This site is intended for Healthcare Professionals only

OTC bookmark icon off

A closer look at men's health

Men cannot afford to be reticent to talk about their health, as UK mortality statistics show. This article explores how pharmacy teams can help men engage with issues of sexual health.

While it’s often something of a running joke that men can be notoriously bad at asking for help with their health, the worrying downside is that there are several physical and mental health conditions that disproportionately impact men in the UK and, on average, men live almost four years less than women.

So what factors contribute to men using health services less often than women and what impact does this have on men’s health outcomes?

Robert Shelswell is a nurse practitioner specialising in men’s health at Torbay & South Devon NHS Foundation Trust. He says some of the issues men cite around not accessing primary care services are:

  • Employers not being supportive of men needing to take time out in the day to speak to their GP surgery or go to an appointment
  • Not wanting to show weakness through admitting feeling unwell
  • Older generations becoming isolated, and lacking the ability to reach out for support, or who are too proud to ask.

The impact, says Robert, is that “men delay accessing health services, and therefore the problem worsens until they are physically unable to work, or the family dynamic is upset.”

Good sexual health is also an important factor in health and wellbeing, with sexual health recognised as a public health priority since the publication of the first national sexual health strategy in 2001. Pharmacies are key settings for the provision of a wide range of sexual health services since people have ready access to a pharmacist, so it is vital for the pharmacy team to feel confident initiating conversations, especially on ‘embarrassing’ topics such as men’s sexual health in the following areas…

Infertility support in pharmacy

A common cause of infertility in men is poor-quality semen, with reasons for this including:

  • A very low sperm count or no sperm at all
  • Sperm that are not moving properly
  • Abnormally shaped sperm, making it harder for them to move and fertilise an egg
  • Damage to the testicles, undescended testicle(s), or testicular cancer.

In addition, some men experience problems that can make it difficult for them to ejaculate, or they may have an abnormally low level of testosterone – known as hypogonadism – the male sex hormone involved in making sperm.

Certain types of medicines can sometimes cause infertility problems, including:

  • Sulfasalazine – an anti-inflammatory medicine used to treat conditions such as Crohn’s disease and rheumatoid arthritis – can temporarily decrease the number of sperm
  • Anabolic steroids – often used illegally to build muscle and improve athletic performance – can reduce sperm count and sperm mobility
  • Chemotherapy can sometimes severely reduce sperm production
  • Illegal drugs, such as marijuana and cocaine, can also affect semen quality.

“When it comes to fertility treatment and awareness, it is often one-sided and female-focused,” says Dr Catherine Hill, head of policy and public affairs at Fertility Network UK. “Yet when it comes to fertility issues, we know that male fertility is half of the problem. Research conducted by our charity, alongside Leeds Beckett University, found that a majority of respondents (93 per cent) stated that their wellbeing had been impacted by fertility issues, leading [men] to feelings of being emasculated and isolated, harming their self-identity, and causing stress, depression, anxiety, and low self-esteem.”

As a result, Catherine’s advice for pharmacy teams is to “approach male fertility with equal importance and sensitivity as they would with female-related fertility issues”, as well as being able to signpost to spaces for men to feel “comfortable and supported” in their experiences, such as Fertility Network UK’s HIMFertility support group.

While it may be difficult at first, seeking advice on sexual health issues will most definitely lead to improved overall health.

default quote view
default card view
default quote view

Dealing with STIs

People can have a sexually transmitted infection (STI) – such as HIV, chlamydia, gonorrhoea, trichomoniasis, genital warts, genital herpes, syphilis and human papillomavirus (HPV) – without realising, putting them at risk of health and fertility complications and increasing the possibility that they could infect their partner/s during sex.

STI symptoms in men can include discharge from the penis, and pain in the testicles and when passing urine; itching, burning or tingling around the genitals; and blisters, sores, spots or lumps around the genitals or anus.

Some pharmacies may also provide testing for some STIs, with the National Chlamydia Screening Programme (NCSP) including pharmacies from the start in 2003. Chlamydia is the most common bacterial STI, with sexually active young people at highest risk. However, since NCSP chlamydia screening in community settings such as pharmacies and GP surgeries is only proactively offered to young women, this means men will not be proactively offered a test unless an indication has been identified, such as being a partner of someone with chlamydia or having symptoms.

Pharmacy teams can recommend adults looking for information on chlamydia and chlamydia testing to visit the NHS website or the Government’s Sexwise website ( – part of The Department of Health and Social Care’s (DHSC) programme to promote sexual and reproductive health information across England. People may also be able to access online test kits by searching for local online sexual health services.

Since many STIs have no symptoms at all, the only way to know for sure is to get tested. Pharmacy teams should advise anyone who is worried about STIs to visit a sexual health clinic if they or a partner have symptoms of an STI, if they are worried after having sex without a condom, or if they are pregnant with symptoms of an STI.

Human papillomavirus (HPV) infection in men

HPV infection causes cancer and other serious diseases, but has predominately been focused as a ‘female-only’ disease when in fact it affects men too. Thankfully, that is changing now, in part from a Government pledge to eliminate cervical cancer by 2040 for the first time ever, which could save thousands of lives every year in England. 

There are around 200 types of HPV and while many are harmless – and for most people HPV usually goes away on its own – some can cause warts on the penis and anus, and others can cause cancer of the penis, anus, head and neck.

Most people with HPV don’t know they’re infected because there are no symptoms, making the HPV vaccination the best way of protecting against HPV and the diseases it can cause – including up to 99 per cent of cervical cancers. Girls in the UK have been vaccinated against HPV since 2008 and HPV vaccination for boys started in September 2019.

Following the latest advice from the Joint Committee on Vaccination and Immunisation (JCVI), the NHS recently updated its HPV vaccination programme to a single dose instead of two doses for under 25s. One dose of the vaccine is now being offered to those in year eight (aged 12 or 13 years) via the school aged immunisation service. Children are also able to get their vaccine either in school or at a community clinic. Anyone eligible who hasn’t received their one dose HPV vaccine can catch up until their 25th birthday via their GP practice.

Reaching out on men’s health is vital, with men less likely to seek help than women.

default card view
default quote view
Copy Link copy link button