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Men’s health

### Quick facts
- Prostate cancer is the second most common cancer in men
- Most cases are diagnosed in men over 50
- It might not show symptoms, and may require little or no treatment

It’s that time of year again, when men grow moustaches — ranging from flattering to funny — in support of Movember. 

The campaign raises awareness and funds in three areas: [male suicide](/your-health/signs-of-depression-in-men/) — which claims 60 men every hour globally — as well as [testicular cancer](/your-health/testicular-cancer-how-to-spot-the-signs/) and prostate cancer. 

Here we talk to Dr Rhianna McClymont, a Kry GP, about the facts on prostate cancer.

### What is the prostate? 

Around the size of a walnut, the prostate is located just below the bladder and in front of the rectum. It’s a gland only men have.

Its main function is to produce the thick, white fluid that creates semen when mixed with sperm produced by the testicles. 

### Prostate cancer — common among older men

The Movember campaign has made many of us more aware of prostate cancer. Thankfully so, as it’s the second most common cancer in men, and the fourth most common cancer overall.

In fact, more than 1.2 million new cases of prostate cancer were recorded globally in 2018 and in excess of 350,000 deaths. 

The UK is in the top 18 countries with the highest rate of prostate cancer.

### What increases the risk of prostate cancer?

__Age__ – Most prostate cancer cases are diagnosed in men over 50. ‘Age is an important risk factor, with the risk of getting prostate cancer rising as you get older,’ says Dr McClymont. 

__Ethnicity__ – ‘Research has shown that men from an African-Caribbean or African descent are more likely to get prostate cancer’.

__Family history__ – ‘If you have a dad or brother who has developed prostate cancer, particularly if this developed earlier in life before the age of 60, then the risk is higher,’ Dr McClymont says. 

__Obesity__ – According to the NHS, recent research suggests obesity increases the risk of prostate cancer.

### What are the symptoms?

Prostate cancer often shows no symptoms in its early stages and, in fact, may require no or minimal treatment. 

However, as the disease progresses common symptoms can include:
-  Passing urine more frequently (particularly at night)
- Difficulty in starting to pee, or a weak flow of urine
- Feeling like your bladder hasn’t emptied completely 
- Feeling like you need to pee urgently

### How is prostate cancer tested?

‘If you have any of the above symptoms, you may be offered a Prostate-Specific Antigen (PSA) test (taken as a blood test) and an examination of your prostate by your GP,’ says Dr McClymont. The latter will include a rectal exam. 

‘A PSA test can indicate a problem such as prostate cancer, but your PSA level can also be raised for a number of other reasons, so it’s not conclusive,’ she points out. 

‘Usually, an MRI scan will also be used to assess the prostate if a PSA level is raised, and prostate cancer is then diagnosed with a biopsy.’ 

### How is it treated?

Treatment for prostate cancer depends on the severity of the cancer, whether it has spread outside the prostate to other areas of the body, your general medical fitness, and other health conditions you may have. 

‘There are numerous treatment options, including surgery, radiotherapy, hormone therapy or “watchful-waiting”. This is where the cancer is unlikely to affect your natural lifespan, so symptoms are controlled while the cancer is monitored, to make sure it’s not progressing,’ says Dr McClymont. 

‘Any form of treatment involves potential side effects,’ she points out. ‘If surgery to remove the prostate gland is recommended to treat the cancer then these are important considerations. 

‘Following a prostatectomy (removal of the prostate), for example, many men subsequently suffer with difficulties getting or sustaining an erection, and also with urinary incontinence.’

It‘s worth remembering that while prostate cancer may be a serious disease, most men who are diagnosed with it do not actually die from it. 

Watchful waiting has advantages and disadvantages. You won’t have side effects from any treatment or need regular scans or biopsies, and if you begin to suffer from symptoms such as pain or swelling, there is treatment to help manage them. But most men never need treatment. 

Disadvantages can include the possibility of the cancer growing and spreading, and the man and his loved ones having the psychological worry that he’s not being treated.

‘Usually, the watchful waiting approach is for men with mild cancers that are not causing significant problems — and are unlikely to develop them throughout their lifetime. Or for men with other health problems who may not benefit from more invasive treatments like surgery or radiotherapy,’ Dr McClymont points out.

Talk to a doctor if you have any symptoms or concerns.

__This article has been medically approved by Dr Rhianna McClymont, Lead GP at Kry__


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See a GP about prostate cancer

Kry.co.uk > Your health > Prostate cancer — a doctor’s guide

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Men are less likely than women to see a GP over worrying symptoms. But here’s why prostate cancer shouldn’t be ignored

Prostate cancer — a doctor’s guide

Men Health

Men's Health

Around a fifth of men have a low sperm count. For couples experiencing difficulties in conceiving, male infertility is the main cause in about 20% of cases.
  
But research has found that lifestyle factors play a key role in semen quality and healthy sperm motility (this refers to the sperm’s ability to move forward or ‘swim’ to fertilise an egg during conception).
 
In fact, 3 months before you’re planning to start trying for a baby, it’s advisable to deal with pre-existing health problems with your doctor and to make healthy lifestyle changes such as those listed below. This will help to make sure that your sperm quality is the best it can be.

## 1. Lose excess weight

If you have a raised body mass index (BMI), then try to lose weight. Obesity has a massive influence on male fertility problems, and studies show that it can affect hormone levels causing reduced sperm production and concentration. Similarly, although the evidence is more conflicted here, there may also be a link between obesity and reduced sperm motility and morphology (this refers to the shape of a sperm). All of this can reduce the chances of the sperm fertilizing the egg. 

It is also becoming clearer that male obesity can affect the molecular health of sperm and damage sperm DNA. Integrity of sperm DNA is essential for successful fertilization and normal development of a baby.
Some research shows that paternal obesity can even affect the health of your future children, through increased susceptibility of offspring to chronic disease. 

The best way to achieve an ideal weight is through healthy diet and exercise.  

## 2.  Stop smoking

Smoking can reduce ejaculate volume as well as sperm density and motility. Smokers might have a lower zinc content in their semen, which can reduce sperm production.
 
The tiny hairs that help semen move along the tubes of the epididymis (the tube that transports sperm produced in the testes) may be damaged in smokers, which can also negatively affect sperm function. Smoking can also harm erectile function.
 
Continuing to smoke also puts your partner at risk through passive smoking.
 
The good news is that these negative effects can be reversed if you give up smoking. Do ask your doctor if you need help stopping smoking, as there are NHS stop-smoking programmes that could improve your chances of stopping.

Want to give up smoking? Read our guide on the options available.


## 3.  Cut back (or cut out) alcohol

Drinking alcohol excessively can affect the quality of sperm. It lowers levels of testosterone, follicle-stimulating hormone and luteinising hormone (LH), which is one of the main hormones that controls the reproductive system. Alcohol raises oestrogen, which can contribute to reduced sperm production: one study found that drinking as little as 5 units of alcohol a week could adversely affect sperm quality.


## 4.  Avoid recreational drugs

Marijuana and cocaine are thought to affect male fertility, but large-scale studies are perceived as unethical, so it’s impossible to say for sure.
 
Anabolic steroids (sometimes taken by men to bulk up their bodies), amphetamines (speed), as well as heroin and methadone also damage sperm quality. If you’re using any of these drugs then talk to your doctor to work out a way to stop your habit.


## 5.   Do regular exercise

It’s important to be active for good cardiovascular health and to be at an ideal weight for fertility.
 
But research has repeatedly shown that generally active men also have higher sperm counts than their sedentary counterparts. Aim for at least 30 minutes of moderate exercise, 5 times a week.


## 6.   Manage your stress levels

Stress can reduce hormones such as LH and testosterone. In theory, this can affect sperm quality, although more studies are needed to make a definite connection.
 
‘Mental stress affects us in many ways. It affects our libido, potentially our reproductive abilities and probably also sperm quality,’ says Dr Rosen, Kry GP.
 
Learn a few simple breathing and meditation techniques that you can regularly turn to during stressful moments. [The Headspace app](https://www.headspace.com/headspace-meditation-app) is a great starting point.


## 7.    Keep an eye on temperature

Increased temperature of the testicles might impair sperm quality. Try to avoid sitting for prolonged periods with a warm laptop on your groin area or carrying a warm phone in your pocket. Also, don’t take long hot baths, saunas and Jacuzzis.
 
Instead, wear loose-fitting trousers and undergarments (such as boxer shorts). If you work in a hot environment or sit down for hours at a time, it’s important to move around and get outside regularly.


## 8.    Eat a healthy diet

Diets that are high in processed meat, caffeine, red meat, saturated fatty acids and trans fats are linked to low quality semen.
 
Fruit, vegetable, wholegrain and fish rich diets are linked to better sperm quality. In fact, a Mediterranean style diet for heart health will support fertility.
 
Make sure your diet is rich in antioxidants such as vitamin C, folate, zinc and B12. These are best obtained from your diet, so aim to eat at least 5 portions of fruit and vegetables each day. Talk to your doctor about your diet specifically, just in case you might need to take a food supplement - for example, because you’re vegan.
 
Foods rich in omega-3 fatty acids such as walnuts or oily fish (including salmon, sardines, mackerel and herring) help sperm production.


## 9.    Talk to your GP

If you have existing medical conditions that might affect fertility, such as sickle cell or thalassaemia or other hereditary diseases, take the opportunity to see your doctor for a preconception chat.

Similarly, if you are a man who has had groin surgery or treatment for testicular cancer, then you might want to discuss fertility with a doctor sooner.
 
Remember to get STI excluded (or treated) by being tested as soon as possible, if that’s appropriate.
 
If you have not conceived as a couple after having unprotected sex for a year, then consult your doctor together; fertility treatment options such as IVF might be a consideration.


__Reviewed by: Dr Rhianna McClymont, Lead GP, Kry__






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Male fertility – 9 lifestyle factors that help

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