In Honor of Our Veterans, Let's Talk About Men's Health

I always like to frame men's (and women's) health in the context of one simple question: What do we really care about?

We care about a long life filled with fulfillment, connection, and happiness. We want to continue doing the things that bring us joy well into old age. That may mean pickleball, golf, gardening, cooking, playing with grandkids, or having sex—whatever gives us purpose.

Yes, we want long lives. But what we really want is quality of life.

The increased attention toward extended quality of life is often referred to as healthspan.

What Are the Barriers to Healthspan?

There are four primary chronic illnesses that derail both healthspan and lifespan: atherosclerotic cardiovascular disease (ASCVD), metabolic diseases such as type 2 diabetes, neurodegenerative diseases such as dementia, and cancer. These are often referred to as "the four horsemen."

The fact that these chronic diseases account for the vast majority of deaths and morbidity among U.S. men is actually good news. Why? Because there are things we can do to prevent them.

Simply put, we must identify risk factors as early as possible and address them. This is where doctors come in.

It also means following the basic tenets of a healthy lifestyle. This is where you come in.

The web of connections between all the variables that contribute to chronic disease is complicated, but the strategies to reduce risk are not.

Let's break the plan down into seven simple steps.

This means screening for common cancers such as prostate, colon, and skin cancer. These cancers are increasing in prevalence, and screening saves lives.

It also means evaluating risk factors for heart disease through blood pressure checks, cholesterol testing, and other appropriate screening tools. Many men are unaware they have coronary artery disease until a heart attack occurs.

Early evaluation for metabolic disease is equally important. Identifying problems before they become diabetes can dramatically change long-term outcomes.

No amount of alcohol is truly beneficial, and excessive use increases the risk of every one of the four horsemen. Smoking remains one of the greatest contributors to cancer and cardiovascular disease.

There is no single perfect diet for every man. That said, it's hard to argue with a Mediterranean-style approach rich in protein, healthy fats, fruits, vegetables, and whole foods while limiting refined sugars.

Above all, avoiding excess calories is critical. Obesity increases the risk of cardiovascular disease, metabolic disease, many cancers, and reduced testosterone levels.

This cannot be overstated.

Exercise is better than almost any medication I can prescribe. It reduces the risk of all four horsemen while improving mental health, sleep, sex drive, and overall quality of life.

Two factors are highly associated with longevity: maintaining skeletal muscle mass and preserving cardiovascular fitness. Both can be improved through consistent resistance training, aerobic exercise, and proper nutrition.

Sleep is receiving more attention than ever, and for good reason.

Quality sleep improves memory, focus, mood, sexual health, immune function, and metabolic health. It also lowers the risk of cardiovascular disease and dementia.

Most people do best with seven to nine hours of quality sleep per night. Alcohol and many sleep aids can significantly impair sleep quality, even when they seem to help you fall asleep.

This is a tough one.

Chronic stress has profound effects on the body, contributing to metabolic dysfunction, increased cardiovascular risk, impaired concentration, reduced testosterone, and a host of other health concerns.

Finding ways to reduce stress is critical. Exercise, meditation, social connection, hobbies, and spending time with family and friends can all help.

I wouldn't be a good urologist and men's health specialist without mentioning testosterone.

Low testosterone is associated with increased visceral fat, obesity, type 2 diabetes, cardiovascular disease, falls, fractures, and loss of muscle mass. It can also negatively affect mood, cognition, sleep, sexual health, and exercise tolerance.

In many ways, low testosterone sits right in the middle of declining healthspan, both as a cause and an effect.

Every man should know his level.

The ball is in your court, gentlemen.

We get one shot. Make it count.

The average life expectancy for a U.S. male is just over 76 years—more than five years shorter than women.

A CDC study found women are 33% more likely to visit the doctor than men and twice as likely to seek preventive health care. Sixty-five percent of men report waiting as long as possible before seeking medical attention, even when symptoms persist.

We can do better.

Let's do the things, fellas. For ourselves and for our families.

And many thanks to our veterans for your tremendous service to our country.