The question
I'm a healthy 35-year-old male. Do I really need an annual physical exam?
The answer
Many men in their mid-30s tend to avoid doctors unless something significant affects their normal well being. This approach could lead to more serious conditions arising and potentially less-than-optimal health over the long run.
If you're healthy and do not have any known risk factors at age 35, you do not need to have an annual physical examination.
In general however, I recommend my male patients aged 30-45 to have a regular check-up every two to three years.
A full check-up will offer your family doctor an opportunity for primary prevention, meaning preventing a disease before it happens, by addressing risk factors in otherwise healthy individuals. Many conditions such as heart disease, high blood pressure, and others can be without symptoms until they become serious.
By having a general check-up, your doctor can work with you to potentially prevent these illnesses before they occur.
Specifically, your complete check-up may consist of:
1. Discussion of healthy and unhealthy behaviours: Your doctor may ask about smoking, substance use, diet, exercise and other behaviors that can increase or decrease your risk of illness. According to the Public Health Agency of Canada, the leading cause of death in Canadians in your age group is injury. For this reason, your doctor may use this as an opportunity to discuss safe driving, helmet and seat belt use and safe alcohol consumption.
2. Counseling for disease prevention: Conditions such as heart disease, diabetes and some types of cancer can potentially be prevented with certain lifestyle changes such as stopping smoking, weight reduction and management of cholesterol and blood pressure. Another example is osteoporosis, which affects 1 in 8 men over the age of 50. Bone density is known to decrease in men in their 30s, so your doctor may counsel you to start taking vitamin D and calcium to prevent osteoporosis.
3. Review of your family history: If there is a history of certain diseases in your family such as cancer, heart disease or depression, your doctor can begin screening at an early age to potentially detect diseases before they begin or early in their course to reduce your risk.
4. Physical examination and investigations: A physical exam may consist of measurement of blood pressure, weight, visual check and other tests depending on your risk factors. If you have moles, your doctor may inspect your skin to ensure that none are abnormal. If you are sexually active, he or she may recommend an examination for sexually transmitted infections.
While many men may not be jumping towards the prospect of a rectal exam or a testicular exam, they are recommended for men at specific ages and those with certain risk factors to help detect diseases that can cause much suffering if left undiagnosed. In general, if you have no other risk factors or symptoms, a rectal examination to assess the prostate gland begins at age 50 and a testicular examination is usually done in men before the age of 40.
5. Update your immunizations: Your doctor will review and ensure that you are up-to-date with all your immunizations, including: tetanus which is recommended every 10 years and others depending on your medical history and potential risk of exposure to certain infectious diseases in your home, workplace or if you are traveling overseas.
Finally, having a regular check-up gives you the opportunity to develop a trusting relationship with your doctor for your health needs now and for the future.
Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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