On average in the U.S., men die younger than women, are sicker throughout their lives, get sick earlier than women, and have more chronic diseases than women.i Men, however, don’t go to the doctor as much as women. Many diseases can be better treated or completely treated if found early.

A yearly physical for older men is important since many of the top 10 causes of death are preventable. Helping people lose weight, stop smoking, eat a healthier diet, check blood pressure, and have routine labs can help to prevent heart disease, strokes, COPD, and diabetes. Certain screening tests for cancer, diabetes, and kidney disease can help men live longer and better if they are found early.

Yearly physical
One of the problems found during a yearly physical is high blood pressure. I see someone with high blood pressure every day. Many people with high blood pressure never feel sick or have any symptoms, but it can cause kidney disease, heart attacks, and stroke if not treated. Diseases like high blood pressure can be treated easily.

In the past, a yearly physical for a man over 40-50 included the dreaded “digital rectal exam” or prostate exam. This has changed in recent years. In many cases, a screening prostate exam is not required. ii Bottom line is that if you’re not having problems or symptoms that could be linked to your prostate, you may not have to have an exam. This is a decision made between patient and provider.
Many diseases, like COPD or gout, cause gradual and worsening damage each time they flair. It is important for these to be addressed to reduce the permanent damage that is caused.

Diseases and conditions
As of 2010, the odds that a man would die from heart disease, cancer, COPD, accidents, diabetes, the flu, pneumonia, kidney disease, and severe infection were higher than women. Yet, on average, women go to the doctor more than men. A yearly physical can help to treat factors that increase the risk of these major illnesses.

Testicular cancer is a young man’s cancer as well as an older man’s cancer. We try to educate young men starting at age 15 to perform monthly testicular exams since that is the age at which we begin to see testicular cancer.

Prostate cancer is an older man’s cancer but can start in the 40s. Most prostate cancers are nonaggressive but a few cases out of 100 are aggressive and can spread. It is important for men to get checked if they have any unusual problems with urination or a family history of prostate cancer.
Erectile dysfunction is a more common problem for men over 40 years old and can be caused by several issues. This should at least be evaluated in a visit to the doctor, and blood tests may be required.
While low testosterone has been a cash cow for some designer practices in recent years, it remains a problem in men that can lead to changes in quality of life. Some of these changes include low energy, depression, and sexual dysfunction. It can be associated with other metabolic diseases in men, like diabetes. A man with diabetes is twice as likely to have low testosterone levels and may benefit from testosterone replacement.

Prevention
• Don’t smoke or stop smoking if you already do. Avoid exposure to secondhand smoke.
• Eat a healthy diet. Choose vegetables, fruits, whole grains, high-fiber foods and lean sources of protein, such as fish. While there are many diet plans out there, trying to eat less processed foods of all types, in moderation seems to be the best advice.
• Maintain a healthy weight. Losing excess pounds — and keeping them off — can lower the risk of heart attacks as well as various types of cancer.
• Exercise. Exercise can help control weight, lower risk of heart attacks and stroke and possibly lower the risk of certain types of cancer. Many men believe they have to kill themselves with intense activities to gain anything from exercise. This is not true. Gardening and walking have benefits.
• Eliminate alcohol. The risk of various types of cancer, such as liver cancer, appears to increase with the amount of alcohol you drink and the length of time you’ve been drinking regularly. Too much alcohol can also raise your blood pressure. Recent evidence suggests that even amounts of alcohol once thought safe can affect how well we remember things. An estimated 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the fourth leading preventable cause of death in the United States.iii In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths (31 percent of overall driving fatalities).iii
• Manage stress. Unmanaged stress can lead to problems like high blood pressure and diabetes. Many options and avenues exist for helping to manage stress, only one of those includes medications. Exercise, good diet, and close family and friends can lead to better stress management.
• Colonoscopies starting at age 50, blood work to screen cholesterol, and depression screening are common tests suggested for men.

Genetics
Genetics and Family history are very important when a patient is initially seen. Many diseases are passed from generation to generation. If your father had heart disease or seasonal allergies, the chance of you having heart disease or seasonal allergies is higher. High blood pressure, diabetes, high cholesterol, and prostate cancer are among conditions that have some genetic link and may be passed on through generations.

i http://www.health.harvard.edu/newsletter_article/mars-vs-venus-the-gender-gap-in-health
ii https://www.guideline.gov/summaries/summary/45309/screening-for-prostate-cancer-a-guidance-statement-from-the-clinical-guidelines-committee-of-the-american-college-of-physicians?q=Digital+Rectal+Examination
iii https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics