Men's Health Archive

An approach called active surveillance allows some men with low-risk cancer to delay the decision to treat.

Biomarkers are "chemicals" that can indicate both normal and abnormal processes in the body. One of the most famous is prostate-specific antigen (PSA). The PSA test, which detects abnormally high blood levels of PSA, has been used for decades to screen for prostate cancer and potentially catch it early.

There are two problems with the PSA test. First, PSA levels can tell you that something is going on with the prostate — but that "something" isn't necessarily cancer. High levels may mean other benign prostate conditions. Second, when high PSA levels do turn out to be the result of prostate cancer, the PSA level alone won't tell you which cancers are aggressive and need treatment, and which are slow-growing and can be managed more conservatively.

Q. I am scheduled to have my prostate removed and am concerned about the risk of erectile dysfunction (ED) after the surgery. I've heard that taking an ED drug daily during my recovery could help. Do you recommend this?

A. About half of men lose some erectile function after radical prostatectomy, which removes the entire prostate gland. ED drugs help men to have erections after surgery, but so far research has not shown that taking it daily produces better results than taking the medication as-needed—when you anticipate sexual activity.

Discomfort with intercourse happens to men, too. But most obstacles can be overcome.

To most men, an active sex life is essential. If you go by what you see in the health press, the only thing standing in your way is erectile dysfunction (ED), the inability to get and keep an erection sufficient for intercourse. The drugs approved to treat ED all work to a greater or lesser extent for most men with erectile difficulties, and there are other options if they don't.

Is brain damage an inevitable consequence of American football, an avoidable risk of it, or neither? An editorial published yesterday in the medical journal BMJ poses those provocative questions. Chad Asplund, director of sports medicine at Georgia Regents University, and Thomas Best, professor and chair of sports medicine at Ohio State University, offer an overview of the unresolved connection between playing football and chronic traumatic encephalopathy, a type of gradually worsening brain damage caused by repeated mild brain injuries or concussions. The big question is whether playing football causes chronic traumatic encephalopathy or whether some people who play football already at higher risk for developing it. The Football Players Health Study at Harvard University hopes to provide a solid answer to that and other health issues that affect professional football players.

Be skeptical and get the big picture from multiple sources.

When you need to find a hospital or medical center to have non-emergency surgery or a diagnostic procedure, you often have a choice—assuming you clear it with your insurance provider. How do you figure out the best place to go?

Many men consider taking a daily low-dose aspirin to reduce the chance of having a heart attack or stroke. You should do so only if the chance of being helped outweighs the chance of triggering unwanted bleeding, since aspirin interferes with normal clotting. But about one in 10 men who take protective aspirin may not really qualify, according to a national study in the Journal of the American College of Cardiology.

Experts recommend that aspirin might be considered in someone whose chance of experiencing a cardiovascular problem is at least 6% in the next 10 years. At that tipping point, the chance of being helped is great enough to justify the risk of unwanted bleeding.

Q. What are the most effective treatments for premature ejaculation? Do erectile dysfunction drugs like Viagra help with this problem?

A. Premature ejaculation, usually defined as ejaculation within one minute of starting intercourse, is initially treated with behavioral techniques to delay climax. This includes the squeeze technique, which involves applying pressure just behind the head of the penis when ejaculation approaches and maintaining pressure until the
sensation passes. However, in many men, this doesn't prevent ejaculation.

Simple strategies can help you regain control.

As men age, the simple act of urinating can get complicated. Prostate surgery often leaves men vulnerable to leakage when they cough, sneeze, or just rise from a chair. Or the bladder may become impatient, suddenly demanding that you find a bathroom right now. "Thousands of years ago, it was not as much of an issue," observes Dr. Anurag Das, a urologist at Harvard-affiliated Beth Israel Deaconess Medical Center. "There were lots of trees, and you could just find one and go."

But tricky bladders can be whipped into shape. The first step is a careful assessment of what triggers those difficult moments. Then your doctor can suggest helpful strategies and possibly medication to improve urinary control.

Just as regular exercise has a host of health benefits for the body, staying mentally active appears to preserve memory and general sharpness. But for getting a good night's sleep, light workouts for both body and brain may be best, according to a study in the Journal of the American Geriatrics Society.

The study focused on 72 people, ages 67 to 79, who reported poor sleep as well as declining mental sharpness. They were assigned at random to do either strenuous aerobic exercise or a gentler stretching routine, paired with either watching educational DVDs (followed by short quizzes) or engaging in more demanding computer-based brain training.