The Man Manual

By Donna Duggan

The Man Manual
From erectile dysfunction to depression and hair loss, find out what’s holding men back, what to be aware of and what can be done to manage men's health issues.

Research shows men are less likely than women to visit their GP. Reasons include time, money, fear, pride and not wanting to hear what they might be told. One step to staying healthy is finding a doctor you trust to talk to about “man stuff”, from depression to heart health and your prostate.


Each year in Australia, close to 3300 men die of prostate cancer. Around 20,000 new cases are diagnosed annually. In the early stages of prostate cancer there may be no signs but as it develops, symptoms can include: the need to urinate frequently, particularly at night; sudden urges to urinate; difficulty in starting urine flow; a slow, interrupted flow and dribbling afterwards; pain during urination; or blood in urine or semen.

While these symptoms can also indicate other, less serious, problems, any men who notice them should see their doctor immediately for a simple blood test or DRE (Digital Rectal Examination). The test is simple and can detect prostate cancer early. Men aged between 50 and 70 are in the highest-risk category.


According to a French study published in the Annals of Oncology, men who start to lose hair at age 20 are more likely to develop prostate cancer in later life. Men who only started to lose hair when they were 30 or 40 had no increased risk.

Androgenic alopecia, also known as male pattern baldness, is common, affecting 50 per cent of men throughout their lifetime. Previous studies have established a link between baldness and androgenic hormones – it is the androgens that also play a role in the growth of prostate cancer. The French researchers say it is too soon to recommend early screening and are continuing their work to explore the link between androgens, early balding and prostate cancer.


Compared with women, men are more than 2.5 times as likely to die from melanoma. Australian men have the highest reported rate of melanoma in the world, according to the Melanoma Institute Australia, with one in 14 Australian men developing melanoma by the age of 85. Melanoma makes up only 2.3 per cent of all skin cancers but is responsible for 75 per cent of skin-cancer deaths.

While most skin-cancer deaths can be prevented through the use of sun protection and early detection, only one-quarter of the population uses proper protection, according to the Cancer Council Australia. Proper protection means wearing a long-sleeved top, broad-brimmed hat, sunscreen and sunglasses.

Dermatologist Dr Phillip Artemi says he is not surprised by the statistics. “The number of people I see who haven’t used proper sun protection is alarming,” he says. He also wants to remind parents to make sure their kids always have adequate sun protection as “80 per cent of sun exposure happens in the first 20 years of life”.

If you think you need to be in the sun all day every day to be at risk, you’re wrong. Melanoma is most strongly related to intermittent sun exposure, the kind you get at the weekend or on holiday.

Melanoma appears as a new or existing spot, freckle or mole that changes colour, size or shape. It usually has an irregular or smudgy outline and is more than one colour. Melanomas develop over weeks and months and they can grow anywhere on the body.


Impotence, or erectile dysfunction, is a common but regularly ignored problem. Many men have (often temporary) erection problems at times, and the likelihood increases with age. Estimates seem to be on the rise as more careful studies are done and as men become more prepared to seek help. Some estimates indicate that about 40 per cent of men over 40 will have erection problems.

Occasional erectile dysfunction is normal and may be a result of too much alcohol, stress or anxiety, or a lack of sleep. However, if impotence persists, it can sometimes be a symptom of a more serious illness such as heart disease, depression or diabetes so should always be discussed with a doctor. Treatments include oral medication, counselling, external devices, injections and surgical treatments.


Australians are growing, and not in a healthy way. According to the Global Burden of Disease Study (2013), Australia is ranked the 30th most overweight country in the world, behind America (20th) and Tonga (1st). Statistics published by Heart Foundation Australia record that in 2011/12, 42 per cent of Australian males aged 18 and over fell into the overweight or obese category.

The health risks of being overweight are many, including cardiovascular disease, type 2 diabetes and some cancers. If you have been trying to lose weight without much success talk, to your health professional. Commit to an exercise programme you don’t mind doing most days and talk to a nutritionist about an eating plan. You may also want to consider talking to a counsellor if you overeat for reasons other than hunger, such as anxiety or depression.


“High cholesterol is one of the risk factors leading to heart disease,” says naturopath Mim Beim. “A diagnosis of high cholesterol levels and being told to go on cholesterol-lowering medication is a reason why many men seek nutritional advice. They don’t want to take tablets for the rest of their lives if something natural can be done instead.”

Beim’s first piece of nutritional advice for men dealing with high cholesterol involves lowering saturated fat intake. “Choose leaner cuts of meat. Also, avoid deep-fried food. Omega-3 fatty acids, in particular fish oil, can lower cholesterol levels. Soluble fibre is also able to remove cholesterol in the bowel and prevent it from being reabsorbed back into the bloodstream,” she says.


According to a random telephone survey of 300 men across Australia commissioned by national depression initiative Beyondblue, many men still think taking a bloke to the pub, or telling him to put on a brave face, would be helpful to someone with depression.

Beyondblue deputy CEO Dr Brian Graetz says the study shows work still needs to be done on some attitudes concerning depression. “Many men still think depression and other mental health problems are things that can be readily addressed by a better attitude – they believe it’s a simple case of mind over matter,” he says.

According to Beyondblue, around one in eight men in Australia will experience depression in their lifetime. They recommend that if you have any of the following common symptoms of depression for more than two weeks, it’s time to start talking to someone you trust and consult your doctor: moodiness that is out of character; increased irritability and frustration; finding it hard to take minor personal criticisms; spending less time with friends and family; loss of interest in food, sex, exercise or other pleasurable activities; being awake throughout the night; increased alcohol and drug use; staying home from work; increased physical health complaints such as fatigue or pain; taking unnecessary risks; thoughts and actions slowing down.

Anxiety is also common in men in Australia, with one in five experiencing an anxiety disorder in their lifetime. Anxiety is when feelings of stress continue even when a challenging situation has passed, or for no apparent reason.

Associate professor and Beyondblue former clinical advisor Michael Baigent says he is very concerned that many men reported that alcohol helped them with their anxiety.

“Anxiety disorders can severely disrupt people’s lives, but they are very treatable and people should be aware you don’t have to put up with them. A doctor can help,” says Baigent. “When men use alcohol to try to avoid anxiety … they can put themselves in a dangerous situation, as people with anxiety also frequently have suicidal thoughts. This fact alone emphasises how important it is to get help.”


The Australian Cancer Council says that detecting cancer early offers one of the best chances to combat the disease. Look out for the following symptoms and, if you notice any unusual changes, or if these symptoms persist, visit your doctor.

• Lumps, sores or ulcers that don’t heal.

• Unusual changes in your testicles – changes in shape, consistency or lumpiness.

• Coughs that don’t go away or bring up blood, or a hoarseness that hangs around.

• A loss in weight that can’t
be explained.

• Moles that have changed shape, size or colour, or bleed, or an inflamed skin sore that hasn’t healed.

• Blood in a bowel motion.

• Persistent changes in toilet habits or urinary problems.


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