Found a suspicious lump, new mole or unexpected pain that you've been ignoring for a while? Unfortunately, men often experience symptoms that they don't communicate to their doctor. According to a survey by Macmillan Cancer Support almost half of men feel discouraged from talking about changes to their health in case they're perceived as making a fuss, but the health consequences can be serious.
More than 38 per cent of men have been kept awake at night in the last year because of health worries, the wider survey found, and 11 per cent delayed calling the doctor because of fear that their symptoms might be a serious health condition. However, the earlier you talk to your doctor about an unusual symptom, the quicker it can be resolved.
We spoke to Dr Sarah Brewer, medical director at Healthspan, Dr Hilary Jones, GP and ambassador for Tena Men, specialists Samantha Briscoe and Dr Zainab Laftah from London Bridge Hospital, and John Newlands, senior cancer information nurse specialist at Macmillan Cancer Support, to find out which symptoms men should never ignore:
1. Erectile dysfunction
Erectile dysfunction (ED) has a number of causes, one of the most common being age. As high as 52 per cent of men aged between 40 and 70 have reported experiencing ED, but there's still a lot of embarrassment and stigma associated with it. ED can be a constant thing or something that occurs occasionally, Dr Jones explains.
'You may be able to get erect when masturbating or when you wake up, but unable to get aroused with your sexual partner,' she says. 'In this case, psychological stress or a relationship problem is most likely to be the cause. Therefore, take some time to unwind and relax. If you find it hard to get erect in any situation, the cause is most likely to be physical. When symptoms persist for more than a few weeks, it's time to see the doctor.'
2. Frequent constipation
An average of 182 people are admitted to hospital every day with constipation. It's a common condition that can affect just about everyone. However, for some people, constipation can be a long-term (chronic) condition that causes significant pain and discomfort.
'Up your daily intake of fibre, make sure you drink plenty of fluids, and try to get more exercise,' says Dr Jones. 'If these changes don't help and the problem continues, see your GP. Continued constipation can lead to other conditions such as rectal bleeding, haemorrhoids and diverticulitis – where pouches in the lining of the colon develop and become inflamed.'
3. Difficulty swallowing
There are 50 pairs of muscles and nerves used to help you swallow, so many things can lead to issues with swallowing – from everyday conditions like acid reflux, all the way up to serious diseases like stomach cancer. If you're struggling to swallow foods or liquids with ease, it might not indicate anything serious – but it's worth getting checked out.
'Problems with swallowing are commonly associated with sore throat or tonsillitis, but if you have persistent difficulty swallowing without pain, tell your doctor as soon as possible,' says Dr Brewer. 'This can indicate a problem with the swallowing mechanism, throat, oesophagus or stomach.'
4. Chronic acid reflux
The majority of people will experience acid reflux or heartburn at some point in their life; after a heavy night of drinking or a particularly large meal. Anyone who's had it can testify to the extreme discomfort and pain that is associated with the condition. Chronic acid reflux is often a symptom of gastro-oesophageal reflux disease (GORD), where acid from the stomach leaks up into the oesophagus, says Dr Jones.
'Other symptoms of GORD include heartburn, bad breath, bloating, sickness and pain when swallowing,' she explains. 'You don't necessarily need to see your GP if you only have symptoms occasionally. However if symptoms are regular and severe, and medication isn't helping, make an appointment. Stomach acid can damage your oesophagus and cause further problems including ulcers and scarring. Changes in the cells lining the oesophagus could also lead to cancer.'
5. Unintended weight loss
Sudden weight loss can often happen after a traumatic or stressful life event, such as divorce, redundancy or bereavement, or due to an eating disorder, such as anorexia or bulimia. Certain illnesses can also cause unintended weight loss, including depression, an over- or under-active thyroid, and cancer.
'Although many people would be happy to lose weight through a sensible diet and lifestyle, unexplained weight loss should never be ignored,' says Dr Brewer. 'It can be a sign of an undiagnosed illness and may not always be accompanied by loss of appetite.'
6. Pain or blood when urinating
Men only account for 20 per cent of diagnosed urinary tract infections, but they are more likely to be hospitalised than women. Normal urine should not contain any detectable amounts of blood and so if you do experience this, it needs to be investigated by a doctor, says Dr Jones.
'Often cause by a urinary tract infection (UTI), the blood will have come from somewhere within the urinary tract – the kidneys, bladder or the tubes that urine passes through,' she says. 'Blood in the urine can also be a result of an infection in the bladder and kidneys, kidney stones, urethritis, and an enlarged prostate gland. For adults over 50, this could be a sign of cancer in the bladder, kidneys or prostate.'
7. Changes to a mole
It is not uncommon to develop new moles, with the majority appearing before the age of 40, says Dr Laftah. 'Some of the changes that occur in moles can be harmless,' she says. 'Some moles can become more raised and appear more prominent or become flesh-coloured as we get older. It is also not unusual for some moles to disappear.'
However, if a mole changes, it can indicate melanoma, or skin cancer. You should monitor both new and existing moles using the ABCD criteria:
Asymmetry: Do the two halves of the mole differ in shape?
Border: Have the edges become irregular or blurred?
Colour: Is it uneven, with different shades of black, brown or pink?
Diameter: Is it increasing in size? Is it larger than 6mm?
These changes can happen over weeks or months, so keep checking your moles. 'Early treatment of skin cancer saves lives, so you should always seek medical review with your dermatologist or GP if you have a changing mole or any concerns,' Dr Laftah says.
8. Severe chest pain
Most chest pain is not actually heart-related and is unlikely to be a sign of a life-threatening problem – however, it should never be ignored. Some common causes of chest pain include GORD, costochondritis and panic attacks. If the pain feels heavy, lasts longer than 15 minutes, and spreads to other parts of your body, such as your arms, back or jaw, call 999 for an ambulance immediately.
'Severe chest pain can be a symptom of angina, where blood supply to the muscles of the heart is restricted, or a heart attack, where blood supply to part of the heart is suddenly blocked,' says Dr Jones. 'The main differences between these conditions is that chest pain caused by angina tends to get better with rest after a few minutes, but symptoms that last more than 15 minutes and occur at rest are more likely to be caused by a heart attack.'
9. Changes in your poo
While changes in bowel habits are often harmless, they can indicate an underlying condition such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). A change means opening your bowel more or less frequently than is usual for you, says Dr Brewer.
'The stools may also chance in consistency, so you develop constipation, or a general slowing down of bowel movements, or diarrhoea and a speeding up of your intestines,' she says. 'If this continues for more than a week or two, seek medical advice – earlier if you develop abdominal pain or notice blood or slime in your motions.'
10. Urinary leakage
Urine leakage occurs in one in four UK men over the age of 40, and can be triggered by simple things such as drinking too much coffee or lifting heavy weights at the gym. There are a number of possible causes for male urinary incontinence: birth defects with the urinary tract, treatment from prostate cancer, obesity and ageing.
It's important to understand the cause of urinary leakage – in some cases, it could be due to a more serious underlying condition like neurological or prostate problems. 'Men experience urine leakage due to a variety of reasons, the most common of which is associated with the prostate,' says Dr Jones. 'You will have an increased and urgent need to urinate and will often wake up in the night to go to the toilet.'
11. Sleep disturbances
Sleep patterns and habits vary from person to person, hence the concept of morning larks and night owls – however, when your sleep pattern or quality changes and begins to affect your daytime functioning, it might be time to seek help, says Briscoe. 'Common daytime effects of poor sleep can include poor memory, difficulty concentrating, poor mood, slower reactions, reduced ability to problem solve and impaired judgement,' she says.
If you are sleeping too much, too little, or having trouble falling or staying asleep, book an appointment with your doctor. Your sleep disturbances could be due to a condition like anxiety or depression, or a potentially serious sleep disorder such as sleep apnea. This condition is characterised by pauses in breathing and loud snoring during sleep, and can increase the risk of heart attack and stroke.
12. A tight, tender foreskin
Only 15 per cent of men in the UK have been circumcised, compared to well over 50 per cent in the US. An uncircumcised foreskin should retract easily from the head of the penis and not be sore red itchy or inflamed, says Dr Jones, so seek medical attention if you experience these symptoms.
'A mild bacterial or fungal infection could be the cause often triggered by mechanical irritation during sex,' she says. 'Occasionally the foreskin becomes spontaneously tighter, itchy, painful or non-retractile due to the formation of scar tissue – a condition known as lichen sclerosus. Treatment with steroid cream can often ease the symptoms.'
13. Weight gain
If weight gain leads you to become overweight or obese, it has implications for your health and wellbeing – increasing the likelihood of high cholesterol, high blood sugar, heart disease and stroke. Unintentional weight gain occurs when you gain weight without increasing your intake of food or liquid and without decreasing your activity levels.
'Weight gain is usually due to eating more calories than your body needs to maintain weight based on your metabolic rate and level of activity,' says Dr Brewer. 'Occasionally, it can be a sign of a hormone imbalance, such as an underactive thyroid, or fluid retention – for example, due to liver, kidney or heart problems – so do see your doctor, especially if you feel unwell, fatigued, short of breath or notice swelling of your extremities.'
14. Testicle lumps
Men are 60 per cent more likely to get cancer and 70 per cent more likely to die from the disease than women, according to Macmillan Cancer Support. Men are less likely to go to the doctor when they notice a change in their body, and this is thought to contribute to the higher death rate. If you notice a lump in your testicle, you should get it checked by a doctor.
'Most cases of testicular lumps aren't serious or cancerous,' says Dr Jones. 'In fact, testicular cancer is rare – and it's curable if you find it early. However, since it's difficult to figure out the cause of a testicular lump, you should make an appointment with your doctor if you notice any lumps, swelling, or pain in your testicles. What's more, by regularly self-examining your testicles, you will be able to find these changes early.'
15. Changes in nipple or surrounding area
Breast cancer rarely occurs in men – only around 350 men in the UK are diagnosed each year – so it's understandably not the first thing to come to mind if you notice a change. Many people don't know that men can get breast cancer because they aren't aware that men have breasts, says Newlands.
'In most men, breast cancer is first noticed as a painless lump under the nipple or areola,' he explains. 'Other signs may include an inverted nipple, changes to the size or shape of the breast, a rash or bleeding from the nipple, a swelling or lump in the armpit or an ulcer on the skin of the breast.'
16. Excessive bruising
While bruising is usually a sign of tissue injury, if you start to notice them popping up frequently, make an appointment with you doctor. It may not be anything nefarious – people tend to bruise more easily as they get older – however sometimes unusual bruising can indicate the presence of a serious condition.
'If you bruise easily, it could indicate a problem with blood clotting, such as a low platelet count, liver disease or an inherited condition associated with abnormal blood clotting proteins,' says Dr Brewer. 'Easy bruising can also occur as a side effect of some medications – such as aspirin and prednisolone – or from fragility of blood vessels, for example, due to a lack of vitamin C or simply advanced age.'
17. Low mood, anger issues or anxiety
If you are experiencing low mood, anger issues, or anxiety, it may indicate the presence of a mental health condition, such as depression. Men with depression are more likely to experience symptoms such as irritability, risk-taking and aggression, and may be more likely to use alcohol and drugs to cope with these feelings, rather than talking about it.
'Few people are blessed with a happy mood all the time,' says Dr Brewer. 'One day you may feel cheerful and the next you are gloomy and withdrawn for no obvious reason. This is a normal part of everyday life, but if your mood swings too low, a full-blown depressive illness can result. If you are concerned about low mood, mood swings, anger or anxiety it is important to seek professional advice – talking therapies can help.'
18. Persistent cough
Most coughs are caused by a cold or the flu, but sometimes heartburn, allergies such as hay fever, and infections such as bronchitis can be to blame. It's very rarely a sign of something serious like lung cancer. If a cough is persistent, defined as a lasting for a period of eight weeks or longer, it's worth visiting the doctor.
'A cough is caused by irritation of the airways or can suggest that your lungs are not working as well as they might,' says Dr Brewer. 'This needs checking out urgently if you also notice chest pain or cough up blood. Persistent cough can be a sign of coronavirus infection and of so-called long-COVID.'
⚠️ If you experience any of these symptoms, make an appointment with your GP. The earlier you talk to your doctor about an unusual symptom, the quicker it can be resolved.
Last updated: 30-12-20
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