Men’s Health | Extreme Overhaul

Men’s Health | Stan, a 48 year-old man, walks into my office the other day with the chief complaint of, “Doc, my wife sent me here because I lost my sex drive “. He hasn’t been to a doctor in 15 years. The last time he saw one was to get a hernia repaired. He otherwise told me he’s healthy. On the surface, he is right. He takes no medications, has never been hospitalized and almost never calls in sick. As a urologist, I see hundreds of men a year just like this. Common in men’s health - guys don’t go to the doctor unless something really hurts or doesn’t work. In my field, things that don’t work are pretty important to men - man parts. Men don’t see doctors until they’re 50 to begin annual screenings. Unfortunately, the diseases that kill men most frequently start in the 30s and 40s. These are heart disease, high blood pressure and diabetes. All of these conditions can be detected early and treated effectively. These conditions also are the biggest risk factors for sexual problems.

Let’s get back to my office and men’s health. Stan is a professional, played college sports and then went into the workforce as a sales consultant. He stopped playing sports, started drinking, taking clients out for beers and steak dinners and packed on 30 pounds in the eight years after college. His business is great, he finds a beautiful woman, marries her and they quickly start a family. By age 40, he’s 50 pounds overweight, hasn’t exercised in 15 years and has three wonderful kids that he shuttles to soccer, swimming and dance classes. Career is still going great, nice house in a good school district. Wife is still beautiful, works out daily and is at her sexual prime. He is in a sexual slump – no interest in lovemaking, no constant thoughts about sex. He’s just trying to get through the day. He went from the studly college quarterback with a chiseled mid section to a portly executive with a corner office and huge mortgage in a short 25 years. He’s happy coming home from work, knocking back a few cocktails, eating a full plate of meats, starches and creamed vegetables. Hit the sack and get up in the morning to do it all again.

His physical exam shows a normal, overweight male. His prostate is not enlarged. Since he’s over 40, I also discuss screening for prostate cancer. His dad had the disease and was treated successfully. The blood tests I order, for starters, include electrolytes, blood sugar, cholesterol panel, testosterone level, PSA (a blood test used for prostate cancer screening). What’s going wrong with this man? His wife thinks he just needs a little testosterone. And she’s probably right. But there’s a lot more going on. He needs a men’s health extreme overhaul. His blood pressure is high, his cholesterol is obscene, his blood sugar is teetering toward diabetes and he’s too fat. His PSA is normal, low risk for prostate cancer and his testosterone is indeed also low. His stress level is red-lining, he’s lost interest in most activities and doesn’t think he has time to care.

The men’s health overhaul starts with the basics. It’s boring to hear but let’s talk about diet, exercise and lifestyle modification. His primary physician and I can provide medications to reduce blood pressure, cholesterol and increase testosterone. That’s easy. Stan needs to limit his portions, cut out refined sugars, limit his alcohol to one to two drinks a couple of times a week and start moving. The old athletes can be tough to treat. Their minds remember how good their bodies used to be and they can’t get over the fact they won’t be at that level again. Stan needs to start walking 15 to 20 minutes a day and increase from there until his joints and bones can handle more activity. He can still have his steak dinners once a week or so, just skip the potatoes and go for asparagus without the sauces.

It’s June now, three months into Stan’s new life. He’s 30 pounds lighter, a good clip of 10 pounds a month, walks four miles a day with his gorgeous wife by his side. He has a glass of wine most nights for dinner, is sticking with lean proteins, lots of vegetables and a little chocolate now and again. Thanks to prescriptions from his primary physician and myself, his blood pressure is normal, cholesterol is working its way down and testosterone levels are back where they probably were in college. He brings his wife in to the visit today. She confirms his sex drive is back to the early years of their marriage.

June is National Men’s Health Month, a good time to assess where you are in your life. The weather is perfect for exercise, lots of fresh fruits and vegetables are waiting for you in your grocery store and your grill is begging you to throw some lean steaks or chicken on it. Commit to positive changes, see your doctor for a health overhaul and look forward to how great you’ll feel and look next June as a result.

- Jesse Mills, M.D., is a fellowship trained, board certified urologist specializing in vasectomy reversal and microsurgery who performs more than 150 microsurgical procedures each year. Dr. Mills has a robust surgical practice specializing in vasectomy reversal, microsurgical sperm retrieval, penile implants, surgical management of Peyronie’s Disease and other male reproductive and sexual disorders. His clinical practice focuses on men’s health, male fertility, hormone replacement and other sexual disorders.

Dr. Mills is a cum laude graduate of UCLA and received his medical doctorate from University of Iowa College of Medicine. He completed his urology residency at the University of Colorado College of Medicine. Under Dr. Larry Lipshultz, a world-renowned leader in male infertility and sexual medicine, Dr. Mills completed a one-year fellowship in microsurgery and male reproductive medicine at Baylor College of Medicine.

Learn more about men’s health and Dr. Mills at