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In August 2024, the Men’s health: The lives of men in our communities report by the Local Government Association warned that men in England are facing “a silent health crisis”, dying nearly four years earlier than women, while suffering disproportionately higher rates of cancers, heart disease and type 2 diabetes.
One in five men are also found to die before the age of 65, and 40 per cent of men die before the age of 75, according to the Men’s Health Forum.
In November 2024, Secretary of State for Health and Social Care, Wes Streeting, confirmed plans for a men’s health strategy to address the biggest issues affecting men of all ages. This will form a key part of the Government’s 10 Year Health Plan and could include how to prevent and tackle heart disease and strokes, prostate and testicular cancer, as well as mental health and suicide prevention.
The Men’s Health Forum encourages men to give themselves a ‘DIY Man MOT’, a health check men can do at home, to self-assess many aspects of their health.
Many of these symptoms could indicate a more serious underlying condition. Since men are often reluctant to visit their GP, even when they experience new or worrying symptoms, pharmacy teams are well-placed to offer self care advice and suggest a GP referral when appropriate.
“Some men are quick to dismiss symptoms, often thinking they should just ‘get on with it’,” says Cheryl Lythgoe, advanced nurse practitioner and matron at Benenden Health. “Others may feel concerned but aren’t quite sure what requires medical attention. Understanding which symptoms to look out for can help men take charge of their health and, importantly, seek medical advice when necessary.”
Heart health and blood pressure
According to the British Heart Foundation, coronary heart disease is the leading cause of death in males, with one in eight men dying from this condition every year. Additionally, there are around 1.4 million men in the UK who are living with coronary heart disease. Some men don’t realise they have a problem with their heart until they have a heart attack.
“When we tend to think about a heart attack, we think of the person clutching the left-hand side of their chest and looking grey and sweaty,” says Cheryl. “However, the symptoms can be much more subtle. If men are experiencing regular chest pain, shortness of breath, or unexplained fatigue during physical activity, they should contact their GP immediately. These symptoms could indicate angina or heart disease, and early detection can prevent heart attacks and strokes.”
High blood pressure is one of the biggest risk factors for coronary heart disease. In the Health Survey for England 2022: Part 2, published in September 2024, 34 per cent of men had been diagnosed with high blood pressure compared to 27 per cent of women. Undiagnosed high blood pressure was also greater in men (13 per cent) than in women (10 per cent). Men can get their blood pressure checked through their GP surgery (usually by machine) or at some pharmacies – they can also buy a blood pressure monitor to do this at home.
High cholesterol is another significant risk factor for heart disease. The 2022 Health Survey for England found that 49 per cent of men overall have high cholesterol. This rises to 65 per cent in the 45-64 age group. If men are over 40, they can have a cholesterol test as part of their NHS Health Check, or they can have their cholesterol checked at a local pharmacy.
High cholesterol is mainly caused by eating fatty foods, not exercising enough, being overweight, smoking and drinking alcohol. It can also run in families. The first step to lowering cholesterol levels is making dietary changes, such as cutting down on saturated fat and eating more oily fish, nuts, fruits and vegetables. A GP may prescribe statins if the cholesterol levels remain high.
Smoking increases the risk of death from cardiovascular disease by up to three times. According to the Office for National Statistics (ONS), men in the UK were more likely than women to smoke in 2023, with around 3.4 million men (13.7 per cent) and around 2.6 million women (10.1 per cent) reported as being current smokers. Pharmacy teams should recommend pharmacy-based or NHS smoking cessation programmes, along with nicotine replacement therapy (NRT) products or e-cigarettes to help men quit or cut down.
“There are around 1.4 million men in the UK who are living with coronary heart disease”
Weighing in
According to the Health Survey for England 2022, 67 per cent of men are overweight (including obese males) compared with 61 per cent of women. Men are least likely to be overweight when aged 16-24, and most likely to be overweight when aged 55-64. Only 38 per cent of men surveyed were trying to lose weight compared with 52 per cent of women.
A healthy Body Mass Index (BMI) for men is between 18.5 and 24.9. Men can check their BMI by dividing their weight by their height squared, or use an online BMI calculator. The risks of developing health issues associated with being overweight increase in people who are obese. This is usually a BMI score over 30. However, while BMI is a useful starting point for assessing a man’s overall weight, it is less useful in muscular people (such as weight trainers and athletes), black and Asian ethnic groups, and people over 60. This is because muscle weighs more than fat, so men can be a healthy weight even though their BMI classifies them as obese.
Waist measurement can be a more important measurement as this indicates a build-up of fat around the stomach (belly fat), even if the BMI is healthy. Belly fat can increase the risk of various health problems, including heart disease, stroke and diabetes. The NHS states that a healthy waist measurement is half that person’s height – which is a waist-to-height ratio of 0.5 or below. According to the Men’s Health Forum, men with a waist measurement of over 37 inches are probably overweight, and if it’s over 40 inches, they are probably obese.
Sudden or unexpected weight loss in men should also be taken seriously. “Unexplained weight loss can be a red flag for many underlying health issues, including diabetes, thyroid problems, depression or even cancer,” says Cheryl. “If a man hasn’t changed his diet or activity levels but is shedding pounds – or gaining weight unexpectedly – it’s essential he consults his GP. Addressing weight changes early on can help prevent more serious health consequences such as diabetes or malnutrition.”
Men aged 40 and over should check their blood pressure every year.
Staying active
According to UK physical activity guidelines, adults should be active every day and aim for at least two and a half hours of moderate intensity exercise over a week. Moderate intensity means getting out of breath with an increasing heart rate – such as brisk walking or cycling. The 2022 Health Survey for England found that 22 per cent of men were inactive, and inactivity increased with age.
Men are more likely to be active if they can find something that fits in with their lifestyle. “It’s a good idea to try and focus on what they find fun and stimulating,” says Luke Hughes, personal trainer with a master’s degree in sport science, at Active Careers (activecareers.org.uk). “This could be increasing vigorous activity levels through re-capturing a previous passion such as dancing, five-a-side football, swimming or boxing, through to them trying something new and exciting, such as climbing.”
Exercise isn’t always a formal activity – it may be taking the dog for a walk or doing housework. “Men can keep an exercise journal to track their progress and calculate if they are doing enough physical activity,” says Luke. “This is a simple, cost-effective yet powerful way of keeping themselves accountable and informed of their weekly exertions. Another way to more accurately monitor health improvements is to use a heart rate monitor or a smartwatch.”
Prostate health
In June 2024, Men’s Health Week, run by the Men’s Health Forum, focused on prostate health. If men are passing urine more often than usual, especially at night, and less easily with a weaker flow, it’s important that they see their GP. Benign prostatic hyperplasia (BPH) – an enlarged prostate gland – isn’t usually a serious condition but can lead to some complications. Mild symptoms are often monitored and managed with lifestyle changes, such as drinking less alcohol, caffeine and fizzy drinks and exercising regularly. Medicines to reduce the size of the prostate may be recommended for moderate to severe symptoms – surgery is usually only recommended for severe medicine-resistant cases.
Around one in eight men will get prostate cancer in their lifetime. The risk increases with age and is also higher in black men and those with a family history of the condition. Having an enlarged prostate doesn’t increase the risk of prostate cancer, but men can have both conditions at the same time, which is when the cancer may be diagnosed. Prostate cancer doesn’t always cause symptoms and men can often live with the cancer for many years without needing any treatment. However, the earlier the cancer is diagnosed, the more likely it is to be cured. Treatments include surgery and radiotherapy.
Making customers aware of the signs of prostate cancer can help to catch it early.
Better bowels
According to Cancer Research UK, bowel cancer is the third most common cancer in men. It can affect people of any age but is more common in those aged 50 and over. The earlier the cancer is detected, the easier it is to treat. However, many of the symptoms are similar to those of common digestive problems.
“While digestive health is often overlooked by younger men, it should never be ignored,” says Cheryl. “Persistent or unexplained changes in bowel habits, such as chronic diarrhoea, constipation or blood in the stool, can be signs of conditions such as irritable bowel syndrome (IBS), infections or even bowel cancer. If these symptoms persist for four to six weeks, especially for men over 50, they should make an appointment with their GP.”
If men have symptoms of bowel cancer, their GP will initially offer them an at-home faecal immunochemical test (FIT). The test involves collecting a small amount of their stools and sending it to a laboratory to test for blood, which may be a sign of bowel cancer. Men should also be encouraged to take up invitations to the NHS Bowel Cancer Screening Programme, even if they don’t have any symptoms. Men and women aged 54-74 are invited to take part in bowel cancer screening every two years. If they are aged 75 and over, they can ask for screening test by calling the free bowel cancer screening helpline on:
0800 707 60 60.
“Around one in eight men will get prostate cancer in their lifetime”
Diabetes risk
Type 2 diabetes is more common in men than in women, and people often have the condition for many years before being diagnosed. Men should look out for passing urine more than usual, feeling thirsty all the time, feeling very tired and losing weight for no known reason. Left untreated, diabetes can lead to heart disease and stroke, nerve damage, vision loss, kidney problems, and even erectile dysfunction.
In May 2023, Diabetes UK projected that the number of men aged under 40 living with a diagnosis of type 2 diabetes could hit 200,000 by 2027. White men are more at risk of the disease if they’re over 40, but for people from African-Caribbean, black African, Chinese or South Asian backgrounds, this risk increases from age 25.
“While developing type 2 diabetes isn’t looming large on the minds of most young men, we’re seeing increased numbers of men in this age group developing this serious and life-altering condition,” says Chris Askew OBE, chief executive at Diabetes UK. “Managing weight, eating healthily and doing more physical activity can all contribute to reducing the risk of getting type 2 diabetes, and starting those habits at a younger age can set men up on a healthy path for later life, when we really see people’s risk increase.”
Erectile dysfunction
Up to one in four men experience erectile difficulties but many of them don’t seek the help they need. In June 2024, research by Eroxon found that nearly 70 per cent of men with the condition find it difficult to discuss their intimacy issues with a healthcare professional.
Community pharmacies can offer a range of over-the-counter (OTC) treatments for erectile dysfunction, including tablets (low dose sildenafil or tadalafil), creams, gels and vacuum pumps. Men may need to use a trial and error approach to see what works for them. They (and their partner) may also benefit from seeing a counsellor if there are any underlying mood-related issues or relationship problems. Pharmacy teams should highlight that erectile dysfunction can be caused by some medicines (e.g. finasteride for hair loss or prostate problems) or may be a sign of an underlying heart condition.
Mental health
In the UK, four out of every five suicides are by men. According to the Mental Health Foundation, men are much less likely than women to talk about their mental health. They may also be more likely to use alcohol or drugs to cope with depression.
“Depression, anxiety and stress don’t just impact emotional wellbeing – these can also have a serious effect on physical, social and sexual health,” says Cheryl. “If men are experiencing prolonged periods of low mood, irritability, trouble sleeping or overwhelming anxiety, it’s important to talk about this with someone who can help, such as their GP. Mental health conditions are highly treatable, and support is available through therapies, medications or even lifestyle changes.”
Pharmacy teams should keep the contact details of local mental health services and the Samaritans (116 123 is the free helpline number) if customers need urgent support.
Physical activity is crucial for good health, having both mental and physical benefits.
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