The After Hours Doctor: Is There Such A Thing As PMS For Men?
While every man should have a doctor he trusts, sometimes you have questions that you don’t feel comfortable asking. (Is it us or does that white jacket just seem so judgmental?) Best case would be to have a drinking buddy who also happens to be an MD. You could ply him with questions without fear of embarrassment. That’s basically what this is. Only, no alcohol is involved. And he’s asked us not to call him “buddy.”
When I pee, it is markedly less loud than when other men pee. Is this related to penis size or libido at all? What accounts for the difference?
Lebron James can dunk pretty easily. Is he more manly than you? I mean, sure, probably. But that’s not the point. The point is bodies are different. Bladder capacity, like other forms of measuring “manliness” varies from individual to individual. So a man with a large bladder capacity that is completely full will have a stronger stream than men less endowed (bladder-wise) and full. There are a lot of things you can base your self-confidence on, the size of your bladder shouldn’t be one of them. That being said, if your stream really is weak it could also be due to an anatomical or medical problem. Enlargement of the prostate, bladder outlet obstruction and urethral strictures can decrease flow and therefore the effect the sound of your urine stream. A simple history and physical, including digital rectal screening and urinalysis, will sort out most of the worrisome conditions.
How do I know if I’m clinically depressed, or just blue? And is depression cyclical, like the equivalent of PMS for men? Are there times of the month that I will be more prone to feeling sad?
Because life is basically one world-wearying fight against mediocrity after another—a fight we sometimes lose—it makes sense that you’d get depressed sometimes. Everyone does. But not everyone experiences clinical depression. The main difference is that clinical depression results in measurable impairment of functioning: personal, social, occupational, what have you. The symptoms of depression include loss of interest or pleasure in activities that used to bring pleasure; insomnia; loss of appetite—especially when it results in measurable weight loss; dysphoria or feeling down with depressed mood the entire day, all day, without any significant let up, and that goes on for a period of two weeks or longer; poor concentration resulting in inability to participate in activities of daily living that require concentration; irritability agitation and low self esteem; loss of energy; and most worrisome; thoughts of suicide. You don’t need all of these symptoms to be clinically depressed, though. Five of these nine will meet the criteria. Or suicidal thoughts with any one or two of the other symptoms. Men can have seasonal changes depending on the amount of light they are exposed to, and may find themselves feeling more blue in the dark days of winter, but there’s no real monthly cycle to blame, I’m afraid.
I don’t want to seem lazy, but what’s the bare minimum I should be doing in order to stave off an early death? If there is one exercise I should be doing, what is it?
Physical fitness is a U shaped curve. At low levels of fitness, the risk of disease and premature death is very high. But, remember, it’s not just the dying of disease that’s problematic. Chronic disease can leave you lingering in infirmity for years—10 is the average length for Canadians, in fact. 150 minutes-450 minutes of moderate to vigorous exercise per week is associated with a significant decline in chronic disease, infirmity, substantially improved human psychological and physical performance, leading to vitality and longevity. Within this range of activity however, strength training is the fountain of youth for men. And as a minimum, one would need to focus on core, lower and upper body strength training—a minimum of 20 minutes, 3 times weekly—to barely squeeze into a measurable outcome or benefit. But, you’re lazy. So, if you had to pick one “exercise,” it would be the avoidance of prolonged sedentary time. The best solution is to move your body every hour, either by stretching, or going for a short walk.
Dr. Randy Knipping, BSc, MD, CCFP, is our After-Hours doctor. He is a licensed physician with over 25 years in clinical practice. He is the founding Medical Director of DeerFields Clinic, Canada’s leader in age management medicine (www.deerfields.ca). If you have a question for the After-Hours Doctor, send it to Letters@sharpmagazine.com.
