Most men need to pay more attention to their health. Compared to women, men are more likely to:

• Smoke and drink
• Make unhealthy or risky choices
• Put off regular checkups and medical care

There are also health conditions that only affect men, such as prostate cancer and low testosterone. Many of the major health risks that men face - like colon cancer or heart disease - can be prevented and treated with early diagnosis. Screening tests can find diseases early, when they are easier to treat. It's important to get the screening tests you need.

As is the case with women's health, many people tend to think of men's health as it relates to the reproductive organs. However, just as in women's health, men's health is much broader. While many sex-based influences affect diseases/organs related to reproduction, such as prostate and testicular cancer, many sex-based factors influence diseases and organs unrelated to reproduction. Here are a few examples.

• Osteoporotic fractures in men over 50 are common, yet they are under-recognized and often undertreated.
• Systemic lupus erythematosus, or lupus, is often thought of as a women's disease, yet this condition affects men too. What's more, males with lupus often have more severe disease than females, and they are more likely than females to experience lupus-related kidney failure.
• White male teens and young adults are 55 percent more likely to die of melanoma, the most serious type of skin cancer, than their female peers of the same age.
• Onchocerciasis, the second leading cause of infectious blindness in the world, is more common in men, who work in contaminated rivers in the developing world. Onchocerciasis is thus an example of a gender-based health disparity, since it is caused by a behavior more common to males in certain societies, although it is treatable with antibiotics.

Men have higher rates of getting and dying from cancer than women. You can lower your chance of getting certain kinds of cancer.

Most cancers take years to develop. Many things can affect your chance of getting cancer. Things that raise your chance of getting cancer are called risk factors.

You can’t control some risk factors, like getting older. But you can control many others. In fact, there are things you can do every day to avoid getting cancer. Two of the most important things you can do are making healthy choices and getting the screening tests that are right for you.

Healthy Choices

Quitting smoking is one of the best ways to lower your cancer risk. Smoking can cause cancer almost anywhere in the body. If you don’t smoke, make sure you stay away from other people’s smoke.

The link between smoking and cancer is well-known. But you may be surprised by other things that can lead to cancer.

• Ultraviolet (UV) rays from the sun or artificial sources like a tanning bed, booth, or sunlamp can cause skin cancer, the most common cancer.
• Drinking alcohol raises your risk of getting five kinds of cancer, including liver cancer and colorectal cancer.
• About 40% of all cancers are associated with overweight and obesity.

Screening Tests

Screening means checking your body for cancer before you have symptoms. All screening tests have benefits and harms. Screening is recommended when the benefits outweigh the harms.

Colorectal Cancer Screening

If you’re 45 to 74 years old, get screened regularly.

You should start getting screened for colorectal cancer soon after turning 45, and get screened regularly until you’re 75. Several screening tests are available. Some can be done at home, and others are done in a doctor’s office. Talk to your doctor about which test is right for you.

Lung Cancer Screening

Screening is recommended for people who are 50 to 80 years old and are current or former heavy smokers.

The U.S. Preventive Services Task Force, a group of experts, recommends yearly lung cancer screening with low-dose computed tomography (LDCT) for people who are 50 to 80 years old, have a history of heavy smoking, and smoke now or quit within the past 15 years.

Prostate Cancer Screening

Middle-aged men should talk to their doctor about the possible benefits and harms of screening.

The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread. However, most prostate cancers grow slowly or not at all.

A blood test called a prostate specific antigen (PSA) test is commonly used to screen for prostate cancer. If you are thinking about being screened, learn about the possible benefits and harms of screening, and talk to your doctor about your personal risk factors.

Men are more likely than women to drink excessively.Excessive drinking is associated with significant risks to men’s health and safety, and the risks increase with the amount of alcohol consumed. Men are also more likely than women to take other risks (such as misusing other substances, having multiple sex partners, or not wearing a seat belt), that when combined with alcohol, further increase their risk of illness, injury or death.

Adult Men Drink More than Women

• Almost 58% of adult men report drinking alcohol in the past 30 days compared with 49% of adult women.
• Men are more likely to binge drink than women. Approximately 21% of men report binge drinking, compared with 13% of women. Among men who binge drink, 25% do so at least five times a month, on average, and 25% consume at least nine drinks during a binge drinking occasion.
• In 2020, 13% of adult men had an alcohol use disorder compared with 9% of adult women.

Alcohol is Associated with Injury, Violence, and Other Harms

• Men have higher rates of alcohol-related hospitalizations than women.
• More than three-quarters of deaths from excessive drinking are among males, totaling more than 97,000 deaths each year in the U.S.
• Among drivers in fatal motor vehicle traffic crashes, men are 50% more likely to have been intoxicated (i.e., a blood alcohol concentration of 0.08% or greater) compared with women.
• Excessive alcohol consumption increases aggression and may increase the risk of physically assaulting another person. Alcohol is a key risk factor for sexual violence perpetration.
• Males are more than three times as likely to die by suicide than females, and more likely to have been drinking prior to suicide.
• Alcohol use is one of the most important preventable risk factors for cancer. Alcohol use increases the risk of cancer of the mouth, throat, esophagus, liver, and colon, which are more common among men.Drinking alcohol also increases the risk of prostate cancer.

Alcohol May Affect Men’s Sexual and Reproductive Health

• Excessive alcohol use can interfere with testicular function and male hormone production resulting in erectile dysfunction and infertility.
• Alcohol use by men also increases the chances of engaging in risky sexual activity including unprotected sex, sex with multiple partners, or sex with a partner at risk for sexually transmitted infections.

Men can reduce the amount of alcohol they drink to reduce their risk of health problems and other harms.

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. HPV vaccines can prevent some of the health effects HPV causes.

What is HPV?

HPV is a very common STI. Among 15- to 59-year-olds, 2 in 5 (40%) people will have HPV. There are many different types of HPV; most do not cause any health problems.

HPV is a different virus than HIV or (HSV) herpes.

How do men get HPV?

You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It most commonly spreads during anal or vaginal sex. It also spreads through close skin-to-skin touching during sex. HPV can spread even when a person with the infection has no signs or symptoms.

If you are sexually active, you can get HPV even if you have had sex with only one person. Symptoms can appear years after you have sex with someone who has the infection. This makes it hard to know when you first got it.

What are the symptoms of HPV?

Most men who get HPV never have symptoms. The infection usually goes away by itself. But, if HPV does not go away, it can cause genital warts or certain kinds of cancer.

Talk to your healthcare provider about anything new or unusual on your penis, scrotum, anus, mouth, or throat. This includes:

• Warts,
• Unusual growths,
• Lumps, or
• Sores.

Will HPV cause health problems for me?

Most HPV infections go away on their own and don’t cause any health problems. However, if HPV does not go away, it can cause health problems like genital warts. It also can cause certain kinds of cancer.

We do not know why HPV causes health problems in some people and not others.

What are the symptoms of genital warts?

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. The warts may go away, stay the same, or grow in size or number. A healthcare provider can usually diagnose genital warts by looking at them. Genital warts can come back, even after treatment. The types of HPV that cause warts do not cause cancer.

Can HPV cause cancer?

Yes. HPV itself isn’t cancer but it can cause changes in the body that lead to cancer. HPV infections usually go away by themselves. When they don’t, they can cause certain kinds of cancer to grow. These include:

• Cervical cancer in women
• Penile cancer in men
• Anal cancer in both women and men
• Oropharyngeal cancer, cancer in the back of the throat, including the base of the tongue and tonsils

All of these cancers come from HPV infections that did not go away. Cancer grows very slowly. The diagnosis may not be until years, or even decades, after a person gets HPV. Currently, there is no way to know who will get cancer after getting HPV.

How common are cancers from HPV in men?

Cancers from HPV are not common in men.

Certain men are more likely to develop cancers from HPV:

• Men with weak immune systems (including those who are living with HIV).
• Men who receive anal sex are more likely to get anal HPV. They may develop anal cancer.

Is there testing for HPV in Men?

No, there is currently no approved test for HPV in men.

CDC does not recommend routine testing (also called ‘screening’) for HPV in men. CDC also does not recommend routine testing for diseases from HPV before there are signs or symptoms in men. Some healthcare providers offer anal Pap tests to men who may be at greater risk for anal cancer. This includes men with HIV or men who receive anal sex. If you have symptoms and have concerns about cancer, please see a healthcare provider.

Can I receive treatment for HPV or health problems that develop from HPV?

There is no specific treatment for HPV. But, there are treatments for health problems that develop from HPV. Your healthcare provider can treat genital warts with prescription medication. Cancers from HPV are more treatable when found and treated early.

How can I lower my chance of getting HPV?

There are two steps you can take to lower your chances of getting HPV and diseases from HPV:

• Get vaccinated. The HPV vaccine is safe and effective. It can protect men against warts and certain cancers caused by HPV. Ideally, you should get vaccinated before ever having sex.
• Use condomsthe right way every time you have sex. This can lower your chances of getting all STIs, including HPV. However, HPV can infect areas the condom does not cover. So, condoms may not offer full protection against getting HPV.

Can I get the HPV vaccine?

In the United States, the HPV vaccination recommendation is for:

• All preteens (including boys and girls) at age 11 or 12 years (or can start at age 9 years)
• Everyone through age 26 years, if not vaccinated already.

Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination.

HPV vaccination for ages 27 through 45 provides less benefit. Most sexually active adults have already been exposed to HPV, although vaccination does not target all HPV types.

At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.

What does having HPV mean for me or my sex partner’s health?

See a healthcare provider if you have questions about anything new or unusual on your or your partner’s:

• Penis,
• Scrotum,
• Anus,
• Mouth, or
• Throat

Anything new or unusual could be warts, unusual growths, lumps, or sores.

Even if you are healthy, you and your sex partner(s) may also want to get tested for other STIs.

If you or your partner have genital warts, stop having sex until you no longer have warts. We do not know how long a person is able to spread HPV after warts go away.

What does HPV mean for my relationship?

HPV infections are usually temporary. A person may have HPV for many years before it causes health problems. If you or your partner receive a diagnosis of a disease from HPV, there is no way to know:

• How long you have had HPV;
• Whether your partner gave you HPV; or
• Whether you gave HPV to your partner.

HPV is not always a sign that one of you is having sex outside of your relationship. It is important that sex partners discuss their sexual health and risk for STIs with each other.

Eating Smart

• Eating smart may improve your health and your waistline.
• You can also improve your eating habits by adjusting portion sizes and still enjoy delicious foods and an occasional treat.

A Healthy Eating Plan = A Variety of Foods

• whole grains
• vegetables
• fruits
• lean meats and seafood
• low-fat or fat-free milk products

Easy Tips for Eating Smart

• Sneak in fruits and vegetables. Add berries to your cereal or crunchy vegetables to your sandwich.
• Be aware of what you drink as well as what you eat. Sodas, sports drinks, and juices may be high in caffeine or calories, especially from sugar. Choosing water and other low-calorie drinks may help you reduce extra calories and control your weight.
• Do not overdo it with alcohol. Alcohol can be a major source of hidden calories. A single shot of liquor, about 2 ounces, has about 125 calories. A 5-ounce glass of wine or a 12-ounce glass of beer has 160 calories.

Keeping Portions Under Control

Pay attention to the serving sizes listed on Nutrition Facts labels. For example, the label on a loaf of bread may list nutritional information for one slice. But if you eat two slices in a sandwich, you have eaten double the calories, fat, and other nutrients.

In addition to what you eat, how much you eat also affects your weight. The pictures below give you an idea of what portion sizes look like for some foods. Try to "eyeball" your portion sizes using everyday objects—it may help you control how many calories you consume.

Serving Sizes = Everyday Objects

Eating slowly or eating from a smaller plate may help you control how much you eat. Before you reach for a second helping, stop and ask yourself if you are still truly hungry. When you eat out, try splitting a meal or dessert with a friend or significant other, or taking half of your meal home in a take-out container. You may save big on calories, and it is tough to beat two meals for the price of one.

Take a minute to think about your weight, health, and lifestyle. Are you as fit and healthy as you would like to be? Do you think you might be carrying a little too much weight or body fat?

You can get on track with regular physical activity and healthy eating habits. By making small changes to your lifestyle, you may become leaner and energetic.

Keep reading for tips on how to get on track with healthy habits—chances are, you will find that it is not as hard as you thought.

What is a healthy weight?

Body mass index (BMI) is a tool that is often used to determine if a person is a healthy weight, overweight, or obese, and whether a person’s health is at risk due to his or her weight. BMI is a ratio of your weight to your height. You can refer to the chart below to find your BMI and see what a healthy weight range is for your height.

A BMI of 18.5 to 24.9 is considered healthy. A person with a BMI of 25 to 29.9 is considered overweight, and a person with a BMI of 30 or more is considered obese.

Another way to determine if your health is at risk because of your weight is to measure your waist. Waist measurement does not tell if you are overweight, but it does show if you have excess fat in your stomach. You should know that extra fat around your waist may raise your health risks even more than fat elsewhere on your body. Also, men are more likely than women to carry their extra weight around their stomach.

Men whose waists measure more than 40 inches may be at an increased risk for diabetes, high blood pressure, stroke, and other problems.

A downside of using BMI is that it does not take into account whether body weight is due to muscle or fat. Therefore, someone who is very muscular may be thought to have excess fat, even if he has low or normal body fat. For the vast majority of Americans, though, BMI is a good way to tell if you have increased health risks due to your weight.

Heart disease is a term that includes several more specific heart conditions. The most common heart disease in the US is coronary heart disease (CHD). CHD occurs when the arteries that supply blood to the heart muscle become hardened and narrowed due to the buildup of plaque. The narrowing and buildup of plaque is called atherosclerosis. Plaque is a mixture of fatty and other substances including cholesterol and other lipids. When plaque builds up in the coronary arteries, blood flow to the heart is reduced, which reduces oxygen to the heart muscle. This can lead to a heart attack. Other heart conditions include angina, heart failure, and arrhythmias.

Key Facts

• Heart disease is the leading cause of death for men of most racial/ethnic groups in the United States.
• About 1 in 12 (8.7%) White men, 1 in 15 (6.7%) Black men, and 1 in 15 (6.8%) Hispanic men have coronary heart disease.
• Even if you have no symptoms, you may still be at risk for heart disease.

Eat What Counts

Eat a variety of fruits and vegetables every day. Limit foods and drinks high in calories, sugar, salt, fat, and alcohol. Choose healthy snacks.

Be Physically Active

Be active for at least 2½ hours a week. Include activities that raise your breathing and heart rates and that strengthen your muscles. You don't have to do it all at once. Spread your activity out during the week, and break it into smaller chunks of time during the day.

Pay Attention to Symptoms

Some medical conditions (such as high cholesterol, high blood pressure, and diabetes) and lifestyle factors (such as an unhealthy diet, physical inactivity, and alcohol or tobacco use) can increase your risk of developing heart disease.

Get Your Check-Ups

Just because you may feel fine doesn't mean you don't need your annual check-up. Certain diseases and conditions may not have symptoms, so check-ups help diagnose issues early or before they can become a problem. See your doctor or nurse for regular check-ups.

Prevention Tips

• Eat a heart healthy diet with plenty of fruits and vegetables, low in saturated fat, sodium, and added sugar . Choosing healthful meal and snack options can help you avoid heart disease and its complications.
• Maintain a healthy weight. Being overweight or having obesity can increase your risk for heart disease.
• Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends adults engage in moderate-intensity exercise for 2 hours and 30 minutes every week.
• Don’t smoke. Cigarette smoking greatly increases your risk for heart disease, so if you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.
• Limit alcohol use. Avoid drinking too much alcohol, which causes high blood pressure.

Pick an activity that you enjoy and will do. This activity should get your heart and breathing rates up, but is not so tiring that you cannot talk while doing it.

Tips for Getting Fit

• Start with a level of activity that feels doable and gradually increase the frequency, time, and intensity of your exercise. You might begin with 10 minutes of daily activity for the first week, for example, and then increase your time to 15 minutes a day the next week.
• Work up to an amount of activity that allows you to reach your goal. It may be 45 minutes a day or it may be 90 minutes a day.
• Activities like chores, walking up stairs, and playing outside with the kids count too.
• Remember, you do not have to do 30 minutes of exercise all at once to be healthy. Instead, you can take three 10-minute walks throughout the day.

Exercise Your Options

To get on track and stay on track, you should try different types of exercises and activities. The chart below lists several types of physical activity, provides examples of each, and describes how each activity is good for you.

Most men can safely increase their physical activity without consulting a health care professional, but men over age 40 and those with a history of coronary heart disease or diabetes, should speak with a health care professional before starting a vigorous exercise program.

While mental illnesses affect both men and women, the prevalence of mental illnesses in men is often lower than women. Men with mental illnesses are also less likely to have received mental health treatment than women in the past year. However, men are more likely to die by suicide than women, according to the Centers for Disease Control and Prevention. Recognizing the signs that you or someone you love may have a mental disorder is the first step toward getting treatment. The earlier that treatment begins, the more effective it can be.

Warning Signs

Men and women can develop most of the same mental disorders and conditions but may experience different symptoms. Some symptoms include:

• Anger, irritability, or aggressiveness
• Noticeable changes in mood, energy level, or appetite
• Difficulty sleeping or sleeping too much
• Difficulty concentrating, feeling restless, or on edge
• Increased worry or feeling stressed
• Misuse of alcohol and/or drugs
• Sadness or hopelessness
• Suicidal thoughts
• Feeling flat or having trouble feeling positive emotions
• Engaging in high-risk activities
• Aches, headaches, digestive problems without a clear cause
• Obsessive thinking or compulsive behavior
• Thoughts or behaviors that interfere with work, family, or social life
• Unusual thinking or behaviors that concern other people

Get preventive care to stay healthy.

Many people think of the doctor as someone to see when they’re sick. But doctors also provide services — like screening tests and vaccines — that help keep you from getting sick in the first place.

Get screening tests to find problems early.

Screenings are medical tests that doctors use to check for diseases and health conditions before there are any signs or symptoms. Screenings help find problems early on, when they may be easier to treat.

Depending on your age and medical history, you may need to be screened (tested) for things like:

• Certain types of cancer
• High blood pressure or high cholesterol
• Diabetes
• STDs (sexually transmitted diseases)
• Mental health conditions, like depression

Stay up to date on your vaccines.

Everyone needs vaccines to stay healthy. Ask your doctor or nurse which vaccines you need to stay healthy — then make sure you stay up to date. For example, everyone age 6 months and older needs a seasonal flu vaccine every year.

Cost and Insurance

What about cost?

Under the Affordable Care Act, insurance plans must cover many preventive services. Depending on your insurance plan, you may be able to get services like screenings and vaccines at no cost to you. Check with your insurance company to find out more.

Medicare also covers certain health services at no cost.

If you don’t have insurance, you may still be able to get free or low-cost health services.

Most men probably don’t like thinking about their prostates, but it’s worth doing once in a while. Problems with the small gland are common in men past the age of 50. The good news is that most prostate conditions can be successfully treated.

The prostate is about the size of a walnut. It wraps around the urethra, the tube that carries urine out of the bladder. During sexual climax, or ejaculation, the prostate adds fluid to sperm to create semen, which also leaves the body through the urethra.

For men under 50, the most common prostate problem is prostatitis. It can cause a burning feeling when you urinate or an urge to urinate more often. You might have a fever or just feel tired.

Prostatitis is caused by the prostate becoming inflamed or irritated. Some kinds of prostatitis are caused by bacteria . If you have bacterial prostatitis, your doctor can spot it by looking at your urine through a microscope. Bacterial prostatitis can usually be treated with an antibiotic .

But most of the time, there’s no clear cause for prostatitis. Researchers have yet to identify a clearly effective treatment when the cause is unknown. You may have to work with your doctor to find a treatment that works for you. Changing your diet or taking warm baths may help. No single solution works for everyone.

For men over 50, the most common prostate problem is prostate enlargement, or benign prostatic hyperplasia (BPH). The prostate naturally grows larger as you get older. As it grows, it squeezes the urethra. The pressure can affect bladder control.

BPH can lead to more serious problems, such as urinary tract infections. In rare cases, the constant urination problems can lead to kidney damage.

Several treatments are available for BPH. In recent years, scientists have developed medicines that can shrink or relax the prostate to keep it from blocking the bladder opening. Researchers have also developed devices that allow doctors to remove parts of the prostate without major surgery. The procedures can usually be done in a clinic or hospital without an overnight stay. More invasive surgery is also an option.

The symptoms of prostate cancer, in which cancer cells form in the tissues of the prostate, can be similar to those of BPH. However, most of the time patients are diagnosed with prostate cancer after results from a blood test prompt a prostate biopsy.

Prostate cancer is the most common cancer in American men after skin cancer. But most men with prostate cancer don’t die from it. Many prostate cancers never even cause symptoms or become a serious threat to health. That’s because prostate cancer tends to grow more slowly than many other cancers. A prostate tumor may grow for 30 years before it gets large enough to cause symptoms. Several treatment options are available.

Certain risk factors have been linked to prostate cancer—for example, eating a high-fat diet. NIH-funded scientists are now looking at how prostate cancer can be prevented. NIH also has many research programs aimed at finding treatments for BPH and other prostate problems.

See your doctor right away if something doesn’t seem right to you down there. And if you can’t urinate at all, get medical help immediately.

When to See a Doctor

Tell your doctor if you:

• Have a frequent urge to urinate.
• Need to get up many times during the night to urinate.
• See blood in urine or semen.
• Feel pain or burning when you pass urine or ejaculate.
• Have frequent pain or stiffness in lower back, hips, pelvic or rectal area, or upper thighs.

Men, especially those with lighter skin, are more likely than anybody else to get skin cancer, including melanoma—the deadliest kind of skin cancer.

When you think sun protection, you might think about a day at the beach. But over your lifetime, you get sun exposure doing everyday things like biking, working, running, or even mowing the lawn. Sun exposure is the main source of ultraviolet (UV) rays, which can cause skin cancer. And UV exposure adds up over time, increasing your risk of developing skin cancer.

Skin cancer is the most common cancer in the United States. Every year, nearly 5 million people are treated for skin cancer, at a cost of about $8 billion. Melanoma causes around 9,000 deaths per year in the U.S.

Why Are Men More Likely Than Women to Get Skin Cancer?

Men tend to get more sun exposure than women. Men spend more time outside over their lifetimes than women, and they’re more likely to work outdoors than women. Women’s personal care products, like moisturizer and makeup, often contain sunscreen, while many products for men don’t.

About one-third of U.S. adults get sunburned each year. Sunburn, which can increase your risk of getting skin cancer, is common among white men, young adults, and men who tan indoors. When outside on a sunny day for more than an hour, only about 14% of men use sunscreen on both their face and other exposed skin.

Easy Ways to Protect Yourself

It’s easy to protect yourself from UV exposure—

• Long-sleeved shirts, pants, and a wide-brimmed hat offer the best protection. If you’re wearing a baseball cap or short-sleeved shirt, make sure to put sunscreen on your ears, neck, and arms.
• Stay in the shade as much as possible between 10 a.m. and 4 p.m., which are peak times for sunlight.
• Use a broad spectrum sunscreen of at least SPF 15 on any exposed skin, and don’t forget to re-apply it every two hours, as well as after swimming, sweating, or toweling off.
• If you work outdoors, ask about sun protection at your job, like wearing sun-protective clothing.
• Avoid indoor tanning.

Some health issues, such as erectile dysfunction (ED) and prostate problems, are unique to men. As many as 30 million American men have ED, and benign prostatic hyperplasia is the most common prostate problem for men older than age 50.

Other health issues—such as coronary heart disease, lung cancer, HIV infection, and Parkinson’s disease—are more common in men than women.

Some dietary supplements are marketed specifically for men’s health issues. But many have not been shown to be safe or effective.

For instance, no complementary health approach has been shown to be safe and effective for treating ED. The scientific evidence also does not support using the dietary supplement saw palmetto for any health condition, and yet it is often promoted for urinary symptoms associated with an enlarged prostate gland. And similarly, there is insufficient evidence to support the use of the dietary supplement lycopene for preventing or treating an enlarged prostate gland.

Hormones change as we go through the life cycle. What is normal for a 20-year-old is not the same normal as for a 60-year-old. Although low testosterone (“low T”) is a diagnosis being promoted by the makers of testosterone medications, it is not as simple as just prescribing hormone replacement. A low testosterone level can be due to many factors. A clinician must also take care not to add testosterone too quickly without exploring other therapies first, because once external testosterone is given, it inhibits the body’s natural production of testosterone. Testosterone supplementation is also not without risks, and in terms of long-term use, there is much about safety that we do not yet know.

Key Factors in Optimizing Male Hormones

Maintain Ideal Body Weight

This is probably the most important thing a man can do. As belly fat increases, there is an increase in activity of the enzyme “aromatase” which converts testosterone in the fat cells to estrogen. This reduces testosterone and increases estrogen, which can increase fat deposition in typical female areas (breast, hips, thighs) and increase the risk of enlargement of the prostate and even prostate cancer. With every one-point drop in your body mass index (BMI) your testosterone level will increase by approximately 1 point. In fact, management of obesity may prevent declining total testosterone in the aging male.

Avoid Developing Diabetes

Developing diabetes increases the risk of having a total testosterone level of less than what is considered normal. Over a 10-year period, the risk for developing abnormally low testosterone levels more than doubles in diabetic individuals.

Exercise

A combination of aerobic (increase in heart rate) and resistance (weightlifting) training has been found to increase the production of testosterone. This also helps prevent the most common diseases that men are most likely to die from, heart disease and cancer. Overtraining in endurance sports such as American football and weight-class wrestling and excessive exercise with calorie restriction can cause testosterone deficiency as well.

Sleep Well

Most of the bodys testosterone is made during deep sleep when a person is in Rapid Eye Movement (REM). A disrupted sleep cycle with less time spent in REM has been associated with low testosterone levels.

Avoid Tobacco Products

Tobacco reduces testosterone.

Avoid Excessive Alcohol

Alcohol (more than two drinks a day), increases the conversion of testosterone to estrogen.

Avoid Opioid Pain Medications

Morphine and other opiates decrease testosterone. This can go on for months to years while a person is being treated with opioid medications. Levels can drop as quickly as a few hours after starting opioids. It appears that the higher the dose of opioids, the greater the risk of low testosterone. Fortunately, this side effect should be reversible after stopping the pain medication. Of course, do not stop or change pain medication suddenly without consulting with the prescribing provider.

Avoid Xenobiotics

Xenobiotics are compounds from the environment that mimic the bodys hormones. Research has shown that the average testosterone level in men has gradually dropped over the years. This may be in part due to all the environmental toxins that have accumulated over the years. The main toxins that we know about thus far include the following:

• Bisphenol A (BPA). BPA is found in plastics. To avoid it, don’t microwave food in plastic containers. Avoid plastic containers with the numbers 3, 6, or 7 engraved in the triangle on the product. Buy BPA-free water containers. Drinking water out of containers with the numbers 2, 4, 5, or 7 is OK. Do not drink out of Styrofoam containers.
• Phthalates. These chemicals are used in plastics, coatings, lubricants, and binders. Many are found in hygiene products such as shampoos and colognes. A useful website on phthalate-free products is the Guide to Less Toxic Products.
• Organophosphates. These are mainly found in pesticides and herbicides. Eat organic when possible to avoid exposure to them.

Avoid Excessive Stress

Cortisol levels in the blood are indicators of stress level. This steroid hormone can increase fat deposition, resulting in more conversion of testosterone to estrogen.

Eat Well

Poor nutrition is at the root of many diseases and can also create an imbalance of male hormones.

• Foods to avoid:
  • Excessive sugar
  • Excessive caffeine
  • Red meat and other sources of animal fat
  • Excessive dairy products
  • Food dyes
  • Processed foods

• Foods to include:
  • Green tea
  • Multicolored fruits and vegetables
  • Nuts (particularly Brazil nuts which are rich in selenium – two a day is plenty)
  • Fiber (covered by eating fruits and vegetables)
  • Ground flax seed (1 tablespoon a day)
  • Soy products (soy milk instead of cow’s milk)

Consider dietary supplements

Note: Please refer to the Passport to Whole Health, Chapter 15 on Dietary Supplements for more information about how to determine whether or not a specific supplement is appropriate for a given individual. Supplements are not regulated with the same degree of oversight as medications, and it is important that clinicians keep this in mind. Products vary greatly in terms of accuracy of labeling, presence of adulterants, and the legitimacy of claims made by the manufacturer.

To maintain healthy testosterone levels, the changes discussed above will trump any supplement, but the nutrients below have been found to inhibit aromatase and may be additive benefits.

• Zinc (if levels are low): 25-50 micrograms daily.
• Quercetin: 400 micrograms daily.
• Grape seed extract: 100-300 micrograms daily. You can get all these nutrients by eating nuts, fruits (grapes and citrus) and vegetables.
• DHEA: 25-50 micrograms daily. It is an OTC supplement that is a precursor to testosterone found in the adrenal gland. It goes down when stress (cortisol) goes up. The best way to raise DHEA is to learn to see life in a less stressful way.

Vaccines and Immunization

You can help protect yourself and others against seasonal flu and other vaccine-preventable diseases by getting immunized.

Vaccines are some of the safest medical products. But, like any other medical product, there may be risks. Talk to your health care provider about the value of vaccines and their side effects.

Vaccines to consider

Influenza (flu): People who are 6 months and older should get the flu vaccine (flu shot). Get the vaccine each year because flu virus can change from one year to the next.

Pneumococcal: Older people and those with certain medical conditions are most susceptible to pneumonia. People under 65 will need a booster shot when they reach 65 if more than five years have passed since the initial dose. Learn about pneumococcal pneumonia and vaccines.

Hepatitis A: Recommended for those who travel to other countries or live in a U.S. community with high rates of hepatitis A; or who have chronic liver disease, engage in male-to-male sex, or inject drugs. Learn more about the hepatitis A vaccine.

Hepatitis B: More contagious than HIV, hepatitis B is the type of hepatitis most often spread through sexual contact. It can also be passed from an infected mother to newborn, the sharing of needles or personal items with an infected person, and other contact involving bodily fluids. The hepatitis B vaccine can prevent the disease.

Measles, mumps, rubella (MMR): People born after 1956 and all women of childbearing age who have not had these diseases or been vaccinated against them need to get the shots to be protected.

Chickenpox (varicella): Protection is necessary for those born in the U.S. after 1966 and have not had this disease and have not been vaccinated. Adults are at a far greater risk of complications.

Shingles (herpes zoster): Shingles is a painful, rash-like illness. If you are 50 or older, get Shingrix which provides strong protection from shingles and long-term nerve pain. Even if you’ve had Shingles, it’s important to receive the vaccine because you can get the disease more than once. You may have already got a different shingles vaccine called Zostavax. If you did, you still need 2 doses of Shingrix. Your risk of shingles and complications increases as you age. You need 2 doses of Shingrix. Get the second dose 2 to 6 months after you get the first dose. 

Tetanus, diphtheria, pertussis: Booster doses of tetanus-diptheria (Td) are needed at 10-year intervals. In place of the Td booster, people age 19-64 and those 65 and older who are in contact with infants should get a one-time dose of tetanus-diptheria-pertussis (Tdap) to also protect against whooping cough.

Vaccines for international travelers: Many Veterans and other Americans traveling abroad are likely to be exposed to diseases common in those countries.

Many men need to pay more attention to their health. Compared to women, men are more likely to:

• Smoke
• Drink too much alcohol
• Make unhealthy or risky choices
• Put off regular checkups and medical care

The good news is that you can start taking steps to improve your health today!

How can I take charge of my health?

See a doctor for regular checkups even if you feel healthy. This is important because some diseases and health conditions don’t have symptoms at first. Plus, seeing a doctor will give you a chance to learn more about your health.

Here are some more things you can do to take care of your health:

• Eat healthy and get active
• If you drink alcohol, drink only in moderation
• Quit smoking
• Know your family’s health history
• Get screening tests to check for health problems before you have symptoms
• Make sure you’re up to date on your vaccines (shots)

Eat healthy and get active.

Remember, it’s never too late to start healthier habits. A healthy eating routine and regular physical activity can help control your:

• Blood pressure
• Blood sugar
• Cholesterol
• Weight

By keeping these numbers in a healthy range, you can lower your risk of serious health problems like type 2 diabetes and heart disease.

Make eating healthy and being active part of your daily routine:

• Learn how to eat healthy
• Take steps to get active

In addition:

• If you drink alcohol, drink only in moderation
• If you smoke, make a plan to quit

Small Changes

Make small changes every day.

Small changes can add up to big results — like lowering your risk of type 2 diabetes or heart disease. Here are some examples of small changes you can make:

• Take a walk instead of watching TV
• Try a green salad instead of fries
• Drink water instead of soda or other sugary drinks

Talk about it.

You don’t have to be embarrassed to talk about your health! Start by talking to family members to find out which diseases run in your family.