When men turn 40, they may think about how to keep their hair or lose their belly, but they may not think about seeing a urologist. They should.
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To take charge of their prostate, urinary and sexual health — not just to protect them from prostate cancer — I recommend every man start seeing a urologist regularly at age 40.
Some guys may resist this idea, especially those who need to be dragged to their primary care physician for annual checkups, but doing this will make their everyday lives better.
How a urologist can help you with daily life
As you go through your 40s, quality-of-life issues become more important to you. Prostate and sexual health will play a big role in this. Urologists are experts in managing these issues and can help guide you on what to expect, useful lifestyle changes, when to simply observe and when to treat a problem.
In your late 40s you may begin to have difficulty urinating due to an enlarged prostate, which is part of getting older. But too many trips to the bathroom — day and night — can make daily life more of a pain than it needs to be.
An enlarged prostate can be treated with medications to relieve symptoms or even partially shrink the prostate. These drugs are very effective and side effects are uncommon. Or you may decide on a minimally invasive office procedure to remove part of the prostate or, if necessary, surgery.
Should prostate cancer always be treated?
Erectile dysfunction and declining libido aren’t uncommon for guys starting in their late 40s and early 50s. The cause isn’t always physical, but a urologist can help if it is.
Your urologist can check your hormones with a simple blood test and prescribe testosterone replacements if you have low testosterone. And Viagra®, Levitra® or Cialis® are all effective medications to increase blood flow to the penis.
Most men in their 40s have already completed their families. If you have, consider getting a vasectomy. Without the need for contraception you and your partner’ sex life will be greatly enhanced.
Vasectomy is a safe and simple out-patient procedure with no long-term risks. A urologist can answer any questions and concerns you have about the procedure, give you guidance on other forms of birth control, perform the procedure and let you know when it’s safe to have unprotected sex with your spouse.
You and prostate cancer screenings
There are arguments for and against routine PSA screenings because the test results can be confusing, inconclusive and lead to unnecessary testing and treatment.
I think yearly PSA screenings are overkill. But you should talk with your doctor whether you’d benefit from regular PSA screenings.
For example, a single PSA determination in your 40s can predict your lifetime risk of prostate cancer. I therefore recommend a baseline PSA (prostate-specific antigen) test when you hit your mid-40s. This blood test can help determine your risk of developing prostate cancer and show us specifically what we need to do to screen you in the future.
For example, if your PSA is .7 or below, you may only need to be screened every five years or so. Your lifetime risk of prostate cancer is around 10 percent or less. If you’re at higher risk with a score of 1 or above, you may benefit from more frequent screening.
And if you reach 60 and your score is below a 1 or 2, it’s likely safe to stop screenings altogether.
Regular visits to your urologist can keep you feeling good and make the aging problems all of us men face a little easier to cope with. And of course cancer screenings can be lifesavers.