Many men put pressure on themselves to hold things together and provide. Their perceived duty as a male is to support the ones they care about in every way, be it financially, physically, or mentally. 

And yet, when it comes to taking care of their own health, it’s common for men to ignore themselves completely. But by putting their health aside, men are in greater danger of succumbing to a multitude of dangerous ailments. 

The pressing question for loved ones and healthcare providers all over the world is simple: Why are so many men so stubborn about going to the doctor? 

We at The Fem Word relate to this topic all too well. Co-founder Monika Samtani shared the story of her father, Dr. Vijay M. Varma, a world renowned Thyroid Nuclear Endocrinology physician. Although he took care of patients for over 50 years until he retired in 2019, he chose to ignore the severe arthritis he developed in his own body: 

“At one point, his range of motion was impacted enough that he could barely move either of his arms,” Monika says. But, rather than treating his arthritis, her father took up a “grin and bear it” attitude, and slowly adapted to the pain rather than seeking treatment for the cause. It wasn’t until Monika and her mother insisted that he go to Physical Therapy…and he finally relented. 

Dr. Varma’s tale is all too common and accurately reflects a statistic reported by tricitymed.org. According to consistently validated research, 20% of men will only see a doctor after being coerced by a loved one to do so. 

This holds true even in cases of severe pain and suffering, or in instances like Dr. Varma’s, where the man’s mobility and quality of life are deeply affected by his illness. It seems irrational, and it goes against every natural instinct a person should have when it comes to treating pain and seeking care for themselves. 

So, why do we see this phenomenon happening on such a huge scale?

A TOXIC TREND WITH DEEP CULTURAL ROOTS

It’s easy to blame toxic masculinity for this phenomenon. And while that’s somewhat true, the full situation tends to be much more complex. 

Right from the start, it’s not uncommon to see that men are raised with the expectation that they will uphold particular “masculine” standards dictated by society. They are discouraged from seeking outside help because doing so is perceived as a display of weakness. A study conducted by the American Journal of Men’s Health (Am J Men’s Health) concluded that “from an early age, men receive direct and indirect messages about how they should think, feel, and behave… Avoiding doctors specifically is something that men not only encourage other men to do directly but also indirectly because it demonstrates how tough they are,” (emphasis mine). 

Patrick Wenning, a Physical Therapist at Restore Motion, weighs in on the subject saying that “men seem to think that they can either take care of themselves or that medical problems will go away. I also think that they find navigating the medical field frustrating. And when a man gets frustrated, a typical reaction is to get mad and then to shut down.” Wenning makes a good point that society expects men to be self-sufficient. 

Generally, women are taught that it’s okay to cry and express emotions, while men are expected to remain stoic and calm at all times. Vulnerability means a man is “not really a man,” and he’s at risk of ridicule, judgment, and rejection from other men and women. By growing up with the idea that showing any form of weakness is inherently bad, men learn to ignore their health for the sake of remaining “manly.” 

The pressure only builds as men grow older and take on more responsibilities, particularly those pertaining to family finances. The same Am J Men’s Health study goes on to say that married men with families consider going to the doctor selfish because by taking time off to visit a doctor, they are “taking money away” from their family. Men “choose to put family financial needs above their own health concerns” in order to uphold their role of breadwinner. 

The high cost of seeing a doctor under the American healthcare system, be it a General Practitioner or a mental health professional, is another factor that men cite as a reason to avoid getting help. For example, some healthcare professionals don’t accept private health insurance, and if out-of-network insurance isn’t accepted medical procedures can be very costly. There are practices that take out-of-network insurance or offer payment plans, but doing this research is time-consuming and it’s easy to give up. These are valid reasons why any person would avoid going to the doctor, but it’s especially demotivating for a man whose main concern is keeping their family’s finances afloat. 

It sounds simpler to tough something out rather than taking the time and money to go to a doctor.

THE CONSEQUENCES OF AVOIDANCE ARE KILLING MEN 

Men might think it’s no big deal to not see a doctor for little things like a cold or a mild ailment, but the broader repercussions of men’s avoidance of the doctor are genuinely life-threatening.

For example one of the most important tests for men, the yearly prostate exam, is a widely avoided appointment. 

“Fear and dread of discomfort are two of the main reasons [why men] do not get screened,” Oncology Nursing News reports. The apparent indignity of this test is so engrained in male culture that it’s been made the butt of many jokes (no pun intended), but the punchline is far from funny. By making fun of prostate exams, they aren’t taken seriously –– and thousands of men die from prostate cancer that otherwise could have been treated and eliminated. 

The Prostate Cancer Foundation states that “[p]rostate cancer…is almost 99% treatable if detected early,” which is why getting screened at the appropriate age is essential. But if men don’t feel comfortable having that conversation with their doctor, or worse, if they’re not even comfortable enough to go to the doctor to have this conversation, they put themselves at risk of dying for something that could have been avoided. 

Men need to learn to take charge of their health in spite of their fears. As a society and as loved ones, we need to empower them to take charge of their health and address those fears with compassion and understanding. Feminists have long advocated for healthier, more accepting standards when it comes to health and wellness, and this includes the promotion of an environment that not only encourages but rewards men for taking care of themselves.

 (Oh, and for the record: prostate cancer screening can also be done with a blood test, which is much less intimidating and by some accounts is less invasive than a routine rectal exam.)

A NOTE ON MENTAL HEALTHCARE

It’s worth mentioning another deadly diagnosis that men are used to avoiding: depression. By many accounts, this is also one of the deadliest illnesses men face. Suicide has consistently been one of the top ten leading causes of death for men of all ages, and it is the number two killer of men aged 20-44. These “deaths of despair” outnumber heart disease, cancer, and diabetes by a wide margin.

Mental health treatment is stigmatized because it falls under the category of “weakness” if men admit to needing it. Many men aren’t taught to even recognize their mental health needs in the first place.

Suicide isn’t the only risk, though it is arguably the most serious. When male depression goes unchecked there is a higher chance of self-medicating, and “they may turn to alcohol and other drugs as a way to numb the[ir] pain” says one healthline article. Combining depression and substance abuse devolves into a dangerous cycle that is challenging to break. 

The deeper the cycle, the harder it is to ask for help. Men, please ask for help. It doesn’t make you weak. Your loved ones desperately want you to seek assistance, no matter how vulnerable it makes you feel. Let us help you before it’s too late.

HOW TO HELP MEN BREAK THE STIGMA: FIGHT FIRE WITH FIRE

So, how do we encourage men to take care of themselves? 

It all starts with encouragement. 

Dr. Varma would not have gotten help for his arthritis if not for Monika and the rest of his family’s insistence that he do so. “Men are reluctant to open up and even talk to their friends and family,” Dr. Varma says. “They think they have to be held to a higher standard and take care of the problem themselves.” 

Monika didn’t give up on her father, and she kept pushing him to seek help; when he finally did, he quickly realized how much support came with his diagnosis and treatment. “Once you seek professional help, your life improves: and you can be better for not only yourself but for those around you.” 

Stubborn sometimes need to be met with stubborn. You can’t force a loved one to get help, but if you don’t stop trying they’ll have a harder and harder time denying the problem. 

Of course, it’s equally important to highlight compassion and understanding; men need to know that the healthcare community is a source of support and strength, not judgment. Creating a safe space for discussing physical and mental health for men starts with the ones closest to them. These loved ones are often women, but other men have a responsibility to encourage one another, too. 

Patrick Wenning was taught as a child to respect the knowledge of medical professionals, “it was always encouraged by my family and that is probably the thing that shaped my attitude for the rest of my life.” This demonstrates that talking openly to children and young adults (regardless of their sex) about medical care has a positive impact that lasts a lifetime. 

There is a long road ahead when it comes to breaking male conditioning, but changing the way men perceive healthcare shouldn’t be up to them alone. We can all do our part to shift the conversation toward a positive and open future. 

Nobody should feel ashamed to go to the doctor, regardless of their gender. We all deserve to live our healthiest lives.  

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If you’ve heard of cortisol, you probably know it as “the stress hormone.” In many ways this is an apt description of cortisol––its primary job is to regulate your body’s stress response. There’s a lot more to cortisol than that, however, and that’s what we’re going to explore today.

First, we’ll give you a rundown of what cortisol is, how it works, and why we have it in the first place. Then you’ll learn how this hormone works in the female body, specifically, and why it’s something you need to be aware of.

Finally, we’ll go over a few strategies for keeping your cortisol levels where they need to be. This actionable advice will help you in more ways than the physical ones. We’ve spoken with experts in the field of women’s health and endocrinology to make sure you get the insight and perspective you need to manage your body’s cortisol response for the long term.

Hello, Cortisol, My Name Is…

Your body is not a monolith. In fact, it’s one of the most complex systems on earth, and it’s kind of incredible that it works at all. With so many parts and pieces working in harmony, it seems like an impossible task to get through even one day without a catastrophe.

But here we are! And as it happens, a big part of our ancestors’ ability to survive was (you guessed it) cortisol. 

Most of us have heard about cortisol’s role as the stress regulator. And in a nutshell, yes, that is this hormone’s primary function. But limiting that role to our modern idea of “stress” keeps us from understanding the bigger role this chemical plays in our day-to-day lives. 

Stress to us might mean our job, kids, families, and fiscal situations. To our ancestors it meant a lot of other things. Stress wasn’t just about lions and bears, and it wasn’t always a negative thing. Stress was the sense that it was time to migrate to a new foraging ground, or to keep an extra eye on our kid because there’s something a little off about their color right now, and maybe they’re getting sick or need a certain kind of food…

It was more of a motivator, an alert-system, than a stressor. And in a sense, it still plays that role. Cortisol plays a big role in regulating our fight or flight response, but it’s also a major reason we’re able to notice certain things and filter out others. Think of it as a manager, and a bunch of specific organs and body parts look to it for guidance on what to do in a given situation.

Your cortisol levels help your body determine whether you’re in a time of plenty or famine. Your metabolism looks to it for guidance, then speeds up or slows down based on the information it gets. 

Cortisol helps your body decide which bodily functions are important and which one can be relegated to the “background” at a given time. If cortisol levels are elevated, your body decides that there are important, possibly threatening things going on––it dials down non-urgent functions like white blood cell production and blood flow to your extremities.

This is why, when cortisol becomes a micromanager, we run into problems. If you’re producing too much cortisol, everything starts to look like a stressor requiring a response. That response is all-encompassing yet subtle.

We spoke with Dr. Susan B. Hurson, an experienced OB-GYN who practices Functional Medicine located in Washington, DC. She takes a holistic approach to women’s health. She had some valuable insight on the roles cortisol plays in that health.

“At any given time cortisol levels will be determined by a given individual’s unique circumstances,” she told us. “Cortisol is a hormone with a huge role in regulating metabolism, immune function, and stress response; levels are controlled by the adrenal gland as a result of complex interactions between the hypothalamus, pituitary, and ovarian axis in response to any of many factors, such as sleep, nutrition, exercise, illness and emotional stress.”

Those factors are hard to quantify, sometimes, but the stakes are high. Our bodies are adapted for stress. Cortisol is a big part of that adaptation.

“The body is supremely capable of adapting to a changing milieu, but [it’s] particularly adept at managing short-term elevations in stress,” Dr. Hurson noted. Even so, “Prolonged chronic stress can result in impaired adrenal function and disordered hormone production which can be interpreted as ‘adrenal fatigue’ manifested by exhaustion, impaired immunity, altered metabolism and mood changes, such as feeling ‘tired and wired.’”  

Most of us haven’t really learned to pay attention to the reactions our bodies have beyond the obvious ones. This is especially true for women. In fact, we’re often told to purposely ignore our bodies’ signals. That ‘tired and wired’ feeling is important, but we’re used to ignoring it. We rarely consider the possibility that it’s genuinely worth noticing.

And guess what? Cortisol doesn’t like that. Your body doesn’t like that. Let’s talk about what, exactly, both of them do when you ignore them.

Excuse Me, But Are You Listening?––The Awkward Relationship Between Women And Cortisol

You know that feeling you get when you’re in a meeting and you introduce an idea, only to get ignored? And then the guy next to you rephrases that idea five minutes later, and everyone nods and writes it down like it’s the most original thing they’ve ever heard?

Well, cortisol is usually us in that situation, and we’re the room full of dudes.

Let me explain. Say there’s some kind of wildly inappropriate power imbalance at work. Crazy, I know. Or hey, let’s imagine a hypothetical situation where you somehow come home from work every day and proceed to spend hours doing…well, more work. Your partner and kids––not so much.

Cortisol shows up to say, “hey, this is NOT right, and your environment is super unhealthy.” Instead of listening to that voice, you say that you’re stressed. That’s it. It’s normal to be stressed! Maybe you even say that stress is a good thing! It’s silly to be anxious about “normal life stuff.” The problem is definitely you, not the people, events, and systems around you.

Cortisol says, “excuse me, are you even listening? I SAID THERE’S SOMETHING WRONG WITH THIS PICTURE.” And the cycle begins again.

There are a number of issues with women’s typical response to elevated cortisol levels, number one being the common habit of a) not knowing how our body works or why it reacts to things and b) not taking the time to actually feel our physical sensations or connect them to our mental processes (such as anxiety, frustration, irritability, etc).

In their book Burnout: The Secret To Unlocking The Stress Cycle, Drs. Emily and Amelia Nagoski talk about the way our bodies process stress on both a physical and mental level. Most of us fail to listen to our bodies. We try to reason away the stress, or treat the symptoms in short bursts without admitting that the underlying problems are much larger than that.

Dr. Hurson gave us a good summary of how high cortisol levels can impact our health. It’s a summary that’s worth reviewing. When cortisol levels are continually elevated, the results include things like:

• Seemingly inexplicable weight gain or “bloating” around the abdomen
• Mood swings, irritability, and a reduced capacity for empathy or compassion
• Higher blood pressure and an increased resting heart rate
• Insomnia, including a reduction in the quality of sleep (not just less of it)
• Consistent, noticeable fatigue
• Headaches, sometimes in the form of migraines
• Random and frequent bruising
• Reduced immune response, resulting in your getting sick more often
• Reduced ability to concentrate, even on things you normally enjoy doing
• Muscle weakness, tremors, and/or loss of coordination

There are many other calling cards that indicate elevated cortisol levels, but the principle is this: if you ignore the environmental stressors your cortisol is trying to draw your attention to, it will simply shout louder. It’s as if, rather than seething in the background, you jumped up in the middle of that meeting and started beating the people over the head with your notepad. 

Cortisol doesn’t take anyone’s excuses. Not even yours. And for most women, there’s plenty of excuses coming our way. Until you address the environmental problems and handle that instinct for change, guess what? Your cortisol will continue to shout. It’s trying to protect you and make sure you are in a healthy, reasonably secure place.

You may notice your periods stopping or changing schedule. You might get acne long after your awkward teenage phase ended, or you may notice your skin suddenly getting thinner. Your body will feel like it’s aging at an accelerated pace, and this kind of thing only adds to the tension and stress you’re feeling each day.

And for women, with our notoriously complex endocrine system, cortisol is really, really loud. So, how do we listen to it?

Okay, I’m Listening––Strategies For Addressing Cortisol’s Complaints

Keeping your cortisol levels in balance is about more than mere stress management. In fact, it might be more useful to think of the goal as self-management, or environmental management.

Now, it may not be realistic for you to quit your job, hire a nanny, and fly off to live in the Maldives. So when we say “environmental management,” we’re usually talking about more subtle changes. And yet these subtle changes are at the heart of true progress, and that progress goes beyond stress.

If cortisol is our built-in alarm system, maybe we need to start playing the role of heroic fireman rather than the damsel in distress. That heroism usually involves confrontation, whether it’s with ourselves or with the people around us. 

The usual advice for lowering cortisol levels usually sounds something like this:

• Eat better
• Exercise more
• Write in a journal
• Go outside
• Take vitamins
• Get more sleep
• Meditate
• Take deep breaths (yes, really)

These tips are fine, in and of themselves. All of these techniques are great ways to achieve some temporary relaxation.

Long-term, though? They’re like slapping a band-aid on a knife wound. If your environment causes you constant stress, the problem probably isn’t you. Did your ancestors blame themselves for a sudden lions-and-bears population boom? Did they meditate when they noticed the signs of an impending hurricane?

Considering the fact that you’re alive, and said ancestors were also alive long enough to pass on their genes, we’re going to guess that they handled the situation instead of ignoring it. If that sounds like tough love, that’s because it is! 

Over time, elevated cortisol levels can cause more than minor problems. It’s linked to a higher likelihood of cancer, heart attack, and stroke. It shortens our lifespans and eats away at our health. Women should take their stress seriously, along with all the signals their bodies are sending them about what is causing that stress.

So, our advice for managing your cortisol levels is this: be courageous. Cortisol might not be asking for much, after all. Usually our modern lions and bears aren’t really lions or bears. Or hurricanes. You don’t need to migrate, you need to set boundaries. Enforce the rights you have over your time, your labor, your emotional giving. 

And yes, if you’re in an overwhelming situation where your boundaries aren’t being respected, you may need to consider drastic action. Cortisol tells us when something is wrong. It isn’t our enemy. It’s our ally (most of the time). Even when our cortisol levels go a bit haywire due to normal menopausal changes or, disorders like anxiety, depression, or PTSD, they’re still telling us that something needs to be addressed.

These things aren’t easy, but neither was running away from a lion-infested savannah, or facing a food shortage that necessitated a big change of scenery. You don’t address stressors because it’s merely the right thing to do, or an act of self-care. You do it as a matter of survival. Only then can you benefit from stress-release tactics like cardio or mindfulness.

Next time cortisol is shouting, stop and say, “okay, I’m listening.” It might just save your life (and your career, and your relationships, and your marriage…you get the idea).