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The Goose vs. the Gander

Although I may specialize in women’s health, I have to stress that what’s good for the gander is also good for the goose. Heart disease is the most serious problem facing us men. And when it comes to male cancer, the prostate gland is the most vulnerable organ for non-smokers. If you do smoke, then lung cancer poses a major threat. Unfortunately, most men don’t pay attention to their diets, exercise, etc., until they face a major health crisis. In addition, they are not known to show up for regular medical check-ups — something that could greatly improve their health forecast. Typically men have a casual attitude toward medical evaluations — a fact that has resulted in many premature deaths. Ironically, while women are more likely to seek out their doctors, our system offers men better overall medical care.

Making a Check-up Count

Men need to be aware, however that all physical exams are not equal. Routine physicals given to heads of corporations, done for insurance purposes, etc. can be a bit of a sham. My own father, who was a fairly high-level executive had an in-house physical every six months and when he was fifty-five, he went into serious heart failure. He was eventually placed on heart and high blood pressure medication by another doctor who made no effort to encourage him to change his diet nor exercise. Although my father showed evidence of cardiovascular disease in his mid-fifties, this fact was glossed over by his doctor and my father was treated with benign neglect.

Moreover, his doctors ignored the high amount of protein that kept showing up in his urine (a bad thing). At sixty-one, it was discovered that he had an incurable cancer of the kidney. I don’t think there’s any doubt that his kidney cancer had been caused by the petrochemicals he was exposed to while working in the oil fields years before. Sadly, he died of the disease. A good doctor would have discovered his kidney disease when his high blood pressure developed — something that might have saved his life. His hypertension was directly caused by his kidney disease, and his doctor failed to make the connection. So much for the value of executive physicals. My father-in-law’s acute gallbladder disease also slipped by his doctor.

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Change Your Lifestyle

If we could prevent just half of the coronary artery disease we see today, try to imagine the billions upon billions of dollars that could be saved, not to mention countless lives. Think of the possibilities if the money we saved was put towards prevention. Think even bigger. What if patients were rewarded by insurance companies with lower premiums, trips, etc., for losing weight, lowering their cholesterol levels, or exercising on a regular basis? Rewards work. It makes sense to me.

Have Your Cake and Eat It Too?

Jim was a 70 year old man who had a series of massive heart attacks and was at death’s door. He underwent the customary cardiac surgery and when I saw him, I told him to quit smoking, get on a strong multi-vitamin and mineral supplement, take Transfer Factor and genistein, change his diet and start to exercise. He took my advice and he got better — a lot better. He went from a man who could barely shuffle across the room, to one who walked three miles a day. Unfortunately, in the midst of all this progress, his doctor put him on a cholesterol-lowering drug which gave his stomach fits. He had so many GI problems that he stopped exercising and eventually slipped back into his old ways — smoking, eating lots of red meat, etc.. His attitude, like so many other men was “why bother to take the hard way to health when I can just pop a pill.”

Heart and Cardiovascular disease account for billions of dollars of waste for our economy. How many executives die or are seriously crippled because of heart disease. The stress they suffer is bad enough, add an unhealthy diet and you have a prescription for disaster, it is only a matter of time. Dean Ornish a cardiologist from San Francisco has carefully pointed out the benefits of dietary change and exercise. Actually one can reverse coronary artery disease by following his program. Just how many doctors actually promote or champion his ideas, unfortunately damn few. Go to Amazon, Barnes and Noble, Borders etc. and get his books today for your health!

Not only will you reduce your chance of heart disease but colon cancer as well. A man whose waist size is 40 inches or more doubles his risk of getting colon cancer.

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Prevent Rather Than Treat Prostate Cancer

Simply put, cancer kills a lot of men. Prostate cancer is the most common kind found in men. A man’s risk is now 1 in three and if you get prostate cancer your chance of recurrence is nearly 40%. Over 200,000 new cases are diagnosed annually and it keeps growing, and 31,000 men die from the disease annually. There are more than enough studies confirming the notion that staying at a healthy weight and consuming more vegetables and less animal products can reduce the development of prostate cancer. For example, foods rich in selenium, lycopene and vitamin E are prostate protective, and men who take nutritional supplements have a lower incidence of prostate cancer — not to mention a lower mortality rate from the disease. Whether men want to face it or not, it all starts with their diets.

Prostate Protection: Look at Your Plate

Men, for the sake of your hearts, waistlines and prostate glands, give up the steak and potatoes. Prostate cancer rates in America are almost ten times higher than those in Japan. And Japanese men who settle here and adopt typical American eating habits, lose that advantage.
The Asian diet is full of vegetables, legumes, soy and fish, and it is quite low in red meat. Japanese men get around 40 to 70 mg of genistein from their meals compared to American men who typically consume less than 1 mg. I’ve been taking genistein in supplement form for over seven years because of its impressive prostate-protective properties. With a father who died from kidney cancer and a brother who has had prostate problems, I have good reason to be concerned.

Get Soy Smart

Just as genistein protects breast tissue, it also works to block the binding of a bad form of testosterone and estrogen to prostate receptors cells. These hormones can cause changes in prostate tissue that can lead to the formation of cancer. One study conducted in Finland found that animals given a soybean feed, (which consisted of 7 percent roasted soybean meal), showed a significantly lower incidence of prostate tissue abnormalities when artificially stimulated with hormones. Of equal importance is the fact that cancerous tissue that was transplanted into test rats who ate a diet consisting of 33 percent defatted soy flour developed smaller tumors than control rats on a soy-free diet. Scientists at the University of Alabama at Birmingham found that genistein also protected the prostate gland from malignant tumors by inhibiting the action of protein kinase, which can contribute to cell mutations.

Other studies confirm that drinking 200 mg of soy milk per day for one month reduces circulating levels of dihydrotestosterone as well as serum levels of 17-beta-estradiol (which stimulates the growth of cancerous tumors in the prostate gland). In fact, Harvard researchers are currently looking at soy isoflavones as a treatment for prostate cancer.
Ideally, men should be eating genistein-rich soy foods. Soy is also rich in zinc, which contributes to prostate health and helps to lower cholesterol, which can accumulate in prostate blood vessels. If you can’t adjust to soy foods, then take a genistein supplement every day. I would also recommend eating more whole foods, including seafood, raw nuts and vegetables like avocados, broccoli, tomatoes, cabbage, cauliflower, etc.

Key Supplements for Prostate Health

Vitamin E: According to a recent Finnish study, vitamin E supplementation protects against prostate cancer. The incidence of prostate cancer and the death rate from the disease were significantly lower among male smokers who took vitamin E supplements than those who did not. In addition, the incidence of prostate cancer diagnosis was 32 percent lower among men who took vitamin E (alone or with beta-carotene) than among those who did not. Moreover, the death rate from the disease was 41 percent lower among men who took vitamin E. Researchers concluded that long-term daily supplementation with 50 mg of vitamin E was associated with a substantial reduction in incidence and mortality of prostate cancer.

Selenium: This mineral has been reported to have several anti-cancer actions. Interestingly, low soil levels of selenium have been associated with increased prostate cancer incidence. In one study, over nine hundred men received either a daily supplement of 200 mcg of selenium or a placebo. These men were treated for an average of four-and-a-half years and then followed for an additional six-and-a-half years. For men who initially had normal PSA (prostate-specific antigen) levels, selenium supplementation was responsible for a 63 percent reduction in their incidence of prostate cancer.

Zinc: Zinc levels can also be low in men with prostate cancer. In some studies zinc supplementation actually interfered with the growth of prostate cancer cells. The prostate gland stores zinc, consequently concentrations of zinc are much higher in the prostate gland than in other locations. Zinc also impacts the activity of the 5 alpha-reductase enzyme, which affects the rate in which testosterone converts to dihydrotestosterone (DHT, the bad kind). Zinc is also vital for proper immune function.

Vitamin B6: This vitamin enhances zinc absorption and its chemical conversion in the prostate. Data from the Second National Health and Nutrition Examination Survey (NHANES II) reported that 71 percent of males consume less than the RDA for vitamin B6 on a daily basis. The B vitamins are also vital for the maintenance of the very immune defenses that protect us against the growth of malignant tumors in the body.

Saw Palmetto:
A new study, published in a recent issue of Urology, examined the effects of saw palmetto (160 milligrams taken twice daily) in 85 men over the course of six months. Men taking the herb reported a greater improvement in symptoms compared to those taking a placebo. Over the last decade, double-blind clinical trials have proven that 320 mg per day of the liposterolic extract of saw palmetto berries is a safe and effective treatment for the symptoms of BPH, (Benign Prostatic Hyperplasia). A recent review of studies, published in the Journal of the American Medical Association, concluded that saw palmetto extract was as effective as finasteride (Proscar®) for the treatment of BPH. The clinical effectiveness of saw palmetto has been shown in trials lasting six months to three years.

Pygeum: This extract from the bark of the African tree has been approved in Germany, France, and Italy as a remedy for BPH (benign prostatic hypertrophy). Controlled studies published over the past 25 years have shown that pygeum is safe and effective for men with BPH of mild or moderate severity. These studies have used 50 to 100 mg of pygeum extract (standardized to contain 13% total sterols) twice per day. The triterpenoids found in this botanical help to promote urination; its phytosterols fight inflammation, and its ferulic esters help expedite the removal of cholesterol deposits that accompany BPH.

This mixture Chinese herbs and other natural compounds is rich in phytosterols that appear to lower both cholesterol and testosterone levels in the prostate gland. Test tube studies of cancer cells have found that PC-SPES decreases cell growth, promotes tumor cell death, and reduces PSA (prostate-specific antigen) levels in both hormone-sensitive and hormone-insensitive prostate cancers. One uncontrolled study documented a significant decrease in PSA levels in the majority of the patients who took PC-SPES (that’s a good thing). In another ongoing study, participants with hormone-sensitive prostate cancer and over half of those with hormone-insensitive prostate cancer showed significantly decreased PSA levels with PC-SPES supplementation. Some benefit was also seen in individuals for whom conventional chemotherapy had ceased to work. On-going research at the University of California at San Francisco and in San Diego will shed more light on this compound. To date, it appears to have a significant therapeutic potential for prostate disease and may even cause a remission of prostate cancer. More data is needed. The customary dose of PC-SPES is 320 mg daily.

Lycopene: Abundantly found in tomatoes, this compound provides specific protection against prostate cancer. A lower prostate cancer risk has been noted among men who consumed larger quantities of tomatoes and related lycopene-containing food products. The best way to get enough lycopene is to consume a tablespoon or two of concentrated tomato paste daily.

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Eating for Male Health
My prescription for male health (preventing disease and living longer) is simple:

1. Dramatically reduce or eliminate bad fats and meat. Men love to barbeque. And someone once explained this fettish — “men will cook if danger is involved” — well it often is! That steak you’re “throwing on the barbie” is full of saturated fats, not to mention possible hormones, steroids and antibiotics. Meat also contains high amounts of arachidonic acid. Some by-products of arachidonic acid have promoted prostate cancer in animals. Be particularly wary of well-done or cured meats. And, if you have to eat poultry, take the skins off of chicken and choose white rather than dark meat because it has less fat. Studies show that men who consume high-fat diets have higher levels of testosterone, which might increase their risk of prostate cancer. In one study, prostate cancer patients consuming the most saturated fat (from meat and dairy) were followed for over five years. Researchers found that these men had over three times the risk of dying from prostate cancer compared with men consuming the least amount of saturated fat. Decrease your intake of dairy products as well. Data from a long-term study suggests a possible link between eating dairy products like milk, cheese and ice cream and an increased risk of prostate cancer. Scientists at the Harvard School of Public Health tracked 20,885 men for eleven years; 1,012 of them developed prostate cancer. They concluded that those who consumed dairy products were more likely to develop the disease.

2. Focus on phytonutrients found in green leafy vegetables and fresh fruits. Eating cruciferous vegetables such as cauliflower and broccoli has been shown to substantially lower the risk of prostate cancer. Researchers have found that men who ate twenty-eight or more servings of vegetables per week had a 35 percent lower risk of prostate cancer compared with men who ate fewer than fourteen servings per week. Moreover, men who ate three or more servings of cruciferous vegetables per week had a 41 percent decreased risk of prostate cancer compared with men who ate less than one serving per week. Cruciferous vegetables contain isothiocyanates, which activate enzymes that neutralize carcinogens. This same compound is what protects women against breast cancer.

3. Eat raw nuts and seeds. Flaxseed oil is good for the prostate. How many men to you know that eat flaxseeds? Ground flaxseeds can be added to salads or to juice, and they are also available in supplement form. Pumpkin seeds are also excellent and have proven prostate-protective properties. Raw almonds (eaten in moderation) also provide good fats and user-friendly protein.

4. Eat more fish. Choose salmon instead of steak. Men who regularly consume fatty fish such as salmon and mackerel were up to three times less likely to develop prostate cancer over a thirty-year period than men who did not eat fatty fish. Coldwater fish contain omega-3 fatty acids which have been shown to inhibit the growth of prostate cancer cells.

5. Got Soy? The genistein found in soybeans and many soy foods such as tofu, soy milk and some soy protein powders helps to inhibit the growth of prostate cancer cells, and even works to destroy them. It blocks bad testosterone in the prostate gland in the same way that it works to protect breast tissue against estrogen exposure. Men who consume soy milk more than once a day are reported to have a significantly lower risk of prostate cancer compared with other men.

6. Take supplements. I have heard women complain over and over again that getting their husbands to take vitamins is almost impossible. Come on men! What’s so hard about popping a few pills with breakfast? There’s nothing to it. Take a good vitamin and mineral supplement combined with a strong antioxidant blend that has extra selenium. A crossover study of thousands of men showed that selenium (a trace mineral) reduced the risk of prostate, lung and colon cancer. This reduction was a whopping fifty percent. And in a double-blind study of mostly nonsmoking men, supplementation with synthetic beta-carotene led to a statistically significant 32 percent reduction in risk of prostate cancer in men who initially had the lowest blood levels of beta-carotene.

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Erectile Dysfunction [ED]

Symptoms of Erectile Dysfunction (ED)
  • loss of sexual desire (libido)
  • premature ejaculation
  • inability to achieve orgasm

Traditional ED Treatments

Conventional treatment options for impotence or ED may include psychological and behavioral counseling. You will also need a complete physical to rule out the presence of cardiovascular disease or diabetes. Drug treatments for ED include male hormone replacement therapy (testosterone, DHEA), sildenafil (Viagra®), and medications inserted or injected into the penis (alprostadil). Penile vacuum devices and surgical options, such as penile implants and vascular repair, are usually considered last resorts.

What Causes ED?

Below average levels of testosterone and decreased circulation from plaque deposits in penile arteries are frequently to blame for ED. It is not true, however, that impotence automatically accompanies aging. Healthy men who are eighty and beyond can still sexually function, suggesting that a man’s overall health may be more of a reliable predictor of impotence than age. For example, men who suffer from high blood pressure, heart disease or diabetes are up to four times more likely to become completely impotent later in their lives.

Low HDL (the good kind) cholesterol levels have also been linked to an increased risk for future impotence. A study reported in JAMA found that atherosclerosis of the main artery than runs through the penis is the primary cause of impotence in over half of men over the age of fifty. It is also important to remember that impotence may be one of the first signals of vascular disease or diabetes so you need to check it out with your doctor. Impotence can also occur in men suffering from Parkinson’s disease, multiple sclerosis, hypothyroidism and even lower back problems.

Risk Factors for Impotence

  • smoking
  • heavy drinking
  • inactivity
  • obesity
  • diabetes
  • stress
  • use of some medications (cimetidine, antihypertensives and MAO inhibitors, etc.)

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The Stress Connection

I strongly believe that in the absence of physical factors, ED can be a manifestation of unmanaged stress. Unfortunately, most men who experience impotence fail to seek medical attention. Why? Because men typically associate impotence with notions of lost virility. Hence, the last thing they want to do is talk about it, even to a trusted family doctor who could offer them several treatment options — especially if stress is a problem. Don’t underestimate the role that stress or anxiety may be playing in cases of impotence. Emotional factors, workplace anxiety, strained relationships and the inability to relax can precipitate the problem. A study conducted with a group of men age forty to seventy concluded that after adjustment for age, a higher probability of impotence directly correlated with indexes of anger and depression. (It’s important to keep in mind that while up to 80 percent of impotence is caused by physical factors, once an erection fails, psychological components kick in, compounding the problem.) Various studies suggest that anxiety is common among people with sexual dysfunctions, emphasizing that anxiety management is crucial to normal sexual function and applies not only to men, but women as well. Learning to de-stress through relaxation exercises such as controlled breathing, massage, etc. can be very helpful.

Drug-Induced Impotence

One of the most common but overlooked causes of impotence is the misuse of drugs — both prescription and the illegal variety. Narcotics, antihypertensive drugs, anti-anxiety medications, tranquilizers like Valium, some antidepressants, and even some diuretics can cause impotence. In fact, over two hundred drugs have impotence listed as a possible side effect. Some over-the-counter antihistamines and decongestants have also been linked to temporary impotence. If you suspect a drug is at fault, tell your doctor. Remember that alcohol is also a drug that negatively impacts sexual function. Likewise, smoking actually constricts penile arteries thereby reducing blood flow.

The Drawbacks of Conventional Therapies for Impotence

While Viagra has enjoyed unprecedented popularity, more and more side effects continue to surface as its use escalates. Headaches and visual disturbances along with blackouts caused by sudden drops in blood pressure can occur, especially when Viagra is combined with nitroglycerine. In a recent article in the Washington Post, the FDA issued a warning to all doctors which says “that it may be too risky to give Viagra to whole groups of men including those who recently had heart attacks or very high blood pressure.” Testosterone shots, other drugs and penile implants may help, but these also come with health risks and significant side effects.

Dietary Guidelines for Impotence

I tell men who are suffering from impotence to look at all aspects of their lifestyle and to start from square one. Losing weight, exercising and eating a low-fat, high-fiber diet can help to improve circulation and counteract impotence that is caused by reduced blood flow. It’s also important to avoid alcohol and tobacco, and to limit the consumption of animal fats and highly sugared foods. Foods to emphasize include legumes, nuts, seeds, coldwater fish like salmon, and fresh fruits and vegetables. These foods are naturally high in zinc, essential fatty acids and important B-vitamins, which are all essential for good sexual function. Moderate and consistent exercise is a great way to boost circulation and alleviate stress; however, there is some speculation that exercising right before sex directs blood away from the penis and may hinder an erection.

Is ED Emotional or Physical?

If you’re not sure what kind of ED you have, there are home impotence tests you can purchase to determine whether the condition has a psychological or organic origin. These tests are set up prior to sleeping and determine if any erections occurred during sleep. If there are no erections while sleeping, organic factors are probably at work. If this is the case, contact a urologist for an exam. If you discover that erections do occur during sleep, but you still experience impotence when awake, then the problem may have a psychological basis and an appropriate counselor may provide solutions.

Exercise Can Prevent Impotence

Moderate exercise may help prevent impotence according to a large, long-term study. Researchers found that men who burned a minimum of 200 calories daily through exercise were less likely than inactive men to become impotent. These men were followed for almost ten years, and they had no subsequent problems with impotence. Exercise probably prevents impotence by keeping arteries open, which keeps a good flow of blood to the penis. (Keep in mind that impotence can also be an early warning sign of heart disease, which exercise also may prevent.)

Other Ways to Prevent Impotence

  • Eat a healthy diet.
  • Avoid unnecessary medications.
  • Stop smoking. Men who smoke have been shown to have an increased incidence of ED.
  • Exercise regularly.

Recommended Nutritional Supplements for Impotence

Vitamin E and Vitamin C with Bioflavonoids: Vitamin E helps to boosts circulation and to strengthen reproductive organs by effectively scavenging for dangerous free radicals. Because it helps to prevent arteriosclerosis, it is also beneficial as a preventative nutrient for impotence. Vitamin C (with bioflavonoids) helps to maintain proper circulation and works to keep the penile artery clean, while it strengthens the collagen content of veins. It is also known as the anti-stress vitamin and works synergistically with Vitamin E.

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Zinc: This vitamin plays a profound role in maintaining healthy reproductive organs and contributes to normal prostate gland function. Zinc is involved in virtually every aspect of male reproduction. It works to keep testosterone levels up, and because zinc is found in semen, it can easily become depleted. Zinc deficiencies have been linked to diminished sexual drive. Use picolinate or gluconate varieties. NOTE: Too much zinc can actually lower immune system function so don’t assume more is better.

DHEA (dehydroepiandrosterone): This compound may improve sexual performance. In one double-blind trial, forty men with low DHEA levels who suffered from ED were given 50 mg of DHEA per day for six months. They experienced significant improvement in both erectile function and libido, although no real changes were detected in their testosterone levels.

Arginine: This amino acid is necessary for the production of nitric oxide, which participates in the process of achieving an erection. In one preliminary trial, men with ED were given 2,800 mg of arginine per day for two weeks. Six of the fifteen men in the trial improved, while none taking a placebo did. If your ED is prompted by impaired nitric oxide synthesis, arginine may offer an effective alternative to prescription drug medications.

Asian ginseng (Panax ginseng): This herb has been used for a millennia as a sexual tonic for male potency. A double-blind trial found that 1,800 mg per day of Asian ginseng extract taken for three months helped improve libido and the ability to maintain an erection in men with ED. Animal studies have also found that it raises sperm count and testosterone levels. A human trial using fifty male subjects found that the group taking red ginseng experienced a 60 percent improvement rate in erectile dysfunction. The study stated that red ginseng was actually superior to trazodone, a prescription antidepressant drug used for certain kinds of impotence. It should also be noted that ginseng is especially effective for people over forty who suffer from any debilitating condition that frequently contributes to low sexual desire.

Ginkgo biloba: This brain-boosting herb may also boost blood flow to the penis. One double-blind trial found improvement in men taking 240 mg per day of a standardized Ginkgo biloba extract (GBE) for nine months. Another study of thirty men with drug-inducted ED found that approximately 200 mg per day of Ginkgo biloba extract had a positive effect on sexual function in 76 percent of the men.

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Do Men Have a Feminine Side?

After years of working with and treating women, I have concluded that their ability to cope with pain and discomfort is nothing less than Herculean. Moreover, most men are clueless when it comes to understanding what it means to be a member of the feminine gender. Can a man ever really empathize with a woman? My answer is no. There’s a reason why we males have much lower pain thresholds than women. If we had to endure the physical and emotional trial of monthly bleeds, cramping and childbirth, we’d cry like babies. Furthermore, who among the male sex can really imagine what it’s like to find himself spread eagle on a delivery table? I have a great deal of respect for the poking and prodding women typically endure. They are routinely dehumanized by the very nature of the medical profession with its array of gynecological tests and procedures.

Equally important is that men must come to understand the emotional impact of their partner’s hormonal landscape. It can save countless hours of contention and resentment. Simply stated, don’t take your wife or girl friend’s cyclic behavior personally. A woman’s cycle can profoundly impact her moods, her ability to cope, and her attitude and toward family members. Believe me, estrogen and progesterone surges and drops can make a woman’s fuse short and her emotions raw. See the ups and downs for what they are and learn to be supportive and not combative. Seeing a good OB/GYN together can also help.

As mentioned earlier, men have better access to quality medical care but unlike women, they don’t take advantage of it. Furthermore, men (in general) appear to be less teachable when it comes to their health than women. Trying to get a man to change his eating habits and get off his duff is infinitely harder. So, one way to remedy this problem is to encourage mothers to teach their young sons the basics of good health before they become set in their ways.

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The above comments are excerpts from Dr. Townsend's new book "A Maverick of Medicine Speaks to Women" by Duane Townsend, M.D. and Rita Elkins, M.H. These excerpts may not reprinted in whole or part without permission of the author. All rights reserved. Copyright ® 2003 Duane Townsend, M.D.