Dr. Rajiv Singal, a urologist at Medcan, offers advice on men’s reproductive health in honor of Men’s Health Month in June.
What is the Prostate? The prostate gland is a part of the male reproductive system in men
and has a role to play in fertility. It produces a fluid that mixes with sperm to create semen.
“We were born needing a prostate… its useful role in life tends to be done relatively early, and
then it remains afterward,” says Dr. Singal. It’s in those later years that the prostate can
become enlarged—or even cancerous—and cause symptoms and discomfort.
What Role Does Testosterone Play in Men’s Health? Testosterone is “a normal and a very
important piece that all men need to maintain bone health, a sense of well-being, and to have
energy and a sex drive,” says Dr. Singal. Testosterone is produced in the testicles, which also
produce sperm—a critical component in fertility. Testicular cancer is the most common cancer
in men aged 15 to 35, and it’s important for men to do regular testicular self-exams to check for
lumps, bumps, or other irregularities.
How Prevalent is Prostate Cancer? Over the course of their lifetimes, around one in nine
Canadian men will develop prostate cancer. “That seems like a big number,”’ says Dr. Singal.
“The challenge with prostate cancer is that many people do not need to actually be treated. It
can be slow growing for the majority of people.” And those people can have wonderful lives.
For example, Dr. Singal knows of a patient “who, despite having metastatic prostate cancer,
was golfing his age.” The point? Prostate cancer and its progression depends on the individual.
How Does Men’s Health Change With Age? As men grow older, they may notice they’re
taking more trips to the bathroom at night. That’s because the prostate gland grows slowly over
time. That growth “has the effect of constricting the urethra—the pipe through which we void,”
explains Dr. Singal. A larger prostate can cause benign prostatic hyperplasia (BPH), which is not
cancerous but can cause a slow flow and more urgency and frequency getting up at night.
What’s the Deal With PSA Tests? Some men who experience prostate-related symptoms will
ask their family doctor for a prostate-specific antigen (PSA) test, which can identify prostate
cancer in its early stages by measuring levels of a key protein the gland produces. A larger
prostate will naturally raise PSA levels. It’s important to have a baseline PSA test done, so your
doctor can monitor your levels over time and determine the next steps if levels change.
Can I Do Anything To Treat An Enlarged Prostate? Lowering your consumption of caffeine
and alcohol can help manage symptoms of BPH. Flomax, Rapaflo, and Xatral are common
medications that “don’t actually do anything to change the prostate shape or affect growth, but
they’re very good at actually ameliorating symptoms,” says Dr. Singal. Other drugs called
Proscar or Avodart will slow prostate growth. There are also minimally invasive surgeries that
will help to unblock the urethra.
Why Does Erectile Dysfunction Happen to Some Older Men? Erectile dysfunction (ED) can
often be related to a new stressor in the patient’s life. “It might be entirely managed through
identifying and then working through a life stressor that might have evolved,” says Dr. Singal.
Erectile dysfunction can also be a vascular disease. “You need a blood supply and a blood flow
to get an erection,” says the urologist. “As men get older, that’s an increasing challenge.”
What Can I Do To Promote My Reproductive Health? To ward off erectile dysfunction, it’s
important to engage in regular exercise and eat a healthy diet, both of which promote vascular
health. Similar healthy choices can promote prostate health. “If you eat well, sleep well and
exercise, it’s probably going to have some impact in a positive way on your prostate,” says Dr.
Singal. “What’s good for your heart is probably good for your reproductive health.”
What Else Can I Do To Promote Men’s Health? “We need men to make sure that their
primary care physicians are addressing the prostate side, doing that blood test, getting that
baseline so that we can then establish what that risk might be,” says Dr. Singal. “I think that’s
the main thing: be aware. Don’t suffer in silence. Ask questions the next time you’re in to see
your family physician. I think that’s ultimately what Men’s Health Month is all about.”
In addition to Medcan’s director of urology, Dr. Rajiv Singal is the Surgeon-in-Chief at Toronto’s
Michael Garron Hospital and previously was the hospital’s head of urology. This information
was drawn from ep. 123 of Medcan’s weekly wellness podcast, Eat Move Think, What to Know
About Men’s Health.
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