It’s a well-known fact that men visit pharmacies far less frequently than women, and they are also less likely to seek medical advice when they’re not well. But when men do take the time to come in – or their families come in on their behalf with concerns or questions – pharmacy staff need to be on hand with appropriate support, advice and signposting.
All health advice should be tailored to the individual customer, whatever the issue. It is important to know about some of the most common conditions that can affect men of all ages, and the questions they may have for the pharmacy team.
Many men need to urinate at night as they get older, but while this is common, it shouldn’t be ignored. “This is usually a symptom of another condition, and not a condition itself,” says Abbas Kanani, pharmacist at Chemist Click in Rickmansworth. “It can have a number of causes, such as urinary tract or bladder infections, anxiety or even medicines. If you’re overweight and have a family history of diabetes, you should see your GP. Waking up during the night to urinate is a common sign of raised blood glucose levels.”
Men over 50 should also have their prostate gland examined. “The prostate naturally enlarges with age, known as benign prostatic hypertrophy,” says Dr Luke Pratsides, NHS GP in Newham and lead GP for online health clinic Numan. “This can result in a need to get up to pee in the night, peeing more often in the day, difficulty starting to pee, a feeling of not completely emptying the bladder and a feeling of urgency to pee. If you have BPH [benign prostatic hyperplasia, also known as an enlarged prostate], your GP can prescribe medicines to either slow the growth of your prostate (finasteride) or relax the muscles in your bladder and prostate (tamsulosin) to aid the flow of urine.”
“Erectile dysfunction (ED) is incredibly common. Around 30 per cent of men are affected at some stage in their lifetime, and the incidence rises with age,” says Dr Deborah Lee at Dr Fox Online Pharmacy. “But it’s important, however embarrassing, that [they have] a check-up with [a] GP to discuss possible underlying lifestyle factors, such as diabetes, high blood pressure, obesity, smoking and alcohol. Poor erections may also be a sign of undiagnosed cardiovascular disease.”
Dr Lee says phosphodiesterase inhibitors are the recommended first-line treatments and that “many men say these have saved their relationships”. Examples include sildenafil (Viagara Connect), which is available over-the-counter in community pharmacies after a short consultation to ensure suitability.
As phosphodiesterase inhibitors are not suitable for everyone, and some men do not respond well to them, Dr Lee explains that other treatments are available, including vacuum pumps and penile sleeves. “Psychosexual counselling is also important for
any relationship issues and underlying psychological problems,” she adds.
Two-thirds of men will experience male pattern baldness – also known as androgenetic alopecia – in their lifetime and it’s the main cause of hair loss in men. “It’s thought to be the result of both a genetic tendency as well as hormones, and is characterised by the frontal hairline receding as well as hair loss at the top of the scalp,” says Dr Sreedhar Krishna, consultant dermatologist at Croydon University Hospital.
While there is no cure for the condition, there may be ways of slowing down the process. “If a customer is keen to try treatment, a sensible option may be minoxidil 5% foam,” Dr Krishna says.
Expert trichologist Eva Proudman also recommends minoxidil products and advises that they be used twice daily to give the best results. “Apply these to your scalp, not your hair, in the areas that are thinning,” she says. “Only use the amount as directed, as too much will sit on your scalp and can cause irritation.”
When experiencing male pattern baldness, men may find that they start to experience other hair and scalp issues too. “When your hair is thinning, there’s generally less hair for sebum to travel along, which can make your scalp and hair more oily, so dandruff and seborrhoeic dermatitis can develop,” says Eva. “If your scalp is irritated and flaky, I would recommend treating with a shampoo containing coal tar extract.”
Many men need to urinate at night as they get older, but while this is common, it shouldn’t be ignored
According to the Mental Health Foundation, only one in four men feel able to talk to family and friends when they’re feeling stressed. “Men and women communicate differently,” says psychotherapist and hypnotherapist Nick Davies. “Not just in the way we talk – directly as opposed to women talking indirectly – but in the way we listen and understand. Women, for example, prefer to concentrate on emotion whereas men prefer logic. My advice would be to tell him to talk to a close friend he trusts, or even better, find a therapist he connects with.”
Pharmacy customers experiencing high levels of stress or anxiety can call the 24-hour Samaritans helpline (116 123) or CALM on 0800 58 58 58 (5pm to midnight). They can also make an appointment with a GP or find a local counsellor through the British Association for Counselling and Psychotherapy website at: bacp.co.uk.
The current guidelines for alcohol consumption advise limiting alcohol intake to 14 units a week for both women and men in order to keep health risks from alcohol at a low level. This is equivalent to drinking no more than six pints of average-strength beer (4% ABV) or seven medium-sized glasses of wine (175ml, 12% ABV) a week. If people regularly drink as much as 14 units per week, it should be spread out evenly over three or more days, with at least two alcohol-free days per week.
“Having a couple of pints at lunchtime every day can have a serious effect on your health over time,” says David Wiener, training specialist at AI-based fitness and lifestyle coaching app Freeletics. “Although having one drink at lunchtime every few days is relatively harmless, you need to make sure you don’t go overboard and develop a habit. Alcohol can cause a spike in your blood sugar, which in turn can trigger your body to produce more insulin. Excess beer consumption can also have a negative impact on your liver and pancreas, leading to inflammation, and can harm your heart health. If you still want to indulge in a pint, try opting for a ‘healthier’ option. While a lighter or drier beer can contain between 60 and 120 calories, heavier or darker beers have a calorie count of between 100 and 300.”
Dr Pratsides says maintaining a healthy weight and cutting down on smoking and alcohol to ensure a good number of healthy sperm is important. “Your testicles hang outside the rest of your body because, to produce good-quality sperm, they need to be kept just below body temperature,” he says. “Make sure they’re at the optimum temperature by wearing loose fitting underwear and avoiding tight underwear such as briefs. If you work in a hot environment, go for regular breaks outside. You could also take a male fertility supplement that contains zinc, which is important in maintaining normal testosterone levels to optimise sperm production; and selenium, which contributes to the formation of healthy sperm cells.”
Having high cholesterol doesn’t mean people can’t enjoy food, they just need to be careful and avoid or cut down on eating foods with a high saturated fat content. These include things like fried foods, pastries, fatty cuts of meat or processed meats, cheese, cream, cakes and biscuits. “Most items of food will have a recommended daily allowance (RDA) guide on the packet, which is colour coded. Avoid foods where the saturated fat content is red,” says Abbas. “Foods that are high in fibre can help to lower cholesterol. These include wholemeal options (i.e. wholemeal bread and bran cereals), fruits or vegetables, oats, beans and nuts.”
Supplements can also be used to help lower cholesterol and Abbas says that the ones most commonly recommended are “fish oils, flaxseed oil, phytosterols and psyllium”.
Dr Emeka Okorocha, an NHS doctor who specialises in health and fitness as a Grenade ambassador, says a ‘pot belly’ is basically the build-up of fatty tissue around the lower tummy area. “Although very common, higher levels of fat will increase the risks of type 2 diabetes, high blood pressure and heart disease,” he says. “We encourage patients to lose this type of fat by cutting down on fatty foods and foods high in sugars, and gradually increasing the frequency and intensity of their exercise.”
Dr Okorocha says increasing protein intake can help to build more muscle. “Generally, we recommend approximately 56 grams of daily protein intake for the average man. This, of course, is weight dependent,” he says. “We encourage protein from natural foods like meat, fish, nuts, milk and legumes. However, protein shakes are great for supplementing intake. Most are safe, but be careful to read the full contents and take no more than guided by the company. If your son has any medical and nutritional conditions, I would seek advice from doctor before using any supplements – protein or otherwise.”
Q My dad had prostate cancer when he was 65. Does this make me more likely to get it too? What could increase my risk?
A In the UK, around one in eight men will get prostate cancer in their lifetime, with most men diagnosed between the ages of 65 and 69. “Having a brother or father who developed prostate cancer under the age of 60 seems to increase your risk,” says Saheed Rahid, managing director at BXTAccelyon, a company that provides brachytherapy (internal radiotherapy) to treat prostate cancer. “Research also shows that having a close female relative who developed breast cancer may also increase your risk of prostate cancer. It’s believed that a number of other things can increase your risk as well, including age, ethnic group – prostate cancer is more common among men of African-Caribbean and African descent than in men of Asian descent – and obesity.”
Q I’ve noticed a lump on my testicle, but it doesn’t hurt. Could it be cancer?
A According to the male cancer charity Orchid, a small pea-sized lump can be felt in around 90 per cent of cases of testicular cancer, and in over 80 per cent of cases this will be painless. “Testicular cancer most often presents as a painless, solid lump in either testis,” says Dr Lee. “However, sometimes there’s no obvious lump, and a man complains of pain, tenderness or numbness in their testes or scrotal area instead, or sometimes pain or a dull ache in their lower tummy or groin.”
Dr Lee stress that not every lump will be cancer. “But if you have a lump in your testis, you should see your GP without delay. The doctor will put you at ease and do all they can to help,” she adds.