Melanie Cole MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole, and joining me today is Dr. Anirudh Rai. He's a Primary Care Physician at Henry Mayo Newhall Primary Care, and he's here to tell us about healthy aging for men today. Dr. Rai, it's always a pleasure to have you join us.

The first question I want to jump right into with this, as a woman who's been married for 28 years, how can we get our partners into a doctor for their well visit and their checkup, whether it's they need to see a urologist, whether they need their primary care or a dentist, or any of these doctors, how do we get them in? What do we say to you guys to get you to go see a doctor?

Anirudh Rai, MD: Hey there, always a pleasure to be here. Thanks for having me. And that's a great question. Honestly, that is one of the, I guess, the leading questions that I always ask myself too. And to give you a little bit of interest. Typically when I see patients who are males, it's always the wife kind of telling them to go to the hospital.

There's not really one particular answer that I've had to say, Hey, this says go to the doctor. Particularly men tend to be pretty stubborn and I wish I could give you the direct sort of way to say, Hey, tell them to go to the doctor because X, Y, and Z, but it's just not there at this time.

Host: Well, I knew there was no solid answer to that. Mainly it's just you're going, here's when your appointment is and you're going to go see your primary care for your well visit and get everything checked. Okay, so onto what we are actually talking about. Some of the most common men's health issues that you see, the top reasons that you think men need to look into these well visits and to see various doctors. What are some of the most common things you see as men age.

Anirudh Rai, MD: As our aging population comes to fruition, the most common thing I often see would be high blood pressure. And that's usually the number one thing that every person, particularly males come in for. But one thing that I know that males tend to be more cautious and definitely go to the doctor for, and it's something that does come into, I guess life when you get a bit older would be something like erectile dysfunction and interest in sex. And that is something I always tend to draw males to go to the doctor for sure, I would say.

Host: And now on to screenings because there are a whole bunch now besides colonoscopy and CT lung cancer screening, that's another screening and vaccinations and you know, PSA, all these different things that men should be screened for. Tell us about some of those and what they could expect at a primary care physician visit.

Anirudh Rai, MD: Yeah, screening has come a long way actually. So when it comes to screening for things like colon cancer, we have advanced to a point where we recommend anyone who's at the age of 40 to come to the doctor's office and discuss, hey, possible ways to screen for colon cancer. Because typically for cancers, the sooner we catch it the better.

And I always tell my patients, prevention is better than cure. So if we could always prevent that from getting worse, that would be the ideally the best way to proceed. When it comes to prostate cancer, which is specifically for males, that is more of a discussion we have with our primary care doctor or your own physician.

Typically, we go into history to see what are the risk factors for it, to see if you'll benefit from the screening. And this men get older, the prostate will get a bit bigger. And it's always nice and to be cautious about that because if it gets bigger, the chance of cancers do increase, and that is more of a discussion to always have with your doctor to see if you fit well into that criteria.

Host: Yeah, it's important. These screenings are important, and one of the things that I notice as men get older and we think that maybe when they're younger, that's when they'd have more stress, but men don't like to talk about stress. Dr. Rai, they don't like to talk about depression. They don't like to talk about their worries, and that's supposed to be the manly thing, is to not think about their mental health.

What do you want us to know about? I mean, if we want our men to age healthy, which I certainly do, you know, I want my husband around as long as possible. What about those things? The mental health aspect of all of it?

Anirudh Rai, MD: I think that's one of the leading sort of problems to this day, at least when it comes to the psychological aspect. And typically males do express their emotions a bit differently than females, so to speak, their counterpart. It's hard to say whether, what particulars, I guess, character that you see that may drive, say, Hey, this person may be depressed or anxious.

When it comes to males, it's always good to be confrontational, be like, Hey, I think you're depressed, or, I think you're anxious. Can you tell me about it? Let's talk about a bit more. And when I see males in the clinic, I always try to address them, say anything you're worried about, anything that's making you a bit down.

And typically these sort of open-ended questions are the way to get most of my patients, not males for sure, to kind of open up a bit more to say, Hey, these are things that are bothering me. But when it comes to a household or a family unit, it's always hard for a male to even express their own emotions to their own family members just because it is a place of vulnerability.

So that is where the doctor's office comes into play, where feeling vulnerable tends to be the best way to kind of get the best help you can, and it's a safe environment for vulnerability as well.

Host: I have an interesting question for you, Dr. Rai, as we think about getting our partners into the doctor and we want them to be in as good a shape as they can, as they age. With our teenagers, we always ask as moms, you know, do we go in with our daughters when they go to the gynecologist, do we go in to the pediatrician?

When do we stop? Do we go in with our partners when they go to the doctor, like I went with my husband to the cardiologist. I'm an exercise physiologist. I wanted to have my questions answered. If you were going to see a doctor, would you want your partner in the room or would you feel more comfortable if they're not?

Anirudh Rai, MD: That kind of depends on what the particular questions are. I know some family members or some couples who want their wife out there when they talk about like erectile dysfunction or anything in that nature, just to kind of get more of a sense of what that is, because it is a pretty vulnerable place and people tend to be pretty shy from that.

But when it comes to addressing main stuff like mood, high blood pressure, cholesterol, things like that, it's always nice to have the whole family unit in hand. More often than not, males tend to, I would say, under exaggerate certain symptoms or certain lifestyle choices, so to speak. Like if you ask them if they eat this much, it's, they often under exaggerate a bit.

Always nice to have that second point of view from the wife or family members to say, Hey, you eat a little bit more, and, Hey, you're not been doing X, Y and Zs. I personally do appreciate that, but when it comes to the sensitive subject matters, it varies. I think males do appreciate having this one-on-one time with their physician to talk about more sensitive subject matters.

Host: That was a good answer and very true. I think. So, you're a young guy. How does diet and exercise change as men age, as we think about things that they can do to help counteract some of these age related events that happen, the high blood pressure or erectile dysfunction, any of these things that can happen as a man ages. What about exercise and diet? How should that change as they age?

Anirudh Rai, MD: Usually when we age, it's kind of hard to offset the metabolism associated with aging. As you get older, metabolism slows down, your diet function decreases, your testosterone decreases as well, which is all normal and physiologic. With those changes, you'll have a higher chance of weight gain or you might be sleeping a bit more, you might not be able to exercise as much.

Typically with that, I would recommend having a regimented sort of life where you say, Hey, I'm going to go to the gym at time X, and I'm gonna eat X, Y, and Z. Keeping a track of things like that, it's difficult to do, but it is something that keeps your mind at least awake and aware about your changing body in that sense.

When it comes to how to eat and what to eat, that is a tough choice because as we get older, our diets tend to be a little bit constricted because when we get older, our gut tends to change too. So you become more sensitive to certain things and that's good to be aware of that as well.

But at the same time, it's hard to kind of sacrifice bland foods with things you like to do. So it's always nice to have a good balance of enjoying what you eat. At the same time, not having too much of things that you know are detrimental to you. So it is a balance, but at the same time, I don't want to give up things that you know, you like to eat and drink just for the sole purpose of trying to help one aspect. It's important to enjoy life as well, and that helps with the mental aspect as well.

Host: Well, it does, and I know my husband can't eat as spicy as food as he used to, and I like to cook really spicy food, but I have to tone it down now. So gut health is something that's really important to talk about. You and I'll do a podcast about that one day. But you've mentioned a couple of times the sexual health aspect, and we talked about mental health and stressors and diet and all these things.

But as men age, that sexual libido does tend to change. We women, we look at this a whole different way than men do. It's not part of our complete being as it's as it can be with men. What do you tell your men about this and speak a little bit about the urological sense of PSA, prostate health, keeping a healthy prostate, and the sexual health aspect.

Anirudh Rai, MD: Yeah, absolutely. That's a big thing when it comes to males as they get older. That is something we do see and that's the normal progression of how testosterone decreases. And it's important to be aware of certain signs and symptoms that are present. Personally from my experience when I talk to males, sexual health is pretty sensitive and they do wish for it to be at least, better in certain aspects.

Of course it's not going to be the same as in their twenties or thirties, but it is something that they do appreciate and would like to have that sense of, relief, so to speak. So they want to have some sense of accomplishment or satisfaction in that field. And it's something they, I always do talk about.

And there are a lot of medication online that you could talk to your doctor about to help with that, thankfully enough. And many of my patients, if not most, have had the satisfaction they're seeking from that when it comes to that particular field. Of course, with precaution, we always talk to a physician about that. When it comes to our prostate, testosterone is pretty interesting.

So there are many forms of it, and the most potent form, the DHEAS, which is what caused our prostates to get bigger. It is something that we see naturally. So that form of testosterone will rise. And as physicians we tend to want to keep an eye on particularly the PSA. And the PSA is what kind of measures to see what function your prostate is in the sense that if it's overacting or cells dividing more often than not it that point is to more of a cancerous situation, which is better to address that sooner rather than later.

Again, prevention is better than cure and I would highly recommend if there's any sort of concern about this, definitely talk to your primary care doctor when you can.

Host: This is really great information and I would like every partner who has a man in their life that they love to play this podcast for them and send it around. Share it on your social media. As we finish up, Dr. Rai, and you're just such a great guest as always, summarize the lifestyle habits and proactive choices that can contribute to overall health and quality of life in later years for men.

Anirudh Rai, MD: Yeah, absolutely. As men get older, weight gain is normal. Losing testosterone, libido decreasing, these are all important and vital aspects of every male who's essentially aging to kind of keep an eye on for them. Eating healthy is important, but at the same time, make sure you enjoy life and enjoy things that make you happy as well.

Depression, anxiety do increase as well as men get older, and it's important to always address that just to your doctor. Let them know like, Hey, I'm worried about X, Y, and Z. Showing a sense of vulnerability is hard for males, but at the same time, going to your doctor, you trust talking one-on-one with them. Telling them your concerns goes a long way to not only prolonging your life, but making sure the quality of your life is well. And when it comes to concerns about your prostate, that is something to always talk to your doctor about when there's concerns about prostate cancer, always let them know, Hey, I'm worried about prostate cancer.

Can you talk to me about ways I could either prevent it or signs I should watch out for? As a prostate, it gets bigger, urination becomes a problem as well, and keep an eye on that is small clues to let us know, Hey, let's talk to you about your prostate and how we could address that.

And when it comes to sexual drive, that's essentially paramount and it's actually one of the central features that men do always talk to me about. And it is important when it comes to just, not only self-satisfaction, but also help satisfying your partner. It's a very intimate sort of moments that, the men and women do share.

And I think it's important to always have that function present because not only does it help with your mood, it also helps with many other aspects as well. It also helps kind of determine, okay, are you fit enough for something like this as well? And it is something that I always want to talk to my patients about to see if it's something that they care about because sex is important when it comes to life, and it's not going to get any less important as you get older.

Host: What a great, informative podcast this was. And Dr. Rai, you've given us a lot to think about. So thank you so much for joining us and for more information on maintaining a healthy lifestyle, please visit our free health information library at library.henrymayo.com. That concludes this episode of It's Your Health Radio, with Henry Mayo Newhall Hospital.

I'm Melanie Cole. Thanks so much for joining us today.