Color Logo
Join | Login
Color Logo
Join | Login

Many men don’t feel comfortable talking about their health when problems arise. They may not want to admit a possible medical issue—aka weakness—to a spouse or partner. And guy friends tend to keep their banter to the level of last night’s game.

Still, keeping symptoms to yourself could create a bigger health problem, if left untreated. And with health concerns that aren’t life-threatening, you may deprive yourself of a solution that could improve your quality of life.

The obvious person to confide in is your healthcare provider—but many men are still hesitant to broach topics that could seem awkward or cringe-worthy. Still, there some that should be asked, no matter how embarrassing. Here are seven—and their answers.

Why am I so angry all the time?

Do you find yourself losing your temper, flying off the handle over minor issues? Have you stepped up your drinking lately? What about other dangerous behavior, like driving too fast or partying too much? If you answered yes, you could be depressed.

Depression sometimes looks different in men than it does in women. Men may experience the classic symptoms of apathy, sadness, sleep issues and fatigue, just as women do. But they’re more prone than women to atypical symptoms of anger or aggression, substance abuse and risk-seeking behavior.

Since depression is thought to mainly affect women, these other symptoms may go unrecognized. The fact is that when considering both traditional and alternative symptoms of depression, men and women meet the criteria in equal numbers.

See your healthcare provider if you experience any of these symptoms, especially if they’re out of the ordinary for you.

Why is my penis curved?

If your recent bedroom escapades have led to penis pain, check the shape. If something looks off—specifically, if your erection is curved—that could be a sign of Peyronie’s disease.

Peyronie’s disease usually stems from an injury to the penis, possibly from sex, sports or an accident. That damages blood vessels, which leads to swelling inside the penis and blocks blood flow. Then scar tissue forms, which causes the penis to curve, or bend, when it becomes erect. A sharp-enough bend can make sex painful, or even impossible.

If you’re sure you haven’t sustained an injury but your penis is still curved, the underlying cause may be an autoimmune disease. A 2015 study of more than 1,100 men suggests that men with Peyronie’s disease have a higher rate of autoimmune disease than men without the condition. Researchers think an autoimmune disease may be attacking cells in the penis, leading to the scarring that causes the penis to bend.

What’s this lump on my pec?

Women are well aware that a lump in their breast can be a first sign of cancer. But according to the American Cancer Society, about 1 in 1,000 men can also expect to have breast cancer in their lifetimes. One possible sign is a lump. Others include:

Age, a family history of breast cancer, obesity and heavy alcohol use are among the risk factors for men to develop breast cancer.

Other possible changes to men’s breasts include gynecomastia, a condition in which men grow enlarged breast tissue. The excess tissue usually appears under the nipples. Low testosterone, an overactive thyroid and liver disease could be culprits, as can certain medications and drugs like anabolic steroids and marijuana.

About one in four men between the ages of 50 to 70—especially those who are overweight—develop gynecomastia due to normal hormonal changes. Stopping the medication or drug that’s causing the tissue growth usually takes care of the problem, although other causes of gynecomastia may exist, requiring treatment.

Is there anything I can do about my hair loss?

Going bald may not be dangerous to your health, but it can deal a blow to your self-confidence. Hair loss can trigger feelings of disfigurement and even depression and anxiety. It’s only natural for some men to seek ways to slow or reverse their hair loss.

Two of the most common medication treatments for hair loss are minoxidil and finasteride. Minoxidil is an over-the-counter liquid you massage into the scalp to possibly slow hair loss or regrow hair. Side effects include scalp irritation, hair growth on the face and hands and rapid heartbeat.

Finasteride is a daily pill to slow hair loss and sometimes regrow hair. Side effects include a lower sex drive, problems performing sexually and an increased risk of prostate cancer.

Surgery can also be effective, and it is sometimes used together with medication. Surgeons take sections of scalp with hair follicles, called plugs, and attach them to bald spots. Infection and scarring are possible side effects.

Why do I pee way more than I used to?

If you can’t seem to step out of the house without needing a quick pit stop to the men’s room, you’re not alone. Many men develop a condition called benign prostatic hyperplasia—also known as an enlarged prostate—as they grow older, especially after age 50. The prostate is a walnut-shaped gland near your bladder that produces one of the elements of semen.

Researchers aren’t sure why the prostate grows as men age. But when it does, it blocks urine flow, making it harder for the bladder—a muscular sac—to push urine out. That makes the bladder walls thicker so that it can’t hold as much urine, causing you to urinate more often. Symptoms of an enlarged prostate mostly revolve around urine, and can include:

Benign prostatic hyperplasia can lead to urinary tract infections and bladder or kidney damage. Medications and surgery can shrink the prostate, but you can also make lifestyle changes such as:

Why can’t I lift weights the way I used to?

As you get older, you’ll need to stop trying to keep up with the young bucks on the bench press. Sarcopenia is age-related muscle loss. Most men can expect to lose between 3 and 5 or more percent of their muscle mass per decade after 30 until age 70, when muscle loss accelerates. That adds up to about 30 percent of muscle lost in a lifetime.

Sarcopenia may be caused in part by the decline in testosterone men experience as they age. You can slow your muscle loss by eating enough protein and continuing with your resistance training. Just know your limits and don’t try to set any world records.

My chest hurts; is it just a bad case of heartburn?

That would be a dangerous assumption to make. Chest pain can be a sign of a serious condition that should be checked out without delay. Seeing a healthcare provider doesn’t mean you’re a wimp—it means you care about your health.

Chest pain can be angina—a symptom of coronary heart disease. There are two types: stable angina and unstable angina. Stable angina (also called angina pectoris) feels like a pressure, squeezing pain in the chest which comes about when you’re engaged in physical activity (climbing stairs, raking leaves) or feeling strong emotions, like stress.

It happens when an artery is blocked, reducing blood flow, and lasts for a few minutes. If you experience this type of chest pain, stop what you’re doing, rest to ease the pain and see your doctor for a treatment plan.

Unstable angina is the far more serious kind which usually comes on suddenly when you’re sleeping, resting or exerting little effort. It’s a symptom of artherosclerosis—fatty build-ups in the coronary arteries, which can rupture and create clots, reducing blood flow to the heart.

When you experience sudden chest pain of this kind—you could be having a heart attack—it’s an emergency requiring immediate medical attention.

Other possible causes of chest pain—that aren’t related to heart disease—include a pulmonary embolism, inflammation of the heart (pericarditis), disease of the heart muscle, a lung infection, a panic attack or an artery tear.

Chest pain can also be caused by something minor like a pulled muscle, but it’s better to be safe than sorry. See your healthcare provider right away if your chest hurts.

Sourcing: UpToDate, National Institutes of Health, American Cancer Society, American Academy of Family Physicians, Harvard Medical School, American Heart Association, American Medical Association

Back to Men’s Health

Some men may feel the need to be strong, stoic or fearless, but these traits traditionally viewed as masculine could partly explain why women usually live longer. In some cases, seemingly “macho” behavior can take a serious toll on men’s long-term health and well-being.

Men are more likely to drink too much, smoke and bury their feelings. They’re also more likely to neglect their health. According to one survey, just 4 out of 10 men see their doctor when they should.

“Preventative care is really important and keeping up with it is not a sign of weakness, as many men think,” says Kenneth Perry, MD, Assistant Medical Director and Emergency Medicine doctor at Trident Medical Center in Charleston, South Carolina.

So, listen up, guys. When it comes to your health, here are some of the worst mistakes you’re making that could be shaving years off your life.

Skipping routine doctor’s visits

Research consistently shows that men are less likely to go to the doctor than women. Men often delay seeking medical care, or even mentioning medical problems to their loved ones, according to a 2018 survey conducted by researchers at the Cleveland Clinic.

There could be many reasons why men put off going to the doctor. The American Heart Association speculates that some men believe they don’t have the time to spare while others may not have a doctor they trust. In many cases, men might assume there’s nothing seriously wrong or that they can “tough out” their symptoms, according to Dr. Perry.

Unfortunately, that’s often not the case. Not going to the doctor when you’re due for a checkup or when you’ve developed concerning symptoms is risky and could have serious health consequences. Medical attention is not only helpful when you have an immediate health problem, such as an infection or the flu, but also essential for your long-term health.

Men who skip routine appointments could also be missing out on routine screenings, vaccinations and important conversations with their doctor about changes in their medical conditions and lifestyle habits. Your blood pressure, cholesterol and blood sugar levels are among the numbers that should be monitored over time.

“Small changes for instance, like your blood pressure going up a point here and there or your weight going up by a few pounds every year could be addressed at routine visits, says Perry. “But if they aren’t addressed right away, by the time they are addressed, it could be very difficult to fix.”

You should also weigh the risks and benefits of certain gender-specific screenings, such as testicular exams and prostate cancer screenings, with your doctor. Together, you can determine whether or not you should have the screenings based on your values, age, health preferences and individual risk for the conditions.

Bottom line: talk to your doctor about how often you need to have regular checkups. Routine appointments will enable your doctor to monitor any chronic conditions you have and potentially identify other health issues that may arise. It’s also a good idea to establish a relationship with a primary care physician so you know where to turn if you need medical attention in the future.

Bottling up your feelings

For the past several decades, research has shown that men of all ages and ethnicities are less likely than women to seek help coping with stress and depression—even though they are also affected by these issues. Women have higher overall rates of depression, but research suggests the condition is often unrecognized, undiagnosed and untreated among men.

Avoiding mental health discussions can have some very serious repercussions. The U.S. Centers for Disease Control and Prevention (CDC) reports that men account for more than 76 percent of all completed suicides. Compared to women, men are also less likely to admit that they’re stressed.

This begs the question: why are men less likely to admit they’re stressed, depressed or feeling down? Some men may not be comfortable asking for help, assuming it’s not “manly” or that by voicing their concerns they will become a burden to others. The misconception that available treatments for depression or anxiety aren’t effective could also prevent some men from seeking help. The possibility that something could really be wrong may also be a deterrent, Perry speculates. “Many men are nervous too, that there might be something majorly wrong, and if there is something wrong, that it’s a sign of weakness,” he says.

In many cases, identifying and treating health issues early on leads to better outcomes. Being proactive about your health could prevent health issues from worsening and taking a greater toll on your quality of life. Some of the symptoms you should watch out for include:

If you have any of these symptoms for more than a few days and you think you may be depressed, see your doctor. A combination of medication and talk therapy is commonly used to treat depression and anxiety disorder, and exercise, deep breathing, relaxation techniques, yoga and mindfulness meditation can also help. Surrounding yourself with positive people and finding something you enjoy doing can boost your mood, too.

Overlooking regular dentist’s appointments

Men are also more likely to neglect their oral health, falling short on their brushing habits and not visiting the dentist as often as experts advise.

Most men only brush their teeth 1.9 times per day, which is just under the recommended amount of two times per day. Yet, men are more likely to develop oral and throat cancers and gum disease than women.

Complicating matters, skipping dental checkups and neglecting oral hygiene have been linked to some chronic health issues, like diabetes as well as heart and lung disease.

People with diabetes have an increased risk of gum disease, since they have a harder time fighting off bacteria that infect the gums. Gum disease may increase the risk for respiratory infections since bacteria from the mouth and throat may be inhaled. A 2018 study presented at an American Heart Association meeting also found that adults who brush their teeth less than twice a day for less than two minutes, have a higher risk of heart attack, heart failure or stroke.

“Good oral hygiene helps prevent bacterial buildup in your mouth,” says Perry. “If you have a broken or cracked tooth that’s allowing bacteria to get in, that can be the source of an infection that becomes very, very life-threatening.”

Most men should visit the dentist twice a year and maintain good oral hygiene by brushing and flossing. Keep in mind, there is a proper way to brush your teeth: brush with a fluoride toothpaste, using small circular motions and short back-and-forth strokes—and don’t forget to brush along your gum line, too. Be sure to floss every day; doing so will help remove any leftover food that a toothbrush can’t easily reach. If you notice any symptoms, such as toothaches, sensitivity, bleeding, sore gums, cracked or broken teeth or popping of the jaw, see your dentist. Talk with your dentist about how often you should have regular cleanings or check-ups.

Drinking too much alcohol

Men are more likely to drink excessively than women, the CDC reports. In fact, men are nearly twice as likely to binge drink, or have five or more drinks during one occasion. The CDC also reveals that 23 percent of men admit to binge drinking five times a month.

Men have higher rates of deaths and hospitalizations related to alcohol use, and heavy drinking also increases the risk of aggression, physical assault and suicide in men. Heavy drinking can also affect men’s sexual health and fertility, increasing the risk for impotence and risky behavior.

Excessive drinking is associated with several chronic health issues, including high blood pressure, heart disease, liver disease, stroke, depression, mental decline and alcohol dependence. Even light drinkers, who have no more than one drink daily, are at increased risk for esophageal cancer.

A large 2018 study published in The Lancet, concluded that the safest level of drinking is none, and the health risks associated with drinking outweigh any possible benefits. Health officials recommend that if you haven’t started drinking, don’t start. The 2020 U.S. Dietary Guidelines for Americans recommends that men who do drink limit themselves to no more than two drinks per day. Remember that a standard drink is considered to be: 12 ounces of beer (5 percent alcohol), 5 ounces of wine (12 percent alcohol) or 1.5 ounces of liquor (40 percent alcohol).

If you think you may be addicted to alcohol, talk to your doctor or call the Substance Abuse and Mental Health Services Administration’s confidential hotline at 1-800-662-HELP for local treatment centers, support groups and other resources.

Neglecting your skin

Men are more likely than women to develop melanoma—the most deadly form of skin cancer, according to the American Academy of Dermatology (AAD). They are also less likely to survive the disease. According to the Skin Cancer Foundation, an estimated 9,320 Americans will die of melanoma in 2018 and of those, 5,990 will be men and 3,330 will be women.

Part of the problem may be lack of awareness among men. A 2016 survey from the AAD found that men tend to be less informed about skin cancer. They’re also less likely to wear sunscreen. Meanwhile, women are more likely to use makeup and lip products that often contain sunscreen, which offer an additional layer of protection. Women also tend to interact with the medical community with more frequency as well, which allows them more time to point out any concerns to their primary care doctors, OBGYNs or dermatologists, Perry notes.

But researchers also think that men have thicker skin with less fat underneath than women, which may make their skin more susceptible to damage from the sun’s harmful UV rays. Some studies show that men’s skin reacts more intensely to sun exposure than women’s, and that men’s skin may not heal as well from sun damage. The CDC also reports that on average, most men spend more time outside during their lifetime than women, which can have a cumulative effect and result in more damage.

Men should follow typical skincare recommendations, like wearing sunscreen with at least SPF 30 and reapplying every two hours while exposed to the sun’s harmful UV rays. It’s also a good idea to reduce your sun exposure by wearing long-sleeved shirts and hats or seeking shade during peak daylight hours.

Talk with your dermatologist if you have an increased risk of melanoma or you’re over 50, have large or unusual moles, fair skin or a history of skin cancer, to determine how often you should have regular skin checks. Pay attention to your skin, too: if you notice unusual or changing spots, itching or bleeding, see your dermatologist.

Not talking about problems in the bedroom

While many men suffer from sexual or urinary problems at some point in their lifetime, like erectile dysfunction or trouble urinating, many of them aren’t talking about it—with each other or their doctors. But as you age, it’s especially important to address these symptoms, since some of them may signal underlying health issues. For example, erectile dysfunction (ED), the inability to get or keep an erection strong enough for sex, could be a red flag for vascular disease. Type 2 diabetes, depression, heart disease, high blood pressure, kidney and liver disease, cancer treatment and multiple sclerosis can all lead to ED.

Sometimes, sexual problems are linked to work-related stress, past sexual trauma or relationship problems. Taking certain medications, smoking, heavy drinking, being overweight and being sedentary can also contribute to sexual dysfunction. Being diagnosed and treated for an underlying condition or mental health issue however could reduce or improve ED. Certain lifestyle changes, like limiting alcohol, quitting smoking and maintaining a healthy weight could also help.

Problems with urination are another “below the belt” issue that can affect men. If you’re having trouble urinating, or you’re urinating more often than usual, it could be benign prostatic hyperplasia—a condition that can arise as you get older and your prostate gland grows. Certain medications like nasal decongestants could cause urinary problems, too.

Talk to your doctor if you experience premature or delayed ejaculation, or a notable drop in your sex drive. It’s also important to ask your doctor about any urinary changes.

You and your doctor can work through these issues. Your doctor can determine if you would benefit from medication, hormone therapy or a vacuum device that helps produce an erection. Surgically implanted devices are typically only used as a last resort.

Taking too many risks

Men are more likely than women to drink heavily and take risks, like driving too fast or without a seat belt. This could help explain why unintentional injuries, such as burns, falls, drug overdoses and traffic accidents, are the third leading cause of death among men.

Among drivers involved in deadly car accidents, men are almost twice as likely as women to have been drunk. Heavy drinking also increases aggression, which can lead to fighting and physical injuries.

“I don’t think guys always think through what would go wrong,” Perry suggests.

When men do experience close calls, they tend to brag about them, according to the Cleveland Clinic survey. The researchers found that among men who finally do discuss their health with other men, 36 percent are simply boasting about their injuries. For 42 percent of the men polled, it took brushes with disaster for them to finally open up about their health.

Continuing to smoke

Nearly 18 percent of American men still smoke as of 2016—even though the negative health effects of smoking, such as an increased risk for heart disease, lung disease, cancer, stroke and infertility, are well-established.

Men who smoke are 17 times more likely to die from bronchitis and emphysema and 23 times more likely to die from cancer of the trachea, lung and bronchus. Middle-aged men are also nearly four times more likely to die from heart disease.

So, if you don’t smoke, don’t start. If you do, it’s time to kick the habit. Talk to your doctor about medications and cessation techniques that can help you quit. You could also consider joining the American Lung Association’s Freedom From Smoking program, to learn more about group programs in your area.

You skip exercise—or you neglect flexibility and balance training

You probably know you’re supposed to exercise, but how often are you doing it? And are you including balance and flexibility training in your regimen?

In general, most adults should get at least 150 to 300 minutes of moderate-intensity exercise, like walking or yoga, or 75 to 150 minutes of vigorous activity, like running or swimming, per week. Exercising beyond 300 minutes can provide additional benefits, too.

Unfortunately, only 26 percent of men are actually meeting these goals. Men are also more likely to be overweight.

Skipping exercise and living a sedentary lifestyle can increase your risk of not only physical problems, but also mental health issues like stress and bad moods. The drawbacks of a sedentary lifestyle could also be costly: according to a 2010 study, the annual cost of being overweight is $432 for men and the annual costs for being obese are more than $2,600.

Exercise is an essential part of keeping your mind and body well. It triggers the release of certain brain chemicals—serotonin, dopamine and norepinephrine—which can help ease stress and improve your mood and energy level. Regular physical activity helps reduce your risk of heart disease, diabetes, metabolic syndrome and certain cancers. Breaking a sweat will also help strengthen your muscles, which will support and strengthen your bones as you age.

It’s also important to incorporate strength training into your routine, as well as flexibility and balance training, which can lower your risk of injury, relax your muscles and enhance your range of motion.

In addition to your regular cardio or strength training routines, make sure you stretch regularly. Before stretching, however, be sure to loosen up your muscles by walking and moving your arms in a circular motion. It’s also a good idea to incorporate some flexibility exercises into your exercise regimen, such as the standing hip flexor stretch or seated head-toward-knee stretch.

Sourcing: CDC, Cleveland Clinic, American Heart Association, American Cancer Society, U.S. Preventive Services Task Force, American Psychological Association, National Institute of Mental Health, National Institutes of Health, National Alliance on Mental Illness

Back to Men’s Health

New dads can experience depression during their partner’s pregnancy or after the birth of their child, just as mothers can. It’s called paternal postpartum depression (PPD)—and we don’t talk about it nearly enough.

Estimates vary, but studies suggest that about 10 percent of fathers develop paternal PPD, and under-reporting means this number is probably even higher. When a man’s partner also has PPD, paternal rates may climb as high as 50 percent.

Despite its prevalence, silence surrounding paternal PPD can cause dads to wonder if their condition is real or legitimate and to grapple with their symptoms in isolation. Male gender norms like stoicism and self-reliance—along with a sense of duty to provide for their growing family—can also contribute to men feeling alone and overwhelmed.

But talking about the very real stress of fatherhood may be exactly what your family needs. Left untreated, paternal PPD can interfere with children’s mental and emotional development, worsen maternal depression, and lead dads to hurt themselves, their kids, or their partner.

Mark Boles, MD, an OBGYN affiliated with Fairview Park Hospital in Dublin, Georgia, explains some of the key differences between paternal and maternal PPD and offers practical advice on how to cope with the challenges of being a dad.

What does PPD look like in men?

All new parents—biological moms and dads, stepparents, adoptive parents, and others—may experience traditional symptoms of PPD. These include:

Moms who have given birth undergo dramatic physical and hormonal changes that make them especially susceptible to PPD. Women also are more likely to show sadness, talk openly about their symptoms, and seek help, says Dr. Boles. On the other hand, a lot of men try to be “the strong one” and suppress their feelings.

“For them,” Boles explains, “depression tends to come out in other ways, very few of which are constructive.” Men with PPD may be more prone to:

Many men with PPD demonstrate irritability and a lack of desire to be home or to help with childcare, and it’s common for them to view the baby as the source of their issues, according to Boles. “That’s when a lot of women will say, ‘He doesn’t come home until late; I’m taking care of the baby all the time.’”

“It could be that this dad is experiencing PPD,” Boles adds, “but no one has made that connection.”

Sleep deserves a special mention: A new baby can interrupt your sleep like it’s their job. Poor rest, in turn, can trigger or worsen PPD symptoms, including anger at your baby’s cries. At the same time, depression can aggravate sleep problems like insomnia. This cycle is often a major source of stress for new parents.

What causes paternal PPD?

Many factors contribute to PPD in men, says Boles, and many factors make it difficult for them to get help. “Levels of testosterone and other hormones can change in men following their child’s birth,” he explains. “Sleep deprivation, changes to their relationship, and lack of intimacy may play a role as well.”

In one 2019 study published in the Journal of Family Issues, researchers analyzed online comments from dads with PPD to learn more about its causes and risk factors. A common theme among these posts was a sense of having been forgotten—including by healthcare providers—and a need for better education. Many dads voiced frustration over a lack of dad-directed parenting materials and the fact that paternal PPD is rarely brought up in discussions about postpartum depression.

“Dads often don’t have a provider that they’ve bonded with over the course of pregnancy the way moms tend to have,” says Boles. “So when these symptoms appear, they can feel like they’re on an island. They might not know a provider well enough to be able to be vulnerable and say, ‘I’m having a lot of difficulty adjusting to life with a child in the house.’”

Several studies suggest that feeling distanced from their partner affects dads, too. Since some men rarely—if ever—act vulnerable outside of their intimate relationship, this distance can mean losing their emotional lifeline right when they need it most. Couples may grow apart due to the lifestyle, scheduling, and responsibility changes that can arrive with a baby. In many cases, men’s emotional withdrawal fuels this dynamic as well: Dads may question their right to discuss their thoughts or to “burden” their baby’s mom with their experience. These unspoken worries may increase tension even further.

New territory for dads today

It’s increasingly common for people to define family and parenthood for themselves, rather than according to tradition. That means new dads may be occupying very important but possibly unfamiliar roles with few models to guide them. This can leave dads feeling in over their heads.

On top of that, paid paternal leave remains a rare employee benefit. Returning to work too soon after their child’s birth can add to a dad’s:

Excessive absence also may lead to mounting resentment between a father and mother and can exacerbate maternal PPD.

Be real with yourself, your partner—and other dads

It takes courage to have difficult conversations. It’s not always comfortable, but being upfront about what’s on your mind can lead to solutions.

“The first thing I recommend is talking to your partner,” says Boles. This is crucial because it might help to clear up long-running misunderstandings. “For example, she might be thinking she’s no longer attractive to you after these body changes and assume you must be ‘stepping out.’”

Next, talk to someone who can give you the tools to improve your symptoms, such as your general practitioner or a mental health provider. As Boles advises, “Find someone who can help you understand this diagnosis, who can explain that it’s a real condition, and who can address it with medications, if appropriate, and with talk therapy.”

It also helps to reach out to a broader support system. Friends, co-workers, family members, and on-line or in-person support groups can help you consider issues from fresh perspectives. Finally, since stigma surrounding mental health often keeps men from getting treatment, being transparent with other dads you know might prompt them to seek lifesaving help, too.

The best version of you

Life is better for your family when you’re present and involved, and depression can get in the way of that. Dads with depression are nearly four times more likely to spank their one-year-old child and less than half as likely to read to them, according to one study. On the other hand, seeking help may have a ripple effect, easing depression for your baby’s mom and boosting her interest in parenting.

Here are some places to start:

“Accessing mental health care can somehow be seen as weak or ‘less manly,’” says Boles. “But if there are changes taking place to your brain chemistry, it doesn’t matter how strong you are. Until you do something to address those changes, you’re not going to feel whole and you’re not going to have energy to be there for your kids.”

Sourcing: National Institute of Mental Health, National Institutes of Health

Back to Men’s Health

Heart disease is the number one killer of women in the United States—killing one woman every 76 seconds—yet only one out of five American women actually believe it’s a threat.

Heart disease is a catch-all term that includes a variety of conditions and events—such as heart attacks, strokes and heart failure—and is often related to atherosclerosis, the formation of plaque buildup in the arteries. Warning signs of heart disease are not always the same for women and men, so understanding the symptoms and risk factors is important.

Women can actually respond to heart events differently than men. “Men are more likely to survive a heart attack than women,” says cardiologist Ramavathi Nandyala, MD of Methodist Hospital in San Antonio, Texas. And while both men and women usually experience chest pain and pressure during a heart attack, women can have a heart attack even without that common symptom. Women are in fact more likely than men to have nausea, vomiting and shortness of breath during a heart attack.

Smoking and a strong family history put you at risk for heart disease, but what about your eating habits and stress levels? Here are six things that can increase your heart disease risk—and easy ways to keep your ticker strong.

STRESS OR TRAUMA

Stress—whether it be related to work, relationships or parenting—is the number one risk factor Dr. Nandyala sees in her female patients. “We keep adding more and more responsibility and stress on women,” she says. And traumatic events can also contribute to heart problems.

Stress causes the body to release adrenaline, which can cause arteries to go into spasms and your blood pressure to increase, Nandyala notes. Broken heart syndrome from an event like a death in the family can also cause the heart to “go into shock,” leading to a temporary type of heart failure. In fact, researchers from the University of Pittsburgh School of Medicine collected data from 272 postmenopausal and perimenopausal women to learn more about how traumatic events can impact heart health.

The study findings, presented at the North American Menopause Society’s annual conference in 2017, showed that women who were involved in at least three traumatic events during their lifetime—such as sexual harassment, a car accident or the death of a child—had poorer endothelial function than those women who had not experienced trauma. The endothelium is the inner lining of the heart and blood vessels, and poor functioning may increase the risk of heart disease.

Nandyala says that some stress in our lives is inevitable, but that it’s important to learn to cope with it. She recommends relaxing for a few minutes each day with reading, music, yoga, prayer or any other activity that relaxes your mind. Exercise can also help you manage stress—a quick walk outside is a better move than stress eating, for example—and can even put you in a good mood.

If it’s trauma you’re working through, see your healthcare provider to learn about available resources and treatment options. According to the Centers for Disease Control and Prevention (CDC), common responses to trauma include fear, grief and depression. If symptoms worsen or last more than a month, you may have post-traumatic stress disorder.

MEAT-BASED DIETS

A diet rich in saturated fat and sodium increases anyone’s risk of heart disease, but one study found that a high-protein diet—especially if the protein came from meat—is associated with a higher risk of heart failure among older women.

In one preliminary study presented at the American Heart Association’s Scientific Sessions in 2016, researchers reviewed the self-reported daily diets of 103,878 women ages 50 to 79 from 1993 to 1998. During the course of the study, 1,711 women developed heart failure, and the rates were higher among women who ate more protein compared to those who ate less protein or who ate veggie-based protein. Experts say more research is needed to understand the link between a high-protein diet and heart failure.

When it comes to eating habits, Nandyala says a balanced diet is best. “Strictly avoiding carbs or fats isn’t always the best option because our bodies are made of protein, carbohydrates and fat,” she explains. If you do eat meat, reach for lean meats like turkey and chicken rather than overly fatty, processed meats like sausage and bacon. Plant-based proteins like tofu, beans and nuts are good options, too.

YO-YO DIETING POST-MENOPAUSE

Repeatedly losing and gaining weight, known as yo-yo dieting or weight cycling, can hurt your heart down the road.

One observational study presented at the American Heart Association’s Scientific Sessions in 2016 looked at self-reported weight history for 158,063 post-menopausal women and grouped them into several categories: stable weight, steady gain, maintained weight loss or weight cycling. The findings were eye-opening. Those of normal weight who lost and regained weight during the study period had a 3.5 times higher risk of cardiac death than women whose weight remained the same.

The study also found that those women considered overweight or obese who reported weight cycling had no increase in cardiac death. For women who reported gaining weight but not losing it, or losing weight without gaining it back, there was also no increase in death risk.

Nandyala wants women to know that it’s more important to adopt and maintain a healthy lifestyle overall than to drop weight quickly by employing drastic dieting tactics.

BIRTH CONTROL PILLS

Research shows that there may be a link between birth control pills and high blood pressure in some women. And the link may be stronger for women who are overweight, have kidney disease, have a family history of high blood pressure or high blood pressure during a pregnancy.

Birth control pills are typically made up of estrogen and progesterone, and estrogen is thought to encourage blood clot formation in some women over the age of 35, says Nandyala. Blood clots can lead to heart attack and stroke, and women who smoke and take oral contraception are especially at risk.

The good news is that many of the newer birth control options pose less risk. Speak with your gynecologist and/or cardiologist about the best birth control for you, particularly if you have congenital heart disease.

OBESITY

Nandyala says obesity is another huge risk factor for heart disease. In fact, two out of every three women in the United States are overweight or obese.

“Females are especially affected by hormones, which can sometimes make weight easy to gain and hard to lose,” notes Nandyala. “Testosterone is a fat-burning hormone, while estrogen tends to be a fat-preserving hormone.”

If you’re carrying around extra fat—a body mass index (BMI) over 30 is considered obese—you may be increasing your risk of high cholesterol, high blood pressure, diabetes and even osteoarthritis and breathing problems. Maintaining a healthy weight allows blood to circulate through the body more efficiently and lowers your risk of the health conditions above.

Make sure you measure your BMI at least once a year, and if you are obese, talk to your healthcare provider about weight loss programs that can help you focus on taking in fewer calories and developing exercise habits.

SKIPPING YOUR WORKOUTS

Skimping on regular exercise is a no-no when it comes to keeping your ticker strong. Regular exercise not only reduces the risk of type 2 diabetes and certain cancers but aerobic exercise (think walking, jogging, biking and swimming) strengthens your muscles and bones and can also help strengthen the heart and lungs. And that’s not all. The American Heart Association says that getting just 30 minutes of exercise a day, whether aerobic or resistance training, can:

Despite all the benefits, many women are still skipping out on regular exercise—and it’s affecting their heart health. A study published in the Journal of the American Medical Association in April 2019 analyzed 10 years’ worth of self-reported data for 18,027 women with cardiovascular disease. Researchers found that more than half of these women didn’t meet the recommended physical activity levels, and women over 40 were much more likely to fall short than their younger counterparts. Study researchers suggest that more must be done to improve overall physical activity among women.

Talk to your doctor before you begin any new exercise routine. Once you get the green light, try a combination of both aerobic and resistance training. You can work in other heart-healthy moves like dancing, water aerobics, rowing, stair-climbing and even housework.

NEGLECTING REGULAR SCREENINGS

So many female patients come in and say, “I’m totally fit, so I definitely don’t have heart disease,” says Nandyala. But unfortunately, that’s not always the case. People who have a family history of heart disease should be especially cautious.

If you do have a heart condition like high blood pressure or high cholesterol, the earlier you can get it under control, the less likely you are to have a serious heart event.

The American Heart Association recommends getting blood pressure screenings at least every two years if your levels are below 120/80 mm Hg. If your numbers are higher, you may need more frequent screenings. Every four to six years, you should also receive a fasting lipoprotein profile, a measurement of your cholesterol and triglyceride levels. And starting at age 45, be sure to have your blood glucose checked every three years, or more frequently if you’re at elevated risk.

Sourcing: American Heart Association, National Institutes of Health

Back to Heart Health

Each day your heart beats about 100,000 times and pumps roughly 2,000 gallons of blood throughout your body. During pregnancy, it works harder to pump even more blood and support your developing baby. These changes aren’t as obvious as your growing belly, but you may notice that you’re more tired or short of breath. You could also feel a “fluttering” sensation in your chest. While you should notify your doctor if you have these symptoms, they are usually nothing to worry about.

Some heart-related changes or conditions can be serious, however. In fact, heart disease is now the leading cause of death in pregnancy and the postpartum period, according to a May 2019 guidance released by the American College of Obstetricians and Gynecologists (ACOG).

Understanding how pregnancy affects your heart can help you figure out what’s normal, what isn’t and what you can do to protect your health.

How pregnancy affects the heart

When you’re expecting, your heart sends more blood to your uterus so that your fetus receives the oxygen and nutrients needed for proper growth and development.

“During pregnancy a woman’s blood volume increases up to about 50 percent so her heart has to work that much harder to pump,” explains Jade Pizarro, MD, an OBGYN at Orange Park Medical Center in Jacksonville, Florida. “The heart has to give blood to a growing uterus, placenta, and fetus, as well as enlarging breasts or other areas of the body that change during pregnancy.”

Other experts feel strongly about this too. “Pregnancy is a natural stress test…the cardiovascular system must undergo major changes to its structure to sustain tremendous increases in blood volume,” writes James Martin, MD, chair of the Pregnancy and Heart Disease Task Force, in a May 2019 ACOG statement.

As the amount of blood in your body increases, you can anticipate these additional changes:

During your second trimester, your blood pressure may also drop slightly due to hormonal shifts and the fact that more blood is flowing to your uterus. Your heart function won’t return to pre-pregnancy levels until about six weeks after you deliver.

Symptoms to expect

While your heart is working overtime during pregnancy, you may notice some symptoms, including:

Additionally, you could develop an irregularity with your heartbeat or experience heart palpitations—the sensation that your heart skipped a beat. This fluttering feeling can occur as a result of many different changes during pregnancy, including hormonal changes.

Nearly 90 percent of pregnant women also develop a heart murmur, which is an unusual “swishing sound” between heartbeats. This can occur as the volume of blood flowing through the heart ramps up.

These changes are usually not cause for concern but it’s always important to discuss any new or worsening symptoms with your doctor, especially if you notice them at rest. In some cases, they could be a warning sign of a problem that requires treatment.

Possible heart-related complications

Some women have a heart-related condition that isn’t detected until they become pregnant and the extra strain on their heart worsens the problem. Others can develop peripartum cardiomyopathy, a weakening of the heart muscle that develops during pregnancy, accounting for 23 percent of late postpartum deaths.

To catch any heart-related condition during pregnancy, it’s important to see your doctor regularly, and discuss your medical history before becoming pregnant. In addition, ACOG is now recommending that all women are evaluated for cardiovascular disease both during pregnancy and after. If you are diagnosed with a heart condition, you and your doctor should be monitoring it closely before and during pregnancy.

Many women with heart conditions go on to have healthy babies, but pregnancy can exacerbate some of these issues and lead to complications. Some possible heart-related conditions that may be affected by pregnancy include:

More severe heart problems could pose potentially life-threatening risks to pregnant women, such as:

If you’re affected by one of these serious conditions, you should be evaluated by your doctor so they can determine if it is safe for you to become pregnant. Then, they can advise you about all of your family planning options.

Ways to protect your heart

There are things you can do to reduce your risk for preventable heart-related problems and help control any existing health issues. Taking the following steps can help ensure that your ticker stays strong for nine months and beyond:

  1. Plan ahead. Any heart condition that you have should be under control before getting pregnant. “Women who have known heart conditions should consult with their doctors prior to planning pregnancy to make sure their body is able to undergo the changes involved with pregnancy,” Pizarro says. All medications they are taking will also need to be reviewed to make sure they are safe during pregnancy, she adds.
    No matter what your heart condition, talk with your doctor as soon as you decide you’re ready to start a family. Certain medication adjustments or other health provisions can be made ahead of time, to ensure your body is ready to carry a baby. And if you have heart disease, ACOG recommends you see a cardiologist before trying to conceive so you can receive pre-pregnancy counseling.  If you do get pregnant and haven’t discussed your health conditions or treatment options, notify your OBGYN as soon as possible.
  2. Listen to your body: Increased hormone levels and a faster pumping heart can certainly make you feel more tired during pregnancy—especially in the first trimester as the placenta is forming and vital organs are developing. Take naps or lay down when you’re feeling drained or exhausted. Taking breaks may help reduce your risk for pregnancy-related complications, like preeclampsia.
    “Rest helps to maintain normal bodily functions in addition to the extra work pregnancy puts on the body,” says Pizarro.
  3. Prioritize sleep: It’s a good idea to improve your sleep quality by sticking to a consistent sleep schedule. If possible, sleep on your left side. This will help take pressure off major blood vessels and will also improve placental blood flow.
    Anxiety, excitement, back pain, frequent trips to the bathroom and heartburn can all make it difficult to get enough sleep while pregnant. If you’re having trouble sleeping at night, talk with your doctor about some safe lifestyle adjustments that could help, such as sleeping with a body pillow or limiting beverages before bedtime.
  4. Maintain a healthy weight: Nausea and fatigue can make it harder to stick to a healthy diet during pregnancy (especially in the first trimester). But it’s important that you maintain a healthy weight throughout pregnancy. The Institute of Medicine created specific guidelines when it comes to weight gain during pregnancy, so you should talk to your doctor about what is right for you. Most women should gain between 11 and 40 pounds, depending on their pre-pregnancy weight.
    Staying within these parameters not only helps prevent gestational diabetes and helps with proper fetal growth, but also lowers your risk of conditions like hypertension and preeclampsia.
    Try adopting a diet rich in nutrients and keep exercising regularly (as long as your doctor has cleared you to workout). Talk to your doctor if you have questions about weight gain—or loss. They should discuss specifics with you, like the types of exercises you should include in your routine, how often you should do them and at what intensity level.
  5. Keep all of your perinatal appointments: Of course, one of the most important aspects of a healthy pregnancy is consistently connecting with your OBGYN. “Make sure you’re open and honest with your provider,” says Pizarro. “Keep them updated about changes you notice with your body or any concerns you have.” Doing so will allow them to address any concerns right away, so that you stay healthy during pregnancy and beyond.

Your heart plays a major role during pregnancy, and managing any heart issues prior to pregnancy, regularly checking-in with your doctor and practicing heart-healthy habits can help keep your ticker strong when you’re expecting.

Sourcing: American Heart Association, Merck Manuals, Cleveland Clinic, U.S.. National Library of Medicine, Northwestern Medicine, American College of Obstetricians and Gynecologists, CDC, American Pregnancy Association

Back to Heart Health

If you sometimes feel like your heart “skips a beat”—even when you’re simply drifting off to sleep—it may seem like cause for alarm. The truth is, your heart isn’t really missing a beat. In fact, that sensation, also known as a heart palpitation, is actually an extra beat. While that sounds ominous, it’s usually harmless.

“There is a normal heartbeat, an extra beat and then a slight pause followed by a stronger-than-normal beat,” explains Nelson A. Prager, MD, a cardiologist at The Medical Center of Aurora in Aurora, Colorado.

Understanding why this happens, when you should see your doctor and how you can manage bothersome palpitations can help you feel more at ease.

How the heart “skips a beat”

A “skipped beat” occurs when your heart’s normal steady rhythm is disrupted by an early, extra beat. If this early beat arises from the heart’s upper chambers (atria), it’s known as a premature atrial contraction (PAC). If it originates in the heart’s lower chambers (ventricles), it’s called a premature ventricular contraction (PVC).

Normally, the heart’s chambers fill with blood before each beat. But an extra beat can occur if an abnormal electrical signal triggers an early contraction when the chambers are not yet full, resulting in less blood flow to the body. After this early contraction, the heart’s chambers rest a bit longer than usual before resuming a normal rhythm. During this brief pause, the heart fills with more blood, giving the next beat extra oomph, Dr. Prager notes.

“It is spontaneous electrical activity,” he says. “It can feel like a fluttering in your chest.” For some people, heart palpitations just make them feel uneasy. In more extreme cases, they could make it seem like your heart is flip-flopping or pounding in your chest or neck.

Signs of a more serious issue

While palpitations may be uncomfortable, they’re common and usually not harmful, Prager advises.

People of all ages may be affected. Certain lifestyle factors that produce an adrenaline rush, however, could increase your risk. Things like fatigue, caffeine, alcohol, stress and exercise, for example, can all cause levels of this hormone to rise, resulting in PVCs. Using illegal drugs or taking certain medications, such as decongestants and antihistamines, may have the same effect. Being dehydrated or skipping meals, which can lead to low blood sugar, can also lead to palpitations.

When it comes to PVCs, in particular, whether or not these “skipped beats” are cause for concern depend on their frequency and the severity of your symptoms.

Palpitations that happen only once in a while are usually nothing to worry about—unless you feel dizzy, faint or short of breath when they occur. But if you’re experiencing them very often throughout the day, or in quick succession, it’s a good idea to visit your primary care physician (PCP).

PVCs that persist or occur very often may be linked to heart disease, heart failure, high blood pressure or a weak or injured heart muscle. They may also be associated with low blood levels of certain electrolytes, including potassium or magnesium.

If PVCs happen very frequently, or one right after another, they could also result in a serious type of arrhythmia, or abnormal heartbeat, known as ventricular fibrillation (VFib).

“Frequent PVCs occurring with heart disease can lead to dangerous heart rhythms and even sudden cardiac death, but this is very rare,” Prager says.

How PVCs are detected

If you are experiencing consistent or prolonged heart palpitations, or if you’re having PVCs and you’ve had a heart attack or have a structural heart abnormality or heart disease, visit your PCP. You should also see your healthcare provider right away if you have serious symptoms, including chest pain, lightheadedness or sudden shortness of breath, particularly if these symptoms worsen over time.

PVCs can be hard to detect during an exam but there are certain tools and tests your doctor can use to search for clues that can help determine what’s causing your symptoms.

By listening to your heart and conducting a thorough medical history and physical exam, your doctor may be able to hear a murmur or other signs of a possible heart valve problem. Your PCP may also order blood tests to rule out an underlying condition that may be causing your palpitations, such as a thyroid or electrolyte imbalance or anemia. Your PCP may also refer you to a heart specialist who will order additional tests to make sure your heart is healthy.

PVCs often are discovered during an electrocardiogram (EKG or ECG), a test that measures the heart’s electrical activity. During this test, electrodes are placed on your chest, arms and legs to record your heart’s electrical signals.

If your PVCs occur randomly or infrequently, however, an EKG may not detect them. In this case, your doctor may ask you to wear a portable monitor, such as a Holter monitor, which can help detect any abnormal heartbeats over a longer period of time. Among people with no known heart disease, PVCs are picked up in 1 percent of EKGs, while Holter monitors note occasional PVCs in up to 80 percent of healthy people.

In some cases, an exercise stress test may be used to record your heart’s electrical activity while you walk on a treadmill. It can help determine if your PVCs are triggered by physical activity.

Considering treatment options

Most of the time, there is no underlying disease causing PVCs, and they will simply go away on their own, according to Prager. “Many individuals are comforted to know that these extra beats aren’t harmful,” he says. “This reassurance can be enough.”

For some people, however, these palpitations and the symptoms they cause may be bothersome enough to warrant treatment, he adds.

This may be as simple as making some adjustments to your lifestyle habits, such as drinking plenty of water, getting enough sleep, eating regular meals, limiting alcohol and caffeine, not smoking, avoiding decongestants and antihistamines and taking steps to reduce your stress level. It may be impossible to avoid stress entirely, but finding new coping strategies could help, such as incorporating meditation, deep breathing or another relaxation technique into your daily routine.

If PVCs happen often enough to reduce your heart’s pumping ability and you feel weak, dizzy or faint, the left side of your heart may be working harder to pump the same amount of blood. This is called left ventricular dysfunction, and it is reversible.

Similarly, if your PVCs are caused by an underlying disease, disorder or structural abnormality of your heart, treating that problem may resolve it.

Aside from making certain lifestyle changes, treatment for problematic PVCs may include:

Medication: Beta blockers, which are often prescribed to treat high blood pressure, block the effects of adrenaline on the heart, which can reduce PVCs. “We try these first,” Prager says. “We start with a low dose and can increase it if we need to.”

Other drug options include calcium channel blockers, which are another type of blood pressure medication that can decrease abnormal heart rhythms.

All drugs have side effects so it’s important to weigh any benefits with the risks when treating PVCs, Prager notes. For example, beta blockers may cause dizziness, weakness, drowsiness or fatigue. Calcium channel blockers can lead to weight gain, swelling in the lower legs, feet or ankles or dizziness. “The balance may be in favor of taking medications if PVCs make you feel terrible,” he says.

Procedures: For some people with PVCs who don’t respond to more potent drugs or can’t tolerate them, ablation may be an option. During this minimally invasive procedure, a surgeon burns off tissue in the area of the heart from which the extra beat is coming. Ablation isn’t always an effective treatment for PVCs, but when it is, it’s a cure, Prager notes.

Surgery: Those with PVCs associated with heart disease may need to undergo angioplasty or bypass surgery to restore blood flow to the heart. During angioplasty, a balloon-tipped catheter is inserted into a blocked heart artery to widen it and boost blood flow. Bypass surgery, on the other hand, is an open procedure that involves taking arteries from other parts of your body and using them to reroute the blood around the clogged artery to supply blood flow to your heart.

If you’re experiencing frequent or severe palpitations, it’s important discuss the risks and benefits of your treatment options with your doctor and determine what is best for you.

Sourcing: Heart Rhythm Society, May Clinic, Harvard Medical School, UpToDate, American Heart Association, May Clinic

Back to Heart Health

The image is a familiar one—a man hunched over, clutching his chest in pain. It’s the universal symbol for a heart attack. This chest pain, along with shortness of breath and pain radiating down the arm, are often considered the standard symptoms of a major cardiac event.

But there are more subtle symptoms of heart disease—a condition that includes heart attack, stroke and congestive heart failure.

Here’s everything you need to know about the six lesser-known signs and symptoms.

Sleep apnea
While obstructive sleep apnea, which almost always causes loud snoring, is not a symptom of heart disease, it isn’t just a noisy habit that can keep your partner up at night either, says cardiologist Suman Kuppahally, MD, of Good Samaritan Hospital in San Jose, California. Whether it’s moderate or severe, it may damage your heart as you struggle to breathe while sleeping.

“Sleep apnea causes a drop in oxygen in the blood several times during the night and that causes stress to the body,” Dr. Kuppahally says. “If left untreated, it can lead to cardiovascular problems such as high blood pressure, arrhythmias, heart attack and heart failure.”

If you snore, Kuppahally suggests consulting a sleep specialist right away to begin treatment.

1. Dizziness
Dizziness or lightheadedness may indicate that your brain isn’t getting enough blood, says Kuppahally, especially in women, who often have atypical symptomsof heart problems. Dizziness could indicate an arrhythmia (abnormal heartbeat), heart damage or heart valve problem like aortic stenosis.

If you’re experiencing dizziness along with other heart symptoms, get to the emergency room as quickly as possible.

2. Sweating
A good workout isn’t the only thing that can cause you to break a sweat. If you start sweating suddenly—what’s often described as a “cold sweat”—while experiencing other symptoms, it could mean you’re having a heart attack.

“Sweating more than usual, without exertion, is a sign of stress to the body,” says Kuppahally. “If sweating is associated with discomfort in the chest, arm, neck or jaw or with shortness of breath, it should be taken seriously as a sign of coronary artery disease,” and you should get to the hospital immediately..

3. Fatigue or exhaustion
Most of us can feel worn out after a long day of dealing with work, kids and a mile-long to-do list. However, extreme, unexplained fatigue—the kind that leaves you too beat to climb a short flight of stairs or carry your groceries—could also be a warning sign of something more serious, like a heart attack or heart disease, especially in women.

One study published in the journal Circulation found that more than 70 percent of women experience unusual fatigue in the month leading up to their heart attacks. Some women ignored it as a symptom of a serious heart problem. And women who tried repeatedly to seek medical care often had this symptom misdiagnosed or dismissed by their physicians.

4. Erectile dysfunction
Heart disease and erectile dysfunction (ED)may both be caused by poor circulation, but problems in the bedroom usually occur first. This means that ED could be alerting you to current or future heart disease.

“ED and heart attack are both caused by plaque build-up in the arteries,” says Kuppahally. “Also, there’s a high prevalence of cardiovascular disease in patients with ED. And patients with heart failure or coronary artery disease frequently have other medical problems, such as diabetes and hypertension, which can cause ED.”

5. Tooth loss
Tooth loss can be a sign of poor oral hygiene, but it may also signal a heart problem. A 2018 study presented at an American Heart Association meeting suggests middle-aged adults (ages 45 to 69) who experience tooth loss might have a higher risk for coronary heart disease.

Participants who lost two or more teeth during the eight-year follow-up were at 16 percent greater risk of developing heart disease than those with no tooth loss. The connection between heart disease and tooth loss is not entirely clear, but research suggests inflammation may play a role in both. Tooth loss may not be cause for immediate concern, but it’s a good opportunity to speak with a healthcare provider about ways to reduce your heart disease risk.

Other unusual signs and symptoms
Kuppahally also advises her patients to be on the lookout for a few other unfamiliar symptoms of heart disease:

To keep your heart in tip-top shape, stick with a healthy diet, get daily exercise, keep stress levels low and get adequate sleep.

Sourcing: UpToDate, American Heart Association, Mayo Clinic, Harvard Medical School, Heart Rhythm Society

Back to Heart Health

Are you a vacation slacker, someone who for one reason or another leaves precious, unused personal time on the table at the end of the year?

If you are, and you think you’re an outlier—think again. A May 2018 survey of 1,200 full-time U.S. employees found that 53 percent of those polled failed to use all of their paid vacation time the year before. In fact, 21 percent of the respondents still had more than five vacation days left by year’s end.

A large 2017 online survey of more than 2,200 adults from the online career website Glassdoor also found that, on average, employees who get paid time off as a job-related benefit are only using slightly more than half of these days.

These surveys also provide some clues that could help explain why some employees forfeit a good percentage of their vacation time. Researchers found that many people worry about falling behind or work piling up while they are away. What they may not realize, however, is that not taking vacations could be affecting their health.

Time off is linked to a slew of benefits, including better sleep and improved mental health. There’s also mounting evidence that getting away can help protect your heart.

Vacations linked to heart-health

Time off could help reduce the risk for metabolic syndrome, a cluster of health woes—including high blood pressure, high blood sugar, excess belly fat and abnormal cholesterol or triglyceride levels—that raise the risk for heart disease, stroke and type 2 diabetes.

In a small study published in June 2019 in Psychology and Health, researchers examined the health and vacation habits of more than 60 full time workers (mostly women) who received paid time off. Over the course of a year, the participants used about two weeks of their vacation time. The researchers found that those who vacationed more frequently were less likely to meet the criteria for a diagnosis of metabolic syndrome. Notably, the risk went down by a quarter with each additional vacation taken.

It’s important to note that this was a retrospective study that looked backwards to assess the workers’ risk for metabolic syndrome. Larger, prospective studies—which monitor outcomes as they occur over time—are needed.

These findings do, however, build on one of the most well-known studies on the subject, the Multiple Risk Factor Intervention trial, published in Psychosomatic Medicine in 2000. The study followed more than 12,000 middle-aged men at high risk for heart disease for nine years and found that those who took more yearly vacations were less likely to die from any cause, including heart attacks and other heart problems.

Observational studies like these don’t show a clear cause-and-effect relationship. What they demonstrate are associations, explains Jorge Montilla, MD, a cardiologist at Kendall Regional Medical Center in Miami, Florida. Meanwhile, there could be more to the picture than just the vacation, he points out. It’s possible that people who are able to get away regularly are more financially stable or have good overall job security and satisfaction, which may be associated with other heart-healthy lifestyle choices.

One thing is clear, Montilla notes: taking time off helps relieve stress, which has a correlation with heart disease.

How stress affects the heart

Stress raises levels of certain hormones, such as cortisol and adrenaline. In the short term, this can be helpful, triggering the “fight or flight” response that helps you deal with immediate threats. Over time, however, chronic stress could increase your risk for a slew of health issues, including heart disease.

In fact, repeated stress can lead to episodes of high blood pressure, elevated heart rate and irregular heart rhythms. You might also lose sleep or be tempted to overeat, smoke or drink alcohol in a misguided attempt to de-stress. Those who respond to stress in such unhealthy ways may be increasing their risk for heart problems.

Get away from it all, really

People often worry about how a vacation may affect their workplace or their job status. You may, for example, be concerned that your absence will be too much of a burden on your coworkers or that it could reduce your likelihood of getting promoted. But you shouldn’t look at taking a vacation as an indulgence or something to feel guilty about doing. Instead, view time off as well-deserved and something positive that you’re doing for your health, Montilla advises.

When you do leave the office for a getaway, it’s important to actually unplug to make the most of your vacation—something many people don’t do. The Glassdoor survey found that:

Counterintuitively, taking time off may actually increase your productivity at work. Research has shown that workers expend less effort on routine tasks after their vacation than they did before.

So, how do you leave work behind and effectively de-stress when you’re on vacation? Consider these helpful strategies:

Plan your next vacation: The simple act of planning your next trip can make you smile. A study published in the journal Applied Research in Quality of Life in 2010 found that “vacation anticipation” boosted happiness in the weeks before the trip.

Sourcing: American Psychological Association, Harvard Medical School, American Heart Association, Journal of Applied Psychology, Cleveland Clinic

Back to Heart Health

According to the Centers for Disease Control and Prevention (CDC), over 84 million people have prediabetes, and 9 out of 10 of them don’t know it. What’s more, many people with prediabetes will eventually go on to develop type 2 diabetes within five years.

Prediabetes is a condition in which your blood sugar levels are higher than normal, but not high enough to be considered type 2 diabetes. When a person has type 2, once known as adult-onset diabetes, their body may be able to produce some insulin on its own, but the cells aren’t able to use it effectively enough to manage the amount of glucose, or sugar, in the blood—also called insulin resistance. Doctors and researchers can’t say for sure what causes type 2 diabetes, but genetics, lifestyle and health issues such as being overweight all seem to play a role.

While prediabetes may not sound off any alarms, it does need to be taken seriously. Once type 2 diabetes develops, it takes a great deal of effort to keep it under control, and without proper management, it can lead to a host of health problems including nerve damage, kidney disease and loss of vision. It also increases your risk for heart attack and stroke.

Luckily, having prediabetes doesn’t mean that type 2 diabetes is inevitable. We talked with Jessica Crandall, RDN, CDE, Wellness Center Director of Denver Wellness and Nutrition in Colorado, and Ashley Guild, MD, of the Tristar Medical Group in Hermitage, Tennessee, for ways to reverse your risk and get your health back on track.

1. Take inventory of your diet.
“Nutrition is an investment in your health long-term,” says Crandall, “not only for your energy levels today, but for preventing disease in the future.”

If you’ve been diagnosed with prediabetes, take stock of your pantry and fridge and remove things that contain unhealthy added sugars, such as flavored yogurt, sweetened cereals and sugary drinks. “All those added sugars increase the risk for additional weight gain, and that correlates with diabetes,” says Crandall.

Replace them with nutrient-dense foods such as fruits and vegetables, high-fiber whole grains, lean protein and non-fat dairy. Also, prepare snacks that combine high-fiber carbs and protein, such as whole grain crackers and cottage cheese or string cheese and low-sodium deli meat. This helps slow down sugar absorption for better blood sugar control.

When it comes to carbs, watch how much you eat, as eating too much can cause your blood sugar to spike. “Carbohydrates give us energy, but I always say it’s like the three bears,” says Crandall. “You don’t want too little and you don’t want too much.” How much is the right amount? “It depends on weight and activity, but most women are at around 30 to 45 grams of carbs per meal and 45-60 grams per meal for men.”

One handy way to help keep track of carb intake? “Half of your plate should be covered with vegetables,” says Crandall. “Then a quarter of your plate can be protein and a quarter can be carbohydrates.”

2. Keep an eye on the scale.
Exercising and maintaining a healthy weight are critical to reversing your risk for type 2 diabetes.In fact, according to Dr. Guild, losing just 5 to 10 percent of your body weight can help slow or stop the progression of the disease. Exercise also helps increase your body’s sensitivity to insulin, making you better able to regulate your blood sugar.

If you do need to shed some pounds, Crandall suggests finding small ways to work in activity throughout the day, such as taking a 10-minute walk after lunch or dinner. “Those additional minutes of activity add up,” she says.

3. Check your blood sugar and write it down.
Checking your blood sugar regularly isn’t absolutely necessary, says Guild, but doing so could help you identify which foods tend to drive it up. Keeping blood sugar steady is one important piece of the puzzle when it comes to managing prediabetes.

“It might be helpful in the beginning to keep a food diary and record the foods you eat and your corresponding blood sugars,” says Guild. To do so you’ll need to get a glucose meter, then follow these steps from the American Diabetes Association to be sure your readings are accurate.

Guild suggests checking your numbers in the morning before eating breakfast, two hours after each meal and right before bedtime.

4. Cut back on alcohol and steer clear of smoking.
While a glass of wine every now and then isn’t off limits, it is a good idea to cut back if you imbibe on a regular basis. Not only can alcohol contribute to weight gain and increase the risk of diabetes, it also makes blood sugar harder to control. Stick to no more than one drink per day if you’re a woman, two per day if you’re a man.

As for smoking, we know that it’s bad news for anyone, but especially so for those with prediabetes. According to the CDC, smokers are 30 to 40 percent more likely to develop type 2 diabetes, and lighting up also contributes to insulin resistance.

5. Keep stress in check.
The daily demands of living can drive up anyone’s stress levels, at least temporarily. But living in a state of high anxiety most of the time encourages the production of “fight or flight” hormones that increase glucose levels. People who are chronically stressed are also less likely to eat healthy, exercise and get enough rest.

If you’re tense most of the time, find ways to relax and calm down for the sake of your health. Meditation, breathing exercises, yoga and other forms physical activity can all help.

6. Talk to a diabetes educator.
In addition to your primary care physician, working with a certified diabetes educator (CDE)—check to make sure your insurance covers one—is a great way to be proactive about diabetes prevention. Your diabetes educator can help you better understand the lifestyle changes you need to make to reverse your risk, as well as help you to develop easy-to-follow self-management plans.

“I always tell my clients, you can be in the driver’s seat and prevent the progression of the disease, or you can choose to be the passenger and let the disease take over,” Crandall says. “It’s really up to you, from nutrition, exercise, behavior and working with your team of healthcare professionals.”

Sourcing: CDC, American Diabetes Association

Back to Diabetes

NOT-SO-FRIENDLY FOODS

Certain foods can send your blood sugar level on a roller coaster, with insulin rushing to keep up. The good news is, while there are some surprises, most of these foods fall under the same category: processed food, such as white flour and sugar. “Refined flours and sugar cause huge spikes in insulin and get absorbed quickly, which causes problems,” says Mark Hyman, author of The Blood Sugar Solution (Little, Brown and Company). Look at the whole meal instead of just individual ingredients, adds Jackie Mills, MS, RD. Pairing carbohydrates with protein, fat or fiber helps slow down the absorption process. Watch out for these 10 blood-sugar saboteurs.

WHITE RICE

White rice is a whole rice grain that has been polished until just the endosperm—essentially an easily digestible starch bombs— left. Not surprisingly, recent studies have shown that eating white rice can raise blood glucose significantly, especially if eaten often or in large quantities. One study showed an 11 percent increase in diabetes risk with each daily serving of white rice. If you love rice with your stir-fries, switch to brown rice. Your blood sugar will thank you.

POTATOES

Potatoes may be a whole, natural root veggie, but they’re also notorious for causing blood sugar to spike because they’re digested into the bloodstream quickly. To mitigate this negative effect, cook potatoes with a healthy fat, such as olive oil, and bump up the fiber by adding hearty leafy greens or another vegetable to the mix. Or, make potato salad with plenty of lemon juice and chill it in the fridge. The acid and cold alter the starch molecules in the spuds to slow digestion.

KETCHUP

We tend to think of ketchup as a salty condiment, but many brands list some sort of sweetener as the second ingredient, which can have a disastrous effect on your blood sugar level. “It doesn’t matter if it’s called sugar, evaporated cane juice, high fructose corn syrup, or malt syrup,” Mills says. “They’re all sugar, and all of them will elevate blood glucose.”

WHITE PASTA

White pasta is made from refined white flour, which is an easily digestible starch. That raises your blood sugar level. It also tends to provoke overeating because it’s quickly digested, so you want to eat again, according to Amy Jamieson-Petonic, RD, spokesperson for the Academy of Nutrition and Dietetics and director of coaching at Cleveland Clinic. As if that’s not bad enough, overcooking the pasta worsens the blood sugar impact.

BAGELS

Back during the low-fat diet craze, bagels were darlings because of their “no-fat/low-fat” label, but that’s one of the very reasons they wreak such havoc on blood sugar. “Refined flours cause huge spikes in insulin and get absorbed quickly, which causes problems,” Hyman says. If you must get your bagel fix, pair it with a smear of avocado, which is loaded with healthy unsaturated fat, and a few slices of smoked salmon (a great source of both protein and omega-3 fatty acids) to help slow down digestion and regulate your blood sugar. You get extra points if you have a whole-grain bagel.

ARTIFICIAL SWEETENERS

Many people think artificial sweeteners are harmless additives and a good choice if you have diabetes. Not so, Hyman says. “Artificial sweeteners slow metabolism and increase fat deposition, and can increase the risk of diabetes by 67 percent.” If you need to satisfy a sweet tooth, Mills says, you’re better off enjoying foods made with real sweeteners on occasion and in moderation.

FRUIT JUICE

“If your blood sugar is extremely low and you need to bring it up quickly, juice is your thing,” Jamieson-Petonic says. But that’s not an effect you want when you’re looking to keep your blood sugar level the rest of the time. “The concentration of carbohydrates is very high and tends to cause severe spikes and drops,” she adds. Keep fruit juice on hand to counteract hypoglycemia (low blood sugar), but make water your go-to beverage as part of your everyday diabetes diet.

ENERGY BARS

Because of all the added sugar, “some energy bars may as well be labeled candy bars,” Mills says. Indeed, a single bar can carry a glycemic load over 49 (anything over 20 is considered “high”). That’s more than a king-size Snickers bar! Bars made from refined flours and sugars are the worst culprits, since these have the harshest impact on blood sugar. If you like the convenience of energy bars, read labels carefully and choose bars made with nuts, whole grains and few added natural sweeteners. Don’t forget to account for the carbs in your daily tally.

LOW-FAT SWEETENED YOGURT

It’s obvious that low-fat yogurt has had fat removed, and that seems like a good choice if you have diabetes. While low-fat yogurt has a (small) positive impact on calorie count, it’s not so great for your blood sugar. Manufacturers compensate for that loss of fat by adding stabilizers, thickeners and sugars that can have a detrimental impact on blood glucose. A better approach is to skip the fruit-flavored yogurt and choose plain yogurt sweetened with real, whole fruit.

SPORTS DRINKS AND ENERGY DRINKS

Energy drinks and sports drinks carry all the woes of fruit juice with the added no-no of more sugars. “They’re basically lots of sugar and very low nutrition,” Jamieson-Petonic warns. If you’re trying to stabilize blood sugar, steer clear of energy drinks and sports drinks. Go for water flavored with a spritz of citrus instead.

Sourcing: American Diabetes Association, National Institutes of Health, CDC

Back to Diabetes