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Contraception and birth control Archive

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Can a man with abnormal PSA and a negative diagnostic MRI avoid a prostate biopsy? It’s debatable

Not long ago, an abnormal PSA reading would be followed right away by a standard biopsy to search for potential cancer in the prostate. During such a procedure, doctors take 10 to 12 samples of the prostate from various locations while looking at the gland with an ultrasound machine. These days, however, men with high […]

Breast disorders in men

The male breast is much smaller than its female counterpart, and it cannot produce milk. Because of this smaller size and simpler structure, breast disease is much less common in men than women. Still, men can develop important breast problems, both benign and malignant. Early detection is the key to a successful outcome, so every man should understand the basic elements of male breast disease.

Jogger's nipple

Irritation of the nipple is more common than enlargement of the breast itself. Pain, redness, and even bleeding of the male nipple are fairly common complications of intense, prolonged exercise — hence the common names "jogger's" and "marathoner's" nipple. The cause is not running itself but the mechanical irritation of the runner's shirt rubbing up and down against his chest, especially in hot, humid weather.

You don't have to give up running to cure jogger's nipple. Instead, apply some petroleum jelly to your nipples before you run. Plastic Band-Aids are even better; round "spots" are particularly handy. Or simply run without a shirt when it's hot or humid.

Managing postmenopausal vaginal atrophy

Vaginal dryness is one of the most irritating symptoms of menopause. Here are some ways to relieve it.

Within a few years of menopause, roughly 50% of women develop symptoms related to vaginal atrophy, also called atrophic vaginitis — the deterioration of vaginal tissues due to loss of estrogen. The most common symptoms of vaginal atrophy are dryness, irritation, and pain during intercourse.

Although menopause is the most common cause, vaginal atrophy can result from anything that lowers estrogen production. That includes chemotherapy, radiation, removal of the ovaries during hysterectomy, and use of anti-estrogenic therapies such as aromatase inhibitors, tamoxifen (Nolvadex), and drugs like leuprolide (Lupron) and nafarelin (Synarel), which are used to treat fibroids and endometriosis. Unlike hot flashes, which usually subside with time, vaginal atrophy is likely to persist and become worse without treatment.

Father’s Day: Tools for coping when celebration brings pain

While Father’s Day gets less sentimental build up than Mother’s Day, it may still bring out intense emotions for many men even if they are not parents themselves.

Marriage and men's health

Both married men and unmarried men of a certain age, may remember the tune, if not the words:

Love and marriage, love and marriage,
Go together like a horse and carriage.
This I tell you, brother,
You can't have one without the other.

Big jump in active surveillance for low-risk prostate cancer

News briefs

New findings show a dramatic increase in the number of men taking a conservative approach to low-risk prostate cancer. According to a Harvard-led study published Feb. 19, 2019, in JAMA, use of active surveillance — which involves monitoring the cancer and delaying treatment unless it progresses — almost tripled from 2010 to 2015. The data come from the records of 165,000 men with prostate cancer. Researchers found that among men with low-risk prostate cancer (slow-growing cancer that's not considered life-threatening), active surveillance jumped from 15% in 2010 to 42% in 2015, surgery fell from 47% to 31%, and radiation dropped from 38% to 27%. Other studies also have also shown increasing rates of active surveillance in low-risk cases.

Why the shift? The authors point to national guidelines that now recommend active surveillance in such cases, as well as favorable research findings. "Emerging evidence has shown that active surveillance for low-risk prostate cancer is an effective alternative to surgery or radiation, associated with similar and excellent chances at long-term survival," notes Dr. Brandon Mahal, the study's lead author and a radiation oncologist with Harvard-affiliated Dana-Farber/Brigham and Women's Cancer Center.

Newer breast screening technology may spot more cancers

Digital breast tomosynthesis may also reduce the number of unnecessary and nerve-racking callbacks for additional testing.

If you're in your 40s, you may want to consider switching from digital mammography to digital breast tomosynthesis (DBT) for your next breast cancer screening, say the authors of a study published online February 28 by JAMA Oncology.

A review of more than 170,000 screening mammograms using the two technologies determined that DBT — sometimes referred to as 3D mammography — did a better job at accurately detecting cancers in women of all ages. The advantages were most pronounced for women in their 40s. DBT was also better at finding cancers in women with high breast density, which can make cancers more difficult to spot on screening exams. High density indicates a larger proportion of active tissue in the breast and is a risk factor for breast cancer.

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