General men’s health: The essential guide

Good general men’s health starts before symptoms appear. For most men, the highest value preventive care is simple and measurable: keep blood pressure below 130 over 80 when possible, start average risk colorectal cancer screening at age 45, and investigate persistent hormone symptoms with morning testosterone testing that includes LH and FSH.

Key takeaways

• Stage 1 hypertension starts at 130 over 80 mm Hg, and many men have no symptoms until years of vascular damage have already accumulated.
• Average risk colorectal cancer screening now starts at age 45, while PSA screening is usually a shared decision for men ages 55 to 69, not an automatic test for every man.
• Male hypogonadism requires both persistent symptoms and biochemical evidence: consistently low morning testosterone on a reliable assay, interpreted alongside LH and FSH.
• A healthy lifestyle still has a dose. Adults should aim for 150 to 300 minutes of moderate activity each week, or 75 to 150 minutes of vigorous activity, plus muscle strengthening at least 2 days weekly.
• In the TRAVERSE trial, testosterone therapy was noninferior to placebo for major cardiovascular events in 5,246 men followed for 33 months, but it can raise hematocrit and it suppresses sperm production.

Why preventive care matters in men’s health

Preventive care matters because the biggest threats to general men’s health usually start silently. Blood pressure can rise, insulin resistance can worsen, and artery plaque can grow long before a man feels chest pain, shortness of breath, or a loss of exercise capacity.^{[1] [2]}

According to the 2019 ACC and AHA primary prevention guideline, many of the risks that shorten men’s lives are measurable and modifiable, including smoking, elevated blood pressure, diabetes, poor diet, excess weight, and physical inactivity.^[2] Good men’s health therefore depends on checking the numbers before disease becomes obvious.

Sexual symptoms also belong inside routine preventive care. A 2013 meta-analysis of cohort studies in Circulation: Cardiovascular Quality and Outcomes found that erectile dysfunction was associated with higher risks of cardiovascular events and all-cause mortality, so a change in erections can be an early sign of vascular disease.^[3]

How a modern men’s health plan works

Preventive care works by finding silent risk factors years before they cause a heart attack, stroke, cancer symptom, fertility problem, or clinically significant hormone deficiency.

Blood pressure, lipids, and glucose

Systolic pressure is the top blood pressure number, and diastolic pressure is the bottom number. The ACC and AHA high blood pressure guideline, published in Hypertension in 2018, defines stage 1 hypertension as 130 to 139 systolic or 80 to 89 diastolic.^[1] Under the American Diabetes Association’s 2010 diagnostic criteria, diabetes is diagnosed at an A1c of 6.5 percent or a fasting glucose of 126 mg/dL, and the prediabetes range starts at an A1c of 5.7 percent or a fasting glucose of 100 mg/dL.^[4]

Cancer screening by age

A 2021 JAMA recommendation from the USPSTF says average risk adults should start colorectal cancer screening at age 45 and continue through age 75, with screening offered selectively from 76 to 85.^[5] According to the 2018 USPSTF prostate cancer statement, PSA screening for average risk men is an individual decision between ages 55 and 69, because the test can reduce some cancer deaths but also leads to false positives, overdiagnosis, and overtreatment in some men.^[6]

Hormone and sexual health

According to the 2018 Endocrine Society guideline, male hypogonadism should be diagnosed only in men with symptoms and signs of testosterone deficiency and consistently low morning testosterone on an accurate assay, confirmed by a repeat measurement, not on a single low result.^[7] The 2018 AUA guideline advises measuring testosterone in the early morning, generally between 7 and 11 AM, and measuring LH in men with low testosterone.^[8] High LH with low testosterone suggests primary hypogonadism, while low or normal LH with low testosterone suggests secondary hypogonadism.^[7]

LH is luteinizing hormone, the pituitary signal telling the testes to make testosterone. In men whose total testosterone is near the lower limit of normal, or who have a condition that alters sex hormone binding globulin, the Endocrine Society recommends measuring free testosterone by equilibrium dialysis or estimating it with an accurate formula.^[7] In secondary hypogonadism, treatments that stimulate the testes instead of replacing testosterone aim at preserving fertility. In a 2014 randomized phase II trial in overweight men with secondary hypogonadism, oral enclomiphene raised testosterone while maintaining sperm concentration, whereas topical testosterone gel lowered it.^[9]

Lifestyle dose and pattern

A 2018 JAMA summary of the Physical Activity Guidelines for Americans recommends 150 to 300 minutes of moderate activity weekly, or 75 to 150 minutes of vigorous activity, plus muscle strengthening on 2 or more days each week.^[10] In the PREDIMED trial, republished in the New England Journal of Medicine in 2018 after protocol deviations were corrected, a Mediterranean diet supplemented with extra-virgin olive oil or nuts was followed by fewer major cardiovascular events in adults at high cardiovascular risk than a reduced fat control diet.^[11]

Conditions missed when men skip screenings

Skipping screenings is linked to later detection of hypertension, diabetes, colorectal cancer, prostate problems, erectile dysfunction related vascular disease, and testosterone deficiency.

Hypertension and early cardiovascular disease. Stage 1 hypertension begins at 130 over 80 mm Hg, and stage 2 starts at 140 over 90 mm Hg.^[1] Those thresholds matter because vascular injury accumulates over time, not only after a dramatic event like a heart attack.

Prediabetes and type 2 diabetes. Prediabetes is a measurable metabolic state defined by fasting glucose from 100 to 125 mg/dL or A1c from 5.7 to 6.4 percent, and diabetes begins at fasting glucose of 126 mg/dL or A1c of 6.5 percent.^[4] Prediabetes is frequently silent. When changes are noticed, they are better understood as nonspecific metabolic changes such as increasing waist size, fatigue after meals, slower workout recovery, or worsening erections, rather than common first symptoms.

Colorectal cancer. According to the USPSTF, average risk screening should begin at 45. The Task Force found a moderate net benefit for screening at ages 45 to 49 and a substantial net benefit at 50 to 75.^[5] Screening is meant for people without symptoms; visible blood, unexplained weight loss, or a change in bowel habits calls for prompt diagnostic evaluation.

Prostate disease. PSA is a blood test that can help estimate prostate cancer risk, but it is not a perfect yes or no cancer detector. The USPSTF supports an individual decision for average risk men ages 55 to 69 and recommends against PSA-based screening in men 70 and older. PSA screening can find clinically important cancers, but it can also detect slow growing tumors that may never cause harm, which is why family history, ancestry, other health conditions, and personal preference shape the decision.^[6] Urinary symptoms are a separate matter and warrant clinical evaluation for BPH, infection, or other prostate and urinary conditions.

Erectile dysfunction and testosterone deficiency. Erectile dysfunction is often treated as a quality of life issue only. Across 14 cohort studies with 92,757 participants, men with erectile dysfunction had a 44 percent higher relative risk of cardiovascular events and a 25 percent higher risk of death from any cause, and the association was stronger at younger ages.^[3] Low testosterone is different. It is a diagnosis only when symptoms persist and biochemical testing confirms the problem.^[7]

Therapy mistakes when hormones are handled casually. The 2023 TRAVERSE trial in the New England Journal of Medicine randomized 5,246 men aged 45 to 80 with symptomatic hypogonadism and existing or high cardiovascular risk.^[12] Over a mean follow-up of 33 months, testosterone gel was noninferior to placebo for major adverse cardiac events, although atrial fibrillation, acute kidney injury, and pulmonary embolism were more common in the testosterone group.^[12] Testosterone therapy also suppresses sperm production, so the Endocrine Society recommends against starting it in men planning fertility in the near term and recommends monitoring hematocrit during treatment.^[7]

Signals your body is asking for a checkup

Men often notice the consequences of missed preventive care as ordinary daily changes, not dramatic medical emergencies.

• Your home blood pressure is repeatedly 130 over 80 mm Hg or higher, even if you have zero symptoms.
• Your waist is climbing, your energy crashes after heavy meals, or you feel unusually thirsty and tired during the afternoon.
• You snore loudly, wake unrefreshed, get morning headaches, or fall asleep on the couch even after what looked like a full night in bed.
• Your erections are less reliable than they were 6 to 12 months ago, or morning erections have become less frequent.
• You are getting up to urinate multiple times a night, straining to start, or noticing a weaker stream than before.
• You see blood in the stool, feel a persistent change in bowel habits, or notice unexplained weight loss. Those are not “wait and see” symptoms.
• Your libido is down for months, gym recovery is worse, you have less motivation, or you are losing muscle despite similar training. If that pattern persists, morning total testosterone, free testosterone when total testosterone is borderline, LH, and FSH belong in the workup.^[7]

Myth vs fact

Myth: If you feel fine, you do not need screenings

Fact: Hypertension, prediabetes, and many colorectal polyps are often silent for years. That is exactly why preventive care exists.^{[1] [4] [5]}

Myth: Every man should start PSA testing at 40

Fact: For average risk men, the evidence supports individualized discussion rather than automatic testing, with the strongest USPSTF recommendation focused on ages 55 to 69.^[6]

Myth: Low testosterone is just normal aging

Fact: The diagnosis of hypogonadism requires persistent symptoms plus low morning testosterone on reliable testing. LH and FSH must be measured to distinguish primary from secondary hypogonadism, because the treatment path is different.^[7]

Myth: Testosterone therapy is a simple wellness upgrade for any tired man

Fact: Testosterone therapy is for documented hypogonadism, not casual optimization. It can suppress sperm production, and although the TRAVERSE trial did not show excess major cardiovascular events versus placebo, hematocrit still needs monitoring and fertility plans still matter.^{[7] [12]}

What to do now

A practical next step is a structured preventive care plan built around numbers, age appropriate screenings, and symptoms you can track.

1. Step 1: Get baseline data. Check blood pressure, weight, waist, lipids, and fasting glucose or A1c, and review when you are due for colorectal screening and whether a PSA discussion makes sense for your age and risk profile. If you have low libido, erection changes, infertility concerns, or unexplained fatigue, get a morning hormone panel drawn between 07:00 and 11:00 that includes total testosterone, LH, and FSH, with free testosterone when total testosterone is borderline or sex hormone binding globulin may be altered.^{[7] [8]}
2. Step 2: Build a healthy lifestyle with measurable targets. Aim for 150 to 300 minutes of moderate exercise each week or 75 to 150 minutes of vigorous exercise, add resistance training at least 2 days weekly, build most meals around vegetables, beans, fish, olive oil, nuts, and minimally processed carbohydrates, and protect your sleep.^{[10] [11]}
3. Step 3: Follow abnormalities instead of normalizing them. Repeat home blood pressure checks, act on a rising A1c before it becomes diabetes, schedule the colonoscopy or stool test you have been postponing, and do not treat persistent sexual or hormone symptoms with guesswork. If testosterone is low, classify it correctly. High LH plus low testosterone points to primary hypogonadism. Low or normal LH plus low testosterone points to secondary or functional hypogonadism, where treatment that stimulates the testes’ own production may be an option and fertility can often be preserved.

Veedma offers testing that includes total and free testosterone measured by LC-MS/MS with LH and FSH, or a review of labs you already have, interpreted by licensed providers. When treatment is appropriate, its providers may prescribe enclomiphene, or the enclomiphene plus tadalafil tablet when erection or urinary symptoms are also present. Enclomiphene is not an FDA-approved drug; it is prescribed after a provider confirms the diagnosis and is compounded by a licensed U.S. pharmacy.

The bottom line

General men’s health comes down to a few habits: know your numbers, do age appropriate screenings on time, live a measurable healthy lifestyle, and investigate persistent sexual or hormone symptoms with proper morning testing that includes LH and FSH, not just a single testosterone result.

References

1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13-e115. PMID: 29133356
2. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140:e596-e646. PMID: 30879355
3. Vlachopoulos CV, Terentes-Printzios DG, Ioakeimidis NK, et al. Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systematic review and meta-analysis of cohort studies. Circ Cardiovasc Qual Outcomes. 2013;6:99-109. PMID: 23300267
4. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:S62-9. PMID: 20042775
5. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325:1965-1977. PMID: 34003218
6. US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319:1901-1913. PMID: 29801017
7. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103:1715-1744. PMID: 29562364
8. Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018;200:423-432. PMID: 29601923
9. Wiehle RD, Fontenot GK, Wike J, et al. Enclomiphene citrate stimulates testosterone production while preventing oligospermia: a randomized phase II clinical trial comparing topical testosterone. Fertil Steril. 2014;102:720-7. PMID: 25044085
10. Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA. 2018;320:2020-2028. PMID: 30418471
11. Estruch R, Ros E, Salas-Salvadó J, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018;378:e34. PMID: 29897866
12. Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular Safety of Testosterone-Replacement Therapy. N Engl J Med. 2023;389:107-117. PMID: 37326322