A lot of guys are hesitant to discuss their health concerns, often ignoring or downplaying symptoms instead. But this can lead to slower diagnosis of common, treatable issues affecting everything from your physical fitness and sex life to heart and bone health.
"Unfortunately, men are often embarrassed to come see us, but these problems are very common," says Dr. Akhil Muthigi, a men's health specialist at Houston Methodist. "Male health is health. Sexual health is health. These aren't luxuries, they're necessities of living a healthy life."
The most common problems for men to be aware of include:
- Low testosterone (low T), also called hypogonadism
- Male infertility
- Pelvic floor dysfunction
- Prostate problems, including benign prostatic hyperplasia (BPH)
- Erectile dysfunction
"Various strategies exist for us to address these different issues and help men meet their health goals," says Dr. Muthigi.
Common reasons to see a men's health specialist
When it comes to your health, knowing when to seek the expertise of a specialist can make all the difference. From changes in energy levels to irregularities in bodily functions, here are some important signs indicating that it's time to schedule a visit with a men's health specialist:
Gaining fat and losing muscle despite exercising
"If you're putting on weight — fat, specifically — and not gaining muscle mass even though you're going to the gym, or low energy despite getting adequate sleep at night, we recommend coming in to have testosterone levels checked," says Dr. Muthigi.
Measuring you testosterone level requires a simple blood test, typically performed early in the morning since that's when testosterone readings are most accurate. A repeat test may be required if your first result indicates low T.
"If testosterone is low, we discuss lifestyle changes and next steps for treatment and supplementation, if required," explains Dr. Muthigi. "Taking action is important since testosterone is important for more than energy levels, lean muscle mass and libido. It's also critical for bone and heart health — something many men don't realize."
Fertility planning or concerns about reproductive health
Dr. Muthigi recommends that any man interested in understanding his fertility come in for evaluation — whether for future planning or if you're actively trying to have a child and have been unsuccessful for six months or more.
"It's commonly thought that infertility stems primarily from the female partner, but we now know that male fertility can contribute to up to 50% of infertility issues," says Dr. Muthigi. "We can assess a man's fertility via blood hormone workups and semen analysis. If either of these are abnormal, we can perform further testing to determine how to manage the issue."
Semen analysis can also be a marker of overall health. Linked to chronic conditions like high blood pressure and type 2 diabetes, Dr. Muthigi points out that abnormal semen analysis can potentially be used as a screening tool in younger men aged 30 to 45.
Testicular pain or pelvic pain while urinating
Pelvic floor dysfunction — when muscles in the pelvic area are impaired, causing issues with bowel, bladder or sexual function — is often thought to affect only women, but men may experience it too.
"This can present as testicular pain or pain under the scrotum that travels to the testicles and into the abdomen," explains Dr. Muthigi. "It can happen in men of any age group."
The first step is to rule out the more serious potential causes, like a testicular mass. Tests on the prostate may also be performed to ensure the issue isn't related to prostatitis, which is inflammation of the prostate, or something else. Your doctor may run tests to rule out a urinary tract infection.
"If all that is clear, we start thinking about whether there's an issue with the pelvic muscles that support urination and bladder control," says Dr. Muthigi. "We have pelvic floor physical therapists who can help teach men to strengthen and relax those muscles."
Over the course of three to four weeks, this often helps correct the pelvic floor dysfunction and resolve symptoms like testicular pain.
You're due for prostate cancer screening
Prostate cancer is the most commonly diagnosed cancer in men, with 67 the average age of diagnosis. It's why men with an average risk of prostate cancer are advised to start screening at age 55.
Prostate cancer screening entails a simple blood test to check the levels of a protein called prostate specific antigen, or PSA. High PSA levels can be a sign that something may be wrong with the prostate, warranting further testing.
"Certain factors can elevate a man's risk of prostate cancer and prompt earlier screening," adds Dr. Muthigi. "In these situations, it's a two-way conversation between the man and his doctor regarding whether it's worthwhile to pursue PSA blood test screening before the age of 55 — as early as 40 or 45 in some cases."
Factors that increase the risk of prostate cancer and may warrant earlier screening include:
- Family history of prostate cancer at an early age
- African ancestry
- History of smoking tobacco
Talk to your doctor about earlier prostate cancer screening if any of these risk factors apply to you.
Problems urinating
An enlarged prostate, also known as benign prostatic hyperplasia (BPH), is a common problem among aging men. It's unrelated to cancer, occurring instead as the prostate naturally gets bigger as men age. The first sign of it is often noticing urinary issues.
"If the prostate gets too large, it can block the flow of urine through the urethra and cause urinary symptoms," says Dr. Muthigi. "As the issue progresses, it can also lead to incomplete emptying of the bladder, which can cause bladder irritation and lead to more symptoms."
BPH symptoms can include:
- Dribbling after urination
- Hesitancy of urination (being ready to urinate but taking a while to do so)
- Intermittent urination (stop-and-go stream while urinating)
- Increased frequency of urination
- Increased urgency to urinate
- Getting up at night to urinate
"Diagnosing BPH starts with a measure of urine flow, as well as a quick bladder scan using an ultrasound probe to ensure the bladder is emptying fully," says Dr. Muthigi.
In many cases, BPH is easily managed with lifestyle adjustments and medications. But for more resistant cases, there are also many procedures and surgeries that help shrink the prostate and reduce symptoms.
Difficulty getting or maintaining an erection
In terms of sexual health, erectile dysfunction (ED) is the most common problem men report to their doctor.
"This is when erection issues affect the ability for a man to enjoy penetrative intercourse, which can be related to stiffness or an inability to maintain an erection," explains Dr. Muthigi. "What defines this as a problem varies from man to man, but if you have any concerns at all we recommend getting evaluated."
Diagnosing ED involves blood tests and imaging studies, such as minimally invasive ultrasound to assess blood flow in and out of the penis. ED treatments range from medications to injections and surgical procedures, such as insertion of a penile prosthesis. It's also important to ensure that any underlying health issues — high blood pressure and type 2 diabetes, in particular — are well managed, since these conditions can worsen the problem.
"Erectile dysfunction is a marker of overall health and can be a precursor to these heart-related conditions," adds Dr. Muthigi. "So if a diagnosis is made, we often also recommend following up with your primary care physician or cardiologist to check on your heart health."
Lastly, Dr. Muthigi points to another common issue that can affect penetrative intercourse: Peyronie's disease. This causes a painful, curved erection that often leads to discomfort during sex, as well as stress and anxiety about sex. He adds that there are several treatments available to reduce this curvature.
"We want men to enjoy their sexual lives," says Dr. Muthigi. "These are very common issues in men and the first step is often just overcoming the embarrassment and getting evaluated."
