When I started my practice in medicine in 2007 in age management medicine, my eyes were open to a men’s-centered proactive approach to aging. What surprised to me about it was that in all my years of training and medical school, there was never any attention paid towards the longterm health of men.
Everywhere I turned, I saw women’s health, I saw breast cancer, women’s health residency programs, Even hormone replacement (HRT) implied HRT for women. Bone density scanning was covered for females but there was never any attention or even questioning of what men needed, especially as they got older.
Now to be fair, aging in the female undergoes some very obvious change in the 40s and 50s, ie : menopause. Because menopause is fairly well defined as a short period in a woman’s life where she goes from a general state of vibrancy to aging rapidly. Even the features of menopause, such as hair graying, hot flashes, thin skin, are quite easy to notice. Men on the other hand, the same process occurs, but over a period of 20 or 30 years. When we look at ourselves in our 20s and 30s, we are expected to function like that for the next 20 or 30 years. However, if you look at any man at his 30s and 50s, they are not the same person. They did not change in 6 months or 2 years, they change gradually over decades. When I realized this, that no one was really paying attention to this, I was drawn to this that I realized that I wanted to dedicate my medical career to this path.
Although women’s health is far more accepted in the community at large, men’s health is confounded with issues of over-caution, excessive fear and risk, doing things that are unnatural, a general fear and lack of knowledge by traditional providers, and the worst obstacle, machismo.
We as men, are expected to be hunters and gatherers. We are expected to provide for the family. We are expected to fight through anything to get the job done, be it a physical threat, illness, disease, or aging, nothing should get in the way. We are men. This type of attitude is very common all over the world. And thus, men should never get sick. Therein lies the problem. We are not expected to get sick, and if we do, we have grown in to seeing the idea that we shouldn’t see a doctor.
Women, on the other hand, with their issues being much more apparent, seek out medical help than the average man. Ask yourself this: What is the first sign of heart disease in a typical male? It’s not a headache or alteration in the pulse. It’s not a racing pulse, nor is it a clots in the leg. It’s a heart attack. Think about that for a second. Most men find out that they have a heart disease after the heart attack happens. One factor that contributes to this is that men do not seek out preventative care.
As mentioned before, there is formalized training for women’s health. Other than neurology (which is a surgical specialty), no training exists for men’s health in the U.S. In Europe and other areas of the world, the field of andrology is small, but much more prominent than it is here. Also, if you haven’t picked this up already, women’s health is covered under insurance. There’s no such blanket coverage for men’s health.
Hopefully in the oncoming years, more people will become aware of the need for a dedicated men’s health specialist.