Over decades of practice, I've seen plenty of men ask me questions with their eyes glued to the floor, quiet, and obviously embarrassed. I hope this list can help get some issues out in the open and inspire a few men to pursue evaluation and remedies.
1. My hair is thinning. Can you help?
The big three causes of thinning hair are: thyroid disease, poor nutrition, and stress. Each of these can be evaluated by a practitioner trained in functional medicine. After correcting those issues, taking supplements with biotin (B7), or taking aryuvedic herbs (including amalaki and brahmi) or catalase may help thicken hair and avoid excessive graying. Catalase is also found in high levels in fermented foods.
2. Why am I not having morning erections?
There are many causes of erectile dysfunction (ED), including vascular damage from a poor diet, high cholesterol, smoking, diabetes, low testosterone and excessive estradiol, and excessive marijuana consumption. I can't emphasize enough the role of ED as a clue to heart disease. If you're experiencing this, don't be embarrassed, be curious … it just might save your life.
3. How do I check my testicles?
Testicular cancer affects about 10,000 men in the USA every year and has one of the highest cure rates of any cancer. Early diagnosis is critical. Men should develop a monthly habit of at least checking themselves in the shower by rolling a testicle between thumb and forefinger feeling for a lump, then repeating on the other side.
4. Why did I see blood on my toilet paper?
Most often hemorrhoids or an anal fissure are to blame. However, rectal or colon cancer are possible causes; don't delay an examination by a trained professional.
5. Why do I pass so much gas?
One of my cardiology colleagues received a letter from the Chief of Staff, admonishing him for excessive flatus during heart procedures. While it's often somewhat humorous, excessive gas may be a clue to lactose and other food intolerances and intestinal dysbiosis. Eliminating dairy, gluten, soy or corn one at a time may help. Taking digestive enzymes with meals along with a daily probiotic may reduce the eruptions.
6. My butt itches. Why?
Who hasn't seen a guy look both ways, then scratch his backside? Not so cool. Issues like food intolerances, cleanliness, hemorrhoids, psoriasis and even pinworms could be the culprit. Some simple remedies may include limiting coffee, tea, chocolate, colas, citrus, and tomatoes. Washing thoroughly after bowel movements, applying unmedicated talc powder and/or 1% hydrocortisone cream may cool the fire.
7. Is my breath really offensive?
In close quarters, bad breath can be a problem at work and in relationships. It could be a sign of bacterial breakdown in the mouth, postnasal drip, gastroesophogeal reflux disease (GERD), and gingivitis. Dentists trained in advanced examinations of periodontal health can help solve the problem.
8. Why do I still get butt acne?
This is usually folliculitis or a superficial infection of hair follicles. This may arise from bacterial infections such as staph aureus or pseudomonas. Some triggers are sitting in hot tubs or wearing tight clothing. Maintaining good hygiene, wearing clothes that breathe, applying salicylic acid or benzoyl peroxide, and using exfoliative scrubs can help.
9. Should my penis bend to the side?
Rest assured: some men are born with a mild congenital curvature. Up to 5% of men develop a curvature due to a chronic inflammation of unknown cause and that is called Peyronie's disease. It can lead to pain, loss of organ width and even pain during intercourse. Some men also have thickening of connective tissues in their hands and feet. Treatments using CoQ10, vitamin E, collagenase, and even surgery are considerations.
10. Are my boobs are too big?
Remember Phil Mickelson and comments about his “manboobs” bouncing while he walked the golf course? It got so much attention that Urban Dictionary lists Mickelson as a synonym for gynecomastia, the official name for this situation.
In many cases, the cause is unknown but it's generally a sign of obesity and a low ratio of testosterone/estradiol are considerations. Rarely, liver or kidney diseases are to blame. Losing weight, taking natural or prescription aromatase inhibitors, and even surgery are treatment options.
Men are up to 70% less likely to visit a doctor than are women. Once there, they may be shy about bringing up sensitive topics. Writing questions down to be sure they get asked is a good strategy to avoid a missed opportunity for help. As Hippocrates said, "a wise man should consider that health is the greatest of blessings."
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