Men’s Health

What could cause male infertility?

DEAR DOCTOR K: My wife and I have tried to get pregnant for over a year. We're going to be tested soon to see if anything is wrong. I'm worried that the problem lies with me. What are some reasons for a man to be infertile?

DEAR READER: About one in seven couples in the United States are unable to conceive a child after trying for one year. The infertility is caused either by the man alone (about 40 percent of the time), by the woman alone (about 40 percent of the time) or by both partners (about 20 percent of the time). So it is possible that something about you is responsible for your wife's difficulty with becoming pregnant.

Should I get a prostate cancer screening test?

DEAR DOCTOR K: I've heard so many conflicting opinions about whether or not to get screened for prostate cancer. Are there official guidelines? What do they recommend?

DEAR READER: To say that prostate cancer screening has been controversial is an understatement. I spoke to my colleague Dr. Marc Garnick, clinical professor of medicine at Harvard Medical School, to hear his thoughts.

How can I persuade my husband that he could benefit from therapy?

DEAR DOCTOR K: I'm convinced my husband is depressed, but he refuses to seek help. What can I say to convince him that he could benefit from therapy?

DEAR READER: Most men don't like to ask for help or to talk about their feelings. That's not going to be easy for your husband. However, doing nothing could make it harder for him. If he is suffering from depression and doesn't get help, it could threaten everything important in his life, starting with family, friends and work.

Can you discuss hormonal therapy to treat prostate cancer?

DEAR DOCTOR K: My doctor has proposed androgen deprivation therapy to treat my prostate cancer. Can you tell me about this treatment?

DEAR READER: Androgens are the family of male sex hormones that includes testosterone. When prostate cancer develops, testosterone contributes to the growth and spread of the tumor. Androgen deprivation therapy deprives cancer cells of this stimulation. Also known as hormonal therapy, it can be a powerful weapon in the fight against prostate cancer.

What are some ways besides testosterone therapy to increase my energy?

DEAR DOCTOR K: I often feel quite tired. My doctor says this fatigue may be caused by my low-normal testosterone level. I'd rather not go on testosterone therapy. What are some other ways to enhance my energy?

DEAR READER: Research studies have not demonstrated a clear value in giving testosterone therapy to men who may be experiencing symptoms of low-normal or slightly low blood levels of testosterone. In fact, some studies have even indicated that such treatments may raise the risk of heart trouble. So I can certainly understand if you'd rather avoid testosterone therapy to relieve your fatigue.

Why do women tend to live longer than men?

DEAR DOCTOR K: I've heard that women tend to live longer than men. Why is that?

DEAR READER: On average, women do live about five years longer than men. In the United States, 57 percent of all who are ages 65 and older are female. By age 85, 67 percent are women. You can see this for yourself in most nursing homes or assisted living facilities in the United States: Women usually outnumber men, and the magnitude of the difference is often striking.

Do men need to take a calcium supplement?

DEAR DOCTOR K: Many years ago, my doctor told me that men, like women, should take calcium supplements. So I have been. Now I hear that it's a bad idea. What do you think?

DEAR READER: All of us -- patients and doctors -- wish we had all the answers, and that the answers never changed. Unfortunately, the way the human body works, and malfunctions, is very complicated. To understand it, we conduct research. But no study is perfect, and the answers sometimes change as larger and better studies are conducted.

Should I try testosterone treatment to treat low-normal testosterone?

DEAR DOCTOR K: I'm a 68-year-old man who has been feeling more tired and less "sexy" over the past several months. My doctor says my blood testosterone level is normal, but "low normal" -- a little bit above low. I know that some men take testosterone gel as a treatment for this. My doctor is not so keen on that. What's your opinion?

DEAR READER: I don't know nearly enough about your health or your symptoms to offer you personal advice. But I'll tell you what I think research has shown, at least so far. I'll warn you: It is a controversial area, and I reserve the right to change my mind as new research is published.

Do I need to take medication for BPH?

DEAR DOCTOR K: I have BPH. The symptoms don't interfere with my work or home life very much. My doctor says there are medicines that might reduce the symptoms, but I like to avoid taking medicines. What's your advice?

DEAR READER: Benign prostatic hyperplasia, or BPH, is the most common cause of prostate enlargement. As the name suggests, BPH is harmless; it does not lead to prostate cancer.