How to be a well man

They drink and smoke more than women, and have a poorer diet - but they're often unaware of the risks. To mark Men's Health Week, Dr Sabreena Malik explains the things that every male should know

Mental and emotional health

What you should know...

Although depression occurs as commonly in men as in women, it is not diagnosed as often in males, leaving many untreated.

Depression symptoms are:

Feelings of worthlessness, hopelessness or guilt; problems with concentration or memory; altered appetite; alterations in weight; difficulties sleeping and thoughts about death or suicide.

Men's Health Forum figures show that 75 per cent of all suicides in the UK are by men - most commonly those divorced, separated, widowed, unemployed or self-conscious. It is the most common cause of death in men under the age of 35.

Having sound mental and emotional health can lead to better relationships, higher achievement at work, improved physical wellbeing and a good sex life.

What you should do...

* Tackle causes of stress (eg, confront your boss; talk through relationship issues; ask your noisy neighbour to turn their music down; get financial advice from services such as National Debtline - 0808 808 4000; www.nationaldebtline.co.uk).

* Develop coping strategies by reflecting how you dealt with similar problems in the past. Discuss your problems with a reliable friend or contact the Samaritans (08457 909090; www.samaritans.org).

* See your GP without being embarrassed to explain how you are feeling. You may then be prescribed medication, counselling or behavioural therapy.

* Eat plenty of fruit and veg (especially green vegetables) and exercise regularly.

* Register for Men's Health Week 2006 and the Haynes Brain Manual by Dr Ian Banks at www.malehealth.co.uk.

Skin

What you should know...

More than 1,000 British men die each year from skin cancer, an increase of 31 per cent in the past decade. Skin cancers often occur on men's backs, which is thought to be one reason they go unnoticed. Fewer women are killed by skin cancer as they know what to look for and are more likely to go to their doctors.

Shockingly, a recent Cancer Research UK survey showed 30 per cent of men would not bother going to the doctor even if they noticed changes in their moles.

Malignant melanoma is the most serious form of skin cancer. Non-melanoma skin cancer is more common and easier to treat; it is the most common cancer in men.

What you should do...

* Stand naked in front of a mirror routinely every few weeks to get to know your skin and be aware of changes.

* If a mole changes in size, shape or colour, or starts to itch, hurt or bleed, see your doctor.

* Get your partner or friend to check your back for changes.

* Reduce your risk of skin cancer by avoiding the sun between 11am and 3pm; using sunscreen of factor 15 or higher and never getting sunburnt.

Heart

What you should know...

The latest British Heart Foundation figures indicate 21 per cent of UK men die from coronary heart disease (CHD), compared with 15 per of UK women. CHD occurs when the blood vessels supplying the heart muscles become narrowed with fatty material (atheroma) due to: smoking, high cholesterol, high blood pressure, poor exercise, alcohol, diabetes, obesity or a family history of CHD. If the vessels become blocked a heart attack (myocardial infarction) may occur which could lead to irreversible heart muscle damage.

A recent study suggested that one in 14 men having a heart attack actually drives himself to hospital.

Men with narrow heart vessels are likely to have narrowings in other small vessels around the body, such as those in the penis. This explains why many CHD sufferers experience impotence.

What you should do...

* Keep your blood pressure low by: doing exercise; drinking less alcohol; eating less salt and taking blood pressure tablets if you are prescribed them.

* Don't smoke.

* Ask your practice nurse or GP to calculate your ideal weight or waist size and aim to stick to it.

* Keep your cholesterol low by: eating less meat, dairy produce, cakes and biscuits; eating more oily fish; eating at least five portions of fruit and vegetables a day and taking cholesterol tablets if you are prescribed them.

If you experience chest pain or tightness get medical help.

Lungs

What you should know...

More men die of lung cancer in the UK than women; Cancer Research UK figures indicate that it causes 24 per cent of cancer deaths in British men.

The main risk factor for lung diseases such as lung cancer, bronchitis and emphysema is smoking. Although it is more common among teenage girls than boys, overall more men than women smoke (26 per cent of men, compared with 23 per cent of women). NHS Stop Smoking Services data show men are also less inclined to quit smoking than women.

Almost 1,000 men die prematurely in England each week as a result of smoking-related diseases. Quitting smoking significantly cuts the risk of lung disease and premature death.

What you should do...

Choose a quitting strategy that best suits you: some prefer to go cold turkey, while others like to plan ahead. If it's the latter,

* Choose a specific quit date and promise to stick to it.

* Ask your GP about what medications available to help.

* Practise saying, "No thanks, I have quit" or, "Sorry, I don't smoke."

* Let your partner, friends and work colleagues know that you are determined to stop and that you want their support.

* Find a quit buddy and throw away all your cigarettes, matches, lighters and ashtrays together.

* Work out what you will be able to buy yourself as a reward.

Diet

What you should know...

Two-thirds of English men have a problem with their weight. Recent Department of Health statistics of body mass index measurements (height-to-weight calculations) show 44 per cent to be overweight and 23 per cent to be obese. Central obesity (waist-to-hip calculations) affects 33 per cent of men.

The Food Standards Agency says men eat more fat, meat and sugar and less yoghurt and fruit than women. They also consume almost double the recommended daily amount of salt. Only 13 per cent of men manage to eat the recommended five portions of fruit and vegetables a day, the average male having a daily intake of only 2.7 portions.

One portion of fruit or veg is: one apple, orange or banana; one slice of melon or pineapple; three tablespoons of vegetables or fruit salad; one handful of grapes or berries and one 150ml glass of fruit juice

What you should do...

* Base your meals on starchy foods like bread, cereals, rice, potatoes and pasta - wholegrain versions have more fibre and will keep you fuller for longer.

* Eat at least five portions of fruit and vegetables per day.

* Eat fish twice a week, including oily fish (eg, salmon, trout, fresh tuna, sardines) once a week.

* Eat less saturated fat, such as meat pies, hard cheese, butter, cakes, cream.

* Eat fewer sugary foods.

* Try to consume no more than 6g salt a day.

* Aim to be a healthy weight.

* Drink plenty of water.

* Always find time for breakfast.

Liver

What you should know...

Alcohol misuse is the main cause of chronic liver disease. Men's Health Forum figures indicate that two out of five men drink more than the recommended three to four units a day. Men are also twice as likely to binge drink and be admitted to hospital with alcoholic liver problems as women. The number of men aged 25-64 dying from chronic liver disease has increased five times in the past 35 years.

The first stage of alcoholic liver disease ("fatty liver") can be reversed if excessive drinking is stopped and the liver is allowed to heal itself. If excessive drinking is continued, permanent damage from liver cirrhosis can develop, which may lead to liver failure, liver cancer and death.

What you should do...

Honestly answer the following questions:

* Have you ever thought that you should cut down on the amount of alcohol you drink?

* Have you ever been annoyed by people criticising your drinking?

* Has your drinking ever made you feel bad or guilty?

* Have you ever drunk alcohol first thing in the morning to get rid of a hangover or to steady your nerves?

If you answered yes to two or more of these questions, you are likely to be dependent on alcohol. You should talk to someone about your situation (your GP perhaps, or a close friend, or even Alcoholics Anonymous, 0845 769 7555; www.alcoholics- anonymous.org.uk).

Prostate

What you should know...

The prostate is present only in men. It is a walnut-sized gland situated behind the pubic bone which produces part of the semen.

Younger men may get an infection of the prostate called prostatitis.

Over the age of 50, men are at risk of prostate enlargement (benign prostatic hypertrophy) and prostate cancer. Both cause pressure on the tube carrying urine from the bladder through the penis and give similar symptoms, so it is important to see your doctor for tests.

Prostate cancer is the second most common cancer in men. Your risk is higher as you get older and if a relative has had prostate or breast cancer.

What you should do...

* If you develop any of the following symptoms see your doctor for tests: a slow stream of urine; the need to urinate more frequently (especially during the night); blood in the urine or painful urination or ejaculation which may be accompanied by a fever.

* Eating tomatoes (high in lycopene) and foods rich in vitamin E and selenium (eg, poultry, fish, eggs, nuts and mushrooms) is thought to reduce the risk of prostate cancer, although there is no solid evidence to prove this.

* Contact the Prostate Cancer Charity for information and support (0845 300 8383; www.prostate-cancer.org.uk).

Testicles

What you should know...

Testicles can be affected by a variety of conditions: infection; twisting of the spermatic cord; swelling from a build-up of fluid; swelling from a varicose vein, and cancer.

Testicular cancer is the commonest cancer affecting young men between 20 and 34 years of age. More than 90 per cent of testicular cancer cases are cured but if it is not treated early the cancer can spread. A Men's Health Forum survey showed that, on average, a man waits 14 weeks between spotting a symptom of testicular cancer and seeing a doctor. This is far too long. Early treatment is essential.

You should know the normal look and feel of your testicles.

What you should do...

Examine your testicles every three or four weeks after a warm shower or bath. Hold your scrotum in the palm of your hand. Feel the shape, size and texture of each testicle with your fingers and thumb. If you notice any of the following symptoms, you should make an appointment to see your GP as soon as possible:

* a hard lump

* swelling

* a testicle that feels harder than normal

* an unusual difference between one testicle and the other

* a heavy feeling in the scrotum

* a dull ache in the lower abdomen, groin or scrotum.