacks, blood clots, strokes, and heart failure. And because there is no way to feel these things coming, they often take fit, healthy men by surprise.

I’m not the first doctor to tell you how delicate your heart health is, and I

certainly won’t be the last. Heart disease is the No. 1 killer for men—causing nearly a quarter of all male deaths. Have you been putting off that visit to your cardiologist because you “feel fine”? If you’re waiting for a sign, let this be it: Your heart doesn’t come with a “check engine” light.

Fluids

From lubricant to coolant and everything in between, the many fluids in our car perform important tasks to keep all that complex machinery running smoothly. And we, being about 60% water, likewise rely on our fluids; blood, saliva, and mucus are just three of the dozens of fluids your body makes every day.

We also make our own wastewater, in the form of urine. This is one fluid we need to keep a close eye on—it’s a thankless task, but an important one, and any irregularities could be pointing to serious complications somewhere else.

It goes without saying that men and women have different urinary systems. Males have larger kidneys and different bladder placement, and their urethra is four to five times longer. As such, men are more likely to have urine flow problems.

The culprit there is most often the prostate—yes, that walnut-sized gland your doctor won’t leave you alone about. Though not a direct part of the urinary system, your prostate surrounds the base of your urethra, and when enlarged, it can constrict your passageway and make it tough to get the flow going. Enlarged prostate, also called benign prostatic hyperplasia (BPH), is a typical effect of aging, and affects roughly three-quarters of men over 60.

However, don’t assume it’s “benign.” Issues with your flow can also indicate prostate cancer, which is diagnosed in nearly 1 in 7 men. It is among the more

treatable cancers, but early detection is key. Begin regular screenings at age 55 (earlier if you have a family history).

Men also have different kidney issues than women, being less prone to kidney disease but more prone to kidney failure. They are also nearly twice as prone to kidney and bladder stones. If you have a family history of kidney issues, diabetes, or BPH, get your blood tested every year for kidney dysfunction.

Here’s something you can do for your kidneys right now: pour yourself a nice, tall glass of water. Preferably with ice—it’s getting hotter out there!

Suspension

Bones are the support system for your muscles, much like the rods and linkages that hold your suspension system together. Ounce for ounce, bone is four times stronger than concrete, and men’s bones are 1.5 times denser than

women’s. Arthritis and other bone/joint conditions are less of a man’s concern for this reason. But don’t throw your calcium tablets out just yet! As many as 2 million American men have osteoporosis, with another 12 million at risk.

Air flow

It’s no secret that men tend to snore more. But there’s a reason why: our upper airways are typically longer than women’s, and are more vulnerable to obstruction. This is also why obstructive sleep apnea occurs in around 25% of men, and why pulmonary and respiratory illnesses are deadlier for men, even though their prevalence among genders is the same.

Your body is a sophisticated, fine-tuned machine. Consider this manual a starting point to learn about your structure and function. All maintenance, formal diagnostics, and repairs should be done under the guidance of a trained professional healthcare mechanic.

Routine Maintenance

To get the most mileage out of your vehicle, you need to take it to the shop regularly for oil changes, tire rotations, and brake checks. Your body needs the same kind of maintenance— starting right now. Not sure what needs to be done? See this generalized checklist of what a maintenance schedule looks like through the years.

In Your 20s

Complete physical with baseline labs (yearly)

Self-examine for testicular bumps (monthly)

Self-examine your skin for any abnormal growths (monthly)

STD screenings, if sexually active (yearly)

In Your 30s

Organize your health records. Keep your own copies indexed.

Early colorectal cancer screening (if at increased risk)

Cholesterol screening (yearly)

Blood pressure screening (twice yearly)

Mental health screening (at least yearly)

In Your 40s

Testosterone/ hormone screening (if low-T symptoms present)

Early prostate cancer screening (if at increased risk)

Heart disease screening (if at increased risk)

In Your 50s

Cholesterol and diabetes labs (yearly)

Prostate and colorectal cancer screenings (yearly)

Bone health screening (every three years)

In Your 60s

Additional cardiovascular screenings (if at increased risk)

Early dementia screening (if symptoms present)

Formalize end-oflife documentation (living will, DNR status, power of attorney, organ donation, etc.)

In Your 70s

Cognitive health screening (yearly)

Consider whether certain screening tests are still necessary

Sharing and keeping track of health records with power of attorney

Hormones to a T

Dr. P. Fabian Garcia knows that low energy, waning libido, sour mood, depression, and weight gain all have one common denominator, and it may not be what you think.

Testosterone may be the most notorious of men’s hormones. It conjures up thoughts of muscles and masculinity. And yes, testosterone does fuel sex drive and muscle mass, but it also regulates mood and bone strength. But here’s the thing: when it comes to men’s health, it’s not the only hormone in charge. Insulin is the bigger bully on the playground.

“We are hormonal beings,” says Dr. P. Fabian Garcia, owner of Med- Health Clinical. “Digestion, weight gain, sexual function, diabetes, dementia … they all have a link to hormone deficiencies. When it comes to men, testosterone gets all the attention, but insulin is the hormone we really need to be watching. In fact, studies show that the link between low testosterone—or the symptoms often associated with low-T—often start with hyperinsulinemia.”

Let’s be clear: insulin isn’t the enemy. Insulin is an essential hormone that performs numerous critical functions. For example, if you want to put on healthy muscle mass, you need insulin. “What you don’t need is a flood of insulin circulating in your body all the time,” explains Dr. Garcia. “But that’s what the typical American diet does … it keeps your insulin levels chronically high, which over time leads to health issues. Fatigue. Weight gain. Inability to concentrate. Depression. Left unchecked, it can eventually lead to diabetes, dementia, and yes … even low testosterone.”

Turns out, poor health is more likely to cause low-T than the other way around. According to JAMA, if you are overweight and lose 7% of your body weight, testosterone could increase 10-15% naturally.

“And what happens when you lose weight?” says Dr. Garcia. “You gain more energy. Which leads to more confidence. Which can often re-ignite libido. It’s a ripple effect, which is why it’s so important to look at all the contributing factors. Hormonal supplementation may absolutely be part of a long-term solution, but so will be lifestyle changes, such as implementing a strategic eating pattern to control insulin levels.”

In the end, don’t let embarrassment stop you from seeking help. There is no shame in talking about any issues that affect your quality of life.