Testicular cancer is cancer that develops in one or both testicles. In most cases, only one testicle is affected. It is estimated that 980 Australian men were diagnosed with testicular cancer in 2021, making up about 1.2% of all new cases of cancer diagnosed in men. It most commonly occurs in men aged 25–40 years.

Most (more than 90%) of testicular cancers start in germ cells, the cells that develop into sperm.  There are two main types of germ cell tumours: seminoma and non-seminoma.  Seminoma tumours tend to develop more slowly than non-seminoma cancers, and usually in men aged 25 to 45 years. Non-seminoma tumours usually develop more quickly and are more common in the late teens and early twenties. Stromal tumours are much less common and start in the cells that make up the structural and hormone-producing tissue of the testicles.  They are usually benign and are removed by surgery.

Risk factors for testicular cancer include:

• Undescended testicles as an infant
• Family history of testicular cancer in your father or brother
• Infertility
• HIV and AIDS
• Certain congenital defects, including hypospadias and inguinal hernia

Symptoms of testicular cancer may include:

• swelling or a lump in a testicle, which is usually painless
• a change in the size or shape of a testicle
• a feeling of heaviness in the scrotum
• a feeling of unevenness between the testicles
• pain in the lower abdomen, back, testicle or scrotum
• enlargement or tenderness of breast tissue

Sometimes there are no symptoms at all. There are many other possible causes for these symptoms, but if you notice any lumps or changes in your testicles, it is important to see your doctor for further investigations. Early detection is the key to successful treatment, so self-checking your testicles regularly and seeking advice if you find any abnormalities is important.

Treatment for testicular cancer will depend on the type and stage of cancer (whether it is only in the testicle or has spread to other parts of the body). In some cases, surgery to remove the testicle may be all that is needed, while in other cases this may need to be followed by chemotherapy and/or radiation therapy. In most cases, testicular cancer can be successfully treated and it has the highest survival rates of any cancer, other than common skin cancers.

 For instructions on now to do a testicle self-check visit Cancer Council: Types of Cancer: Testicular Cancer

References:

1. Cancer Council: Types of Cancer: Testicular Cancer
2. Cancer Australia: Testicular Cancer
3.  Health Direct: Testicular Cancer

Muscle Dysmorphic Disorder (MDD) is a type of Body Dysmorphic Disorder (BDD). BDD is a common but often under-recognised mental illness where a person becomes obsessed with parts of their bodies and how they appear to other people.  BDD affects men and women equally, but muscle dysmorphia occurs largely in males.

Men with MDD typically see themselves as not being muscular or lean enough.  It is sometimes referred to as ‘reverse anorexia’ or ‘bigorexia’.  Those who take part in body building are particularly at risk.   Other risk factors including having a low self-esteem, an existing mental health concern or genetic predisposition to mental illness, and a history of bullying about weight and appearance, particularly relating to muscularity.

Some common signs of MDD include:

• Spending excessive time doing strength training and weightlifting, to increase muscle mass
• Being overly preoccupied with  your muscle size, shape and body fat
• Feeling anxious if you cannot train or if you miss a workout
• Overtraining or training when you are injured or unwell
• Disordered eating behaviours, including following special or restrictive diets and using protein supplements to increase muscle size and/or reducing body fat
• Using steroids or other illegal substances
• Compulsive comparing and checking of your body and shape
• Feeling anxious, distressed and/or experiencing mood swings
• Prioritising exercise and training sessions over everything else, including your relationships, work or study
• Being scared about losing muscle if you stop training or using steroids

You may also worry about other aspects of your body or appearance, such as your hair, skin, or genitals.

While there are many benefits of regular exercise, it becomes a problem when it interferes with your life and negatively affects your relationships, work, study and mental and physical health. If you recognise you have symptoms of MDD it’s important to seek help.  Speak with your GP who can discuss treatment options with you, including psychological counselling and medications.

Read more about body image at Reach Out; including hearing from other men about their thoughts around body image

References:

1. Phillipou A, Castle D. Body dysmorphic disorder in men. Aust Fam Physician. 2015;44(11):798-801.
2. Phillips KA, Castle DJ. Body dysmorphic disorder in men. BMJ. 2001;323(7320):1015-1016. doi:10.1136/bmj.323.7320.1015
3. Muscle dysmorphia: Recognising a growing problem among young men.
4. Butterfly: Body Image Disorders

Sexually transmitted infections (STIs) are infections that are passed on during unprotected sex with an infected partner. This includes vaginal, anal or oral sex. Anyone who is sexually active can get an STI if they don’t practice safe sex.

There are many different STIs including Chlamydia, Herpes, Gonorrhoea, Syphilis, Mycoplasma genitalium, genital herpes, hepatitis and HIV.

Symptoms can vary, depending on the type of STI, but may include:

• unusual discharge from the penis or anus
• painful urination
• sores, blisters, ulcers, warts or rashes in the genital area
• pain in the scrotum or testicles
• flu-like symptoms including fever, headache and swollen glands

However, many people who have an STI have no symptoms. This means they could unknowingly pass on the infection to a sexual partner.  Left untreated, STIs can also lead to other health problems and may affect your fertility. That’s why everyone who is sexually active should have regular check-ups with their doctor or sexual health clinic. This is particularly important if you think you’ve been exposed to an STI.

It is recommended that you get tested:

• after any sexual contact with a new or casual sexual partner
• after any sex, if you know or suspect that your partner has had other sexual partners
• after any unwanted or non-consensual sexual contact
• after any sexual contact in countries where HIV and other STIs are common
• if your partner tells you that they have been diagnosed with an STI
• if you are planning a pregnancy, to prevent any infections being passed on to your baby

You can reduce your chances of getting most STIs by using barrier protection during sexual activity, including condoms and dental dams, and by limiting your sexual partners.

And remember that your doctor deals with sexual health problems on a regular basis, so if you are concerned you might have an STI, there’s no need to be embarrassed to ask for help.

For more information visit the Health Direct website

References

• Better Health Channel: Sexually Transmitted Infections
• Health Direct: Sexually Transmitted Infections
• Healthy WA: Sexually Transmitted Infections

Preparing for pregnancy isn’t just something for the girls. Fertility problems are equally likely to occur in men as women.

The good news is that there are a number of things that men can do to improve fertility and increase the chances of conceiving a healthy baby.

Here are the habits that matter most:

• If you smoke, quit. Both active and passive smoking harms sexual and reproductive health in both men and women. For men, it can damage sperm DNA and increase the chances of miscarriage and likelihood of your child developing childhood cancer.
• Limit or avoid alcohol. Alcohol, particularly daily consumption and binge drinking, reduces fertility. If you choose to drink while trying to conceive, do so in moderation.
• Keep your weight healthy. Carrying excess weight is associated with reduced sperm concentration and mobility, damage to sperm DNA and changes in reproductive hormones, all of which can affect fertility.
• Exercise regularly. Spending too long sitting can affect sperm quality and reduce sperm production. Regular exercise has many health benefits and improving sperm quality is one of them!
• Eat a healthy diet. Diets high in antioxidant-rich plant foods including fruits, vegetables, nuts and seeds, and low in saturated fat, are associated with improved sperm quality.
• Avoid recreational drugs such as marijuana and cocaine, which can decrease sperm quantity and increase the number of abnormal sperm.
• Don’t misuse anabolic steroids (e.g. for body-building purposes) as they can lead to shrunken testicles and stop sperm production.
• Have frequent sex. It’s a myth that sperm becomes more potent if a man abstains from sex or ejaculation. On the contrary, sperm that is stored for too long in the testicles can become damaged. So if you are trying for a baby, it is recommended that you ejaculate or have sex 2-3 times per week.
• Keep them cool. Sperm production is optimal when the temperature inside your scrotum is cool so choose boxer shorts or underwear with fabrics that allow for good airflow.
• Review your medications. If you take any prescription medications, check with your doctor if they could affect fertility and may need changing while you are trying to conceive.
• Minimise exposure to environmental chemicals. Chemicals that you may be exposed to at work or in daily life can affect your sperm, including pesticides, heavy metals, some chemicals and plastics and radiation. Try to limit your exposure to these and wear protective clothing if you are trying to conceive.

For more information:
Preconception Health for Men 

References and further reading:
Salas-Huetos A1,2, Bulló M1,2, Salas-Salvadó J1, Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. Hum Reprod Update. 2017 Jul 1;23(4):371-389.

Ricci E1, Al-Beitawi S2, Cipriani S1, Alteri A2, Chiaffarino F1, Candiani M3, Gerli S4, Viganó P2, Parazzini F1,5. Dietary habits and semen parameters: a systematic narrative review. Andrology. 2018 Jan;6(1):104-116.

Ricci E1, Al Beitawi S2, Cipriani S3, Candiani M2, Chiaffarino F3, Viganò P4, Noli S3, Parazzini F3. Semen quality and alcohol intake: a systematic review and meta-analysis. Reprod Biomed Online. 2017 Jan;34(1):38-47.

Sharma R1, Harlev A2, Agarwal A3, Esteves SC4. Cigarette Smoking and Semen Quality: A New Meta-analysis Examining the Effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen. Eur Urol. 2016 Oct;70(4):635-645.

Christou MA1,2, Christou PA1, Markozannes G2, Tsatsoulis A1, Mastorakos G3, Tigas S4. Effects of Anabolic Androgenic Steroids on the Reproductive System of Athletes and Recreational Users: A Systematic Review and Meta-Analysis. Sports Med. 2017 Sep;47(9):1869-1883.

Liu Y1, Ding Z2. Obesity, a serious etiologic factor for male subfertility in modern society. Reproduction. 2017 Oct;154(4):R123-R131.

Metabolic syndrome, also called syndrome X, is a collection of risk factors which together increase the risk of heart disease, stroke and type 2 diabetes. It is estimated that 20-30% of Australian adults are affected.

Risk Factors

Metabolic syndrome is diagnosed when you have three or more of the following risk factors:

• Excess weight around the middle (a waist circumference of more than 88cm for women and more than 102cm for men of Caucasian background but these may vary for those from different ethnic backgrounds – your doctor can advise you on your individual targets)
• High triglyceride (fat) levels in the blood
• Low levels of HDL (‘good’) cholesterol
• High blood pressure
• Insulin resistance or type 2 diabetes

While each of these are risk factors on their own, their combined risks are even greater. If you have metabolic syndrome, your risk of cardiovascular disease (heart disease and stroke) is doubled and your risk of diabetes is around seven times greater than in those who don’t have the condition.

Managing Metabolic Syndrome

While genetics and age both play a part, lifestyle modification is the key to preventing and managing metabolic syndrome. The same lifestyle changes that are recommended for preventing and managing heart disease and type 2 diabetes can help. These include:

• Eating a healthy diet
• Exercising regularly and reducing sedentary time
• Losing weight and reducing your waist measurement
• Quitting, if you smoke
• Getting adequate sleep
• Managing stress levels

Medications may also be needed to manage individual risk factors such as high blood pressure, high cholesterol and elevated blood glucose levels.

In children and adolescents, lifestyle changes including a healthy diet, increasing physical activity and reducing screen time can reduce the risk of developing metabolic syndrome later in life.

If you suspect you may have metabolic syndrome it’s important to see your doctor who can organise the tests needed to diagnose the condition. They will also help you to work out the best way to manage the condition to reduce the risk of future health problems.

For more information:
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/metabolic-syndrome
https://www.healthdirect.gov.au/metabolic-syndrome

Heart disease is Australia’s single leading cause of death. In 2017, heart disease claimed the lives of 51 Australians each day – that’s one person every 28 minutes. While both men and women are affected, men are more likely to develop heart disease than women.

There’s no single cause for heart disease but there are many risk factors which increase your chances of developing it.

Risk Factors

These risk factors include:

• Age
• Family history
• Ethnic background
• Smoking
• Being overweight
• Being physically inactive
• Eating an unhealthy diet
• Having high blood pressure and/or high cholesterol
• Having diabetes
• Social isolation and depression

Fortunately, many of the risk factors for heart disease are modifiable by introducing a few simple lifestyle changes.

You can find out more about what’s involved by speaking with your GP, or visiting the Heart Foundation website

The full article Heart Health can be read on Your Health.

Obstructive sleep apnoea (OSA) is a condition where a person’s breathing repeatedly stops during sleep. It occurs due to partial or complete blockage of their airway while sleeping.

Someone with OSA may stop breathing for anywhere between a few seconds and 90 seconds at a time. These episodes (known as apnoeas) can occur up to hundreds of times each night, depending on the severity of the problem.

While it can affect anyone, twice as many men than women have OSA and it is more common in those who are middle-aged or older.  It is also more likely to occur in those who are overweight, in people who snore and in those with naturally narrow throats or nasal passages, as well as in children with enlarged tonsils or adenoids.

Symptoms of OSA include:

• Snoring
• Pauses in breathing while asleep – this is often noticed by others
• Waking up gasping or choking
• Morning headaches
• Waking with a dry mouth
• Excessive daytime sleepiness

OSA affects more than just sleep.  If untreated, it can increase the risk of developing high blood pressure, diabetes, stroke and heart disease. Due to daytime sleepiness, people with OSA may also have a higher risk of motor vehicle accidents and workplace accidents.

OSA is usually diagnosed by a having a sleep study. This involves an overnight stay in a hospital or a sleep clinic, where measurements are taken of your breathing and sleep patterns and your blood oxygen levels.

There are a number of treatments available for OSA, depending on the severity.  However, the most common treatment is using a CPAP (Continuous Positive Airway Pressure) machine, which helps to keep the airway open at night.  In milder cases, special mouthguards or dental splints may help.  Lifestyle changes are also an important part of managing OSA – this includes losing weight if overweight, limiting or avoiding alcohol in the evening and not smoking. Sleeping on your side rather than your back and avoiding sleeping tablets can also help.

If you think you might have sleep apnoea it is important to see your doctor, who can refer you for further investigations.

For more information:

Download a fact sheet on OSA from the Sleep Health Foundation

 References:

http://www.sleephealthfoundation.org.au/public-information/fact-sheets-a-z/obstructive-sleep-apnea.html

http://www.adelaidesleephealth.org.au/sleep_disorders/sleep_disordered_breathing

Gout is a painful inflammation of the joints. An attack of gout usually comes on very quickly and the joint becomes red, swollen and very painful.  Gout most commonly affects the big toe but can occur in other joints including the hands, wrists, elbows, knees and ankles.

Gout is caused by a build-up of uric acid in the blood, which forms tiny crystals in some joints in the body.  Everyone has some uric acid in the blood but levels don’t usually become too high because uric acid is continuously removed from the body by the kidneys. In some people, however, uric acid isn’t excreted quickly enough or too much is being produced.  The excess uric acid forms crystals in the joints, causing inflammation and pain.

While gout can affect anyone, it is more common in men than women and in older people than younger people. In women, it doesn’t usually occur before menopause.

Gout is also more likely to occur if you:

• are carrying excess weight
• have high blood pressure, high blood fat levels or diabetes
• have kidney disease
• are taking diuretics (medications that remove water from the body)
• drink alcohol, particularly beer and spirits

If you have an attack of gout it is important to see your doctor, who can recommend certain medications to help with reducing the pain and inflammation. They can also provide you with advice on reducing the risk of further episodes of gout, as frequent attacks can cause irreversible damage to the joint and the nearby bone.

Reduce the Risk of Gout

Fortunately, there are things you can do to reduce the risk of gout. These include:

• taking medication to lower uric acid levels,
• avoiding or limiting alcohol intake, and if you do drink, choosing wine over beer and spirits
• losing weight gradually if you are overweight (rapid weight loss can increase uric acid levels)
• avoiding foods high in purines (which can increase uric acid levels) including meat (particularly red meat and organ meats), seafood (particularly shellfish, scallops, mussels, herring, mackerel, sardines and anchovies) and foods and drinks containing yeast, such as vegemite and beer.

For more information:

Visit Arthritis Australia or the MOVE Muscle Bone & Joint Health website

Musculoskeletal Australia

References:

Arthritis Australia

Health Direct

Better Health Vic

Musculoskeletal Australia

Men have a reputation for avoiding the doctor and not always prioritising their health. But regular health checks can pick up problems early, well before you develop any symptoms of disease.  This can help to prevent future health problems, or pick them up early, when they are easier to treat.

Your doctor can explain the specific screening tests you should have and how often you should have them, taking into account factors such as your personal medical history and family history.

Here are some of the tests they might recommend you have:

• Heart health – a blood test to check your cholesterol and triglyceride (blood fat) levels, measurement of your blood pressure. If you are over 50, your doctor may also recommend an Electrocardiogram (ECG) to check your heart’s electrical activity.
• Diabetes check – a fasting blood test to check glucose levels in the blood. This is recommended every three years in those at risk of diabetes and yearly in those who have been diagnosed with pre-diabetes. If you are over 40, you should check your risk with the AUSDRISK tool.
• Bowel cancer – a stool test to check for blood in your stools (called a faecal occult blood test) is recommended every two years if you are aged 50 years or above. If you are at high risk, for example due to a family history of bowel cancer, a colonoscopy might be recommended.
• Skin cancer – check your skin at home regularly for unusual moles and freckles. If you are at high risk (due to working outdoors or having had previous skin cancers) see your doctor at least yearly for a full body skin check.
• Prostate cancer – screening isn’t recommended for all men but if you have a family history of cancer, including prostate cancer, you may need a blood test to check prostate specific antigen (PSA) levels and a digital prostate examination.

When you see your doctor for a health check they will also ask about your family history of disease and your lifestyle including diet, exercise, smoking and alcohol,  and may check your weight and waist measurement, as these factors can all affect your risk of disease and how often you need to have screening checks.

References:

1. Health Direct: Essential Screening Tests for Men
2. Better Health Victoria: Health Checks for Men
3. RACGP: Identifying risk of diabetes in asymptomatic patients
4. Diabetes Australia: Are you at risk type 2

The statistics don’t paint a pretty picture. Heart disease is the single leading cause of death in Australia. In 2015 it accounted for 14% of deaths in males (and 11% in females).  At the age of 40, one in two men is at risk of developing coronary heart disease in their lifetime.

The good news is that there’s a lot you can do to reduce this risk and avoid being a statistic.

The first step to reducing your risk is to know your risk factors.  While there are a few you can’t change, such as age, being male, your ethnic background and family history, there are also plenty that you can change.  These include smoking, being overweight, eating an unhealthy diet, lack of physical activity, having high cholesterol and/or high blood pressure, suffering from depression and being socially isolated.

So what can you do to reduce your risk?

• If you smoke, quit.  If you need help to do this, speak with your doctor or call the  Quitline on 13 7848.
• Eat a healthy diet, based mainly on plant foods including fruits, vegetables, wholegrains, legumes and nuts, and avoid processed foods high in saturated fat and added sugars.
• Exercise regularly for at least 30 minutes each day and reduce your sedentary time by looking for opportunities to move more throughout your day and breaking up your sitting time regularly.
• Achieve and maintain a healthy weight by balancing healthy eating and regular exercise.
• Manage your cholesterol levels and blood pressure – this can be through lifestyle changes, with the addition of medication where needed.
• If you have diabetes, keep it well managed. High blood glucose levels can contribute to heart disease risk.
• Be socially active and if you are suffering from depression, speak with your doctor about treatment options.

If you are over 45 years (or over 35 years if you are from an Aboriginal and Torres Strait Islander background), the Heart Foundation recommend seeing your doctor for a heart health check.

For more information:

• Visit the Heart Foundation to find out more about heart disease and reducing your risk.
• Find out more about a Heart Health Check online.