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Five Symptoms Men Shouldn't Ignore

By Elizabeth CohenCNN Medical Correspondent

(CNN) -- Ask doctors if their male patients ignore big and obvious health symptoms, and they'll respond with laughter -- huge peals and guffaws.

Some doctors say men are more likely than women to ignore symptoms or deny that they even exist.

Once they regain the ability to speak, these doctors will say things such as "I don't even know where to start," and "You don't have enough room in your story for all the symptoms men blow off."

Conventional wisdom, they say, is true. Women listen to their bodies and go to the doctor when something isn't right. Men tend to seek medical attention when they're at death's door -- or when their wives prod them into going.

"I think it's a macho thing," says Dr. Barron Lerner, professor of medicine and public health at Columbia University. "Or maybe it's denial. Maybe they think if they deny a problem, it doesn't exist."

"I call it the ostrich phenomenon," says Dr. Harvey Simon, associate professor of medicine at Harvard Medical School and editor of the Harvard Men's Health Watch newsletter. "Guys are very prone to sticking their head in the sand and hoping when they emerge everything will be back to normal. It's a very, very bad idea."

While the list, according to these physicians, is endless, here are the top five symptoms men ignore -- sometimes until it's too late.

1. Chest pain

You'd think this would be the last thing a man would ignore, but our men's health experts say it happens all the time.

"They think, 'Oh, I'm just out of shape, or I'm having a little indigestion, or I'm under pressure,'" says Dr. Joseph Scherger, a clinical professor of family medicine at the University of California, San Diego. "It's quite classic for men to do that." Watch more from Elizabeth Cohen about men's health »

Simon says, "I tell my medical students that the most common symptoms of a heart attack is chest pain, and the second most common one is denial."

Bottom line: Anyone experiencing chest tightness, chest pain or shortness of breath needs medical attention.

2. A big belly

"Belly fat is the worst fat you can have," says Dr. Harry Fisch, a professor of clinical urology at Columbia. "A big belly is a sign a man has low testosterone levels. And the lower the testosterone, the greater the risk of diabetes and coronary artery disease."

While a woman might go on every diet in the world to lose weight, men often have a different solution: They lower their belts.

"I've had men say to me, 'See, my pants size hasn't changed.' I say, 'Baloney. Your belly is still there. It's just above your belt,' " says Simon.

3. An unenthusiastic penis

Impotence may be purely psychological, but it also could be a sign that a man has cardiovascular disease.

"The penis is the dipstick of the body's health," Fisch says.

If the arteries that supply blood to the penis aren't working right, those supplying blood to the heart and brain might not be working so well either.

Our experts advise men with erectile dysfunction to use their doctors for more than just Viagra dispensers.

"A doctor ought to be working these men up for coronary artery disease, high blood pressure and cholesterol, which are often linked to erectile dysfunction," Simon says.

4. More frequent urination

Urinating more frequently can be a sign of prostatitis, or inflammation of the prostate gland.

"I'll ask a patient if he's getting up at night to urinate, and he'll say, 'Oh, yeah, two or three times.' I ask him if that bothers him, and he'll say no. I tell him it should," Fisch says.

5. Prescription drug addiction

"Men sometimes don't realize they're addicted to prescription drugs," says Dr. Joel Heidelbaugh, a family medicine specialist at the University of Michigan Medical School. "Maybe they're taking medicine for back pain, and a couple of years later they're still on them. They can't function without them, and they don't even know it."

Heidelbaugh says he's seen patients addicted to drugs such as Vicodin and Oxycontin without knowing it. "They never realized they need to get off of them," he says.

There is one area, Heidelbaugh says, where men zip right into their physician without hesitation. "Rashes in the groin, masses in the testicles, pain in that area -- that gets them into the doctor," he says.

Scherger adds, "Men are probably more keyed in to their groins than other parts of their body. They're pretty fixated on their penis and genital area. That's where they have the least amount of denial."

CNN's Jennifer Pifer and Sarah Edwards contributed to this report.


What Are The Early Signs And Symptoms Of HIV In Men?

Symptoms of HIV in cisgender males can vary as much as between two people of different sexes. They may include symptoms of illness such as fever, cough, vomiting, or swollen lymph nodes. These may be mild or severe, depending on the stage of the disease.

If you're reading this, odds are it's because you asked Dr. Google "what are the symptoms of HIV in men," or you're a male assigned at birth (MAAB) who stumbled on this article and is simply interested in becoming better informed about HIV.

The information about HIV below can be useful for people across the gender spectrum. Read on for a complete breakdown of the most common early signs and symptoms of HIV. Plus, information about HIV testing and prevention.

HIV — short for human immunodeficiency virus — is a virus that affects the immune system — more specifically, white blood cells known as CD4 cells, or T-cells, that are part of the immune system.

Because HIV attacks the immune system itself, the immune system is not able to mount a defensive response against this virus the way it can for other viruses. It also means that a person with (untreated) HIV is more susceptible to other infections, illnesses, and diseases.

HIV can be transmitted from person to person through contact with blood, semen, or vaginal fluids that contain the virus.

"It is primarily spread through sex, sharing needles, blood transfusion, and mother to baby during delivery," says Jennifer Veltman, MD, chief of infectious diseases at Loma Linda University Health.

HIV vs. AIDS

HIV is not synonymous with AIDS. Acquired immunodeficiency syndrome (AIDS), also known as stage 3 HIV. It's a late stage of HIV when the immune system cells have been so badly damaged that the body is no longer able to fight off infection.

Thanks to modern medicine, with proper treatment, it's incredibly uncommon for HIV to progress to AIDS. (More on this below).

Before we do a more in-depth discussion about the symptoms of HIV, it's important to understand that left untreated HIV can progress through the following three stages, each of which has a group of associated symptoms.

  • Stage 1: acute illness
  • Stage 2: asymptomatic period
  • Stage 3: advanced infection
  • Below, a complete breakdown of the most common symptoms by stage.

    Stage 1: Acute illness

    Stage 1 of HIV can be considered the "beginning" stage. It's the stage a person enters when they first contract the virus, and it lasts until the body has created antibodies against the virus.

    Antibodies are basically little bodyguards the immune system creates when exposed to foreign invaders.

    Somewhere between 66 and 80 percent of people in stage 1 will experience flu-like symptoms within 2 to 4 weeks of transmission.

    According to doctoral-prepared nurse practitioner Emily Rymland, AAHIVS-certified HIV specialist and clinical development manager at Nurx, these flu-like symptoms can include:

  • fever
  • swollen glands
  • fatigue
  • body rash
  • sore throat
  • joint pain
  • diarrhea
  • headaches
  • Symptoms can also include:

  • ulcers in the mouth
  • sores on the genitals
  • muscle aches
  • nausea
  • vomiting
  • night sweats
  • "The reason HIV causes joint and muscle pain is because the infection causes inflammation in the body," says Rymland.

    When someone has symptoms, their symptoms can last a few days to several weeks, she says. But not everyone who has come into contact with the virus will experience symptoms.

    "It's common for someone to experience no symptoms that would lead them to question whether or not they'd been exposed to HIV," explains Rymland.

    That's why anyone who has these symptoms or thinks they may have contracted HIV should consider scheduling an appointment with a healthcare professional to get tested.

    "You want to know your status as soon as possible, as early treatment is best for preventing future illness or symptoms," she says.

    Stage 2: Asymptomatic stage

    Also known as the clinical latency stage, this stage of HIV is known for its lack of symptoms.

    During this stage, the virus exists — and is multiplying — in the body and is beginning to weaken the immune system. But it isn't (yet) actively causing symptoms.

    A person with HIV at this stage may feel and look totally fine. But they can still easily transmit the virus to others.

    Stage 3: AIDS

    It may take years, even decades, but when left untreated HIV may attack and destroy enough CD4 cells that the body can no longer fight off infection and disease. In short: It breaks down the immune system.

    Once this happens, HIV will progress to stage 3, often referred to as AIDS.

    A person at this stage has a severely damaged immune system, making them more susceptible to something called "opportunistic infections."

    Opportunistic infections are conditions that the body would normally be able to fight off but can be harmful to people who have HIV.

    People living with HIV may notice that they frequently develop colds, flu, and fungal infections.

    The symptoms someone with stage 3 HIV might experience include:

  • nausea
  • vomiting
  • persistent diarrhea
  • chronic fatigue
  • rapid weight loss
  • cough
  • shortness of breath
  • recurring fever, chills, and night sweats
  • rashes, sores, or lesions in the mouth or nose, on the genitals, or under the skin
  • prolonged swelling of the lymph nodes in the armpits, groin, or neck
  • memory loss, confusion, or neurological disorders
  • "When someone's CD4 count drops below 200, that's when someone becomes susceptible to opportunistic infections like pneumocystis pneumonia," says Rymland.

    This may all sound pretty scary, but remember that HIV can be managed with medication called antiretroviral therapy. (More on this below).

    No, not really. Symptoms of HIV are generally the same in people of all genders.

    One HIV symptom that is unique to people with penises that can occur is an ulcer on the penis. They're often caused by a concomitant sexually transmitted infection (STI), like syphilis or herpes simplex virus, or chancroid.

    Hypogonadism, which is a condition marked by poor production of sex hormones, may develop in people who have HIV that's not well managed, long-term HIV, or because of aging.

    People with all sorts of genitals can develop hypogonadism, but it's easier to observe the effects in penis owners.

    Other symptoms of hypogonadism penis owners may experience include:

    "HIV is a human disease, meaning anyone can contract it," says Rymland.

    Unfortunately, due to the virus' early nomenclature as GRID, or Gay Related Immune Deficiency, it's wrongly assumed to affect only gay men.

    Sadly, says Rymland, this pervasive stigma prevents non-gay men, as well as other-gendered individuals, from protecting themselves against HIV transmission or even getting tested for STIs.

    "People of all sexual orientations need to be educated about their risk and informed on how to protect themselves," she says. "And that includes being educated about PrEP, a safe and effective medication for preventing HIV that's not well known outside of the gay community."

    How common is HIV in men?

    Approximately 37.6 million people in the world are HIV-positive, 1.2 million of whom live in the United States.

    Globally, men make up about 47 percent of cases. However, research published in 2018 found that men in the United States made up 81 percent of new cases.

    There are a number of reasons for this gender disparity. Including:

    HIV is typically diagnosed with a blood test. Though, it can also be diagnosed with oral fluid or urine.

    Most commonly, healthcare professionals will order one of the following tests:

  • nucleic acid test (NAT): looks for viral load in blood
  • antigen/antibody test: looks for both antibodies and antigens in blood
  • antibody test: looks for antibodies in the blood
  • It typically takes a few days for NAT and antigen/antibody tests to provide results. But there are rapid antibody screening tests and rapid antigen/antibody tests that take 30 minutes or less.

    Many medical clinics, community health centers, and substance use programs offer HIV tests.

    Another option is to use an at-home HIV test kit. Many of these home tests do not require sending the sample to a lab — a simple oral swab can provide results in 20 to 40 minutes. Regardless of your result, consult with a healthcare professional so that they can confirm with more advanced testing equipment.

    Guidelines suggest that everyone between ages 13 and 64 get screened for HIV, as you would be tested for any disease as a regular part of routine medical checkups.

    But the right cadence for how often you get tested will vary based on your solo and/or partnered sexual activity, the anatomy of your sexual partner(s) and the type of sex had, and intravenous drug use, says Rymland.

    "If someone is in a monogamous relationship with an HIV-negative person, there's no need for continued testing, unless there is concern for outside play," she says.

    However, if you have had sex with different partners, you should, at a minimum, get tested annually. Ideally, sexually active MAABs who have sex with other MAABs should get tested every 3 to 6 months.

    You should also get tested annually if you inject drugs.

    "If you have frequent sex with partners of unknown HIV status, then you may consider getting tested every 6 months," she says.

    "If you have had a known exposure to HIV, you should get tested 18 days after that exposure," explains Rymland.

    "And you should immediately start taking the HIV-prevention medication PEP, which you can think of as emergency contraception for HIV," she says. "It can [help] prevent infection if you begin taking it within 72 hours of exposure."

    First things first: Know your own current STI status.

    An estimated 13 percent of people living with HIV do not know that they have it. Knowing your current STI status can help prevent an HIV-positive person from transmitting the virus to others.

    To know your most current HIV status, it's important to get tested if you have any of the aforementioned symptoms or there's a possibility that you contracted the virus.

    If you test HIV-negative, the best way to remain negative is to avoid exposure to bodily fluids that may carry the virus.

    These measures can help reduce the risk of contracting HIV:

  • Share your current STI and HIV status with any potential partner and ask for theirs. Knowing their status will help you make the most informed decisions.
  • Use condoms for any kind of penetrative play (vaginal, oral, anal). When used correctly, condoms are highly effective at protecting against HIV.
  • Try not to share or reuse needles. Many cities have needle exchange programs that provide sterile needles.
  • Take precautions. Always assume that blood might be infectious. Use latex gloves and other barriers for protection.
  • Talk with your healthcare professional about PrEP. PrEP is daily oral ingestible that HIV-negative people can take to reduce their risk of contracting HIV if they're exposed to the virus.
  • There's no cure for HIV. However, getting a prompt diagnosis and early treatment can slow the progression of the disease and significantly improve quality of life.

    "HIV is absolutely no longer the death sentence it used to be," says Rymland. "I have taken care of patients that were diagnosed in the 80s who have been on treatment and have never been sick. They live full lives. Today's treatment for HIV is easy and effective and, if taken properly, a person can live a long and healthy life and not pass it on to partners."

    Indeed, research shows that people with HIV who start treatment before their immune systems are severely damaged might have a nearly normal life expectancy.

    Read this article in Spanish.


    Man, 62, Diagnosed With 'rare' Breast Cancer After Finding A 'Polo Mint'-like Lump

    A former nurse was diagnosed with a "rare" case of male breast cancer after noticing an unusual lump on his chest. Mark Nock, now 61, discovered the bump after a colleague knocked a bowl of water on his uniform. Having dried himself off in a staff toilet he then noticed a lump like a "huge Polo mint" under his right nipple.

    "As I dried the water off, I felt a lump on my chest and went into the staff toilet and found a big lump like a huge Polo mint under my right nipple."

    To treat the tumour, he underwent a full mastectomy and was prescribed a type of hormone therapy which helps control breast cancer by stopping oestrogen binding to the breast cancer cells.

    However, the drug brought on menopause-like symptoms, including hot flushes, severe dizzy spells which would leave him unable to stand, and morning sickness.

    His symptoms were so severe he took early retirement to focus on his recovery.

    "Breast cancer is very rare in men – the treatments are the same, and I was prescribed Tamoxifen," he said.

    "These drugs have barely been tested on men and are designed for women's hormone balance, so I was a bit of a lab rat.

    "I had symptoms of morning sickness and menopause, I would be red hot one moment and freezing cold the next, sweat would pour off me onto the floor.

    "I would get severe giddy spells in a hot environment and fall over – the spells were very fast and severe, it was like being so drunk you can't walk.

    READ MORE: Expert recommends four natural remedies to tackle hay fever

    "I had a giddy spell so severe that they had to practically carry me to the corridor, and it took two hours before I could walk in a straight line – I called up and resigned that day."

    According to the NHS, men can experience menopause-like symptoms in middle age.

    However these are not usually related to hormones and can be as a result of personal or lifestyle issues.

    It is unhelpful to use the term "male menopause", the health service added.

    Now, thankfully Mark is cancer-free - but is using his experience to encourage men and women to check themselves for breast cancer.

    He said: "The moment I felt that lump I knew what it was, I can't explain it, I just knew.

    "I thought it would be a good idea to raise awareness of male breast cancer, it's possible to save lives with a conversation."

    Symptoms of breast cancer among men can include:

  • A lump in the breast – this is usually hard, painless and does not move around within the breast
  • The nipple turning inwards
  • Fluid oozing from the nipple (nipple discharge), which may be streaked with blood
  • A sore or rash around the nipple that does not go away
  • The nipple or surrounding skin becoming hard, red or swollen
  • Small bumps in the armpit (swollen glands).
  • If you are concerned that you could have breast cancer you should speak to your GP.






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