Men's health – the symptoms worth taking to a doctor

Across South Africa, men attend clinics less often than women, start HIV treatment later, are diagnosed with TB later, and are less likely to have ever had their blood pressure taken. The consequence is not that men get more diseases — it is that they get them found later, when there is less that can be done.

None of the symptoms below are proof of anything serious. All of them are worth a visit rather than a few more months of waiting.

• A cough lasting more than two weeks, night sweats, fever or unexplained weight loss — TB is common here, testing is free, and treatment works.
• Chest tightness, pressure or breathlessness on exertion that eases with rest. This is the classic presentation of heart disease and is often dismissed as being unfit.
• Blood in the urine or stool, ever, even once, even painless.
• A change in urinating: a weak stream, difficulty starting, getting up repeatedly at night, or a sudden inability to pass urine at all.
• A lump, swelling or heaviness in a testicle. Testicular cancer mainly affects young men and is highly curable when found early.
• Erectile difficulties that come on gradually — often an early sign of blood vessel disease or diabetes rather than a purely sexual problem.
• A mole or skin lesion that changes shape, colour or size, or that bleeds.
• Persistent heartburn or difficulty swallowing.

The checks are the same ones everyone needs, and they take one visit: blood pressure, blood glucose, cholesterol from around 40, an HIV test, and a TB symptom screen. All are available free at a public clinic.

Prostate testing is genuinely a decision rather than an automatic recommendation. The blood test can detect cancers that would never have caused harm, and treatment carries real consequences for continence and sexual function. From around 45 to 50 — earlier with a family history or if you are of African ancestry, where prostate cancer is more common and more aggressive — it is worth a conversation about whether testing is right for you.

Men are far less likely to seek help for depression and far more likely to die by suicide. Depression in men often presents as irritability, anger, drinking more, working compulsively or withdrawing, rather than as visible sadness — which is part of why it goes unrecognised by everyone including the man himself.

It is treatable, and the treatment works as well in men as in anyone else. SADAG's crisis line is on the emergency numbers page and answers around the clock.