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Q: I consider myself a healthy man. Do I really need a yearly physical exam?

A: While men often call it the yearly physical, the annual ritual is better named a wellness visit or preventive health appointment. Whatever you call it, men should still have one every year as it remains an important part of primary care.

For many men, this is one of the few extended opportunities for an in-depth conversation about their health. The meeting helps both the patient and the doctor address concerns, look at preventive measures, and create health goals and expectations together.

The traditional annual physical exam that focuses only on routine measurements and tests has drawn criticism in the past. Studies of the cookie-cutter model have suggested that it offers little value to people and does not increase life expectancy.

For many men, the annual wellness visit is more than a snapshot of their current health. Over time, men need the chance to identify and reflect on what is important for their health and what goals they want to accomplish.

Without this regular interaction with their doctor, they can end up running around with no clear idea of where they are in terms of their overall health and the best ways to reach their new goals.

Today, doctors more often call the periodic visit to the doctor a “wellness visit” rather than a “regular check-up” or “yearly physical exam.” It can serve many purposes. During this visit, your doctor will want to:

• Ask if you have any new symptoms or health concerns
• Review your family medical history to see if you have a greater than average risk for certain diseases, such as diabetes
• Review your medicines (both prescription and over-the-counter) and use of herbs and supplements
• Ask about health habits, including diet, exercise and use of tobacco and alcohol
• Perform a physical examination
• Administer vaccines or other preventive treatments

Also, this visit is chance for you to:

• Ask any questions that you might have
• Learn more ways to stay healthy

Does every adult male need a routine physical each year? Not necessarily.

Everyone should have their blood pressure checked every one to two years. I suggest a wellness visit every two years from ages 40-50. Once adults reach age 50, I recommend that they see their doctor once per year.

But don’t wait for a routine visit if you have new symptoms. Call your doctor’s office for advice. Your doctor may not want you to wait for a regular check-up.

Q: I often notice slight swelling in both my ankles, but it is always gone in the morning. What causes it, and why would that start to happen?

A: It sounds like you have edema — swelling in your legs due to fluid in the soft tissues beneath your skin.

This usually occurs when pressure from the fluid inside your veins is high, which forces water out of the blood vessels and into the surrounding tissues.

The most common cause is leaky valves in your veins. Doctors call this venous insufficiency.

One-way valves in your veins help keep the blood flowing in the right direction. Ordinarily, as you walk around, your leg muscles squeeze the veins, which pumps the blood through these valves up toward the heart. When the muscles relax, the valves prevent blood from draining back down the vessels.

If these valves become leaky, the blood gets propelled upward, but much of it drops down again when the leg muscles relax. The result is an accumulation of blood — and an increase in pressure — within the veins. The higher pressure pushes fluid out of the veins, causing leg swelling.

It’s less likely that your edema is due to some other medical problem. But you should make an appointment with your doctor to be sure.

Your doctor will ask if you have shortness of breath, fatigue, or pain in your legs, and whether one leg is more swollen than the other.

Depending on your symptoms and your doctor’s physical exam, he or she might order blood and urine tests to evaluate your kidney and liver health. You might also need an echocardiogram to make sure your heart function is normal, or a leg ultrasound to look for blood clots.

Some medications can cause fluid retention in your legs. This can happen with high doses of ibuprofen (Advil, Motrin), naproxen (Aleve), and other nonsteroidal anti-inflammatory drugs.

Leg swelling is a common side effect of certain calcium-channel blockers, especially nifedipine (Procardia XL) and amlodipine (Norvasc).

To help minimize the swelling, raise your legs whenever you sit down. Even better, try to schedule 20 to 30 minutes during the day when you can lie down with some pillows under your feet to raise your legs above heart level.

You also might consider compression stockings. They help counter the pressure from within the veins and prevent fluid from seeping out of the blood vessels.

Usually, the knee-high versions are sufficient. It’s best to put on the stockings each morning before you get out of bed and then take them off at night.

© 2023 Harvard University. Distributed by Tribune Content Agency, LLC.