Everything under control: how a man can get a complete medical examination

Many people think that you only need to go to the hospital when something happens. However, in order to maintain health, monitor negative changes and prevent diseases, it is necessary to have regular check-ups. As a rule, men are more skeptical about this issue. Mikhail Zabotin, head of medical education department of Basis Genomic Group, endocrinologist and nutritionist, expert of the International Festival of Health and Sports SN PRO EXPO FORUM, explains why men’s life expectancy is shorter than women’s, and what you should pay attention to when undergoing regular check-ups in the hospital.

Why do men live less than women?

According to statistics, in Russia, the average life expectancy for men is much shorter than for women. Even from coronavirus, male mortality in our country is 2.8% of the total statistics against 1.7% for women. The point is not only that men do not like to go to doctors and undergo a lot of examinations, and many diseases are carried “on their feet”. The proportion of those who abuse alcohol and regularly smoke among men is higher than among women.

In addition, men often suffer from hypodynamia (low physical activity), and their diet is often incomplete and not balanced in terms of protein, fats, carbohydrates and calories. As a consequence, overweight is diagnosed in 47.6% of Russian men. Such lifestyle leads to the development of cardiovascular diseases (hypertension and coronary heart disease, myocardial infarction), violation of fat and carbohydrate metabolism (atherosclerosis, hidden type 2 diabetes).

Why should I undergo regular medical examinations?

Many diseases develop gradually and do not cause complaints until later. Today, clinics and laboratories offer check-up programs (check-up – comprehensive preventive medical examination), designed specifically for men and including many tests and instrumental methods of research. Doctors recommend that a certain set of the most important examinations should be performed regularly when you reach the age of 25-30.

What examinations should men undergo?

Blood tests

They are taken on an empty stomach, in the morning before breakfast. Smoking before the blood test is highly undesirable, as well as drinking alcohol the day before. The following tests should be taken:

– general blood count with leukocyte formula and COE (erythrocyte sedimentation rate);

– biochemical detailed blood analysis, necessarily including such indicators as total protein, bilirubin, ALT, AST, GGT, lipidogram (cholesterol fractions), LDH, alkaline phosphatase, creatinine, urea, serum iron, potassium/sodium/chloride, C-reactive protein. If the man is over 40 years of age, this analysis additionally includes: blood glucose, glycated hemoglobin, protein fractions, alpha-amylase, homocysteine, uric acid;

– coagulogram, or blood coagulation test (the importance of the results of this test increases significantly with age);

– a hormonal test for free testosterone; by the way, testosterone levels can begin to decline at a young age, which can result in sexual dysfunction. For men over the age of 40, TTT (thyroid hormone) and parathormone (perithyroid hormone) tests are also required;

– Oncomarkers and markers of prostate diseases: total and free PSA. For men over 50 years old it is recommended to test for the following markers of possible cancer: REA, CA 19-9, CA 72-4, Cyfra 21-1;

– the so-called hospital complex: HIV, RW, HBsAg, HCV (test for HIV, syphilis and hepatitis B and C).

Instrumental methods of research

– Ultrasound (ultrasound examination) of the prostate gland;

– Ultrasound of the abdominal cavity (performed on an empty stomach);

– Ultrasound of the brachiocephalic vessels, that is, the vessels of the head and neck. The examination is especially relevant for men over 40-50 years old;

– esophagogastroduodenoscopy (EGDS) – examination of the esophagus, stomach and duodenum);

– after 50 years of age – colonoscopy or endoscopic examination of the colon, it is desirable to do it at least once every 10 years;

– chest X-ray or at least fluorography;

– electrocardiography (ECG) – a simple, affordable and harmless examination of the heart muscle; since cardiovascular diseases have become “younger”, it is recommended to have an ECG annually after the age of 40. If a man has already been diagnosed with heart problems, as well as at a more mature age, this study should be done at least once every six months.

What examinations can be carried out independently?

Some indicators can be checked by yourself. For example, a tonometer (a device for measuring blood pressure) is readily available for home use. I recommend my patients to check their blood pressure from time to time, especially in case of headaches, swelling, dizziness or weakness. By the way, modern tonometers also measure pulse, and some alarm in case of heart rhythm disturbances. According to WHO recommendations, a blood pressure of 120/70 mmHg is considered normal.

If type 2 diabetes mellitus is suspected, you can check for carbohydrate metabolism disorders with a glucometer (a device for measuring blood glucose). A small puncture with a scarificator on the finger and one drop of capillary blood on an empty stomach will be quite enough. The normal level of glucose in capillary blood is up to 5.5 mmol/L. If the value is in the range of 5.6 to 6.0, then we can already talk about a condition that doctors call prediabetes. Diabetes mellitus is diagnosed when the value is higher than 6.1 mmol/L. In the case of diabetes, self-testing does not cancel the need to visit a doctor. Test strips have a short shelf life, and the error of the glucometer reaches 10%.

You can determine the presence of abdominal obesity by measuring the waist circumference at the level of the navel (do not retract the abdomen!). For European men, the norm for waist circumference is 94 cm. You can assess the degree to which a person’s weight and height correspond by calculating BMI (body mass index). Normal BMI should not exceed 25.0 kg/m2. It is calculated by the formula: weight in kilograms divided by the square of height in meters. For example, a man weighs 77 kg at a height of 170 cm. The body mass index in this case is equal to: 77 ÷ (1.70 × 1.70) ≈ 26.64 kg/m², that is, the man’s body mass is increased, and we can talk about the state of pre-fatness. The exception is men who are actively building muscle mass: their BMI may well exceed the reference value.

Home tests do not cancel the need for regular visits to the doctor. If there are concerns that your health is not all right, you should visit the hospital as soon as possible. The earlier you start treatment, the better the chances of a favorable outcome. Moreover, men retire later than women, which means that they need to stay healthy and able to work as long as possible.