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Men's health issues

"The life expectancy for Australian men and women is among the highest in the world. While our life expectancy is increasing, many of the risk factors that cause chronic diseases remain, particularly in men. These risk factors include smoking, lack of exercise, poor nutrition and excessive alcohol consumption. It's important that men are aware of their risks for prostate problems, depression and heart disease, and are encouraged to consider healthier behaviours and seek medical advice when they need to." Dr Christine Bennett, Chair, Medical Advisory Panel, Bupa Australia

Men and health 

Australia's life expectancy at birth remains among the highest in the world at around 79 years for males. Females still tend to have a longer life expectancy, at around 84 years. Australia's health compares well with that of other developed countries, ranking highly on most health indicators.

When asked about their health Australian men are likely to rate it as highly as their female counterparts - even though they generally don't do as well when we look at the indicators of good health.

Following is some information on common risks men should be aware of and helpful tips on how to manage them.

Heart and vascular health 

Coronary artery disease causes the most 'lost years' through death in males aged under 75 years.

There are many causes of heart disease. One way the heart can be damaged is by blockages and narrowing that occur in the network of coronary arteries (the arteries that supply blood to the heart muscle). Your risk of developing heart disease is composed of several factors - some of which you can change (like your lifestyle), others aren't in your control (for example, your age and family history).

You can reduce your risk of coronary artery disease by making changes to your lifestyle, including:

  • stopping smoking, if you smoke
  • maintaining a healthy weight
  • exercising regularly
  • controlling your blood pressure and cholesterol levels
  • managing stress levels
  • eating a healthy, balanced diet
  • drinking no more than the recommended amount of alcohol.

These lifestyle changes may also reduce the risk of many other diseases such as diabetes, lung cancer, bowel cancer and stroke.

Control your blood pressure and cholesterol levels

High blood pressure (hypertension) is a major risk factor for heart disease. If you have high blood pressure over a long period of time, you are more likely to suffer a heart attack, stroke or kidney failure. Your GP can monitor your blood pressure. If it is high on several separate occasions despite your attempts to improve your diet and exercise, your doctor may recommend medication to bring it back to normal.

Blood pressure is recorded as two numbers, for example, 120 over 80 (120/80). The first number describes the pressure in the arteries as the heart pumps blood out during the beat (known as systolic blood pressure). The second number relates to the pressure as the heart relaxes before the next beat (diastolic blood pressure). 

Blood pressure is measured in millimetres of mercury (mmHg). Blood pressure is usually considered high if it measures more than 120/80 mmHg while 140/90 mmHg or above is considered to be clearly high blood pressure. If you are taking medication to control your blood pressure, it should be checked regularly by your GP.

High blood levels of cholesterol contribute to your risk of developing heart disease. Factors such as smoking and a diet high in unhealthy saturated and trans-fats can raise your cholesterol levels. A total cholesterol level under 5.5 mmol/L is ideal. Your GP can organise for you to have regular blood cholesterol tests.

Eat well

Eating well means eating a wide variety of foods as part of a balanced diet. The Australian Guide to Healthy Eating recommends including the following food groups:

  • Bread, cereals, rice, pasta, noodles
  • Vegetables, legumes
  • Fruit
  • Milk, yoghurt, cheese
  • Meat, fish, poultry, eggs, nuts, legumes.

You should limit your intake of salt, sugar, saturated or trans-fats (found more often in fried and processed foods) and alcohol.

More information about healthy eating.

Be active

Activities such as brisk walking, swimming and cycling improve your overall fitness and your health and wellness. The National Physical Activity Guidelines urge Australians to be active in as many ways as possible. Moderate-intensity physical activity for at least 30 minutes, preferably every day, offers significant health benefits. Your 30 minutes don't have to be in one session - try three lots of 10 minutes, or two of 15 minutes to help you fit exercise into your daily routine.

Manage stress

Taking steps to reduce the stress in your life and changing the way you respond to it can greatly improve your mental and physical wellbeing. Consider relaxation techniques, like meditation or yoga, and set time aside to relax or do things you enjoy.

Prostate health 

A national survey revealed that prostate problems are very common in men over 40 years and these problems increase with age.

Enlarged prostate

The prostate is a gland which is located between your bladder and urethra (the tube for passing urine). Non-cancerous enlargement of the prostate (known as benign prostatic hyperplasia or BPH) becomes more common as men get older. Sometimes men have an enlarged prostate, but no symptoms at all. If you experience any of the following symptoms, see your doctor:

  • inability to urinate or difficulty with the strength of your urine stream
  • painful urination
  • any blood in the urine at all
  • any unusual discharge from the penis
  • back pain
  • pain in the groin
  • urgent and frequent urination.

Prostate cancer

One in 11 Australian men develops prostate cancer by the age of 70. It mostly occurs in men over 65 but your risk of it increases after turning 50. The causes are unknown but there is also an increased risk if a close relative such as your father or brother have had it.

An enlarged prostate due to cancer can press on the urethra and block the flow of urine. As a result you may have difficulty urinating, need to urinate more often, experience pain on passing urine or have blood in the urine. However, if you have these symptoms there may be another cause besides cancer, so it's best to discuss your symptoms with your doctor.

Prostate cancer is often slow growing and in some older men the best treatment may be "watchful waiting" (regular medical review with no treatment). In other men, surgery, radiotherapy or hormone therapy may be considered. Whether or not you have treatment depends on many factors including your age, general health, stage of the cancer and side effects of the treatment.

More information about Prostate cancer.

Testicular health 

Men should self-examine their testes regularly every four weeks or so - it only takes a few minutes. If you notice any changes such as swelling, lumps or pain, you should see your GP. Performing testicular self-examination should become part of your routine - while you can see your GP for specific advice, general instructions include:

  • Make sure your scrotum is warm and relaxed. You may like to perform the testicular examination after showering or bathing
  • It may help to examine your testes in front of the mirror so you can see as well as feel what you're doing
  • Check one testicle first, then the other
  • Gently roll one testicle using the fingers and thumbs of both hands
  • Feel along the underside of the scrotum to find the tube that sits at the back of the testicle - this is called the epididymis. It should feel like a little bunch of tightly curled tubes
  • Repeat the procedure on the other testicle
  • The examination shouldn't be painful or uncomfortable. If you're experiencing any discomfort, ease back on how hard you're pressing.

Torsion of the testicle

Torsion of the testes (a 'twisted testicle') occurs when a testis twists around the scrotum resulting in severe pain and swelling. An emergency operation is usually required to fix the problem. Unless testicular torsion is treated within a few hours, there may be permanent damage. Torsion of the testicle can occur at any age but is more likely between the onset of puberty and the mid 20s.

Men's sexual health 

Erectile dysfunction (impotence)

Impotence is an on-going inability to get or maintain an erection sufficient for sexual intercourse. The likelihood of being affected increases with age.

Erectile dysfunction is often a symptom or consequence of some other problem. It was once thought that erectile dysfunction was mainly caused by psychological factors, such as anxiety or depression, but it is now known that most cases actually have a physical cause.

While occasional erectile dysfunction is normal, ongoing impotence can be a symptom of an underlying physical illness, such as blood vessel disease, diabetes, or high blood pressure. These particular problems also affect the heart and the blood vessels that supply the heart.

Although treatments are available, studies show less than half of men experiencing sexual dysfunction see their doctor about it. Because of the established links between erectile dysfunction and chronic medical conditions, if you notice that impotence is an ongoing problem for you or your partner, it is important that you speak with your doctor to exclude physical illness as the cause. Your GP can also advise you about appropriate treatment, which may include prescription medicines and devices.

More information about erectile dysfunction (impotence). 

Sexually transmissible infections

Some of the most common sexually transmissible infections (STIs) are chlamydia, genital warts and genital herpes. Using condoms can reduce the risk of becoming infected with, and spreading, many STIs.

More information about STIs.

Mental health 

Depression is more than feeling sad - it's a health condition for which you can and should seek help. Depression in men may often go undiagnosed. Researchers are trying to understand the different ways men and women can develop and experience different symptoms of depression, and the implications it may have for diagnosis and treatment.

Signs and symptoms associated with depression in men include:

  • general slowing down or restlessness
  • withdrawing from family and friends
  • becoming confused or agitated
  • negative self-talk
  • excessive worry about finances
  • violent or abusive behaviour
  • inappropriate rage
  • neglecting responsibilities (not looking after yourself)
  • alcohol or substance abuse
  • thoughts of suicide.

Depression is a known high-risk factor for suicide. The suicide rate in Australia is four times higher in men than women. If you have thoughts of suicide, get help as soon as possible. If you don't want to talk to a doctor, reach out to:

  • A family member or friend
  • A mental health provider or other healthcare professional
  • Call a crisis centre or hot line such as SANE Australia (1800 18 7263), Lifeline (131 114).

Remember, depression is treatable, so don't suffer alone.

More information about depression.

Questions to ask your doctor 

  • What can I do to achieve and maintain good levels of blood pressure, cholesterol and blood sugar?
  • What modifications should I make to my diet, physical activity and lifestyle to ensure best health?
  • What is the best way to quit smoking and reduce my alcohol consumption?
  • How do I assess my family history and risk of conditions like prostate problems, and what precautions should I be taking?
  • I want to know more about bowel cancer screening.

Further information 

National Heart Foundation

www.heartfoundation.org.au

Australian Physical Activity guidelines

www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines

Andrology Australia

www.andrologyaustralia.org

Sources 

Andrology Australia. Prostate disease. [online] Clayton, VIC: Andrology Australia. May 2010 [Accessed 13 Jul 2011] Available from: http://www.andrologyaustralia.org/

Andrology Australia. Early detection of prostate cancer in general practice: supporting patient choice. [online] Clayton, VIC: Andrology Australia. Dec 2009 [Accessed 13 Jul 2011] Available from: http://www.andrologyaustralia.org/

Andrology Australia. Male genital examination: step-by-step examination of male genitals and secondary sex characteristics. [online] Clayton, VIC: Andrology Australia. May 2010 [Accessed 13 Jul 2011] Available from: http://www.andrologyaustralia.org/

Andrology Australia. Testicular cancer. [online] Clayton, VIC: Andrology Australia. May 2010 [Accessed 13 Jul 2011] Available from: http://www.andrologyaustralia.org/

Australian Bureau of Statistics. Causes of death, Australia, 2009. [online] Belconnen, ACT: Commonwealth of Australia. May 2011 [Accessed 13 Jul 2011] Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/3303.0

Australian Government. National STI Prevention Program. [online] Canberra, ACT: Commonwealth of Australia [accessed 6 Jul 2011] Available from: http://www.sti.health.gov.au

Australian Government Department of Health and Ageing. Physical activity guidelines. [online] Canberra, ACT: Commonwealth of Australia. 2005. [Accessed 9 Jul 2011] Available from:  http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines

Australian Institute of Health and Welfare (AIHW). Australia's health 2010. Cat. no. AUS 122. [online] Canberra, ACT: AIHW. June 2011 [Accessed 8 Jul 2011] Available from: http://www.aihw.gov.au/publication-detail/?id=6442468376&libID=6442468374&tab=2

AIHW Australian GP Statistics and Classification Centre. SAND abstract No. 110 from the BEACH program 2006-07: Erectile dysfunction. [online] Sydney: AGPSCC. 2007 [Accessed 8 Jul 2011] Available from: http://www.fmrc.org.au/Beach/Abstracts/110-Erectile_Dysfunction.pdf (PDF 147 kB)

beyondblue. Depression in men. Hawthorn West, VIC: beyond blue. Sept 2007 [Last modified Jan 2011, accessed 9 Jul 2011] Available from: http://www.beyondblue.org.au/index.aspx?link_id=7.981&tmp=FileDownload&fid=800

Holden CA McLachlan RI Pitts M et al. Men in Australia Telephone Survey (MATeS): a national survey of the reproductive health and concerns of middle-aged and older Australian men. The Lancet. 2005; 366: 218-224.

Kellett E Smith A Schmerlaib Y. The Australian Guide to Healthy Eating. [online] Canberra, ACT: Commonwealth of Australia. 1998 [accessed 9 Jul 2011] Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/E384CFA588B74377CA256F190004059B/$File/fd-cons.pdf (PDF 2Mb)

McVary KT. Clinical practice - Erectile dysfunction. N Engl J Med. 2007; 357(24):2472-2481. [online] Available from: http://www.nejm.org/doi/full/10.1056/NEJMcp067261

National Heart Foundation of Australia. Cardiovascular conditions. [online] Australia: National Heart Foundation of Australia [accessed 8 Jul 2011] Available from: http://www.heartfoundation.org.au/your-heart/cardiovascular-conditions/Pages/coronary-heart-disease.aspx

National Heart Foundation of Australia. Guide to management of hypertension 2008. [online] National Heart Foundation of Australia. 2008 [Last updated Dec 2010, accessed 30 Jun 2011] Available from: http://www.heartfoundation.org.au/information-for-professionals/Clinical-Information/Pages/hypertension.aspx

National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand. Position Statement on Lipid Management - 2005. Heart Lung and Circulation. 2005; 14: 275-291.

Last published: 30 July 2011

Disclaimer
This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

Bupa Australia Pty Ltd makes no warranties or representations regarding the completeness or accuracy of the information. Bupa Australia is not liable for any loss or damage you suffer arising out of the use of or reliance on the information. Except that which cannot be excluded by law. We recommend that you consult your doctor or other qualified health professional if you have questions or concerns about your health. For more details on how we produce our health content, visit the About our health information page.