As we near the end of November, which is men’s health month, we focused our monthly free webinar last night on raising awareness of men’s health with a special spotlight on the prostate. Led by Dr Asim Vine of our Integrative Doctors and also a GP, we learnt first of all why it’s important that we talk about men’s health and also how an integrative approach can be helpful.

Men’s physical health can often be neglected. Men are notoriously worse than women at looking after themselves which means they have an earlier mortality rate than women and a higher incidence of disease for many serious conditions. Testosterone, the main male sex hormone, causes a higher LDL (low-density lipo- protein) cholesterol level which predisposes men to cardiovascular problems so they tend to have a higher incidence of strokes and heart attacks. In fact, statistics show us there is a 1/7 prevalence of cardiovascular disease in men, rather 1/11 for women. Men also have lower T-cells so a less active immune system. Conversely this means they don’t always get the same autoimmune conditions that women are more prone to. But men on average do tend to die younger than women and have less healthy lives overall.   Men also tend to have more accidents and injuries and again this can come down to testosterone, which can cause more risk taking behaviour than women might do.

But this doesn’t totally explain why men’s health tends to suffer more. Perhaps a lot can also be explained to society and the expectations placed on men – men are often expected to be stronger, less emotional which can result in worse health outcomes. For instance, men tend to have a higher death rate in cancer because diagnosis is often later than that of women, so the prognosis is generally worse. Men are often reluctant to go and seek help or get symptoms checked – with the shocking statistic that men are approximately 40% more likely to die of cancer overall.

The first point of encouragement for men is to try to understand themselves and get to know their own health better. For instance, some basic health awareness such as knowing their weight and BMI is always helpful; what the recommended level of activity is considered healthy for their age and what a normal blood pressure range is would be are all good key starters. For men over 40, the NHS offers a free health check at your local GP surgery, which will assess the risk for conditions such as heart disease, diabetes and stroke.

The integrative approach would also urge men to look into lifestyle options as a means of prevention for any serious conditions. Integrative Medicine takes a whole person approach, bringing together conventional, lifestyle, functional and holistic approaches to support men in their journey to health. There are many lifestyle measures men can be encouraged to make to improve their cardiovascular health. These would include weight control, exercise as well as cutting down or out alcohol and smoking. We can have very sedentary lifestyles nowadays and particularly men who are office based tend to spend a large portion of their lives sitting down so trying to make modifications to daily working lives too can have a big impact. These are all simple adjustments, but men might either lack the motivation or have the knowledge and awareness on how to make these changes. 

An awareness generally around cardiovascular health is very helpful. Some men for instance might not know that erectile dysfunction can be an early sign of heart disease so it’s important that people are armed with the right knowledge about early warning signs not just the symptoms once the disease is in its acute phase. Dietary modifications can be very helpful when we are talking about cardiovascular disease – there is much research around the mediterranean diet in particular. Lots of vegetables and beans, as much colour and diversity as possible, lots of fibre, nuts and seeds, healthy fats and oils and the inclusion of lean protein such as fish over red meats. For both men and women, its generally regarded that the inclusion of foods such as cruciferous vegetables, soya and flaxseed can be very helpful for balancing hormones – something which can be forgotten when we think of men’s health.

Mental health in men has also come to the forefront more recently as suicide rates are increasing. Men continue to account for ¾ of all suicide deaths in the UK. Again women are much more inclined to go and seek help when their mental health is suffering, and will consider options such as therapy to learn more about their symptoms. Within the integrative approach, whilst medication might be an option for men suffering with mental health problems, we would also look at the whole picture. What nutrition is that man getting? We would consider how much omega 3 fatty acids is in his weekly diet which can be found in oily fish amongst other places. What is his vitamin D status and how much magnesium is he consuming for mood. Food can have a huge effect on our mental health so diet is always something which can be easily looked at and modified and supplementation can sometimes be discussed where levels aren’t optimal. 

We would also potentially recommend lifestyle measures such as CBT (Cognitive Behaviour Therapy), acupuncture and massage therapy which also all have studies backing up their efficacy with mental health issues. And we would look at a mind body approach so recommendations for mindfulness, yoga and meditation which men can sometimes feel discouraged by but Integrative Medicine teaches us to personalise medicine to suit the person. Men often tend to do better with and be more willing to try lifestyle measures such as including more aerobic exercise in their daily lives which can also be a really good outlet for symptoms such as anxiety.

Lastly, with men’s health we should always pause and think about lower urinary tract health. This is because men, especially as they age, can develop issues with their prostate, a small organ below the bladder. Around 30% of men over 50 do experience some problems with their prostate because after 40 the prostate starts to enlarge. One of the most common issues is a condition called Benign Prostatic Hyperplasia (BPH) with symptoms such as increased urgency to urinate, a weak urinary stream, incontinence, nocturia (needing to urinate at night) and erectile dysfunction. But these symptoms could also point to other conditions, such as an enlarged or inflamed prostate. If you are overweight or have metabolic syndrome, you are more likely to experience symptoms with your prostate so losing weight or reversing metabolic syndrome will certainly help. Other lifestyle adjustments that can be made are including zinc rich foods in your diet regularly – this would include seafood, poultry and red meat and for plant-based sources pumpkin seeds is especially high in zinc. In terms of herbal remedies, Saw Palmetto is one of the most well studied, but studies are mixed and inconclusive as to the benefit of taking it and it does have interactions with medications so it’s always best to check with a trained medical practitioner before taking these herbal remedies.

 Interestingly, although symptoms with the prostate are physiological they can also be a manifestation of mental health issues that we mentioned earlier such as mental tension or anxiety. Similar to how we can get a sore neck or backache when we are stressed. So sometimes with the prostate, there can be other routes to treating symptoms such as therapy, pelvic floor relaxation exercises, prostate massage and acupuncture.

Prostate cancer is one of the leading causes of cancer in men – 1 in 8 will develop it at some point in their lifetime. This is more common in men over 70 and there is also a hereditary element to it and men of African heritage are more prone to this type of cancer. Other risk factors for prostate cancer include being overweight, particular weight around the circumference, having a diet low in fibre and fruits and vegetables, high cholesterol, smoking and drinking and a sedentary lifestyle. Foods which can help protect the prostate are tomatoes (particularly cooked) which are high in a phytochemical called lycopene. As mentioned before, cruciferous vegetables, soya and omega 3 fatty acids are all considered to be very beneficial and can help reduce the effect of testosterone. There is some evidence to also suggest that lowering or limiting dairy in men could be beneficial to preventing prostate cancer but as studies aren’t completely conclusive it’s not recommended to totally cut dairy out of the diet. Lastly, another prevention for prostate cancer would be increasing movement and exercise which can help with weight and reduces inflammation and oxidative stress within the body.

Do take a look at this time important campaign running for men to increase bin in public toilets for men. A small but overlooked detail which could help so many men in future.

https://tackleprostate.org/boys-need-bins-campaign/

I hope you have found this useful – remember if you have any health concerns Dr Asim Vine who led the webinar last night, is our resident men’s health expert and would be happy to discuss options in a holistic consultation. Click here: Integrative Medicine Clinic – NCIM – National Centre for Integrative Medicine to see more about our clinical services.