Two Doctors Answer The Questions They’re Always Asked

Is Erectile Dysfunction Normal? What Causes It?
“Erectile dysfunction, also known as impotence, is very common, especially in men over 40. It is usually caused by stress, tiredness, anxiety or drinking too much alcohol, although psychological problems can play a role. You should visit your GP if it keeps on happening, but losing weight, stopping smoking, eating a healthy diet, exercising regularly, and reducing stress and anxiety can all help. Intermittent fasting can substantially reduce a man’s risk of impotence and those regularly missing meals are twice as likely to have a healthy love life, according to research. The idea that fasting slows your metabolism is a myth. Under conditions of marked energy deficit – 800 calories per day or less – not only do you simply lose weight by eating fewer calories, but your body responds to the stress of fasting by enhancing hormone function to facilitate weight loss and burn fat for energy.” – Michael

I Feel Constantly Exhausted – Why Might This Be?
“We all feel tired at times, but if your tiredness feels overwhelming and isn’t helped by sleeping, it could be a symptom of a wider problem. One of the most common reasons for feeling tired is iron deficiency, or anaemia. While anaemia is more common in women, it can also affect men, particularly if you have stomach problems or are taking anti-inflammatory drugs. A snorer with a neck over 17 inches? You might just have sleep apnoea, which is more common in middle-aged, overweight men. Drinking and smoking makes it worse. The condition causes your throat to narrow or close during sleep, interrupting your breathing. It can be reversed by losing weight, eating healthily and reducing your alcohol intake. Men are also more likely to develop type 2 diabetes, with a key symptom including extreme tiredness. It is possible to reverse type 2 diabetes through a healthy lifestyle, including intermittent fasting and regular exercise. Other reasons for tiredness include an underactive thyroid, coeliac disease, glandular fever, and depression and anxiety. If you are feeling tired all the time, visit your GP.” – Dr Toby Fielding

I Want To Start Eating Healthier – Where Should I Start?
“We should be looking to the Mediterranean to keep us healthy. A traditional Mediterranean diet is rich in oily fish, veg, legumes and olive oil, with little in the way of sugary snacks. Eating this way will help improve both your mood and your weight. The Mediterranean diet is low in sugar, but rich in healthy fats such as salmon, mackerel and nuts. Eating fruits and vegetables, as well as full-fat yoghurt and the occasional glass of wine in the evening is also encouraged. Food is based around traditional Mediterranean cuisine which – as well as being filling and tasty – has been shown in numerous studies to lead to long-term weight loss, reduced heart disease, risk of type 2 diabetes and a host of other health benefits. A healthy diet can also improve mental health. People who are overweight or obese are much more prone to depression and anxiety, and that seems to be directly linked to visceral fat, which is the fat around the gut. Visceral fat doesn’t just sit there; it sends out inflammatory signals. So when you pile on the pounds, particularly around the waist, you are not only damaging your heart but your brain as well.” – Dr Michael Mosley

Should I Be Checking For Testicular Cancer?
“Although testicular cancer is relatively uncommon, it is the most common type of cancer to affect men between the ages of 15 and 49. White men are at a higher risk than other ethnic groups, and genetics seem to play a big role. Testicular cancer is considered to be very treatable, but it is easier to treat when it is diagnosed early. From puberty onwards, men should get into the habit of checking their testicles regularly, and get to know what feels normal. Testicles should be smooth, firm and not hard. If you notice any lumps, swellings or anything unusual, you should visit your GP as soon as possible. There are lots of conditions that can cause swelling or lumps in the testicles, but it is better to be safe than sorry.” – Toby

What About Prostate Cancer – Does This Only Affect Older Men?
“The chances of developing prostate cancer increase as you get older, and most cases occur in men over 50. Around this age, you should ask your GP for a screening test, unless you have a higher than average risk. Prostate cancer is more common in men of Afro-Caribbean and African decent, although experts don’t really understand exactly why this is. New research also suggests obesity increases the risk of prostate cancer. If you fall into a higher risk group, you should start testing from your early 40s.” – Toby

How Do I Know If I Have An STI?
“The only way to know if you have a sexually transmitted infection (STI) is to get tested at a sexual health clinic. However, some STIs don’t have any symptoms, so if you have had unprotected sex, you should have a test to protect yourself and any future partners. Common symptoms include an unusual discharge from the penis or anus; pain when peeing; lumps or skin growths around the genitals or anus; a rash; itchy genitals or anus; and blisters or sores on the genitals or anus.” – Toby

Am I Exercising Enough?
“I swear by short HIIT exercises over low or medium-intensity movement. The biggest problem with exercise is compensatory eating and relaxing afterwards. People go on a treadmill for 30 minutes, burn around 120 calories, then lie around and reward themselves with a muffin. The theory with HIIT seems to be that it suppresses your appetite, so this is less likely to happen. Researchers have also learned that, unlike normal-intensity exercise, HIIT directly targets visceral fat, burning away the fatty deposits that can lead to insulin resistance and type 2 diabetes. Get out in your garden if you have one for some fresh air – if not, clear a space in your lounge, open the windows for some short bursts of daily HIIT. Just 20 minutes a day of activity that makes you out of breath will help you maintain a degree of fitness.” – Michael

Am I A Healthy Weight?
“No matter how much you weigh, a healthy lifestyle benefits everyone. However, checking the number on the scales or your BMI isn’t always the best way to check if you are healthy. Instead, take a look at the weight around your middle. Compared to fat around the hips, fat around the waist is more metabolically active, is closely related to insulin resistance and seems to be more strongly associated with the risk of heart disease, stroke and diabetes. The build-up of visceral fat is normally the result of a number of different factors, which include eating too much sugary, starchy food, drinking too much alcohol (particularly beer), not doing enough exercise, feeling stressed and sleeping badly, and, of course, genetics. Fortunately, visceral fat responds well to weight-loss regimes and exercise. To ascertain whether you are carrying too much visceral fat, measure your waist (around your belly button) with a tape measure. Ideally your waist should be less than half your height. So if you are 6ft, your waist should be less than 36in. Do not rely on your trouser size.” – Michael 

I’ve Been Feeling Down Lately – Could It Be Depression?
“Signs and symptoms of depression can look different in men and women, and some men can find it difficult to talk about mental health, or may downplay how they are feeling. Like women, men with depression can feel sad or hopeless, feel extremely tired and have difficulty sleeping or sleep too much. However, there are other symptoms of depression that are more common in men, which are less widely acknowledged. These include: escapist behaviour, including spending a lot of time at work or playing sports; physical symptoms such as headaches, digestive problems and pain; problems with alcohol and drug use; controlling, violent or abusive behaviour; inappropriate anger; and risky behaviour like reckless driving. The sooner you see your doctor, the sooner you can get help.” – Toby

Am I Drinking Too Much?
“Current UK guidelines – which are much lower than in Italy and Spain – advise limiting alcohol intake to 14 units a week (or around seven 175ml glasses of 12% ABV wine). However, the problem with units is that they are almost impossible to pin down. The effect of alcohol differs between individuals, depending on body size, gender and also how you metabolise alcohol. I try to drink within the recommended guidelines of seven medium-sized glasses of wine a week, and I follow the principles of 5:2, having a drink five nights a week and not drinking for two. Alcohol is also high in sugar, which is not only bad for your teeth and waist, but your brain too. This is partly because sugar, like alcohol, can be horribly addictive. Unless you do lots of exercise, all those excess calories will be laid down as fat. We know people who are overweight or obese are much more prone to depression and anxiety, and that seems to be directly linked to the fat itself. Some studies have shown there are benefits in drinking a glass of red wine, but after a glass or two a day, the benefits drop off pretty dramatically and disadvantages start to emerge. Try to drink mindfully – stick to one or two glasses a night. If you slow down and really enjoy what’s in your glass, you’ll probably drink less too.” – Michael

I’m Worried I Have Coronavirus – What Should I Be Looking Out For?
“Most people with Covid-19 have one of three main symptoms: a high temperature; a new, continuous cough; and a loss or change to your sense of smell or taste. If you don’t have a thermometer, check if you feel hot to touch on your chest or back. If you think you may have Covid-19, you should get tested as soon as possible, and call 111 if you’re not sure what to do. Data suggests men might be at higher risk of becoming seriously ill from Covid-19, particularly if you are overweight or obese. This may be because men seem to have weaker immune systems than women, or that men are more likely to have pre-existing conditions that make them vulnerable to becoming very ill with coronavirus. These include cardiovascular disease, respiratory disease and diabetes. It’s really important to protect yourself and others by losing weight if you fall into these categories. Intermittent fasting is an effective way to do this.” – Toby

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*Features published by SLMan are not intended to treat, diagnose, cure or prevent any disease. Always seek the advice of your GP or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programmes.