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Health and masculinity
‘Men are more reluctant to go to the doctor, and less likely to be honest once they get there – and this is putting them at risk.’ - NZ Health Navigator
Men can experience external pressures to uphold stereotypical masculine traits; to appear tough, brave, strong, self-reliant and mentally stable. Common phrases like "man up" or "harden up and be a man" can create pressure that males needs to act and feel strong, or risk losing status and respect.
It's essential we break down these perceptions about health and wellbeing. Monitoring your health and getting any health concerns addressed mean that if there is a problem, this gets identified and managed at an early stage. Concerns may turn out to be nothing, but it's important to get checked out just in case.
This page covers some of the more common health concerns that can affect men.
MAJ Rousseau Speaks about Men's health
Testicular cancer
Testicular cancer is the #1 cancer in younger males aged 15-35 (Ministry of Health), but is highly curable when caught early. The most important thing is to be familiar what's normal for you, so if you notice a change – or that something doesn't feel right – you'll know to act on it.
Regularly examining your testicles (balls) will help you know what your normal is, so you are more likely to notice changes early. They should feel smooth and firm. Sensitive, but not painful. Look for unusual changes over time. Stuff like swelling, a lump on your testicle, or changes in size, shape or consistency.
It’s important to note that unusual swelling or soreness doesn’t automatically mean something's wrong. Lumps and swelling in your testicles are fairly common and there are many reasons why it might happen. Rather than jumping to conclusions, take action and see your doctor straight away. Early action can make a huge difference in prognosis if further attention is required.
For more information on symptoms, treatment, and a guide on how to check your testicles, see Testicular Cancer NZ.
Prostate cancer
Prostate cancer is the second most common cancer in Kiwi men, and the most prevalent cancer for older men in Aotearoa (Ministry of Health). Due to its gradual development, understanding the risk factors means that prostate cancer can be caught early and this can improve outcomes.
The prostate is a male sex gland found just below the bladder near the rectum. It plays a crucial part of the male reproductive system by secreting fluids into the urethra (the tube that carries urine and semen out of the body through the penis), functioning to enrich and protect the sperm.
Anyone with a prostate gland can develop prostate cancer, including transgender women, male assigned non-binary people or intersex people. It is more likely to develop with age and is more common where there is a familial linkage (eg BRCA1 or BRCA2 genes). If there is a strong family history of cancer, particularly breast, uterine or prostate cancer, and risk-indicating factors such as multiple cancers in an individual, early onset (younger than 50years) or male breast cancer, a GP can request referral to genetic services.
Signs and symptoms
Prostate cancer is often asymptomatic, especially at the early stages. When cancer continues developing undetected, this increases the risk of it spreading. This is why any suspicion or unexplained changes from your normal behaviours/routine should be investigated.
Symptoms to look for:
- Feeling the frequent or sudden need to urinate
- Finding it difficult to urinate
- Discomfort when urinating
- Finding blood in the urine or semen
- Pain in the lower back, upper thighs or hips
- Bone pain
- Unexpected weight loss
Screening
Often, early prostate cancer causes no symptoms – so it’s important to check in with your doctor even if you’re feeling fine. If you’re over 50, or over 40 with a family history of prostate cancer, talk to your doctor about regular screening.
One screening option is a digital rectal exam. Because the prostate gland lies in close proximity to the rectum, your doctor can physically assess the gland via a rectal exam. This is a relatively quick procedure where your doctor will look for any lumps or abnormalities on the prostate gland.
An alternative screening option is a PSA blood test. This measures the levels of Prostate Specific Antigen (PSA), a protein produced by the prostate gland. The amount of PSA protein in the blood sample can indicate whether malignant cells are present or not, as they will start to alter to normal function of the gland.
Although this test is a useful tool for detecting prostate cancer, elevated PSA levels may be caused by other factors, such as an enlarged prostate, old age, or prostatitis. Requesting a PSA blood test needs to be discussed with your doctor to be added in your annual health check-up.
There are also actions you can take reduce your risk of developing cancer before screening age. These involve maintaining a healthy body weight, regular exercise, sustaining a healthy diet, reducing alcohol intake and stopping smoking. In particular, it's thought that men who take part in regular physical activity are less likely to develop prostate cancer and have better outcomes if they do. See the 'Keeping fit and healthy' section below and the Prostate Cancer Foundation NZ for further information.
Testosterone deficiency
Testosterone is a reproductive hormone produced by the testes. It is released in response to a cascade of hormonal signals originating at the brain. Once released, testosterone circulates in the bloodstream and provides endocrine/hormonal signals to various organs/body systems. Whilst it is often known for its sex drive and vital role in sperm production, testosterone is also associated with regulating bone and muscle mass, male fat storage and red blood cell production.
Testosterone production increases as a man goes through puberty. These levels are then regulated and produced at a steady rate until around the age of 30 when they begin to decline.
What happens if there's a deficiency in testosterone?
Because testosterone plays such an important role in regulating the male reproductive system, there are many symptoms that could be a sign of a decreased level:
- Decrease in energy or feeling lethargic
- Low libido
- Affected sexual function
- Low sperm count
- Enlarged breasts
- Erectile dysfunction - More information can be found on Healthify|He Puna Waiora
- Reduced hair and muscle growth
It’s also important to note that low testosterone is becoming increasingly linked to the development of heart disease and type 2 diabetes.
A testosterone deficiency can present in various ways and is only confirmed by a consult with a health professional. If you suspect you may have low testosterone, consult your nearest Defence Health Centre or doctor.
How do I prevent testosterone deficiency?
It is common and normal for testosterone levels to reduce with age. However, testosterone levels shouldn't get low enough to affect your life or wellbeing. It's good to be mindful of this and start thinking about ways to mediate any testosterone depletion. This includes maintaining exercise, restorative sleep patterns and a healthy weight and diet, whilst reducing alcohol, tobacco products and opioid pain medications (eg morphine).
If you are concerned about changes that you think may be related to a drop in testosterone levels speak to your doctor.
Keeping fit and healthy
Whilst most people understand the basic need to ‘keep fit and healthy,’ this is can be easier said than done. Every person’s situation may present challenges to gaining weight, maintaining a fitness programme, healthy eating or maintaining a balanced lifestyle. However, it is important to keep fitness and general health at the forefront of your mind, utilising small and simple steps to navigate challenges and incorporate healthy practises into your routine.
Check out our physical fitness and activity guidelines.
You can find information about this and other topics related to men’s health on these websites: