“Man Up”: The Health Issues Men Don’t Talk About

Movember | Men’s Physical Health Awareness Month

A man in his mid-40s living with Peyronie’s disease (a condition in which scar tissue causes significant penile curvature, pain, and sexual dysfunction) had convinced himself that enduring it quietly for years was somehow more dignified than seeking help. Although this is the story of one specific patient, his instinct to stay silent about intimate health problems is far from unique to him.

This “Movember”, we are shedding light on many of the health problems men are least comfortable discussing: erectile and ejaculatory dysfunction, infertility, testicular abnormalities, urinary symptoms, and prostate disease. These conditions are very different, but they share one important feature – men often delay seeking help because the symptoms feel embarrassing, private, or tied to their sense of masculinity.

Yet these symptoms can carry important medical information. For example, persistent erectile dysfunction may be related to psychological distress, medication affects, hormonal abnormalities, diabetes, or vascular disease. Infertility can arise from hormonal, testicular, genetic, or anatomical causes and male factor infertility accounts for up to 50% of infertility cases [1]. Testosterone deficiency can be a result of advancing age, testicular disease, or disorders of brain structures such as the hypothalamus or pituitary gland leading to hormonal imbalances. Many men may initially present to a doctor with non-specific symptoms such as fatigue, reduced physical strength, or decreased libido.  

Testicular health matters particularly for younger men. Testicular cancer is the most common cancer diagnosed in Canadian men between ages 20 and 35 [2]. Young men should know what is normal for their testicles and seek medical assessment if they notice a new lump, swelling, or persistent change (#knowthynuts). 

Teenage boys and young adult men should also be aware of testicular torsion, a medical emergency that occurs when the testicle wraps around the spermatic cord that holds it. This causes extreme pain and usually requires emergency surgery to untwist the testicle to restore its blood supply and prevent it from dying and needing to be removed. 

Urinary symptoms are also important to notice, especially in older men. Difficulty initiating urination, a weak stream, urgency, waking up many times to urinate, or incomplete emptying are often defining symptoms of benign prostatic hyperplasia (BPH) – which is the non-cancerous enlargement of the prostate that occurs with advancing age. Roughly one in four men will be affected by BPH at some point in their life after age 40 [3]. On the other hand, prostate cancer – which is the most commonly diagnosed cancer in Canadian men excluding non-melanoma skin cancer – can have less noticeable early symptoms [4]. This is monitored with blood tests at regular physical check-ups, and imaging if required. 

While this short snapshot of men’s physical health conditions is not comprehensive, the key takeaway is that seeking help early is not an admission of weakness. Embarrassment should never be the reason a medically important symptom goes unexamined. 

Written by:

Youssef Garras

MD Candidate, BMSc