A woman’s guide to her man’s health

When was the last time your husband had a checkup? If you can't remember, you're certainly not alone. Bring up a visit to the doctor, and you quickly find out that most men would rather help you shop for jeans than set foot in an MD's office.

In fact, in a WomansDay.com poll, 92 percent of you said that the only way your husband goes to the doctor is if you nag, nag, nag or make the appointment and take him there yourself. Blame it on testosterone: One recent study from Rutgers University found that guys who consider themselves "macho" are 50 percent less likely to seek preventive health care. "Men aren't as used to seeing their doctors every year as women are," notes Ian Kerner, PhD, a New York-based relationships and sex therapist. "We hate getting poked and prodded, and a lot of men are terrified of their mortality. We think if we go to the doc, he'll find something wrong."

But the key to living a long, healthy life is catching early anything that might be wrong. "Men are notorious for waiting too long to see their physician," notes Harry Lodge, MD, a New York-based internist and co-author of "Younger Next Year." "A lot of what happens in our bodies takes place silently, so while he may think he's just putting his head in the sand, he's really digging a huge hole for himself."

So it's up to us to help the men take charge of their well-being. Step one: knowing what they need to be concerned about. Here's our guide to some of the main issues he may be facing over the years.

In his 30s

With those crazy 20-something days behind him, he may not run as fast, feel as strong or recover as quickly as he used to. "Starting at age 30, our body physically starts to age and we see a decline in maximum heart rate and muscle," explains Dr. Lodge. The good news is that regular exercise and a healthy diet can significantly counter the aging process, and the earlier you start, the better. Here's what else he needs to do to keep himself fit:

• Get an idea of his baseline. Even just a handful of checkups in his 30s can go a long way toward keeping him healthy for the next half-century. "Establishing a good relationship with a doctor now and knowing where he stands on key heart disease and diabetes screenings will help the doctor better detect any noteworthy changes in years to come," says Jahangir Rahman, MD, assistant clinical professor of medicine at Columbia University.

• Know his family history. Heart disease is probably the furthest thing from his mind, but if his father, mother, aunt or uncle had a heart attack at a young age (before 60 for a man, 70 for a woman), he may also be at risk. Cardiovascular disease (including heart disease and stroke) accounts for more than half of all deaths in men, so it's never too early to get heart-healthy and know your risk factors. "Numerous studies have shown that even teenagers may have atherosclerosis (plaque deposits in the linings of the arteries), so he may already be developing a major heart attack risk," says Arthur Agatston, MD, a cardiologist and associate professor of medicine at the University of Miami. Also, make sure he tells the doc if he has a family history of diabetes, high cholesterol or colon cancer. If any of these run in his family, he should be screened before he turns 40.

• Keep sex fun. "When intercourse focuses on babymaking — rather than the act of sex itself — some men can have trouble achieving a normal erection or climaxing," notes Abraham Morgentaler, MD, an associate clinical professor of urology at Harvard Medical School and author of "Testosterone for Life." Putting an emphasis on pleasure can help reignite the spark.

• Get vaccinated. If he's never had chicken pox or gotten the vaccine, now's the time. "Many people over 40 today have already been exposed, and their kids are vaccinated, but there's still this group of 30-somethings in the middle who've missed out," explains Dr. Rahman. Adult chicken pox can lead to complications like pneumonia (not to mention a world of discomfort), so he should ask his MD for the shot now. He should also make sure his tetanus shot is current (you need one every 10 years) and get an annual flu shot.

• Make exercise a habit. Work and family are probably eating into his time now more than ever, but being active is crucial to staying heart-healthy, staving off weight gain and keeping disease-causing belly fat in check. So encourage him to keep it in his weekly planner — whether it's jogging around the local track, joining an athletic league at work or regularly shooting hoops with his friends.

• Do a below-the-belt check. Younger men are at a higher risk for testicular cancer (peak ages are between 18 and 35), so encourage your mate to do a monthly lump check and stay on guard. “Testicular cancer is 95 percent curable when it’s caught early,” says Dr. Morgentaler. Here’s how it’s done: Move the penis out of the way and check one testicle at a time. Holding the testicle between thumb and fingers, gently roll back and forth, feeling for any hard, smooth or rounded bumps or changes in size, shape or consistency of the testes. (Don’t count the epididymis, the tube behind each testicle that holds sperm and feels like a small bump.)

In his 40s

This is when many men really begin to feel the signs of impending age — especially if they've been ignoring their health up to now. "In the 40s we begin to see a marked increase in weight gain, high blood pressure, diabetes and physical issues like back problems," says Dr. Lodge. But don't despair. "This is a great decade to turn your health around. You can easily knock 20 years off your age if you take the right measures," he adds. Encourage him to begin here:

• Make his checkup an annual affair. "Now is when we really need to start keeping an eye on things like diabetes, heart disease and cancer, especially if there's a strong family history," says Dr. Rahman. It's also a good time for him to talk to his doctor about a PSA (prostate-specific antigen) test, which checks PSA levels in the blood. If they're elevated, it may indicate prostate cancer. The American Urological Association now calls for a baseline check at 40.

• Curtail cocktail hour. Research shows that men in their 40s feel more burdened than at perhaps any other time. A glass of the hard stuff may seem like a good way to unwind — but watch out. "Most people think alcohol is a destressor, but it makes you more impatient and irritable," says Dr. Rahman. And heavy drinking can also lead to more serious damage, including liver and heart disease.

• Commit to date night. It's a great stress reliever and relationship strengthener. "In this economy, many couples sacrifice things like going out for dinner and a movie, and their relationship often falls to the bottom of the list," notes Dr. Kerner. "But getting out together can go a long way toward countering daily pressures because it helps you stay connected and emotionally support each other." More surefire stress busters: a good night's sleep (between 7 and 9 hours), regular exercise, a healthy diet and some hanky-panky.

• Deflate the spare tire. By their 40s, men are much more likely to have belly fat, which can signal metabolic syndrome, a precursor to diabetes and heart disease. "A bigger belly can be a sign of inflammation, which is linked to so many life-threatening conditions," notes Dr. Roizen. The danger zone is a waist size that's over 40 inches.

• Stock up on healthier fare. Around age 40, your body isn't as able to get rid of the fat, extra calories and artificial ingredients it doesn't need, says Dr. Roizen. Foods to avoid: those high in saturated fats, trans fats, simple sugars, syrups (like high-fructose corn syrup) and nonwhole grains (white bread and rice).

• Be aware of performance problems. "Many men in their 40s will notice their orgasms are not as intense," says Dr. Morgentaler. Erectile dysfunction (ED) and a reduced sex drive may also start to surface. Some of this is due to lower testosterone levels, which are now on the decline after a peak in the mid-30s. Have him get his testosterone levels checked and consider getting treatment if the numbers are abnormally low. "As many as a third of men over the age of 40 have low testosterone levels," says Dr. Morgentaler. Ask for the levels of both total testosterone and "free" testosterone, or the portion that his body can actually use, he adds. "A fair number of men whose total testosterone is normal may still have low levels of free testosterone, which can contribute to ED and a lower sex drive, as well as to chronic fatigue, irritability and depression." Another sign his testosterone levels may be slipping: He no longer needs to shave every day.

• Stay social. This is often a time of intense career focus, so some of his buddies from his youth are likely to slip off his radar. “After their school days are gone, many men have a lot of trouble forming new deep friendships,” says Dr. Lodge. Think of it as more than just finding someone to watch sports with; loneliness may increase health risks (men without a strong circle of friends and family have double the death rate from heart attacks and twice the risk of developing Alzheimer’s), so it’s crucial for him to stay connected to his pals.

In his 50s

For many men, these 10 years are a transition period — if they're not taking steps to stay healthy, they're really feeling it by the end of this decade. "You need to step things up to keep feeling young," says Dr. Lodge. Here's what he needs to do to keep up the smooth sailing.

• See the eye doc. If he hasn't already made a trip to the ophthalmologist, now's the time to start. Glaucoma affects over 4 million Americans and is the leading cause of blindness among African-Americans. Caught early, it can be managed, but there are rarely symptoms in the initial stages, making it crucial to get an exam measuring intraocular pressure.

• Watch for nighttime bathroom runs. Many 50-somethings are starting to have signs of an enlarged prostate, which often means more frequent urination with more urgency. Encourage him to talk to his doctor about getting his PSA levels checked yearly, although there's some controversy over how often and aggressively they need to be monitored. "We're looking for a change in PSA, rather than just a high number," explains Dr. Morgentaler. And those with a higher risk (men with a first-degree relative who was diagnosed with prostate cancer before 65, as well as African-Americans) should take extra precautions.

• Check the plumbing. The American Cancer Society recommends that all adults with average risk factors get screened for colorectal cancer starting at age 50. Certain risk factors, including having a family history of colorectal polyps or cancer, warrant screening younger (usually 10 years before the age at which your relative was diagnosed). "Most colorectal cancers develop from growths called polyps in the colon or rectum," explains Mark B. Pochapin, MD, director of The Jay Monahan Center for Gastrointestinal Health at New York-Presbyterian Hospital/Weill Cornell Medical Center. "Colon cancer screening is crucial so we can detect and remove these polyps before they turn cancerous."

• Don't ignore warning signs. In many cases, what seems like bad indigestion is actually the beginnings of a heart attack. "In your 50s, you're much more likely to have symptoms of heart disease," says Dr. Agatston. These can include a pressure or tightness in the chest when you exert yourself that lasts longer than a few minutes or goes away with rest and returns; shortness of breath; nausea; and discomfort in areas like the back, arms, neck, jaw or stomach. "If you're having pain that's more severe or different from anything you've had before, or have a family history of heart disease, call your doctor right away," Dr. Agatston adds. By now he should also be getting a full workup yearly that includes blood tests to check cholesterol and triglyceride levels. If he's having symptoms, the doc will order an echocardiogram and a stress test. Some patients with risk factors may also benefit from a coronary calcium scan (which measures the buildup of calcified plaque in the coronary arteries) as well as carotid artery imaging (an ultrasound that checks for narrowing and stiffening of the arteries).

• Supplement with fish oil. Research has shown that omega-3 fatty acids (found in fish like salmon, tuna, trout and mackerel), have many health benefits, from lowering blood pressure to helping brain function and preventing macular degeneration, the leading cause of blindness. But since experts say you have to eat fish at least twice a week to get the benefits, it may be easier to pop a fish or krill-oil pill. Ask your doctor which brands he recommends.

• Hit the weights. Aerobic exercise, like swimming and walking, remains crucial to keeping weight in check and cardiovascular benefits high. But regular strength training also becomes more important as muscle mass begins to decline and joints become creakier. “By the 50s, there’s not as much spring in your joints,” notes Dr. Lodge. “Your muscles can compensate to an extraordinary degree, but only if they are strong.” Resistance exercises (with machines, dumbbells or resistance bands) can help build more lean mass and protect the joints.

In his 60s and beyond

"Research shows that people in their 60s and 70s are markedly happier than at other points in their lives," says Dr. Lodge. Avoid chronic disease and he can expect to reap the rewards of healthy living if he's paid attention to diet, exercise and preventive medicine for the past few decades. But it's still never too late to start.

• Keep up the exercise. Senior doesn't mean sedentary. If he's not strength training yet, he should start now. "You can build high-quality muscle mass through your 60s. By your 70s, it's more about living off what you've already built, like a retirement fund," Dr. Lodge says. Aerobic exercise also counts. He should consider doing some form of interval training, mixing bursts of high intensity with moderate intensity. (Of course, you can start this younger!) A recent study found that people who did this type of exercise for 40 minutes a week had twice the fitness gains as those who did a steady-pace run for 150 minutes a week. At age 63, Dr. Agatston does his own routine of 15-second sprints followed by 30 seconds of recovery. "Interval training also helps keep your metabolism up," he notes.

• Get on Facebook. Study after study shows that seniors who are most socially connected live longer and have a lower risk of Alzheimer's. Facebook is a great way to link up with old friends and find new ones. If he's not a fan of new media, help him get involved in other community groups.

• Take some D. Many doctors advise that all adults take D supplements, but older adults in particular are at risk of a deficiency, which can raise their odds of heart disease, cancer, weak bones and even memory loss. "Vitamin D is largely made by the body as a result of sun exposure, but many older adults aren't getting out in the sun that much," notes David Katz, MD, director of the Prevention Research Center at Yale University School of Medicine in Derby, Connecticut. Guidelines call for at least 400 IU of D daily for adults ages 51 to 70, and 600 IU for those who are older, but experts advise taking as much as 800 to 1,000 IU for optimum benefits.

• Look and listen. Eyesight and hearing can really start to wane now, which can be dangerous. “Declining hearing and vision levels can often lead to falls and injury, causing fractures and potentially serious health issues,” says Dr. Katz. In fact, a third of all seniors report falling each year — it’s the leading cause of death from injury among those 65 and older — and two-thirds of those who fall will fall again within 6 months. Make sure he gets a hearing, vision and balance test at his annual visit.

This article can be found in the June edition of Woman’s Day.