November is Men’s Health Awareness Month. This annual awareness month is an appropriate opportunity to highlight various men’s health initiatives and reflect on some of the health issues men face today.

Men’s health in the community

Men are less likely to visit their GP or pharmacy than women. A recent study by the National Pharmacy Association found that men visit their GP four times a year compared to six times for women. Nine in 10 men do not like to trouble their doctor or pharmacist unless they are suffering from a serious medical problem. (source: A.Vogel UK)

This tendency can be particularly concerning for those with chronic health conditions. For example, diabetic middle-aged men are often identified as one of the higher-risk diabetic groups due to this reluctance to seek medical help, which can lead to a higher risk of complications associated with diabetes.

If you find yourself worried about your health at any point, it is really important to seek help from your GP, as they will be best placed to advise further.

Breast Cancer in Men

In addition to maintaining contact with their GP in the community, there are various health conditions unique to men involving the testis and prostate for which urgent treatment is essential.

It is also important to recognise that men can develop breast cancer. Although it is less common in men than in women, early detection and awareness are similarly vital.

The symptoms of breast cancer in men include:

• a lump in the tissue around/behind the nipple (breast). This is usually hard, painless and does not move around within the breast
• the nipple turning inwards
• fluid oozing from the nipple, which may be streaked with blood
• a sore or rash around the nipple that does not go away
• the nipple or surrounding skin becoming hard, red or swollen
• swollen glands/small bumps in the armpit. (Source: NHS)

If you notice any of these symptoms, it is important to make an urgent appointment to see your GP straight away.

Testicular Cancer

Testicular cancer is the most common type of cancer diagnosed in younger men. However, it is highly treatable if caught early.

The main symptom of testicular cancer is a pain and swelling or a lump in one of the testicles or any change in shape or texture of the testicles. However, testicular cancer can also cause other symptoms, such as:

• an increase in the firmness of a testicle
• a difference in appearance between 1 testicle and the other
• a dull ache or sharp pain in your testicles or scrotum, which may come and go
• a feeling of heaviness in your scrotum. (Source: NHS)

Testicular cancer may not manifest itself in a painful way or as an obvious lump attached to the outside of the testicle. It can grow outwards from within the testicle, hence the need to check for firmness above. It is, therefore, very important to try and make time to regularly check your testicles for these signs.

The best time to do this is after you have taken a bath or shower. For more information, please see Movember’s ‘Guide to Checking Your Nuts’.

If you think that you may be suffering from any of the above, it is important to check this with your GP, who will perform an examination. Only a very small minority of lumps or swellings are testicular cancer. Other diagnoses include varicoceles, which are small and swollen blood vessels, as well as benign cysts in the tubes around the testicle (epididymal cysts).

The sooner testicular cancer is identified, the sooner you can start treatment and the greater the chance of survival. For testicular cancer that has not spread beyond the testicles, the survival rate is 99%. According to Cancer Research UK, the 10-year survival rate for all cases is 91%. Whilst testicular cancer is highly treatable if localised, it is important to increase awareness so that more cases can be caught early.

Prostate Cancer

Whilst only 1% of testicular cancer cases are found in men over 75, the peak rate of prostate cancer cases, according to Cancer Research UK, is at ages 75-79.

Similar to testicular cancer, however, it also has a high survival rate: 80% of patients will survive their condition for 10 years or more.

As the population becomes older, cases have increased dramatically (+48% since the early 1990s). The condition also may not reveal any symptoms until it has developed long enough to affect the bladder. It is, therefore, extremely important to attend regular check-ups with your GP and to be aware of the signs and symptoms should they occur:

• needing to pee more frequently, often during the night needing to rush to the toilet
• difficulty in starting to pee
• straining or taking a long time while peeing
• weak flow feeling that your bladder has not emptied fully
• blood in urine/blood in semen. (Source: NHS)

Testicular Torsion

Testicular Torsion is a process where the testicle twists inside the scrotum, cutting off its blood supply.

Testicular torsion can happen at any time: during exercise, sitting, standing or even sleeping. Symptoms include:

• pain in the testis/scrotum – pain is often severe, often comes on suddenly and may be associated with feeling or being sick. Pain may come and go but tends not to go away
• swelling and redness, especially on one side of the scrotum
• abdominal (‘tummy’) pain
• your testicle may have been sitting higher than usual in the scrotum and may be in a more horizontal position than usual. (Source: Cambridge University Hospitals)

Testicular Torsion is a medical emergency requiring prompt diagnosis, often at A&E, and immediate medical attention thereafter to restore the blood supply and save the affected testicle.

Although testicular torsion is rare, it is important to attend A&E if you are suffering from moderate to severe pain in your testis, or any of the signs above.

Epididymitis

When looking at testicular health, it is also important to mention Epididymitis, an infection of the tube at the back of the testicle. Symptoms include:

• sudden or gradual pain in one or both of your testicles
• tender, warm and swollen scrotum
• a build-up of fluid around your testicle (a hydrocele) that feels like a lump or swelling. (Source: NHS)

In order to minimise the damage caused by the infection and reduce the risk of it developing further, it is important to see a GP or attend a health clinic, who will be able to perform an examination and advise further.

Mental Health in Men

Last but not least is mental health, and it is encouraging that the stigma around mental health has significantly reduced over the last ten years.

However, this stigma still remains and is difficult to ignore, particularly as suicide remains the leading cause of death in young men.

Societal expectations and traditional, embedded and outdated ideas of masculinity can still make it difficult in 2023 for men to express their feelings, seek help, or even acknowledge that they may be suffering in the first place.

The value of seeking help if you need to cannot be emphasised strongly enough, whether talking to a family member, a friend, or even a colleague at work. You do not have to have a mental health issue in order to want to improve your mental health. Simply by engaging in discussions and recognising that your mental health is something that exists and has value, you are taking steps to improve it, as you would through exercise when working on your physical health.

If you do not feel able to share your struggles with someone you know, there are also numerous charities that offer free support, some of which are set out below.

One must also recognise the importance of making time for exercise, self-care and relaxation away from the pressures of everyday life.

Amy Rose, rehabilitation coordinator at Ashtons Legal, has recently written on this subject, and her article contains a helpful guide on how to manage stress.

Men’s health charities

There are also many men’s health charities which offer support to men of all ages up and down the UK:

• Movember is a charity which aims to raise awareness and money for men’s health, specifically prostate cancer, testicular cancer, mental health and suicide prevention
• ManUp is a charity that aims to break the stigma around male mental health, changing people’s attitudes, opinions and minds
• Men’s Sheds run across the UK and provide a space for men to come together and connect over a community project
• The Men’s Health Forum has many resources to support men’s health, such as a simple ‘MOT’ checklist of things we can do to top ourselves up physically and mentally
• Andy’s Man Club runs talking groups for men. They have groups across the UK, and their goal is to ‘get men talking’ about anything and everything
• ManHealth is a UK-based charity that provides access to peer support to men who are experiencing struggles in their lives
• Further resources can also be found on the Blue Ribbon Foundation website.

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