Men’s health in general practice

What a health check covers

The content depends on age, family history and existing conditions rather than following a fixed script. Broadly, a general check looks at blood pressure, cholesterol and diabetes risk, weight and waist measurement, alcohol intake, smoking, physical activity, sleep, mood, and any symptoms that have been quietly tolerated.

Cardiovascular risk assessment is recommended for all people aged 45 to 79, from 35 for people with diabetes, and from 30 for First Nations people. It uses a calculator combining several factors rather than treating any single number in isolation, which is why a normal cholesterol result on its own does not settle the question.

Bowel screening now starts at 45

This changed on 1 July 2024 and is still widely misreported. The National Bowel Cancer Screening Program is now open to everyone aged 45 to 74, with a free test every two years.

There is a catch worth knowing. From age 50 the kit arrives in the post automatically. Between 45 and 49 it does not — the first kit has to be requested, either online or by phone. A great many eligible people in that age band simply do not know they qualify.

Screening is for people without symptoms. Blood in the stool, a persistent change in bowel habit, or unexplained weight loss should be assessed straight away rather than waiting for a kit.

Prostate testing: what the 2026 guidelines say

Australia’s prostate cancer early detection guidelines were substantially revised in 2026, approved by the NHMRC in May and released in August. They are more specific than what came before, and they change the advice for several age groups.

For men at average risk aged 50 to 69, testing every two years is recommended after an informed discussion with a GP. For men at higher risk — a family history, Black sub-Saharan African ancestry, or a known BRCA2 variant — those conversations and two-yearly testing start from 45. Routine testing is not recommended for men aged 45 to 49 at average risk. From 70, whether to test depends on overall health and life expectancy rather than age alone.

The guidelines also set PSA thresholds that vary by age and risk, recommend repeating a raised result within one to three months before acting on it, recommend an MRI of the prostate before any biopsy, and advise against routine digital rectal examination as an addition to PSA testing in general practice.

What a raised PSA does and does not mean

A high PSA does not mean prostate cancer. PSA rises with age and prostate size, and with benign prostatic enlargement, prostatitis, urinary infection, recent ejaculation, vigorous exercise, and some medications. A raised result leads to more tests, not to a diagnosis.

It also runs the other way — PSA can be normal when cancer is present. This is precisely why the guidelines require a conversation before the test rather than after it. The decision worth making in advance is not whether the number will be high, but what you would want to happen if it were.

Early prostate cancer usually causes no symptoms at all. Urinary symptoms — a weaker stream, going more often, getting up at night — are far more commonly caused by benign enlargement, and having them does not mean cancer.

Testosterone: when testing is useful

Testosterone is one of the most requested and least useful tests when ordered without a clear reason. A low result on its own does not establish androgen deficiency, and the gradual decline of roughly one per cent a year with age is not a disease.

When testing is warranted, how it is done matters. Samples need to be taken in the morning, fasting, and at least two measurements on separate days — along with LH and FSH — are needed before a diagnosis can be made.

Low-normal testosterone alongside excess weight, poor sleep, heavy alcohol use or significant stress is common, and usually improves when those are addressed. Treating the number rather than the cause tends not to help.

Erectile dysfunction is a cardiovascular signal

Erectile dysfunction affects around one in five men over 40 and more than 60 per cent of men over 70. It is treatable, and it matters well beyond the symptom itself.

The arteries in the penis are only one to two millimetres across, so narrowing shows up there before it shows up in the larger coronary arteries. Erectile dysfunction commonly appears years before cardiovascular symptoms, and is associated with roughly double the risk of heart attack, stroke and cardiovascular death even after accounting for the usual risk factors.

Only about 30 per cent of Australian men with moderate to severe erectile dysfunction have discussed it with a health professional. Raising it is worth doing on its own terms, and it should trigger a proper cardiovascular assessment rather than a prescription alone.

Mental health

Nearly one in five Australian men aged 16 to 85 experienced a mental illness in the previous twelve months. Suicide accounted for 2,419 male deaths in 2023, around three times the rate in women, and the highest rate is in men aged 55 to 59 — not, as often assumed, in young men.

Help-seeking is the bottleneck. Only about a quarter of men say they would be likely to seek help from a mental health professional, and almost a quarter say they would not seek help from anyone. Since most men do see a GP, that appointment is often the only realistic opportunity for the subject to come up — which is a reason to raise it even when it is not the reason for the visit.

When not to wait

Some things should be assessed the same day rather than at the next check: chest pain or pressure, breathlessness on exertion, or pain in the jaw or arm; a new testicular lump, swelling or heaviness; blood in the urine or an inability to pass urine; and blood in the stool or a persistent change in bowel habit.

Thoughts of suicide or self-harm need help now, not at the next appointment. Lifeline is 13 11 14, MensLine Australia is 1300 78 99 78, and in an emergency call Triple Zero (000).