Dr. Kevin Billups – PEARLS and Responses to Questions
December 15, 2015
If you missed the last Colorado Black Health Forum of the year in November 2015, you missed a treat. We started our quest in 2015 to be the healthiest Black folks in the nation. To get us there we need to know about all the things that can contribute to poor health. We also wanted to provide a take home holiday message about something that might not be as well known in our community. The learning session was kicked off by some great role playing by the “CBHC Players”. Their skit set the tone and Dr. Billups, our keynote speaker, said they covered it all! We had a wonderful day and we can’t give you all the happenings. However, we will give you a brief recap based on Dr. Billups presentation and his answers to questions in the Xalter Newsletters published by Ms. Pamela Jenkins earlier this year.
Dr. Kevin L. Billups is an Associate Professor of Urology and Medicine, The Johns Hopkins School of Medicine and Founder and Director of the Johns Hopkins Men’s Health & Vitality Program. He has a passion for educating the community about issues that significantly impact our health, especially among Black men. In the Pearls and Questions section, you will see that Erectile Dysfunction
(ED), difficulty getting or keeping a firm erection sufficient enough to permit satisfactory sexual intercourse, is more than just a man’s problem!
“In general, men take better care of their cars than themselves”
Dr. Kevin Billups
PEARL:
If a man is between ages 40-49 and has ED, he has about a 50-fold increased incidence of having a heart attack, stroke, or major event within the next 10 years compared to a guy who doesn’t have ED. If a man is between the ages of 50-59, there’s about a 20-fold increased incidence of these conditions. The men who really need this message are between the ages of 35-64. Some guys have pre-diabetes or undetected high blood pressure.
PEARL:
The penile artery is half the size of the coronary (heart arteries) so the smaller penile arteries suffer blockage from plaque earlier than the larger arteries. Therefore, ED may be apparent before a coronary event due to the smaller size of the penile arteries. ED precedes coronary artery disease in 50% of affected subjects; therefore ED indicates early heart disease
Question: Does ED just effect men over 60 and what is the youngest age a man can begin to experience ED?
Editor’s comment: Men aged 70 are 3 times more likely than men aged 40 to have ED. However, younger men do experience ED.
ED becomes more common as a man ages. I’ve seen men as young as 25 [with ED], but most of the younger men were also experiencing other medical problems like diabetes.
Question: Is ED related to lifestyle choices?
Definitely yes, 70% of men I have seen in my practice have significant lifestyle issues that are contributing to ED and overall poor health. A number of these men also lived a more sedentary lifestyle, had poor eating habits, and were overweight, stressed out and not sleeping. If we get everyone to stop smoking, moderately drink alcohol, exercise more, watch what they eat and work on better sleep habits, managing ED and other chronic disorders would be a bit easier.
PEARL:
Getting less than 6 hours of sleep can increase risk for obesity, stroke and diabetes by 20% and increases risk for [Coronary Artery Disease] CAD by 30%.
Question: We’re hearing more and more about prostate cancer, ED, Viagra, etc., is this because we’ve become more comfortable talking about it or because of the revolutionary advancement in science and health. Have these issues always been prevalent?
I think for ED, it has always been there and people are way more comfortable taking about it. ED has always been there, however because of lack of education, it went undetected.
Prostate cancer is serious for African American men. African American men still have a 60% higher incidence and 2-fold higher death rate compared to other ethnic groups in the US. We need to understand that the recommendation (from the US Preventive Services Task Force) against PSA screening does not apply to African American men. I often see African American men in their 40’s and 50’s that aren’t getting the PSA testing because their medical provider heard the test was no longer needed. But for African American men, at a minimum age 40 you should be getting this test, and earlier if your family has a history of the disease.
Question: As women, we don’t know or understand the effect these issues have on men. What are some of the cancer, erectile dysfunction and other areas men deal with?
There is a psychological [mental] component to ED, prostate cancer and other areas men deal with.
80-90% of erectile dysfunction has a medical cause. Only about 10% is purely mental: anxiety, depression, etc. In fact, depression is its own medical risk factor. Let’s take a guy who has ED, do you think that guy is not stressed? After a while he will start to avoid his wife or significant other. I try to encourage couples counseling or clinical counseling because the psychological factors are there.
Sometimes it is safe to say that it is a medical problem because that helps a lot with the men. With the lack of performance, men get more and more frustrated and that adds to their anxiety. This can make the situation even worse. Most women are very supportive; but I do have some men who come in and say that their partner is pissed. But then that poor guy now has to deal with new issues, which is the possibility of a break-up. This is why I try to get couples to come in to discuss all areas and when I can’t assist, I suggest relationship counseling.
Question: For some men does their [sexual] performance define their manhood?
Yes, because that adds to their masculinity, and their masculinity is very important. But on the flip side, some women are so supportive that their love goes beyond whether or not he can perform. In some cases, they will discover other ways to please their wives or significant other. They find other ways to adapt. With older men, say 65 and older, they come in knowing they have other medical problems, but even they want to know if the problem can be fixed. They want that because they still want to please their wives.
PEARL:
High blood pressure, diabetes, and heart disease may affect the vitality of men
The Big Three: high blood pressure, diabetes and heart disease, are major chronic illnesses which can
cause premature death and suffering among men. Erectile dysfunction can occur years before you get
diagnosed with any of those three. So if you come in while there are signs of ED, this can be an early marker signaling me to take a closer look. I can get to you before the heart attack or if you are pre-diabetic, I can get to you before other health issues could increase.
PEARL:
I think people underestimate the importance of sexual health in our society. The whole theory or driving force behind my practice is that it is an important drive for men and women, which is why we look at the whole person: the emotional side, physical side, psychological side, etc. People come in and admit how devastating it is and so we try to deal with the whole person to get them the help they need. I even ask men if their wives are having any problems too because sometimes it’s not always the men. I focus on men’s health, however if we find out that the woman has a problem, then I refer them to an expert.
If you have any other questions or comments please send us a message @ [email protected].