Globally, men die 4.5 years earlier than women for largely preventable reasons.

In most countries — including Ireland — men have poorer health and die before their time. Irish men are more likely than women to die from preventable and treatable diseases. Seven out of twelve top causes of male mortality could be reduced with lifestyle changes such as improving diet, regular exercise and seeking medical help sooner. However, some male health problems are more complex and require a different approach.

Three out of four suicides are men

In Ireland, three out of four suicides are men; and although the male suicide rate has been falling for several years, it is the leading cause of death in 15 to 34-year-old males.

Risk factors include acute stress, low mood, social isolation along with the belief that they shouldn’t talk openly about their feelings. This can deter them from seeking help and receiving treatment which can lead to men struggling in silence until it’s too late.

The most diagnosed cancer among younger men (under the age of 45) is testicular cancer.

Prostate and testicular cancers on the rise

Ireland has the highest rate of prostate cancer in the European Union; although, this may be partly related to high levels of prostate-specific antigen (PSA) testing. The most diagnosed cancer among younger men (under the age of 45) is testicular cancer.

There has been a huge increase in biomedical research investment for both cancers since Movember began in 2003. This includes funding for a team from University College Dublin, through Movember’s international GAP1 project, who went on to develop the epiCapture DNA test which measures the aggressiveness of prostate cancer without the need for biopsies. Despite these breakthroughs, there are still unanswered questions about the best way to diagnose and treat these cancers.

We can’t afford to stay silent

Male cancers and mental health issues strike at the very heart of what it is to be a man. Men worry about them but find it difficult to talk about them openly. Although progress has been made in recent years, there is still a huge stigma surrounding mental health. Many live in fear of mental health challenges being revealed, especially in the workplace. For many men, urological symptoms are still shrouded in shame and embarrassment which deter them from seeking help — even if it might be life-threatening.

No one says it’s easy for men to talk about what’s worrying them; but by challenging those outdated attitudes and behaviours, we can make it okay for men to seek help when they need it.

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It was the summer of 2016. I was on a holiday of a lifetime when I found out about my prostate cancer.

I was watching Coldplay in Concert. That day, I had been writing one of the final chapters of my memoir ‘The Boy on the Shed.’ An unexpected heart attack three years prior had focused my mind on putting my life to date down on paper. It was all going so well until I noticed I was getting up in the night to pee a little more often than usual.

Know when to see a doctor

I knew not to take any chances. I made an appointment with my doctor. One palpation of my prostate later, I was having a PSA (prostate-specific antigen) test. My PSA was high. I was put on a fast-track programme to see a urologist. I got a letter telling me to ignore the first one I’d received, and that another one would follow. I did ignore it — for four months!

It was all going so well until I noticed I was getting up in the night to pee a little more often than usual.

I assumed I wasn’t a priority and waited. I’d all but forgotten about it until I made my way to the toilet at the Coldplay concert. I stood at the urinal and waited — nothing came. I couldn’t tell you what Coldplay sang for the rest of the night. My mind was elsewhere. It was on the fact that something was very wrong and wondering where my letter was.

Catching it early

I called the hospital when I got home. I had my appointment. I had my biopsy — I had prostate cancer. I opted to have a prostatectomy. I hoped that would cure it. It didn’t. There was a positive margin. I was back in the hospital a year later for radiotherapy and hormone treatment.  I’m four years clear now. I live with the side effects of my treatments — incontinence, erectile dysfunction, infertility and penile shrinkage (indeed!). Sometimes, that gets me down. Then, I remind myself that I‘m one of the lucky ones. My cancer was caught early enough, even if it did take a ruined Coldplay concert to get me back on track.

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‘World Cup Fever’ is in the air. Men across Ireland have planned their viewing schedules, stockpiled enough refreshments to see them through a nuclear winter and made arrangements with their friends to share this four-yearly experience.

The World Cup has created a common bond among many local men. They have a reason to be in each other’s company. They are well-informed about what lies ahead. They are motivated, excited and enthusiastic. They are likely to show more emotion than usual —they’ve obviously caught a bug. Maybe ‘World Cup Fever’ is a medical condition after all.

Men’s health risks

There is clear evidence that men in Ireland are facing other medical conditions that attract much less attention. Put simply, local males experience a disproportionate burden of ill health and die too young. They —

• [Mostly] die younger than women;
• Have higher death rates for almost all of the leading causes of death and at all ages;
• Adopt lifestyles that can cause chronic diseases;
• Often present too late to health services for effective treatment;
• Are more likely to engage in risk-taking behaviours (eg. speeding, drunk driving);
• Eat less healthy, are more likely to be overweight and drink more alcohol;
• Have mental health needs which often remain under the radar and unmet.

The Republic of Ireland was the first country to adopt a National Men’s Health Policy and, subsequently, a Healthy Ireland – Men Action Plan.

An interesting fact

The Republic of Ireland was the first country to adopt a National Men’s Health Policy and, subsequently, a Healthy Ireland – Men Action Plan. This action plan is now being reviewed and updated. It provides both the bedrock of and a mandate for, a focus on men’s health needs.

Men’s health initiatives

There are many practical initiatives which have been piloted in Ireland to improve men’s health. These include Men’s Health in Numbers; Men’s Health Week; The Engage National Men’s Health Training Programme; Farmers Have Hearts; Sheds for Life; Men on the Move; GAA Healthy Club Project; HSE ‘Engaging Men’ and ‘Masculinities and Men’s Health’ webinars.

These initiatives demonstrate that men are (contrary to public perception) interested in their health — if we offer them the right things in the right ways. The Irish squad may not be through to the final stages of the 2022 FIFA World Cup, but we can still use this time of ‘goodwill among all men’ to focus on male health needs and play our part to improve the lot of men and boys — now, that would be a momentous win on the world stage!

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Even though as many as one in four men over 50 years old can experience urinary leakage, a need to destigmatise the topic helps men feel empowered to keep control of their bodies.

It’s not always easy for men to talk about involuntary urine leakage. Whether experiencing light drips and dribbles or heavier leaks, it can leave men feeling isolated and anxious, affecting their self-confidence.

Momentary leakage

Community pharmacist Mark Jordan believes that lifestyle changes can help reduce the impact and prevent urinary incontinence — defined as involuntary loss of urine — from becoming more serious.

As a pharmacist in a village in northwest Mayo, he says: “Urinary incontinence within the male population affects roughly half of the individuals I come into contact with aged 50 and over.”

A community pharmacy can be the first point of contact for men who require help and advice for urinary incontinence. The condition broadly falls into three main categories: momentary leakage; a moderate degree of incontinence; or complete loss of control where medication or referral to a urologist is necessary.

Lifestyle changes

Momentary leakage could be where the loss of control is due to strenuous activity, laughing, ingesting something that encourages leakage — like a caffeinated drink — or increased bladder fill.

“It can move to a moderate degree of urinary incontinence where there is less control and possibly more urgency and frequency involved,” says Jordan, who is active with the regulatory body Pharmaceutical Society of Ireland.

A community pharmacy can be the first point of contact for men who require help and advice for urinary incontinence.

“We are looking at abstinence from caffeinated drinks and trying to increase overall wellness, so men have better control of their bladder. Anybody experiencing symptoms of incontinence or a change in bladder control should seek advice from a medical professional,” he adds.

The community pharmacist may also advise products that help with urinary incontinence.

Breaking the stigma

Stressing the importance of breaking the stigma, he acknowledges that urinary incontinence is openly discussed in reference to women’s health. But for men, it is not something they are comfortable discussing.

“When I talk to men about this, I point out how common urinary incontinence is and how products like discreet male protective pads and underwear can help. It is heartening to know how they offer good control for many men. Incontinence can often be treated, and products like TENA MEN can help you manage,” he adds. “By educating people who experience urinary incontinence, we can remove the stigma and assist in treating what is a common problem. It gives people the tools to avoid suffering in silence.”

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