Men and health care

14. June 2021

At loggerheads with health care?

Men are often at loggerheads with health care

So far, our health blog has mostly been about women’s health. Today we want to deal with the health prevention issues that concern men. 

It is well known that men rarely or never see a doctor. In addition, they live in a much more unhealthy way than women. Men smoke more, drink more and eat less healthily, which means that their life expectancy is on average five years below that of women.

Men often only go to the doctor when they are genuinely ill, and even then they often have to be pressured by their wives. When a man has back pain, he walks crookedly around for weeks before seeing an orthopaedic consultant or physiotherapist.

A minor burn or cut? Put a plaster on it, and done. Men often just grit their teeth when they experience pain and injury before they go to see a doctor. On the other hand, men are also known to feel more sorry for themselves than women.

Men who feel sorry for themselves

This reminds us of the advertisement for a cold medicine that aired recently. He is lying in bed, the wife comes into the bedroom, he acts like a dying swan and whispers with his last strength: Call my Mum. The wives and life partners of men are sure to come up with a few more anecdotes.

That is of course funny, but it is also true for men that they should go to preventive care regularly, even if they like to leave this field to women. As a survey by the Robert Koch Institute showed, for example, only 40 percent of men go for cancer screening. In the case of women, it is a good two thirds (67.2 percent).

Men often see no point in it

The fact that men go less to preventive care than women is said to be due to stereotypical male characteristics such as strength, independence and willingness to take risks. The explanation is perhaps much simpler: Men just don’t see the point in seeing a doctor if nothing is hurting.

That is exactly the principle of prevention, which is the reason why it is called that. Preventive medical check-ups are aimed at people who do not have any pain yet, who do not yet have any symptoms.

The aim is to identify and localise diseases in their early stages. Some diseases such as cancer, diabetes, heart problems or high blood pressure do not cause any noticeable symptoms at first, and that is precisely the tricky thing. During a preventive check-up, the doctor can identify diseases at an early stage and thereby significantly improve the success of treatment and the chances of recovery.

Many health insurance offers for men

For men, the statutory health insurance companies offer examinations for cardiovascular diseases, diabetes, kidney diseases as well as skin, prostate and colon cancer. After cardiovascular disease, cancer is the second leading cause of death in men.

Since January 2018, the ultrasound scan for the early detection of an abdominal aortic aneurysm has been a new addition for men, because men are much more frequently affected by this dangerous dilation of the artery in the abdomen than women. Health insurance companies bear the costs of all early diagnosis examinations, but only from a certain age onwards, because then the risk for the respective disease increases, the AOK reports.

An abdominal aortic aneurysm manifests itself in back or abdominal pain or pain in the side. An aneurysm is a little known, but an all the more dangerous disease because you do not feel the disease developing.

If the abdominal artery enlarges too much, it can burst. Then it becomes life-threatening. Men aged 65 and over are most at risk. The doctor can use an ultrasound scan to identify possible vascular damage at an early stage.

Young men should also go to preventive care

From the age of 35, men can currently have a health check-up with a family doctor every three years. The main aim is to identify risk factors for cardiovascular diseases, diabetes mellitus (diabetes) and kidney diseases at an early stage. In the event of an acute illness, the health insurance company will take over all further necessary examinations.

These preventive medical checkups are usually harmless. First, the doctor asks the patient about his lifestyle, how he eats, whether he smokes and how much exercise he does. He also asks about possible illnesses in the family in order to get an idea.

The blood pressure is then measured and the blood and urine are examined in the laboratory. If the blood pressure or blood sugar levels are increased, the doctor can recommend prevention courses on nutrition, exercise, giving up smoking, etc. The doctor will issue a medical certificate for this.

This is the basis on which the person’s health insurance company can decide whether to cover the costs. Meaningful preventive measures for men over 35 include: Vaccinations, regular check-ups, a skin cancer check-up every two years and a check-up at the dentist once every six months.

The first real health problems can occur in men in their fifties. From the age of 50 there are therefore additional preventive medical checkups that are covered by the health insurance company. These include: Prostate cancer screening – once a year, colorectal cancer screening with a stool test – once a year, and the health check – every three years. 

Colorectal cancer screening

Colorectal cancer is the third most common cancer in men. Since 19 April 2021, men aged 50 and over can have a colonoscopy, which is paid for by the health insurance. Until now, the so-called colonoscopy has only been available to all insured persons aged 55 and over. Women continue not to be able to have the examination until they are 55 years of age. However, health insurance companies only undertake a major colonoscopy every 10 years. The reason for the timing is that it takes many years for colon polyps to develop into cancer.

Blood in your stool can be a sign of colorectal cancer. If the result is abnormal, a colonoscopy is carried out to determine whether a malignant disease is the cause. The AOK writes regarding this: “A great advantage of a colonoscopy is that it is the only real preventive examination in which the doctor can remove the preliminary stages of colorectal cancer, so-called polyps or adenomas, and thereby possibly prevent cancer from developing”.

This is one reason that since colonoscopy was introduced for early detection, fewer people develop colorectal cancer and die. People who find a colonoscopy too uncomfortable can alternatively opt for the test for hidden blood in the stool, which they are entitled to every two years.

Prostate cancer screening – take advantage of your cancer screening appointment

Prostate cancer is the most common cancer in older men. The tricky thing about the disease is that it rarely causes symptoms in the early stages. Health insurance companies offer men over the age of 45 to have their external and internal genital organs examined by a urologist once a year. The PSA test, which is also covered by the statutory health insurance companies, is only used in the event of abnormalities.

However, the PSA test is controversial. Out of five large scientific studies, only two showed that the PSA test can save men from dying from prostate cancer. On the other hand, the studies consistently showed that the PSA test also finds tumours which, with a high degree of probability, would never have caused symptoms, reports the German consumer advice centre. To clarify any abnormal findings, the doctor can also do an ultrasound examination and a tissue sample.

That has changed since the end of 2019

To summarise again: With Check-up 35, younger insured persons between 18 and 34 years of age have also had a one-time right to a full medical examination since 2019, and insured persons aged 35 and over every three years.

And because men develop colorectal cancer more often and earlier than women, they are now offered a colonoscopy from the age of 50. The colonoscopy can be carried out in the practice of a specialist doctor.

In addition, insured persons will in future receive an invitation and an information sheet in which the advantages and possible disadvantages of the preventive medical examination are explained. When it comes to colorectal cancer screening, the level of acceptance is roughly the same for both sexes: About as many men as women have a colonoscopy.

So, men, it’s off to preventive health care and stay healthy!