How to beat men's problems: Why men MUST seek help if their love life's falling flat 

  • Around 40% of men over 40 suffer from a form of erectile dysfunction
  • Impotence is 'very often' warning sign of serious health problems
  • Could be powerful sign that diabetes may not be being controlled properl

Do men torpedo their chances of good health because they're too shy, too macho or too busy to ask for help?

'British men visit their GP half as often as women — and die at a younger age than women globally,' says Steve Robertson, professor of men, gender and health at Leeds Beckett University.

'The two facts can seem connected. But it's actually a more complicated picture.'

On the one hand, men seem more sensitive to mild ailments such as flu. Data from the Medical Research Council's Common Cold Research Unit shows men tend to over-rate how bad the symptoms are compared with women.

But surveys also show men believe that 'putting up with pain' is part of manliness. 'When men brag they haven't seen a doctor in years, they're behaving as they think men should,' says Professor Kate Hunt, a leading researcher in gender and health based at the University of Glasgow.

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Around 40 per cent of men over 40 suffer from some degree of erectile dysfunction (file photo)

Around 40 per cent of men over 40 suffer from some degree of erectile dysfunction (file photo)

One reason men might not seek help is that GP practices tend to 'a feminised space', adds Professor Robertson.

'It's a place where women go for breast and cervical cancer screening, for contraceptive advice and where they take their sick children and older relatives. It can be off-putting for men,' he explains.

This has led to health educational programmes increasingly being run with football clubs in order to encourage men to stop smoking or lose weight.

And men do seek help more quickly for serious problems. A recent study, led by Professor Hunt, found very little difference in how often men and women saw a GP in the six months before they were diagnosed with lung cancer, colorectal cancer or malignant melanoma.

Yet there's one significant area of health where men are still failing to seek advice and treatment — and ironically it's a problem that's often easy to treat.

Around 40 per cent of men over 40 suffers from some degree of erectile dysfunction. While for some the cause is psychological, it's important to get treatment as impotence is 'very often' a warning sign of serious health problems, specifically diabetes and heart disease, says Dr Steve Mowle, a spokesperson for the Royal College of General Practitioners.

Just how closely connected impotence is to men's health is now being recognised.

While for some the cause is psychological, it's important to get treatment as impotence is 'very often' a warning sign of serious health problems (file photo)

While for some the cause is psychological, it's important to get treatment as impotence is 'very often' a warning sign of serious health problems (file photo)

Take heart disease. A British Heart Foundation survey found that seven out of ten men with a heart condition have also had erectile dysfunction.

'It's a very common symptom that takes a toll on physical health as well as on their relationships,' explains Julie Ward, the charity's senior cardiac nurse.

It happens because the penis is 'essentially a blood vessel', says Dr Mowle. 'That's why poor lifestyle choices, notably smoking, can cause weak erections.'

Heart disease is characterised by narrowing and hardening of the arteries, and reduced blood flow. 

Because the arteries in the penis are so narrow, problems there show up earlier, meaning erectile dysfunction is often the first warning sign of heart disease — on average three years before a man might have a heart attack, says Lorraine Grover, a psychosexual nurse specialist at the London Clinic.

Impotence is also closely linked with diabetes. If it's undiagnosed or poorly controlled, the condition damages blood vessels and eventually the nerves. 

'The damage occurs first in the areas furthest from the brain: that's your feet and hands and, for men, your penis,' says Douglas Twenefour, clinical adviser at Diabetes UK.

Until recently, it was thought nearly one million men with diabetes have erectile dysfunction (800,000 already diagnosed with diabetes and 150,000 who are undiagnosed). Yet Diabetes UK believes the true figure is even higher. 'It's such an embarrassing subject it's widely unreported,' says Mr Twenefour.

'A more accurate figure may be that 90 per cent of the 1.6 million men with diabetes are impotent.'

Erectile problems are a powerful sign that diabetes may not be being controlled properly. Despite this, experts say impotence is routinely ignored in GP consultations. 

'Men will often talk about minor problems and only mention erectile dysfunction if the GP asks them if there's anything else,' says Dr Mowle. 'Even worse, GPs often prefer to avoid the subject.'

One chance for men to talk is at their NHS Health Check, which should be offered every five years to men and women aged 40 to 74 — and is intended to be a comprehensive heart-health check.

Even so, it may be the patient who has to take the initiative. 

'It's the right moment to check on the sexual health of men with heart disease,' says Geoff Hackett, a consultant urologist at Heartlands Hospital, Birmingham and professor of men's health at the University of Bedfordshire. 

'Yet I see people who've just been given the all-clear in the Health Check. They're seeing me about erectile dysfunction but didn't mention it to the doctor because 'nobody asked'.'

And the same is true with diabetes. Under NICE guidelines, doctors should offer men with type 2 the chance to talk about erectile dysfunction at their annual diabetes review.

Yet research by Professor Hackett showed that while three out of four men with diabetes experienced impotence, only one in five had received treatment for it in the past four years.

Erection problems in men with chronic health problems are particularly responsive to Viagra-type drugs. 

These have always been available on the NHS for men with diabetes, but since August, sildenafil (a generic form of Viagra) can be given to any man with erectile dysfunction if appropriate.

Diabetes is also linked to low testosterone and low libido, and some experts believe men with impotence should be offered testosterone treatment as well.

Previously, men with heart disease have not been offered Viagra. 'It harks back to when doctors believed sex was dangerous for them,' says Professor Hackett.

But the drugs are licensed to treat raised blood pressure in the lungs. They are being tested as a treatment for heart failure, too.

And research published in October suggests Viagra-type drugs boost the function of blood vessels. 'A man whose cardiac disease is being treated effectively should be able to use Viagra — though each patient's history should be considered,' says Ms Grover.

Do prostate checks do more harm than good?

While most people know that men have a prostate gland, few have much knowledge beyond that.

A survey of men aged 45 and over conducted by Prostate Cancer UK found that 70 per cent knew nothing about the gland.

The prostate is a doughnut-shaped gland under the bladder, wrapped around the urethra (the tube that carries urine from the bladder). It helps produce seminal fluid.

The most common conditions affecting it are benign prostate enlargement and prostatitis (see article on far right). But every year, more than 42,000 men in the UK are diagnosed with prostate cancer.

Symptoms are typically the need to urinate more frequently, especially at night, painful ejaculation and blood in the urine or semen. There can also be pain or stiffness in the lower back, hips or thighs.

A survey of men aged 45 and over conducted by Prostate Cancer UK found that 70 per cent knew nothing about the gland

A survey of men aged 45 and over conducted by Prostate Cancer UK found that 70 per cent knew nothing about the gland

But not all men with the disease will have symptoms, and often it's spotted in a routine check-up.

Early diagnosis is crucial, since up to 98 per cent of men who are diagnosed when the cancer is still contained within the gland will live for more than five years. That drops to 30 per cent if the cancer has spread.

So why is there no national screening programme? The best available check is a blood test to measure levels of Prostate Specific Antigen (PSA), a protein produced by the gland. It's a marker for prostate cancer as well as for an enlarged prostate and prostatitis.

B ut the reason it's not used for a national screening programme is because research suggests it would do more harm than good.

The European Randomised Study of Screening for Prostate Cancer has followed 162,000 men for 18 years, comparing survival rates for men who had the PSA test with follow-up biopsies and surgery to remove cancer against those who had neither the PSA test nor follow-up treatment.

While PSA testing reduces death rates by 20 per cent — so a screening programme would save 2,300 lives in the UK every year — for every life saved, 48 men would be diagnosed with cancer, with all the psychological damage that involves, and without any 'survival benefit' because their cancer has no significant symptoms or doesn't cause death. 

'This is because some types of prostate cancer are slow growing, and doctors can't reliably tell which should be treated urgently and which can be safely left alone,' explains Sarah Williams, Cancer Research UK's senior information officer. 'This means some men needlessly suffer the anxiety and side-effects of treatment.'

Three in 50 men having a biopsy will develop a serious infection. Seven out of ten who have surgery develop erection problems, and one in five will leak urine. Both side-effects can be permanent.

Dr Richard Ablin, the U.S. scientist who discovered PSA 45 years ago, says that in the U.S., where there is an unofficial screening programme, an estimated one million men 'who could have lived painlessly with their tumours until the end of their natural lives are unnecessarily frightened, impotent and incontinent' as a result.

Men in the UK over the age of 50 are entitled to a free PSA test if they request it, so should you get it done?

Roger Kirby, professor of urology at the University of London and a former Chair of Prostate Cancer UK, recommends it, adding: 'A PSA of more than four in the over-60s and over 2.5 in the over-50s is a good enough indicator that further investigation is needed.'

But Professor Sir Michael Rawlins, the former head of NICE, isn't keen. He had one, followed by a biopsy, which turned out to be negative — and has not had one since.

'If cancer had been detected, I would have faced an awful choice,' he says. 'Would I want to have it removed, or would I have gone for watchful waiting, with all the anxieties of that? I would rather not have to make the decision.'

  • A useful aid is the online risk calculator from the Prostate Cancer Research Foundation at

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