Health – Not all bad news for men

I am a man, and have been all my life, except for when I was a boy. Up until now I hadn’t thought of this as a disadvantage, until I spent a depressing morning reading men’s health statistics. 

It is well established that men lead shorter, more disease-ridden lives than women. Between the ages of 50 and 75 years, male death rates are 30 percent higher and overall life expectancy is several years less. 

Most of this is due to cancer, heart disease, diabetes, liver disease and trauma, and concerningly, men still commit suicide at more than twice the rate of women in New Zealand. Conditions such as Parkinson’s disease, gout and aortic aneurysm are more common in men, and to top it off we are more likely to have severe Covid. Despite this, a focus on men’s health as a priority and a speciality has been slow to develop.

“Men’s health” clinics have sprung up, but they tend to focus primarily on sexual dysfunction and testosterone supplementation, giving the impression that these things are all we care about. And, to be fair, a cultural expectation still drives men to under-report symptoms, emotional distress and feelings of not coping. To “man up” can have both good and bad connotations. It usually takes a crisis, like a heart scare or the death of a mate, to drive men to my door to do the check-ups that they all know they should be having. 

But there is some good news. Social initiatives, such as Movember and Blue September, have heightened public awareness and developed resources to improve men’s health. 

Movember was dreamed up in 2003 by a couple of Aussie guys, but Kiwis have taken to it big time, and now the world has caught on as well. Blue September is run by the Prostate Cancer Foundation of New Zealand and annually raises close to a million dollars to fight this disease and get men to be more open in talking about prostate issues. 

Unfortunately, prostate screening in our country is a bit of mess. Mostly this is because we are still uncertain about when to do PSA blood testing in men with no symptoms. PSA is a simple test to detect early prostate cancer, but it’s not perfect. It can be elevated in men who have benign prostate enlargement and tends to increase normally with age. Cycling, exercise and sexual intercourse can temporarily increase PSA and should be avoided for three days before the blood sample. On the other hand, a proportion of cancers do not produce PSA, so the test will be a false negative. There are also cases where the benefit of early detection of prostate cancer can be questionable, as many tumours are slow growing and may not affect mortality. 

Nevertheless, men are encouraged to “have a conversation” with their GP at age 50 years, or 40 if they have a family history. This will cover the risks and benefits of prostate screening and a physical exam will be offered.

But there is more to manhood than our anatomical distinctives. It feels like we are making real progress in getting men to be more honest, proactive and mutually supportive when it comes to wellbeing.