D.C. Council pokes Congress and Congress strikes back

By Peter Rosenstein - February 16, 2023 12:00 am

February is American Heart Month. According to the Centers for Disease Control, heart disease is the leading cause of death for men of most racial/ethnic groups in the United States.

During 25 years as a urologist, I have had the privilege of taking care of thousands of men. It is essential to form a good relationship with your doctor and be honest about your medical history in order to properly address your potential issues with regard to your overall health and well being.

Men develop heart disease almost 10 years earlier than women, on average. They also have an early warning sign that few can miss: erectile dysfunction (ED). Sexual problems often foretell heart problems.

Sometimes heart disease may be “silent” and not diagnosed until a man experiences signs or symptoms of a heart attack, heart failure, or an arrhythmia. When these events happen, symptoms may include:

• Heart attack: Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath.

• Arrhythmia: Fluttering feelings in the chest 

• Heart failure: Shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins.

• Even if you have no symptoms, you may still be at risk for heart disease.

Most medical issues I encounter are related to issues with blood vessels. Of course, any history of smoking, diabetes, high cholesterol, or high blood pressure must be addressed, and the ability to have physical intimacy is a strong motivator for change.  

Going deeper, I look for a family history of cardiovascular disease in men with early erectile dysfunction since ED often precedes heart disease. I frequently send patients for heart scans, which can now predict early cardiovascular disease with great accuracy.

I also discuss physical fitness with my patients. Men over 40 need two or three days of cardio and two or three strength-building days every week. I especially like circuit training with lighter weights and more reps, reducing the risk of injury, and augmenting cardiovascular fitness. I discuss the importance of avoiding injury that will set men back and the need for consistency. Increased muscle mass will boost a man’s basal metabolic rate, which is the number of calories a man burns every day just by being alive. Men also feel better about themselves when they are leaner and more muscular, and this boosts libido.

Testosterone supplements are good for libido, energy, concentration, sleep, athletic performance, muscle building, and fat burning. I used to be conservative about replacing testosterone, getting men back to “normal” levels, but I have discovered that men do much better when their testosterone levels are around 1000, and I have seen very few adverse effects.

In summary, it is important that men take steps to improve and maintain good overall health and wellness. The key to all of this is good heart/cardiovascular health. Regular medical checkups are very important, and will help ensure a good quality of life, and improved health outcomes. 

Dr. Judson Brandeis is a board certified urologist specializing in men’s sexual, hormonal, and physical health and author of the men’s health book, “The 21st Century Man.” Reach him via brandeismd.com.

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