Jun 2, 2018 6 min read

When we’re young, we feel invincible. But once we’ve aged out of appointments with the pediatrician, it’s time to start seeing a doctor for adults. This month, Total Health is focusing on men’s health. We asked Dr. Thomas Tambouratzis with Washington Health System Internal Medicine how men’s health and their doctor’s checkups should change with age.

Men in their 20s

Men in their 20s should start by checking their weight and diet.

Tambouratzis said to ask yourself, “Are you eating too much sugar? Are you fat? If yes, why? Then, what is your plan to improve your weight? Obesity can lead to heart disease, hypertension and diabetes.”

Exercise is important at every age and Tambouratzis said good habits in your 20s will pay off now and especially later in life.

“It’s so sad for me to see a new male patient in their 20s who is obese, weighs 280 pounds, 300 pounds, 320 pounds and find out that this man weighed 150 pounds in high school, but had not followed good diet and exercise habits,” said Tambouratzis. “I work with them, help them as best we can, but an ounce of prevention is worth a pound of cure!”

He also urges men in their 20s to practice safe sex, use condoms and be careful about sexually transmitted diseases. He warns to stay away from tobacco and avoid heavy alcohol use, and be aware of signs of depression.

Tambouratzis said, “Get blood tests done every two to three years, screening for new onset medical conditions such as high cholesterol, liver problems (fatty liver disease, alcohol related hepatitis) and diabetes.”

At any age, Tambouratzis adds to be aware of any new lumps or bumps on your neck, armpits or groin, and see a doctor if they last more than four weeks. Most of the time, it’s nothing. But it could be a sign of infection or something more serious. Also interesting is this fact he offers: Motor vehicle accidents account for 11 percent of deaths in men in their 20s.

“Work on safe driving, including paying attention to what other drivers are doing on the road,” he said. “Safe driving is preventive medicine.”

Men in their 30s

If you are man in your 30s, Tambouratzis said follow the guidelines for men in their twenties, plus see your family doctor every one to two years for a routine visit, blood tests and a blood pressure check.

“If you are a tobacco smoker, it is important to try quitting during your 30s,” he said. “You are still young enough to avoid the serious chronic lung damage that will occur in men that are older who smoke, and you can cut your risk of developing coronary artery disease and having a heart attack in half.”

After age 35, he recommends asking your doctor if you have any cardiovascular risk factors.

“The risk for coronary heart disease in asymptomatic persons can be predicted based on the traditional risk factors included in the Framingham risk score,” said Tambouratzis. These include age, sex, blood pressure, cholesterol levels, cigarette smoking and diabetes. He also advises men with snoring or sleep issues get checked for sleep apnea at this age.

Men in their 40s

At this age, you should keep following the previous recommendations. However, now is the time to add in a few other tests.

If you have a family history of colon cancer, get a colonoscopy. Tambouratzis also believes now is the time for a prostate cancer screening.

“There is an ongoing debate about the prostate specific antigen (PSA) blood test,” he said. “My view is that men should consider getting a PSA blood test in their late forties, especially if prostate cancer runs in their family and then yearly.”

Yes, now is the time to also start getting that other prostate test as well.

“We start doing a rectal exam to check prostate in male patients who are over the age of 45,” he adds.

While some studies are questioning its value and accuracy, some studies show the PSA blood tests often show false positives for prostate cancer. Tambouratzis recommends a combination of both saying, “My view, you should never rely on the rectal exam as your only prostate cancer screening test.”

Men in their 50s, 60s and 70s

When you enter these decades, keep following the guidelines for younger men, but also see your doctor every one to two years.

“If you have developed hypertension (high blood pressure), diabetes, heart disease or lung disease, you should see your family doctor twice yearly or more often if needed,” said Tambouratzis.

He recommends a flu shot every year, a pneumonia vaccine and possibly a shingles vaccine, as well as making sure you get a tetanus shot every decade. Once you are over 50, Tambouratzis said, “Every man should have a colonoscopy done to screen for colon cancer.”

Men in their 80s and beyond

Tambouratzis recommends men older than 80 see their doctor at least once a year and more often if needed. He also advises you to review all of the guidelines he’s given for younger men with your doctor and to make sure you haven’t missed any important screenings, such as for colon or prostate cancer.

Depression can also be an issue as men age as well as strength and balance difficulties.

Tambouratzis has a unique way of putting all of these lifetime checkups into perspective: Think of them as a tune-up.

“I wish every man took care of his body and his health the way many men proudly take care of their cars,” he said. “The state of Pennsylvania requires an annual inspection of cars, but there is no requirement for annual inspection of men by a doctor or other healthcare provider. Why not? If a man doesn’t take care of his health and then develops a serious health problem that was preventable … what a tragedy.”