Men over 40 need to start keeping a closer eye on their health. (File image) Photo: 123rf
From the age of 40, men are wise to start keeping an eye out for two big yet "preventable" health issues - cardiovascular disease and prostate cancer, says Dr Nick Oscroft.
"We're often nabbing blokes [for check-ups] when they come in with their injuries or things that are perhaps a little bit more safe to talk about.
"It's important that guys are a little bit vulnerable and a little bit real and that doesn't mean pulling out tiny little violins but just being human," the Wellington community GP tells RNZ's Saturday Morning.
Dr Nick Oscroft: Addressing men's health issues
Dr Oscroft sees himself as a family doctor - a role he says is "under significant threat" these days.
"As a sector, it's hard for us to be available as we'd like to be. You do build these things over time, and ideally, you're catching a person when their father is passing away or they're having their first kids and you're growing old with them.
"It's a little bit of a romantic ideal but there's hard evidence that it's tremendously beneficial. We really know that having a relationship with a GP leads to a longer life. There's good research on that. If you want to boil it down to dollars, $1 invested in primary care saves $14 in downstream costs."
The root cause of ill health
Dr Oscroft said around 40 percent of the ill health he sees in men over 60 - including heart attacks, strokes, kidney failure and vascular dementia - is due to cardiovascular disease.
"People often don't realise that the clogging up of your arteries is one of the major avoidable causes of memory loss and dementia."
Cardiovascular disorders definitely impact sexual function, he says.
"One, you've got to get fuel through to the penis, and so if your blood vessels are blocking off that doesn't help … Also there's some stress in times of life. We can't talk about sexual function without talking about stress … The ancestors who stopped for a shag were selected against. They were killed from the gene pool."
For Pākeha men, 40 is a good time to start checking heart health - via a blood test with your GP, cholesterol and sugar level and blood pressure checks.
Māori, Pasifika and Indian men, who have a slightly higher risk of cardiovascular issues, do well to start getting these check- ups earlier - in their 30s.
As we age, blood pressure climbs yet isn't symptomatic until it becomes dangerously high so it's good to check on this annually, Dr Oscroft said.
"That doesn't have to be necessarily a structured, formal check. There's plenty of opportunities. If you're in the pharmacy you can get your blood pressure checked. [There's also checking at the] Heart Foundation and sometimes out at supermarkets or community events."
When blood pressure is too high, medication offers "risk mitigation", he says, but lifestyle also plays big a big role.
"Salt intake has got a big impact on your blood pressure so limiting that, eating healthy food, exercise, limiting alcohol intake and smoking - all those boring things that the GP talks about all the time. I don't think it's particularly cutting-edge or sexy but it's a real thing."
Alongside heart health, hearing loss and loneliness are also important to watch out for with dementia prevention, Dr Oscroft says.
To guard against hearing loss, although it may sound obvious, he recommends avoiding loud noises and keeping yourself active and engaged in listening and hearing.
"The brain needs input to calibrate all its various different functions, and that input is auditory and also social. So if you're isolated, loneliness is a factor on its own. Understandably, hearing loss contributes to loneliness. You get the double whammy there."
From the age of 45, Dr Oscroft encourages men to get a PSA blood test to check for prostate cancer.
PSA is a protein from prostate tissue that all men have in their bloodstream, he says, and in the absence of prostate cancer symptoms - such as reduced or strained urine flow and blood in your urine - a normal level is "reasonably reassuring".
Unlike cervical screening and breast screening, though, there are some definite pitfalls to prostate screening, Dr Oscroft says, which can show elevated PSA levels after recent exertion.
Despite these, he personally believes it's a useful screening tool.
"You can cause a bit of harm if it's falsely elevated definitely but if guys have got symptoms of their prostate functioning abnormally it's worth getting there and checking in on that."