Both Sexes Make Mistakes in Caring for Health

Last Editorial Review: 6/28/2005

WebMD takes aim at common health blunders men and women make.

WebMD Feature

Reviewed By Brunilda Nazario

We are besieged daily by health advice: Take this, eat that, don't do the other. Yet even the most health aware -- not to mention the doctor averse -- can make mistakes in caring for themselves.

Common Health Mistakes Men Make

The conventional wisdom says that the average man takes better care of his car than his body . "All male health blunders come from the essential male blunder, and that is the notion (many men have) that a real man is a man with no vulnerabilities," Terry Real, MSW, a family therapist and author in Watertown, Mass., tells WebMD

"Unless something is falling off," Larrian Gillespie, MD, a urologist in California, tells WebMD, "men won't go to the doctor."

Men have a shorter life expectancy compared with women, Real says, because they don't take care of themselves. "They don't recognize that they need help, they don't seek it, and when they do seek it, they don't do what the doctor days." The bottom line, Real says, is that men die. "I could call that a big blunder -- costly."

Men experience depression differently than women, says Real, who is author of You're Not Crazy It's Your Hormones. "A woman knows she is depressed, feels the pain, asks for help. But even if a man knows what he is experiencing, he won't ask for help."

Some of the symptoms of depression include feeling sad, sleeping too little or too much, a drop in libido, and a feeling that nothing in life is giving pleasure.

"Many more men than women have what I call hidden depression," Real says. "It isn't as pronounced because they are doing everything they can to ward it off -- drinking, running around with women, lashing out and being irritable or even violent, or watching too much TV. Many health professionals will miss the signs."

Yet treatment of depression is a health success story. Real says that nine out of 10 people who seek some form of help report substantial relief. "The problem is, fewer than one in five will seek help."

Women Can Help

Real aims this message toward women, ironically. "Women get men to see that this is a chemical imbalance, biological and genetic, and thus there are medications that work. Depression is not moral weakness! There was also a time when men didn't get help for diabetes. Soon depression will be in that same routine category of treatment."

Some other health errors men tend to make:

  • Denying the obvious. Blood in the stool, weird rashes or moles, sudden thirstiness. "Men are great deniers," Gillespie says.
  • Denying even something as serious as a heart attack. Most men have read about the symptoms of a heart attack (which can be different for women): fatigue, numbness in the left arm, chest pains, shortness or breath, nausea, or a feeling of extreme weight on the chest. Sometimes all of these begin to appear. "Yet, men will drive themselves to the hospital," Gillespie says. When the signs of a heart attack appear you should immediately call 911.
  • Not getting a prostate exam because it's unpleasant. A digital rectal exam is a screening test for prostate cancer, and is recommended to be done along with a PSA blood test. There may be some discomfort with the rectal exam but it does not cause significant pain. "Every man should have a PSA test after 40, especially men who have unhealthy diets and are obese, which increase the chances of prostate cancer." She recommends a "fractionated" PSA, which can break down the likelihood of benign vs. cancerous lesions, from a blood test. Not all cancerous prostate lesions turn deadly, either. Your doctor can advise on both points.
  • Not being examined for colon cancer. Ninety percent of intestinal cancers can be prevented. Most men (and women) should have a colonoscopy starting at 50 and every five to 10 years thereafter.
  • Not being aware of testosterone levels. Gillespie recommends getting serum testosterone blood tests in middle age. Some medications can lower levels of this sex hormone and cause sexual and mental problems, Gillespie says.
  • Not checking yourself for testicular cancer. This is a cancer that strikes younger men, 15 to 35. Look at it this way: Self-examination means no trip to the doctor.
  • Eating an unhealthy diet. "Men are the biggest purchasers of drive-through," Gillespie says. Yet men are more sensitive to fat than women and should keep their intake to 10% of the diet.
  • Smoking. This applies to both men and women. "This is a real issue," Gillespie says. She recommends getting your teeth cleaned before quitting. "Nicotine can leach out of the crevices and create cravings," she says. Other tools that can help you quit smoking are nicotine patches, gum, nasal spray, inhalers, and lozenges; call-in "quit lines;" and prescription drugs such as Zyban. Your doctor can give you a regimen.

Women Also Make Health Blunders

Women have a rep for running to the doctor all the time, and statistics show they do go more often than men. But this doesn't mean they always exercise the best judgment in terms of their health.

"The biggest blunder women make is taking care of everyone instead of themselves," Suzanne Merrill-Nach, MD, an ob-gyn in practice in San Diego, tells WebMD. "They make dad and the kids go to the doctor and take their medicines, but they may neglect themselves."

Being careless about birth control is a big blunder, Merrill-Nach says. "I still see a lot of unintended pregnancies and sexually transmitted diseases. Women need to say it's condoms or nothing (no sex). This is a shared issue. He is benefiting, too. How do you decide when to use birth control and when not to? Use it!"

Merrill-Nach says you may not hear much about birth control pills these days, but they are still a "wonderful" method of birth control. "They have lots of advantages," she says. "We use them for many purposes, cramps, irregular periods, acne." There are also skin patches that deliver medication and a vaginal ring. "These are effective and easy," she says.

There are also injections that fend off pregnancy and a new IUD that is safer than older forms. "A new implant is also coming," Merrill-Nach says.

Of course, none of these methods is a barrier against viruses, such as HIV and the hepatitis viruses. HIV/AIDS may not be in the press as much these days, but it is still a huge problem, even for older people. There are also other STDs out there, including gonorrhea and a resurgence of syphilis.

Smoking and Other Blunders

Merrill-Nach is also adamant about smart women who still smoke. "Do you think it will keep you thin?" she asks. "Do you want to look good in your casket?" Heart disease kills more women than breast cancer; it's No. 1. Smoking contributes to it. "Smoking can also cause bladder cancer," Merrill-Nach says. "And wrinkles!"

Other health mistakes women make:

  • Crossing their legs at the knee. This can restrict blood flow and cause varicose veins. Better to sit with your feet flat on the ground.
  • Skipping breakfast. You will not rev your metabolism into action and function as well in the morning. Then you will pig out at lunch.
  • Wearing perfume in the sun. This can set up a chemical reaction leading to a rash.
  • Not self-examining breasts. A trip to the gynecologist once a year and a Pap test are no substitute for monthly self-exams. If you do feel a lump, get a mammogram or a sonogram. Nearly 10,000 breast cancer patients a year did not receive immediate treatment because mammograms looked normal.
  • Not getting routine blood tests. Women, especially those who have risk factors for diabetes, also need periodic diabetes screening tests. Thyroid test and cholesterol screening should also be part of a routine blood exam.
  • Thinking you can't get pregnant after age 40. "This is the dumbest!" exclaims Gillespie. "Even if you think you are going into menopause, you can get pregnant."
  • Using too many feminine sprays. "These upset the normal flora and fauna in the vagina," Gillespie says. "If you have chronic odor worries, it could be a sign of thyroid problems, type 2 diabetes, or a shortage of estrogen."
  • Not recognizing a heart attack when they feel it. Women and men experience symptoms of heart problems differently. Women often don't get the "elephant on the chest" heavy feeling, Gillespie says. Instead, the No. 1 symptom can be draining fatigue and sleepiness. A feeling such as heartburn or indigestion can also signal a heart attack in women.

Both men and women need to eat better, exercise regularly, and not be afraid to insist on their rights to decent, timely health care. It's only a life or death matter.

Star Lawrence is a medical journalist based in the Phoenix area.

Published June 27, 2005.

SOURCES: Terry Real, MSW, family therapist, Watertown, Mass.; author, How Can I Get Through to You. Larrian Gillespie, MD, urologist; and author, You're Not Crazy It's Your Hormones. Suzanne Merrill-Nach, MD, ob-gyn, San Diego.

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