Men's Health
Erectile Dysfunction
The majority of men over 45 years of age have some form of erectile dysfunction (ED). Some conditions make ED more likely: increasing age, heart disease, diabetes, high blood pressure, obesity, high cholesterol, and smoking. The processes that lead to ED can also lead to heart disease, so ED can be an early warning sign for heart disease. Sometimes ED is due to a psychological factor.
Due to associations between ED and other conditions, it's important to see your doctor to assess for these issues, even if you are not seeking treatment for the ED.
ED can be managed by improving your overall health (smoking cessation, exercise, losing weight, drinking less alcohol etc.), psychology/sex therapy if required, and medications.
Premature Ejaculation
Premature ejaculation (PE) is very common, affecting up to 31% of males. PE can co-exist with ED, or be present on its own. It can be managed using medications and/or psychology/sex therapy too. Some men find it helpful to wear condoms or masturbate before sexual activity.
Hair Loss
Male pattern hair loss is more common with older age, and has a genetic predisposition. There are medications you can apply to the scalp, or medications you can take orally that can help slow down hair loss, and maybe stimulate hair regrowth. It takes 6-12 months to see any changes initially, and the treatments must be continued long-term for sustained benefit.
Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH) is an enlarged prostate. It's very common, and increases in prevalence as men age. In some men, it doesn't cause any noticeable issues, regardless of size. In other men, it can cause many issues: poor stream, issues starting or stopping, urinating frequently or at night etc. Your doctor will do some investigations, and if it is BPH, there are medications and surgical procedures available to treat it.
Prostate Cancer Screening
We can screen for prostate cancer using a blood test for prostate specific antigen (PSA).
Currently, we do not do population-based screening for prostate cancer. This is because when we consider the benefits vs harms of doing the PSA testing, the benefits are not clearly outweighing the harms.
The benefits of PSA testing are:
Reassurance
Early detection
An opportunity to commence early treatment
The harms of PSA testing are:
False positives - PSA is elevated, but it's not caused by cancer
False negatives - PSA is low despite the presence of prostate cancer
Overdiagnosis and unnecessary treatment of slowly progressing cancer
This information sheet has more details and an infographic to demonstrate the benefits vs harms: "Should I have prostate cancer screening?"
Knowing the above, it is your choice whether you do PSA testing or not.