Time to talk: paying lip service to men's health not enough

They're at greater risk of dying of suicide. They're at greater risk of dying from accidents and violence and they die younger than their female counterparts. There's even some data to suggest they may be at greater risk of dying from Covid-19. Men's health is suffering - and 2020 is only making that worse.

Men's mental health remains a huge issue. When I knew I was writing this article, I took a straw poll of the men I work with - lots of young and middle-aged men, educated, gregarious and socially engaged types. When I asked who they'd talk to if they were feeling low, almost all of them said the same thing: "No one."

When I asked the married ones why they wouldn't talk to their wives, they said they "wouldn't want to worry them".

We typically say men talk shoulder-to-shoulder, not face-to-face. They're more comfortable having a chat, sitting side by side at a bar or watching a game than women, who make conversations their whole focus.

But those options of meeting a pal for a pint or going to a match have been pulled away from us. Options like going for a walk or a coffee are not part of the repertoire for lots of men, and this is a particular problem for older, rural or socially isolated men.

We're all living under the cloud of lockdown and Covid, so our mental health is under increased pressure. Now is the worst possible time to lose social supports, but that's the reality of where we're at.

Anecdotally, young men are better than older men at staying connected digitally or on social media, but everyone's social circle has become reduced. This adds to our problem while eroding the solution.

Men also tend to define their identity in terms of their role or their job (as opposed to women, who often define themselves by their relationships). So with many men finding their job, business or livelihood under threat, anxiety levels are particularly high at the minute.

We often think about young men when we focus on suicide prevention, but it's actually middle-aged men who are the most at risk. Fear of ageing and feeling trapped in your life, but unable to change a path you think is set in stone - these are common experiences for men over 50. But most people when they feel that way believe themselves to be the only one going through it, which is isolating and debilitating.

It's no coincidence that alcohol use, gambling, overeating and domestic strife have increased during the pandemic. These dysfunctional coping strategies are the fallout from the mental strain we're all under.

Men often fail to even recognise they're suffering with depression, writing off symptoms like insomnia, irritability, loss of libido, inability to concentrate or communicate as normal, or 'just stress'. It's really important we get the message out there that it isn't normal to lose all enjoyment in life or to feel constantly on edge - and there are lots of effective strategies and treatments to change those feelings.

There's some good news around male cancers, too. David Bouchier Hayes, consultant urologist in the Galway Clinic, says great strides have been made - particularly in the area of testicular cancer, which is largely a cancer of young men aged 18-35. In the past, men died from it, but now chemo is so effective that we see survival rates of 95pc and above. It's also important to remember when you're checking yourself that a normal testis feels a bit like a small boiled egg and if you do find a lump, most are entirely innocent.

Prostate cancer is the most common solid organ cancer in men - affecting mainly an older group. But it often runs a relatively indolent course, so many men will have it but thankfully not die from it. The symptoms often involve difficulty with urination - problems starting and stopping; getting up a lot at night to go; or a poor stream. But these can also be symptoms of benign prostate changes.

The important thing is to discuss any problems with your doctor to decide what tests you might need. The initial ones are normally a PSA blood test and a rectal exam - which isn't nearly as bad as people fear.

New advances like MRI scanning and robotic surgery have improved outcomes, and medications and active surveillance can now save men from unnecessary invasive treatments.

The common theme running through all these issues, though, is that stigma and a difficulty in talking about problems is putting men off getting checked. Women's health tends to suffer because they're too readily dismissed by medical professionals - but with men, the problem is they won't, or can't, engage in the first place.

It was International Men's Day on Thursday - and the old joke that every day is international men's day doesn't ring entirely true. In a world where men are the last category of humans you can insult with impunity, it isn't all plain sailing for them.

Many of them feel unable to get help when they need it. Fear, stigma and convention all work against them expressing their vulnerability - which they feel, just like everyone else. So if you're having any symptoms - physically or mentally - go see your GP.

They are open and they know it's hard for you to say this stuff.