Men’s Health After 40

The health checks, symptoms and lifestyle priorities that matter through midlife and beyond

Many men seek healthcare only when something is clearly wrong.

That approach can miss important problems that develop quietly, including high blood pressure, high cholesterol, diabetes, kidney disease, depression and some cancers.

After 40, preventive healthcare becomes increasingly valuable. The aim is not to test for everything. It is to identify meaningful risks early, investigate symptoms properly and protect physical, sexual and mental health over the decades ahead.

A useful men’s health check should look beyond the prostate. Heart health, metabolic risk, sleep, mood, weight, alcohol, smoking, sexual function and family history often matter just as much.

Start with cardiovascular risk

Heart disease and stroke remain major causes of illness in Australian men.

Risk is influenced by:

• Age
• Blood pressure
• Cholesterol
• Smoking
• Diabetes
• Kidney disease
• Family history
• Physical activity
• Weight and waist circumference

High blood pressure and high cholesterol usually cause no symptoms.

From the mid-40s, most men should discuss formal cardiovascular risk assessment with their GP. This generally includes blood pressure, cholesterol, smoking status, diabetes risk and relevant medical history. Aboriginal and Torres Strait Islander men should begin cardiovascular risk assessment earlier.

The purpose is not simply to label one number as high or low. It is to estimate your overall chance of heart attack or stroke and identify which changes or medicines are most likely to help.

Know your blood pressure

Blood pressure should be checked routinely throughout adult life.

One high reading does not necessarily mean you have hypertension. Stress, pain, caffeine and poor measurement technique can temporarily raise the result.

Repeated clinic readings, home monitoring or a 24-hour blood-pressure monitor may be needed when the result is uncertain.

Persistent high blood pressure can damage the heart, brain, kidneys and arteries without causing obvious symptoms. How often it should be checked depends on your previous readings and overall cardiovascular risk.

Check cholesterol and diabetes risk

For most healthy adults, cholesterol testing is commonly recommended from age 45 and repeated about every five years. Testing may begin earlier or occur more often when cardiovascular risk is higher.

Type 2 diabetes may also develop without symptoms.

From age 40, men should generally have regular diabetes risk assessment. A GP may use the Australian Type 2 Diabetes Risk Assessment Tool and arrange HbA1c or fasting glucose testing when indicated. Screening is often considered about every three years, with more frequent testing after an abnormal result or when risk is high.

Risk is increased by:

• Family history
• Excess weight around the waist
• Physical inactivity
• High blood pressure
• Previous high glucose
• Sleep apnoea
• Some cultural backgrounds
• Smoking

Do not ignore erectile dysfunction

Erectile dysfunction means difficulty obtaining or maintaining an erection adequate for sexual activity.

It is common and becomes more frequent with age, but it should not automatically be dismissed as normal ageing.

Possible contributors include:

• Cardiovascular disease
• Reduced blood flow
• Diabetes
• High blood pressure
• High cholesterol
• Obesity
• Sleep disorders
• Low testosterone
• Depression or anxiety
• Relationship difficulties
• Alcohol, smoking or other drugs
• Medicine adverse effects

Because the penile arteries are relatively small, erectile dysfunction can sometimes be an early sign of vascular disease. A health review may therefore include blood pressure, cholesterol, diabetes risk, medicines, sleep, mood and cardiovascular symptoms.

Effective treatments are available. Do not buy erectile-dysfunction medicines from unregulated websites, as counterfeit products may be unsafe.

Testosterone is not a general anti-ageing treatment

Testosterone levels gradually decline with age, but symptoms such as fatigue, reduced motivation, weight gain or low mood are not specific to testosterone deficiency.

Possible features of clinically significant low testosterone include:

• Reduced sexual desire
• Fewer spontaneous erections
• Erectile dysfunction
• Reduced muscle mass or strength
• Reduced body hair
• Infertility
• Low bone density

Diagnosis requires compatible symptoms and properly timed blood tests, usually repeated to confirm a low result.

Sleep deprivation, obesity, acute illness, some medicines and heavy alcohol use can lower testosterone temporarily.

Testosterone treatment is appropriate for selected men with confirmed deficiency. It is not a routine treatment for ageing, tiredness or improving gym performance. It can affect fertility and requires monitoring.

Prostate cancer screening requires a decision

Australia does not have a national population screening program for prostate cancer.

The prostate-specific antigen, or PSA, blood test may identify cancers that could benefit from treatment. It can also detect slow-growing cancers that would never have caused harm, leading to additional tests and possible treatment adverse effects.

Men without symptoms should discuss the potential benefits and harms before testing.

Current Australian guidance generally recommends that men who choose regular PSA testing consider:

• Testing every two years from age 50 to 69 when there is no family history
• Starting from about age 40–45 when family history substantially increases risk

A PSA result does not diagnose prostate cancer. Benign prostate enlargement, inflammation, infection and recent sexual activity can raise the level. An abnormal result may need repeating before further investigation.

At-home PSA kits are not recommended.

Urinary symptoms are common but deserve assessment

Urinary symptoms may include:

• A slow or interrupted stream
• Difficulty starting
• Dribbling
• Urgency
• Frequent urination
• Waking repeatedly at night
• Feeling that the bladder has not emptied

These symptoms are commonly caused by benign prostate enlargement, bladder problems, infection or medicines rather than cancer.

Seek earlier assessment for:

• Blood in the urine
• Pain during urination
• Inability to pass urine
• Fever or systemic illness
• Unexplained pelvic or back pain
• Rapidly worsening symptoms

A normal PSA does not explain every urinary symptom, and urinary symptoms do not automatically indicate prostate cancer.

Complete bowel screening

Bowel cancer screening begins at age 45 in Australia.

Eligible people aged 45–74 can access a free bowel screening kit every two years. The test looks for tiny amounts of blood in bowel motions.

Do not leave the kit unopened. Screening only helps when it is completed and an abnormal result is followed up.

Speak with your GP rather than relying on the screening kit alone if you have:

• Visible blood in bowel motions
• Persistent bowel-habit change
• Unexplained weight loss
• Iron deficiency
• Abdominal pain
• Previous polyps or bowel cancer
• A significant family history

Symptoms require diagnostic assessment.

Consider lung screening if you have smoked

Australia’s National Lung Cancer Screening Program is available to selected people aged 50–70 with a substantial smoking history who currently smoke or stopped within the past 10 years.

The program uses low-dose CT rather than a chest X-ray.

A persistent cough, coughing up blood, unexplained breathlessness or weight loss requires assessment and should not wait for routine screening.

Stopping smoking remains beneficial at every age.

Protect your skin

Australian men have a high burden of skin cancer.

Become familiar with your skin and seek assessment for a lesion that is:

• New
• Changing in colour, shape or size
• Bleeding
• Persistently itchy
• Not healing

There is no single national skin-check schedule for everyone. Men with previous skin cancer, many unusual moles, fair skin, significant sun exposure, immune suppression or strong family history may need planned professional checks.

Sun protection remains important throughout adulthood.

Look after sleep

Poor sleep affects more than energy.

Obstructive sleep apnoea is common in men and may contribute to:

• Loud snoring
• Breathing pauses
• Waking gasping
• Morning headaches
• Daytime sleepiness
• Poor concentration
• High blood pressure
• Erectile dysfunction

Speak with your GP if these symptoms are present. Assessment may involve a home or laboratory sleep study.

Alcohol, weight, nasal obstruction and sleeping position may affect symptoms, but not every person with sleep apnoea is overweight.

Mental health may look different in men

Depression and anxiety do not always appear as obvious sadness or worry.

Men may instead experience:

• Irritability or anger
• Withdrawal
• Poor sleep
• Loss of motivation
• Reduced enjoyment
• Increased alcohol or drug use
• Risk-taking
• Overworking
• Physical symptoms
• Relationship conflict

Persistent symptoms deserve assessment.

Ask for help early rather than waiting until work, relationships or safety are seriously affected.

Call 000 if there is immediate danger. Lifeline provides 24-hour crisis support on 13 11 14.

Alcohol and smoking matter

Smoking substantially increases the risk of cardiovascular disease, lung disease, cancer and erectile dysfunction.

Stopping remains worthwhile even after decades of smoking.

Alcohol may contribute to:

• High blood pressure
• Poor sleep
• Weight gain
• Liver disease
• Depression and anxiety
• Sexual difficulties
• Several cancers

Australian guidance recommends no more than 10 standard drinks per week and no more than four on any one day. Less is safer.

If you drink heavily every day or experience tremor, sweating or anxiety when you stop, seek medical advice before abruptly ceasing alcohol.

Preserve strength and muscle

Muscle mass and strength gradually decline with age, particularly when activity reduces.

A balanced exercise routine should include:

• Aerobic activity
• Resistance training at least twice weekly
• Mobility and balance work
• Less prolonged sitting

Strength training supports metabolism, bone health, posture, physical function and healthy ageing.

Protein intake also matters, especially during weight loss, recovery from illness or increasing age.

The goal is not simply to weigh less. It is to remain strong, mobile and metabolically healthy.

Review vaccinations and screening

By midlife, check whether you are up to date with:

• Annual influenza vaccination
• Current COVID-19 recommendations
• Tetanus, diphtheria and pertussis boosters
• Shingles vaccination when eligible
• Pneumococcal and RSV vaccination later in life or for medical risk
• Bowel cancer screening
• Skin assessment based on risk
• Eye and dental checks
• Hearing assessment when symptoms develop

Your GP or pharmacist can check the Australian Immunisation Register, although some older doses may not have been recorded.

Family history changes the plan

Tell your GP if close relatives have experienced:

• Heart attack or stroke at a young age
• Prostate cancer
• Bowel cancer
• Melanoma
• Diabetes
• Sudden cardiac death
• Aneurysm
• An inherited cholesterol disorder

The age at diagnosis and number of affected relatives matter.

A detailed family history may lead to earlier testing or specialist referral.

When to seek urgent help

Call 000 for:

• Chest pain or pressure
• Sudden severe breathlessness
• Collapse
• Facial weakness
• New weakness or numbness on one side
• Difficulty speaking
• Severe bleeding
• Sudden severe testicular pain
• Inability to pass urine with significant pain
• Immediate risk of self-harm

Do not wait for a routine men’s health appointment when symptoms are severe or sudden.

Start with one change

Choose one practical step:

• Book a preventive health appointment
• Check your blood pressure
• Complete your bowel screening kit
• Discuss whether PSA testing is right for you
• Raise erectile difficulties with your GP
• Ask about diabetes and cholesterol testing
• Begin two strength sessions each week
• Seek help to stop smoking
• Tell someone if your mood has changed

A useful men’s health check is not one blood test. It is a structured review of the risks and symptoms that matter to you.

The bottom line

Men’s health after 40 is about much more than prostate testing.

Priorities include cardiovascular risk, blood pressure, cholesterol, diabetes, bowel screening, skin health, sleep, mental wellbeing, sexual function, smoking, alcohol and maintaining strength.

PSA testing should be an informed decision rather than an automatic annual test. Erectile dysfunction, urinary symptoms, fatigue and low mood deserve proper assessment rather than embarrassment or self-treatment.

Preventive care works best before serious illness appears. A regular GP review can help you identify risks early and stay healthier for longer.