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Colonoscopy

Dr. Jonathan Apasu

Testosteron Experte von Adon Health

Why men shouldn't postpone a colonoscopy

A colonoscopy , also known as a colonoscopy , is one of the most important and effective preventative examinations in men's health. It makes it possible to detect colorectal cancer early or even prevent it before it develops. And yet, it is often suppressed, postponed, or ignored out of shame, especially by men.

A timely colonoscopy can save lives . Additionally, it provides information about chronic inflammation, irritable bowel syndrome, silent inflammatory processes, and the composition of the gut flora – topics that are particularly important in connection with testosterone deficiency , the immune system, and energy balance.

What is a colonoscopy?

A colonoscopy is a medical procedure in which the doctor uses a flexible endoscope to examine the entire large intestine (colon) from the inside. The endoscope is a thin tube with a camera and light source at its tip. The examination is performed through the anus and usually only takes 20 to 30 minutes.

Objective of the study:

  • Detection and removal of polyps
  • Detection of inflammation, diverticula or mucosal changes
  • Early detection of colorectal cancer
  • Clarification of chronic digestive problems

Colonoscopy is usually performed on an outpatient basis, and if desired under sedation (i.e., under light anesthesia) or short general anesthesia, so that most men sleep through the examination.


Why is colonoscopy particularly important for men?

Men have the following advantages compared to women:

  • a higher risk of colon cancer
  • a lower willingness to take precautions
  • more frequently a pronounced visceral fat distribution (belly fat)
  • Increased silent inflammatory processes in the intestine
  • a lower proportion of protective intestinal flora

All of this increases the likelihood of colorectal cancer, irritable bowel syndrome, or inflammatory bowel diseases such as Crohn's disease or ulcerative colitis, especially between the ages of 40 and 60.

Risk factors for bowel changes:

  • Age over 50 (earlier if there is a family history of the condition)
  • low-fiber diet
  • high meat or alcohol consumption
  • Excess weight, especially visceral fat
  • chronic stress (high cortisol)
  • Smoking, lack of exercise

What is the procedure for a colonoscopy?

1. Preparation (2-3 days in advance)

  • Switching to a low-fiber diet (e.g., white bread, rice, clear broth)
  • Drinking laxatives the night before

Goal: No solid stool in the intestines on the day of the examination

2. Examination

  • Performed in supine or side-lying position
  • Optional: Sedation or short-term anesthesia
  • Insertion of the endoscope through the anus
  • Inspection of the entire large intestine (possibly also the transition to the small intestine)
  • If necessary: ​​removal of polyps or taking small tissue samples (biopsies)

3. Follow-up care

  • Observation after sedation (30–60 minutes)
  • Eating is usually possible again on the same day
  • Results immediately after the examination, or after a few days (in the case of biopsy)

Which symptoms justify a colonoscopy?

Even though many men have no symptoms, there are clear warning signs when a colonoscopy is advisable:

  • Blood in stool (visible or microscopic)
  • frequent constipation or diarrhea
  • unexplained abdominal pain
  • unintentional weight loss
  • constant bloating or pressure sensation
  • Abnormal laboratory values ​​(e.g., iron deficiency without a discernible cause)

Even in men with chronic stress, long-term poor nutrition or hormonal imbalance (e.g. testosterone deficiency with a tendency towards inflammation), a colonoscopy can provide revealing insights.

What are polyps and why is their removal important?

Polyps are small growths of the intestinal lining. They are usually benign, but can develop into malignant tumors over the years. The good news: They can be removed directly during a colonoscopy, without any additional procedures. This means real-time cancer prevention.

Regular colonoscopies help to identify polyps and remove them in time, before they cause damage.


How often should men have a colonoscopy?

The recommendations for frequency depend on age and risk profile:

Risk status

Recommendation

Men over 50 every 10 years (health insurance benefit)
Men with a family history of genetic predisposition from age 40 or 10 years before the relative's age of illness
After polyp removal Monitoring interval depending on the type: 3–5 years
In case of noticeable symptoms according to medical assessment

Even men who have no symptoms benefit from colonoscopy as part of a modern prevention concept.

Are there any risks or side effects?

Colonoscopy is considered a safe, routine procedure . Complications are rare, but can occur in individual cases.

  • temporary bloating or abdominal cramps
  • slight bleeding after polyp removal
  • Extremely rare: Perforation of the intestinal wall (< 1:10,000 cases)

With experienced doctors and good preparation, the risk is minimal!

Conclusion: Act early – live safely

Colonoscopy is one of the most effective yet least used preventative measures in men's health. It offers the opportunity to detect changes early and thus prevent serious diseases such as colon cancer.

Men who get a colonoscopy at the appropriate time are acting proactively and responsibly, and gain peace of mind. Especially from the age of 50 onwards, a colonoscopy should be a regular part of a personal health check.

Tip: Learn more about recommended preventive health checkups for men. In our blog article " Preventive Health Checkups for Men: Act Early, Stay Healthy, " we show you which checkups are truly important and why timely prevention is crucial.

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Reduced testosterone due to increased conversion to estrogen (via the enzyme aromatase in adipose tissue) Chronically elevated inflammation markers (e.g., CRP) that put a strain on organs and blood vessels Insulin resistance with long-term risk of type 2 diabetes and fatty liver Erectile dysfunction , loss of libido and decreased performance Increased cardiovascular risk (hypertension, arteriosclerosis, dyslipidemia) Impaired mental clarity , lack of motivation and "brain fog" Visceral fat, that is, fat in the abdominal area, is particularly critical. It is metabolically active, produces pro-inflammatory cytokines, and negatively affects hormone regulation. Measurement methods: How can body fat percentage be determined? The accuracy of the measurement varies depending on the method. The following methods are commonly used in practice: Bioimpedance analysis (BIA) - easy to use, but highly dependent on hydration status Caliper measurement (skinfold measurement) - quite accurate when used correctly. DXA scan (dual-energy X-ray absorptiometry) - gold standard, but expensive and not available everywhere. Photometric apps and smart scales – usable as a rough guideline, but to be interpreted with caution. Regardless of the method, the trend over time is more important than a single measurement. How can body fat be reduced sustainably and in a hormone-friendly way? A high body fat percentage cannot be reduced in a targeted or short-term manner. It requires a holistic approach that combines training, nutrition, sleep, and hormonal health. Effective strategies: Strength training with progression (at least 2-3 times per week) → increases muscle mass, raises basal metabolic rate, improves insulin sensitivity Moderate calorie deficit with a high-protein diet → protects muscles and promotes fat loss Avoiding sugar, trans fats and ultra-processed products Intermittent fasting (e.g. 16:8) for calorie reduction and stabilization of insulin and fat metabolism HIIT or brisk walking after meals to control blood sugar Stress management (reducing cortisol) - e.g. through sleep, meditation, breathing exercises Supplement micronutrients such as zinc, magnesium, omega-3, and vitamin D if proven to be effective. A persistently high body fat percentage often cannot be corrected simply by "more exercise". Targeted diagnostics are particularly advisable when hormonal imbalances or stressors are present. 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