Addressing the gap in men’s health

An overview of the key determinants in men’s health, including the role of healthcare professionals in reducing avoidable disease

Men’s health remains a significant public health challenge in Ireland. Irish men live, on average, four years less than women and experience higher rates of premature death from cardiovascular disease (CVD), cancer, and suicide. Despite this, men are often less likely to engage with preventive health services or seek timely medical advice. Cultural norms around masculinity, stigma, and lower health literacy can act as barriers to healthcare.

Healthcare professionals are ideally positioned to address this gap, through health screening, educating patients on lifestyle interventions, and participating in health promotion campaigns. We can support men to take a proactive role in their health, playing an integral role in reducing avoidable disease and improving health outcomes.

Barriers to healthcare

Research shows that men are less likely than women to access healthcare until illness is advanced. In Ireland, men are less likely to attend GP appointments or participate in screening programmes. Stigma around masculinity can reinforce the perception that seeking help is a sign of weakness, leading many men to delay intervention. Health literacy also plays a role, with men less likely to seek or fully understand health information. Practical barriers, such as work commitments and limited access to primary care, further discourage engagement.

Community healthcare services offer a highly accessible environment for men to engage with healthcare. GPs, nurses, and pharmacists can provide early interventions such as blood pressure and cholesterol checks, lifestyle advice, and health promotion support. By normalising conversations around health and providing approachable services, healthcare professionals can help men adopt proactive health behaviours and reduce the risk of preventable disease.

Cardiovascular disease

CVD is one of the leading threats to men’s health in Ireland. Men not only develop CVD at younger ages than women, but also experience higher mortality from heart disease and stroke. Major risk factors, including hypertension, high cholesterol, smoking, obesity, physical inactivity, and excessive alcohol, remain highly prevalent among Irish men.

CVD encompasses a wide range of conditions that disproportionately affect men. Ischaemic heart disease, including angina and myocardial infarction, is the most common presentation. Stroke occurs more frequently in men and often at younger ages. Peripheral arterial disease may present subtly, for example, as claudication or erectile dysfunction (ED). Heart failure is increasingly observed in older men, frequently following untreated hypertension.

While pharmacological treatments are essential, there is substantial opportunity for early recognition and prevention. Simple measures, such as regular blood pressure checks, cholesterol testing, and lifestyle modification, can delay, prevent, or detect early the onset of CVD. By introducing cardiovascular screening and counselling into routine practice, healthcare professionals can help shift the focus from late-stage disease management to early intervention and prevention, reducing the burden of CVD among Irish men.

Mental health

Mental health is a major challenge for men in Ireland. Men are less likely than women to seek help for psychological distress, yet they experience disproportionately high rates of suicide, depression, and substance misuse. The male suicide rate is approximately four times higher than the female rate, with the greatest burden among men aged 20-34 years.

Depression and anxiety are often underdiagnosed in men, partly because symptoms can present differently. Men are more likely to report irritability, anger, or risk-taking behaviour rather than low mood. Alcohol and substance misuse are also closely linked to poor mental health outcomes.

Traditional ideas of masculinity that emphasise self-reliance may discourage men from seeking professional help, compounded by stigma around mental illness. Campaigns such as the HSE’s ‘Connecting for Life’ suicide prevention strategy and local community initiatives aim to encourage open conversation and reduce isolation.

Again community based healthcare staff can play a vital role by recognising signs of psychological distress, offering supportive conversation, and referring to GPs or mental health services. They are also central to ensuring safe and effective use of pharmacological treatment, while encouraging adherence and addressing stigma around mental health treatment. By promoting early intervention and reducing stigma, we can contribute to closing the mental health gap that disproportionately affects men.

Cancer

Cancer is a leading cause of mortality among men in Ireland, with prostate, colorectal, lung, and testicular cancers accounting for the majority of cancer diagnoses and deaths. Men are less likely to engage in preventive behaviours such as cancer screening, sun protection, smoking cessation, or seeking medical advice, which contributes to later-stage presentation and poorer outcomes.

Prostate cancer is the most common cancer in men. While many cases are treatable or do not cause serious harm, it remains the second leading cause of cancer death. Routine screening is not offered, but men are encouraged to discuss prostate-specific antigen testing with their GP, particularly if they have a family history or are over 50 years old.

Testicular cancer, though rarer, is the most common cancer in men aged 15-34. Outcomes are generally good with early detection, but delayed presentation can result in significant morbidity. Awareness campaigns promoting testicular self-examination and prompt medical review of changes are essential.

Colorectal cancer is another common cancer in Irish men. The HSE BowelScreen programme currently offers free screening every two years for men and women aged between 57 and 71 years, and will be extended to those aged between 50 and 74 years on a phased basis. However, uptake remains suboptimal. Healthcare professionals should encourage participation in the programme, as early detection markedly improves survival.

Lung cancer remains the leading cause of cancer-related death in Irish men. Smoking is the major risk factor for developing lung cancer. Patients should be offered smoking cessation support, which is the single most effective intervention for reducing mortality, and signposted to the ongoing lung cancer screening pilot.

Sexual and reproductive health

Sexual and reproductive health is an important, but often overlooked, aspect of men’s health in Ireland.

Key issues include ED, sexually transmitted infections (STIs), and contraception. Men are often reluctant to seek support in these areas, with stigma and embarrassment acting as major barriers. Community healthcare staff can play a proactive role by normalising discussion, reducing stigma, and providing accessible advice and treatment options.

ED affects a significant proportion of Irish men, with prevalence increasing with age and co-existing conditions such as diabetes, hypertension, and CVD. Beyond its impact on quality-of-life, ED can also be an early marker of underlying CVD, providing an opportunity for broader health intervention.

In Ireland, phosphodiesterase 5 inhibitors (sildenafil and tadalafil) are now available without prescription following a structured consultation with a pharmacist. This ensures timely access for men while maintaining safety through pharmacist assessment of cardiovascular risk factors, contraindications, and potential drug interactions.

STIs remain an important concern in men’s health. There has been a sharp rise in cases of gonorrhoea, chlamydia, and syphilis, particularly among younger men and men who have sex with men. Stigma, embarrassment, and fear of judgement can deter men from testing or treatment.

Healthcare staff in the community can play a role by promoting STI awareness, offering advice on safer sex, and signposting patients to free or confidential testing services. Contraception and responsibility are traditionally viewed as women’s issues, yet men have an important role in shared responsibility. Condom use remains the primary method of male contraception, but uptake is inconsistent. By fostering open conversations around contraception, we can help normalise male involvement and encourage safer practices, reducing unwanted pregnancy and transmission of STIs.

Lifestyle factors

Lifestyle choices are among the strongest determinants of men’s long-term health, with diet, physical activity, smoking, and alcohol consumption all important factors. Many Irish men are overweight or obese, with a higher prevalence than women. Encouraging balanced nutrition, portion control, and reduced intake of processed foods can significantly reduce the risk of CVD, diabetes, and certain cancers. At least 150 minutes of moderate-intensity exercise per week is the recommended activity level, with many men falling short of this. A sedentary lifestyle is linked to obesity, poor mental health, and increased risk of chronic disease.

Ireland continues to rank among the highest in Europe for alcohol consumption, with men disproportionately affected by binge and harmful drinking. Many Irish men report drinking at levels that pose health risks, contributing to injuries, liver disease, cancer, and worsening of mental health.

Smoking prevalence has declined in recent years, but remains higher in men, particularly in disadvantaged groups. Tobacco use is the single greatest preventable cause of death, linked to cancer, CVD and respiratory illness. Finally, sleep and stress are often overlooked, but play an important role in physical and mental health. Men may be less likely to address these issues proactively, despite their impact on health.

References available on request