A Men's Health Doctor on the Symptoms That Are Easy to Dismiss and Dangerous to Ignore

Edward Karpman, M.D., medical director of men’s health at El Camino Health, has spent decades watching men walk into his office focused on one thing while missing a much bigger picture. His message is direct: The symptoms most men dismiss or feel embarrassed to bring up are often the ones that matter most.

Karpman starts with erectile dysfunction (ED). For years, ED was treated as a stand-alone issue, something to address with a prescription and move on from. That changed in the early 2000s, when clinicians began noticing that men who had been prescribed Viagra were returning years later with their first cardiac events. The realization was significant: ED was not just an inconvenient problem. It was a symptom of cardiovascular disease. The blood vessels that supply the heart and the blood vessels that enable erections are affected by the same underlying pathology, and in many cases, the erectile symptoms appear first. Today, Karpman’s approach is clear. When a patient comes in asking for a prescription, he gives them the prescription and sends them to a cardiologist.

The second commonly overlooked symptom is snoring. Most men either do not know they snore or have convinced themselves that it is harmless. Karpman disagrees. Snoring is a significant indicator of sleep apnea, a condition that for decades went largely unrecognized and untreated. In his residency 25 years ago, sleep studies were virtually nonexistent, and patients with classic sleep apnea symptoms like frequent nighttime urination were treated with medications and surgeries that never addressed the root cause. Today, the evidence is clear: Untreated sleep apnea is associated with arrhythmia, stroke, and hypertension, making it a cardiovascular concern as much as a sleep one.

When it comes to screening, Karpman outlines three essential areas. For prostate cancer, the American Urological Association recommends annual PSA testing, with screening starting at 45 for African American men and those with a first-degree relative who has had prostate cancer. For cardiovascular disease, annual cholesterol and blood pressure checks are foundational, with EKGs and stress tests available for deeper evaluation. For diabetes, hemoglobin A1c testing offers a three-month average snapshot of blood sugar that is far more revealing than a single fasting glucose test, and continuous glucose monitors now available over the counter are helping patients identify patterns on their own.

The model at El Camino Health puts urology, cardiology and sleep medicine under one roof, bringing specialists to the patient rather than the other way around. He estimates that those three specialties address 90% to 95% of the health problems men will encounter as they age, and having fast, coordinated access to all three, he argues, can make all the difference.