June is National Men’s Health Month, which is an opportunity to encourage the men in our lives to take care of themselves, whether it be exercising more, quitting smoking, addressing their physical and mental health concerns or making that long overdue appointment for their routine screenings.
Brigham and Women’s Faulkner Hospital is proud to be a leader in men’s health. This year, we asked some of our experts to address frequently asked questions about men’s health.
Chief of Benign Urology and Director of the Men’s Health Center
View Profile View ProfileWhen should I have my first prostate exam?
Dr. Trinh: The appropriate age to start prostate cancer screening varies based on individual risk factors. General guidelines suggest that men with average risk should discuss screening with their primary care provider at age 50. Men at higher risk, such as those with a family history of prostate cancer or African American men, should consider starting discussions earlier, around age 40 to 45.
What is benign prostatic hyperplasia (BPH)?
Dr. Kathrins: BPH is enlargement of the prostate gland which can cause urinary bother. It is not prostate cancer.
What are the treatment options for BPH?
Dr. Kathrins: There are lifestyle, pill-based and surgical options to treat BPH. Your urologist will help you find the best treatment option for you.
How do you screen for prostate cancer?
Dr. Trinh: Prostate cancer screening typically involves two tests:
The first is the Prostate-Specific Antigen (PSA) test. This blood test measures the level of PSA, a protein produced by both cancerous and noncancerous tissue in the prostate. Higher levels of PSA can indicate the presence of prostate cancer, but other conditions like an enlarged prostate or inflammation can also raise PSA levels.
The second is the Digital Rectal Exam (DRE). During this exam, a healthcare provider manually feels the prostate through the rectum to check for any irregularities or bumps.
What are the treatment options for prostate cancer?
Dr. Trinh: Treatment options for prostate cancer depend on various factors, including the stage of the cancer, its aggressiveness (Gleason score) and the patient’s overall health and preferences. Treatment options include:
How do you know if you have low testosterone?
Dr. Kathrins: Symptoms of low testosterone include low sex drive, erection problems and low energy. We check for this with an early morning blood test to measure testosterone.
What are the treatment options for low testosterone?
Dr. Kathrins: While some lifestyle changes can improve testosterone, there are other options to treat low testosterone, including topical gels, pills, self-administered injections and long-acting testosterone pellets that can be put under the skin in a doctor’s office a few times a year.
What are the treatment options for erectile dysfunction?
Dr. Kathrins: While some lifestyle changes can improve erectile dysfunction, there are other medical therapies such as pill therapies taken on demand to improve erections. If that is not effective, some men learn how to inject a medication into the side of the penis with a small needle to help with erections. There are also surgical therapies which are considered a last resort.
Are there any treatment options for premature ejaculation?
Dr. Kathrins: There are over-the-counter topical treatments which numb the penis and can help with premature ejaculation. If that is not effective, there are pill-based therapies that a urologist can prescribe. Some men may benefit from meeting with a sexual therapist for this problem.
What are the treatment options for urinary incontinence?
Dr. Kathrins: There are few reasons why a man may have urinary incontinence. You should meet with a urologist for testing to determine the cause. Treatments generally include lifestyle changes and pill therapies. However, if those are ineffective, there are procedures that can be offered which can help.
What does it mean if I have blood in my urine?
Dr. Kathrins: If you see blood in your urine, you should have an evaluation by a urologist. The primary goal of the evaluation is to rule out cancer in the urinary tract.
How do you screen for infertility?
Dr. Kathrins: We can screen for infertility via a semen analysis (sperm test), which is provided in a private room in a laboratory in the hospital. The interpretation is done with a urologist at a later date. A semen analysis can be ordered by your primary care provider or a urologist.
What are the treatment options for infertility?
Dr. Kathrins: There are some lifestyle changes that can help with infertility such as diet and exercise. However, some men will benefit from medication therapy or surgery. A consult with a urologist is important to investigate why you are experiencing infertility and come up with a treatment plan.
Am I a good candidate for vasectomy?
Dr. Kathrins: There are not many reasons that a man would not be a candidate for vasectomy. However, a clinical visit is required by a urologist and generally a very brief physical exam is performed. The procedure is explained in detail and then a date for the procedure is selected.
What does the procedure entail?
Dr. Kathrins: Most vasectomies take about 20 minutes and are performed in clinic with some numbing medication in the scrotum. The tubes (one on the left and one on the right) are cut so the sperm does not flow out of the testicles.
What is the recovery time after vasectomy?
Dr. Kathrins: Generally, couch rest is needed for two to four days. After that, mild pain is expected for about two weeks.
Can vasectomy be reversed?
Dr. Kathrins: While vasectomy reversals can be attempted the success rates are not perfect. You should not go into your vasectomy procedure with the assumption that it is reversible.
Published 6/1/24
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