June is Men’s Health Month, a great time to be aware of preventable health problems and early detection of diseases that affect men. To address these issues, Yale is developing a comprehensive Men’s Health and Wellness Program encompassing a wide range of conditions that may affect men’s sexual, reproductive, prostate and cardiovascular health.
These conditions are often connected. For example, erectile dysfunction (ED) may be related to diabetes or cardiovascular disease. Yale urologist Dr. Charles Walker delves into the underlying causes of ED to evaluate his patients’ overall health. “Men care about their sexual health,” he said. “They’re more willing to pay attention to their health if they can’t have an erection and are more willing to make lifestyle modifications if it will help their ED, so that’s an opportunity for us to educate and screen for other conditions.”
Dr. Stanton Honig, who is also a urologist, notes that after leaving the care of their pediatrician as an adolescent, men often don’t go to the doctor until they turn 45. But screening and early detection play an important role in men’s health care, just as they do for women. For example, men should perform testicular self exams every month for early detection of testicular cancer, the most common cancer in men of reproductive age.
Yale already conducts annual free prostate cancer screenings every September for employees and the public. Men between the ages of 55 and 69, African American men over age 40, or those with a family history of prostate cancer have a higher risk of getting the disease. A high-fat, low-fiber diet may further increase the risk for these groups. If you are African American or have a family history of prostate cancer, Dr. Walker recommends that you begin formal screening at age 40 and that all men have a PSA test done in their 40s to establish a baseline.
Research to Improve Men’s Health
Besides offering state-of-the-art clinical care, Yale has an active clinical research program to help develop new treatments for conditions that affect men’s health.
Dr. Honig participated in clinical trials that led to the FDA approval of Xiaflex to treat Peyrone’s disease, a condition that causes curvature and shortening of the penis, making intercourse difficult or impossible. “I think Xiaflex is a great breakthrough in terms of options,” he said. This novel and effective treatment was developed thanks to clinical trials to test its safety and effectiveness.
Dr. Honig also conducts research to help treat low testosterone, which can cause a decrease in sex drive and energy level. There is much controversy at the present time regarding the over prescribing of testosterone and the FDA has set new recommendations for this. In addition, there has been much concern regarding the relationship between testosterone use and cardiovascular disease, despite the fact that the research published has not been rigorous. - Testosterone should be carefully prescribed, however. Dr. Honig participated in a study showing that testosterone use has increased dramatically in recent years in men between the ages of 18 and 40 and this may have a negative impact on fertility.
Dr. Walker is interested in conducting research to explore the disparities that exist in doctor-patient communications regarding prostate cancer screenings, particularly with African American patients, where they are lacking. He also hopes to show that electronic medical records can be used to facilitate health screenings, especially in underserved populations in cities such as New Haven, which has an African American population of 35% and a Hispanic population of 27%.
The development of a Men’s Health Program at Yale will provide opportunities to design clinical trials, and provide much needed public awareness of gender-related care to improve a multitude of conditions. “Everything we do is an opportunity for research that may ultimately improve the health of men everywhere,” he said.