Testosterone treatment may help some older men regain sexual desire, but it won’t give them more energy. That’s the conclusion of a recent that looked at how well this treatment worked.
Although sometimes difficult to acknowledge or discuss, sexual complaints such as erectile dysfunction and premature ejaculation are common and increasingly easy to address through consultation or medical or surgical care.
Dr. Adam Perzin, Urologist at Lourdes Health System, is here to discuss men's health issues to help you better understand your options and to help make it easier for you to discuss your concerns with your doctor.
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Men's Health Issues: Low Testosterone and Erectile Dysfunction
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Learn more about Dr. Adam Perzin
Adam Perzin, MD
Dr. Adam Perzin's specialty is Urology.Learn more about Dr. Adam Perzin
Transcription:
Men's Health Issues: Low Testosterone and Erectile Dysfunction
Melanie Cole (Host): Most men need to pay more attention to their health. Compared to women, men are more likely to smoke and drink, make unhealthy or risky choices, put of regular checkups and medical care. There are also some health conditions that affect only men such as prostate cancer and low testosterone. My guest today is Dr. Adam Perzin. He’s a urologist with Lourdes Health System. Welcome to the show. Dr. Perzin, as a urologist, do you think one of the biggest problems with men’s health is getting them into see you in the first place?
Dr. Adam Perzin (Guest): Well, Melanie, first of all it’s a pleasure to be with today. I think you hit on the most important issue that you could discuss with men today which is getting in to see a physician and dealing with their health problems. Women, traditionally, are far better in taking care of themselves. Men tend to have that sort of perspective where they’ll put their heads in the sand and deny and deny and hope that things go best; whereas, women are really accessing their health care far better. What we always encourage our male patients in our practice to do is to get in to see a physician and to make sure that there are certain things which they are always going to do to make sure that their health care is optimal and that they take care of themselves as well as women do.
Melanie: What are those things you tell your men that there are certain things you would always like them to make sure to get checked?
Dr. Perzin: Well, I think men need to be aware of a couple key things. We try to simplify it for men because men, I think, like it simple. We have simpler minds. We tell our male patients there are two numbers--two critical numbers--they need to be aware of. One of them is their PSA. That stands for “prostate specific antigen”. It’s a blood test that men begin to obtain usually when they’re in their mid-forties to the age of 50. It’s a yearly blood test and it essentially assesses their risk of whether they might develop prostate cancer. That’s a very, very important blood test that they have. The other important one that we encourage them to obtain is a testosterone level. Testosterone deficiency is incredibly common in men. It can account for a variety of symptoms that include a lack of libido or sexual interest, sometimes a lack of sexual performance, and often very vague sorts of symptoms just like a decrease in their energy level, their sense of well-being, their get up and go. They are very subtle symptoms that a lot of times men just forget about or they’re told to go take a vitamin or do something like that. If we get those two critical blood tests once a year, we can be very proactive and make sure the men’s health is really optimal.
Melanie: Is there an age at which you like them to start taking a testosterone test?
Dr. Perzin: We see low testosterone levels in men, actually, before the age of 40 but, in terms of what I think is practical, it’s somewhere around the age of 40 that they begin to have that done on a yearly basis. Certainly, if men are younger than that and they start to have some of those symptoms, if they don’t feel like their energy level and their sense of well-being is what it should be, they need to be proactive. They need to go to their family doctor and say, “Hey, I’ve heard about this testosterone test. Is it important for me? Is it a blood test I should have?” because sometimes it takes a little nudging on the part of the patient to get their medical doctor to go ahead and order what might be a very important test for them.
Melanie: Okay. And, the PSA you said between 40 and 50. It’s just a simple blood test.
Dr. Perzin: It’s simple.
Melanie: Why are men so afraid to come and see you because the digital is usually involved?
Dr. Perzin: Right. So, the blood test is a screening test and it’s a very controversial test. It’s controversial for lots of reasons but the one thing I don’ think is controversial is that men need to be educated in obtaining that blood test once a year—educate them as to what their risk is. Once that blood test is obtained, and it’s usually done through their family physician, if that blood test is abnormal, the family physician may make a referral to a urologist, in which case, they probably will have a digital exam. They, most likely, will have had it by their primary physician but I think the important thing is that men need to understand this test takes literally about ten seconds. It takes a minimal amount of discomfort. It is quick and easy. Women go through a far more involved evaluation when they’re being tested for a whole host of different issues. Men have to realize this is a digital exam that you eluded to that can save their lives. It can detect cancer very, very early. Prostate cancer is no different than any other cancer in the sense that when it is found early, it is curable. That’s what we want men to understand. We want to find something early on in the course of its life so that we can intervene easily and save people’s lives.
Melanie: Dr. Perzin, as men age, they almost, in a very large number, get BPH. Explain about that as an issue but not cancer.
Dr. Perzin: Right and the vast majority of men will have BPH or “Benign Prostatic Hyperplasia”. That’s simply means an enlargement of the prostate. Although most men will suffer from that, very few men will have symptoms will have symptoms as a result of it. So, although we can demonstrate BPH in almost any man over the age of 50 or 60, only a small percentage of those men will actually need treatment. The treatment and evaluation for those symptoms is, again, simple and straightforward. The symptoms that men may begin to experience are things like a slow urinary stream, frequency, getting up at night, a severe urge to urinate. Men don’t have to put up with those things. They can really intervene in a very simple fashion and find that we can minimize these symptoms. In the old days, surgery used to be a very common treatment but nowadays with new technology and with some of the new advanced medications we can address these symptoms and really minimize the impact on their life. Men have to realize that the treatment for this is really about their quality of life and that’s really what we’re trying to improve when we undergo treatment for BPH.
Melanie: So, sometimes when they hear “BPH” or “prostate cancer”, they worry almost more about the side effects of the treatment like erectile dysfunction and the ads, Dr. Perzin, all over tv and the media talk about the medications and things. So, men are very concerned about this. Speak about erectile dysfunction and does it happen at times that are not just side effects of treatment of other things?
Dr. Perzin: Sure. Well, some of the statistics themselves are actually scary. Fifty percent of the men in this country when they become 50 will have erectile dysfunction. What I tell my patients when they come into the office--because most men at that point are somewhat ashamed, they’re down on themselves, their self-esteem has been diminished--I tell them that they are not in the minority of men who have this problem, they are actually the majority of men. It’s a very, very common problem and the first thing men have to understand is just that. This is a part of aging. It can occur for a variety of reasons. It can occur as a result of diabetes, high blood pressure. As you alluded to, many of the medications take for those sorts of problems can contribute to erectile dysfunction and some of the treatments for BPH or prostate cancer can also contribute to erectile dysfunction. So, again, getting back to, I think, probably the most important thing, is that men need to be empowered. They need to be told there are simple, easy treatments to get these problems better. Some of them involve medication. Some of them involve other types of treatments but, invariably, we can get this problem better for men and we do it routinely every day. The difficulty in successfully treating that condition nowadays, again, with the new medications and the technologies, we get these problems better every single day.
Melanie: Are there other conditions such as blood pressure and the medications that you might be on for that. Can any of those contribute to low testosterone or erectile dysfunction or any of these other conditions?
Dr. Perzin: Sure. Having high blood pressure, having diabetes and the treatments for those conditions, mainly the medications, can actually contribute to erectile dysfunction. Not so much low testosterone but certainly erectile dysfunction. One of the first things we do when we evaluate men is to see if we can make some adjustments in those medications. If we can without compromising their high blood pressure control, we may go ahead and adjust some of those medications. However, quite often we might find that it’s been a difficult road to get them controlled on their high blood pressure, in which case, in conjunction with their medical physicians, we may, sort of in a collegial way, come up with a treatment plan that allows them still to maintain their blood pressure control but also get them on the right path to getting the erectile dysfunction improved.
Melanie: It’s really great information. In the last few minutes, give your best advice to women in getting their men in to see you and to the men about why it is so important to be your own best health advocate and get in and not be afraid to come see the doctor.
Dr. Perzin: Women should be complimented for lots of reasons and only one of those reasons is the fact that they are so much more attuned to health and taking care of themselves. Quite often, in many relationships, women are the individuals who really encourage their husband to go ahead and seek medical treatment. Erectile dysfunction, for example, is really not just a problem for men, it’s a problem for that entire relationship. So, very often, we will have women come with their husbands, spouse, boyfriend, and girlfriend. They come in as a couple and that’s actually the best way to come in because it is a problem for two people. I think men could learn a really good lesson from women. Women are very proactive, they get issues addressed and they get resolutions to a lot of these problems far sooner than men do. So, I think we could definitely listen to our female colleagues and friends and partners and follow their lead and get into see doctors earlier because the results are going to be far, far better.
Melanie: What great information. Why should women get their men into Lourdes Health System for their care?
Dr. Perzin: Well, Lourdes Health System does a great job in taking care of individuals needs whether it be men or women. They have the resources, the physicians, talent. The urologic services at Lourdes are superior and we’ve had so much success and address these problems so easily in the past. I think that women and their husbands, boyfriends, will be very, very satisfied with the care they get and find that a lot of these problems which they thought were very significant turn out to be very easily dealt with and improved.
Melanie: Thank you so much. It’s absolutely great information. You’re listening to Lourdes Health Talk. For more information you can go to lourdesnet.org. That’s lourdesnet.org. This is Melanie Cole. Thanks so much for listening.
Men's Health Issues: Low Testosterone and Erectile Dysfunction
Melanie Cole (Host): Most men need to pay more attention to their health. Compared to women, men are more likely to smoke and drink, make unhealthy or risky choices, put of regular checkups and medical care. There are also some health conditions that affect only men such as prostate cancer and low testosterone. My guest today is Dr. Adam Perzin. He’s a urologist with Lourdes Health System. Welcome to the show. Dr. Perzin, as a urologist, do you think one of the biggest problems with men’s health is getting them into see you in the first place?
Dr. Adam Perzin (Guest): Well, Melanie, first of all it’s a pleasure to be with today. I think you hit on the most important issue that you could discuss with men today which is getting in to see a physician and dealing with their health problems. Women, traditionally, are far better in taking care of themselves. Men tend to have that sort of perspective where they’ll put their heads in the sand and deny and deny and hope that things go best; whereas, women are really accessing their health care far better. What we always encourage our male patients in our practice to do is to get in to see a physician and to make sure that there are certain things which they are always going to do to make sure that their health care is optimal and that they take care of themselves as well as women do.
Melanie: What are those things you tell your men that there are certain things you would always like them to make sure to get checked?
Dr. Perzin: Well, I think men need to be aware of a couple key things. We try to simplify it for men because men, I think, like it simple. We have simpler minds. We tell our male patients there are two numbers--two critical numbers--they need to be aware of. One of them is their PSA. That stands for “prostate specific antigen”. It’s a blood test that men begin to obtain usually when they’re in their mid-forties to the age of 50. It’s a yearly blood test and it essentially assesses their risk of whether they might develop prostate cancer. That’s a very, very important blood test that they have. The other important one that we encourage them to obtain is a testosterone level. Testosterone deficiency is incredibly common in men. It can account for a variety of symptoms that include a lack of libido or sexual interest, sometimes a lack of sexual performance, and often very vague sorts of symptoms just like a decrease in their energy level, their sense of well-being, their get up and go. They are very subtle symptoms that a lot of times men just forget about or they’re told to go take a vitamin or do something like that. If we get those two critical blood tests once a year, we can be very proactive and make sure the men’s health is really optimal.
Melanie: Is there an age at which you like them to start taking a testosterone test?
Dr. Perzin: We see low testosterone levels in men, actually, before the age of 40 but, in terms of what I think is practical, it’s somewhere around the age of 40 that they begin to have that done on a yearly basis. Certainly, if men are younger than that and they start to have some of those symptoms, if they don’t feel like their energy level and their sense of well-being is what it should be, they need to be proactive. They need to go to their family doctor and say, “Hey, I’ve heard about this testosterone test. Is it important for me? Is it a blood test I should have?” because sometimes it takes a little nudging on the part of the patient to get their medical doctor to go ahead and order what might be a very important test for them.
Melanie: Okay. And, the PSA you said between 40 and 50. It’s just a simple blood test.
Dr. Perzin: It’s simple.
Melanie: Why are men so afraid to come and see you because the digital is usually involved?
Dr. Perzin: Right. So, the blood test is a screening test and it’s a very controversial test. It’s controversial for lots of reasons but the one thing I don’ think is controversial is that men need to be educated in obtaining that blood test once a year—educate them as to what their risk is. Once that blood test is obtained, and it’s usually done through their family physician, if that blood test is abnormal, the family physician may make a referral to a urologist, in which case, they probably will have a digital exam. They, most likely, will have had it by their primary physician but I think the important thing is that men need to understand this test takes literally about ten seconds. It takes a minimal amount of discomfort. It is quick and easy. Women go through a far more involved evaluation when they’re being tested for a whole host of different issues. Men have to realize this is a digital exam that you eluded to that can save their lives. It can detect cancer very, very early. Prostate cancer is no different than any other cancer in the sense that when it is found early, it is curable. That’s what we want men to understand. We want to find something early on in the course of its life so that we can intervene easily and save people’s lives.
Melanie: Dr. Perzin, as men age, they almost, in a very large number, get BPH. Explain about that as an issue but not cancer.
Dr. Perzin: Right and the vast majority of men will have BPH or “Benign Prostatic Hyperplasia”. That’s simply means an enlargement of the prostate. Although most men will suffer from that, very few men will have symptoms will have symptoms as a result of it. So, although we can demonstrate BPH in almost any man over the age of 50 or 60, only a small percentage of those men will actually need treatment. The treatment and evaluation for those symptoms is, again, simple and straightforward. The symptoms that men may begin to experience are things like a slow urinary stream, frequency, getting up at night, a severe urge to urinate. Men don’t have to put up with those things. They can really intervene in a very simple fashion and find that we can minimize these symptoms. In the old days, surgery used to be a very common treatment but nowadays with new technology and with some of the new advanced medications we can address these symptoms and really minimize the impact on their life. Men have to realize that the treatment for this is really about their quality of life and that’s really what we’re trying to improve when we undergo treatment for BPH.
Melanie: So, sometimes when they hear “BPH” or “prostate cancer”, they worry almost more about the side effects of the treatment like erectile dysfunction and the ads, Dr. Perzin, all over tv and the media talk about the medications and things. So, men are very concerned about this. Speak about erectile dysfunction and does it happen at times that are not just side effects of treatment of other things?
Dr. Perzin: Sure. Well, some of the statistics themselves are actually scary. Fifty percent of the men in this country when they become 50 will have erectile dysfunction. What I tell my patients when they come into the office--because most men at that point are somewhat ashamed, they’re down on themselves, their self-esteem has been diminished--I tell them that they are not in the minority of men who have this problem, they are actually the majority of men. It’s a very, very common problem and the first thing men have to understand is just that. This is a part of aging. It can occur for a variety of reasons. It can occur as a result of diabetes, high blood pressure. As you alluded to, many of the medications take for those sorts of problems can contribute to erectile dysfunction and some of the treatments for BPH or prostate cancer can also contribute to erectile dysfunction. So, again, getting back to, I think, probably the most important thing, is that men need to be empowered. They need to be told there are simple, easy treatments to get these problems better. Some of them involve medication. Some of them involve other types of treatments but, invariably, we can get this problem better for men and we do it routinely every day. The difficulty in successfully treating that condition nowadays, again, with the new medications and the technologies, we get these problems better every single day.
Melanie: Are there other conditions such as blood pressure and the medications that you might be on for that. Can any of those contribute to low testosterone or erectile dysfunction or any of these other conditions?
Dr. Perzin: Sure. Having high blood pressure, having diabetes and the treatments for those conditions, mainly the medications, can actually contribute to erectile dysfunction. Not so much low testosterone but certainly erectile dysfunction. One of the first things we do when we evaluate men is to see if we can make some adjustments in those medications. If we can without compromising their high blood pressure control, we may go ahead and adjust some of those medications. However, quite often we might find that it’s been a difficult road to get them controlled on their high blood pressure, in which case, in conjunction with their medical physicians, we may, sort of in a collegial way, come up with a treatment plan that allows them still to maintain their blood pressure control but also get them on the right path to getting the erectile dysfunction improved.
Melanie: It’s really great information. In the last few minutes, give your best advice to women in getting their men in to see you and to the men about why it is so important to be your own best health advocate and get in and not be afraid to come see the doctor.
Dr. Perzin: Women should be complimented for lots of reasons and only one of those reasons is the fact that they are so much more attuned to health and taking care of themselves. Quite often, in many relationships, women are the individuals who really encourage their husband to go ahead and seek medical treatment. Erectile dysfunction, for example, is really not just a problem for men, it’s a problem for that entire relationship. So, very often, we will have women come with their husbands, spouse, boyfriend, and girlfriend. They come in as a couple and that’s actually the best way to come in because it is a problem for two people. I think men could learn a really good lesson from women. Women are very proactive, they get issues addressed and they get resolutions to a lot of these problems far sooner than men do. So, I think we could definitely listen to our female colleagues and friends and partners and follow their lead and get into see doctors earlier because the results are going to be far, far better.
Melanie: What great information. Why should women get their men into Lourdes Health System for their care?
Dr. Perzin: Well, Lourdes Health System does a great job in taking care of individuals needs whether it be men or women. They have the resources, the physicians, talent. The urologic services at Lourdes are superior and we’ve had so much success and address these problems so easily in the past. I think that women and their husbands, boyfriends, will be very, very satisfied with the care they get and find that a lot of these problems which they thought were very significant turn out to be very easily dealt with and improved.
Melanie: Thank you so much. It’s absolutely great information. You’re listening to Lourdes Health Talk. For more information you can go to lourdesnet.org. That’s lourdesnet.org. This is Melanie Cole. Thanks so much for listening.