A closer look at men's health

While it’s often something of a running joke that men can be notoriously bad at asking for help with their health, the worrying downside is that there are several physical and mental health conditions that disproportionately impact men in the UK and, on average, men live almost four years less than women.

So what factors contribute to men using health services less often than women and what impact does this have on men’s health outcomes?

Robert Shelswell is a nurse practitioner specialising in men’s health at Torbay & South Devon NHS Foundation Trust. He says some of the issues men cite around not accessing primary care services are:

• Employers not being supportive of men needing to take time out in the day to speak to their GP surgery or go to an appointment
• Not wanting to show weakness through admitting feeling unwell
• Older generations becoming isolated, and lacking the ability to reach out for support, or who are too proud to ask.

The impact, says Robert, is that “men delay accessing health services, and therefore the problem worsens until they are physically unable to work, or the family dynamic is upset.”

Good sexual health is also an important factor in health and wellbeing, with sexual health recognised as a public health priority since the publication of the first national sexual health strategy in 2001. Pharmacies are key settings for the provision of a wide range of sexual health services since people have ready access to a pharmacist, so it is vital for the pharmacy team to feel confident initiating conversations, especially on ‘embarrassing’ topics such as men’s sexual health in the following areas…

Infertility support in pharmacy

A common cause of infertility in men is poor-quality semen, with reasons for this including:

• A very low sperm count or no sperm at all
• Sperm that are not moving properly
• Abnormally shaped sperm, making it harder for them to move and fertilise an egg
• Damage to the testicles, undescended testicle(s), or testicular cancer.

In addition, some men experience problems that can make it difficult for them to ejaculate, or they may have an abnormally low level of testosterone – known as hypogonadism – the male sex hormone involved in making sperm.

Certain types of medicines can sometimes cause infertility problems, including:

• Sulfasalazine – an anti-inflammatory medicine used to treat conditions such as Crohn’s disease and rheumatoid arthritis – can temporarily decrease the number of sperm
• Anabolic steroids – often used illegally to build muscle and improve athletic performance – can reduce sperm count and sperm mobility
• Chemotherapy can sometimes severely reduce sperm production
• Illegal drugs, such as marijuana and cocaine, can also affect semen quality.

“When it comes to fertility treatment and awareness, it is often one-sided and female-focused,” says Dr Catherine Hill, head of policy and public affairs at Fertility Network UK. “Yet when it comes to fertility issues, we know that male fertility is half of the problem. Research conducted by our charity, alongside Leeds Beckett University, found that a majority of respondents (93 per cent) stated that their wellbeing had been impacted by fertility issues, leading [men] to feelings of being emasculated and isolated, harming their self-identity, and causing stress, depression, anxiety, and low self-esteem.”

As a result, Catherine’s advice for pharmacy teams is to “approach male fertility with equal importance and sensitivity as they would with female-related fertility issues”, as well as being able to signpost to spaces for men to feel “comfortable and supported” in their experiences, such as Fertility Network UK’s HIMFertility support group.