What Doctors Wish More Men Would Ask Them
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It's no secret that men — especially young men — don't like to visit the doctor. But even when they do drag themselves to a check-up, they're not always willing to ask the questions that really matter.
A large part of what keeps men out of the doctor's office is fear of discovering that something is wrong. They're uncomfortable with body exams and don't want to answer personal questions, too. That's a problem, said Jesse Mills, the director of the Men's Clinic at UCLA.
"In general, men are taught that we're supposed to be the tougher gender — we're supposed to not take time for ourselves because we have to be the provider and the strong one in the family," Mills told ATTN:. "We really internalize that, and so we aren't thinking of looking at physicians as part of a dialogue, but rather as a barrier to that thought of being invincible. Men are notoriously bad at ignoring warning signs."
I asked Mills what questions he and other doctors wish more Millennial men would ask them.
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(This interview has been edited for length and clarity.)
1. What can I do to improve my health?
"The time to ask that question is when he's in his 20s and 30s. If you look at most of the chronic health conditions that we see — especially as a men's health expert and a sexual medicine doctor — that affect men in their 50s and 60s, it probably is related to lifestyle habits that they adopted in their 20s and 30s that were not good for them.
"The most common things that I see that affect sexual dysfunction — and I see a guy in his 50s and 60s — it's cigarette smoking, obesity, diabetes — especially Type 2 diabetes — high blood pressure, high cholesterol, and low testosterone. So if you look at that, every single one of those things I just mentioned can be improved by adopting healthy lifestyle habits in a man's 20s and 30s."
2. What is normal sexual function for a man?
"One of the other things that I get a lot is that men, they don't know what is normal for them in terms of how often they have sex, how long they have sex, how long is it normal for a man to be able to maintain an erection before ejaculation. I think one of the things that we don't get a lot of — and a lot of men are very shy to bring up — is either problems with erections or problems with premature ejaculation.
"And I think one of the biggest, untalked-about sexual health issues facing men anywhere is premature ejaculation, and it's because we don't have an FDA approved therapy for it, so we don't have TV commercials talking about. But I think if a guy felt very comfortable with his physicians, and he could bring that up, there are a lot of really good therapies for that condition that a doctor can prescribe. And that's one of the things that very difficult to elicit from a guy who's somewhat bashful when talking about his sexual health."
3. What is normal in terms of alcohol and drug use?
"Drug use in general, like anything else, and alcohol for that matter, there is this moderation issue. With Millennials and the accessibility and the openness of marijuana in this country, [it's] something we haven't really dealt with from a sexual medicine standpoint.
"Interestingly, there are a lot of men who are taking ADHD medication — which, again, we didn't have growing up for guys that are the boomers and before — we didn't have Ritalin, we didn't have Adderall. But a lot of the guys that I see that have erectile dysfunction in their 20s and 30s are on ADHD medicine as well. So, yeah, there is a drug use issue that we haven't addressed with things that are much more socially acceptable in this generation and hadn't seen before.
"Alcohol use, too. The whole idea of moderation probably applies here as well. Men that have a beer or two, or a glass of wine or two, are not going to really see any difficulty with their sexual function. But excessive drinking can certainly lead to not only hormonal but sexual dysfunction."
4. Am I too stressed out?
"I think male mental health is one of the pillars of men's health. Mental health is where most of the pathology happens to young men.
"If you look at the suicide rate in men under 30, it's far more frequently a male problem than a female problem, and a lot of that does come from stress and, probably, the way that most men deal with problems — which is to internalize instead of being able to talk.
"And I think that's, again, one of the most important things: ... to be able to screen for mental health problems and discuss stress and the environment that leads to that elevated stress in men."
5. Am I getting enough sleep?
"The other thing that I would throw in — a real national problem is a lack of sleep. Sleep medicine is another entire field within men's health that affects everything from mental health to cardiovascular health to sexual health. Men that are sleep deprived tend to have worse problems in all of those categories."
